Increased Intake Of Vegetables Research Articles

Experiences participating in federal nutrition assistance programs during the early months of the COVID-19 pandemic: an investigation in Vermont

BackgroundFederal nutrition assistance programs serve as safety nets for many American households, and participation has been linked to increased food security and, in some instances, improved diet quality and mental health outcomes. The COVID-19 pandemic brought new and increased economic, social, and psychological challenges, necessitating inquiry into how nutrition assistance programs are functioning and associated with public health outcomes.MethodsUsing data from a representative statewide survey administered in Vermont (n = 600) between July and September 2020, we examined participant experiences with major federal nutrition assistance programs: the Supplemental Nutrition Assistance Program (SNAP), the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and school meal programs. We explored quantitative and qualitative responses regarding perceptions of program utility, and used nearest neighbors matching analyses in combination with bivariate statistical tests to assess associations between program participation and food insecurity, perceived stress, and fruit and vegetable intake as indicators of dietary quality.ResultsOne in four respondents (27.3%) used at least one federal nutrition assistance program. As compared to non-participants, we found higher rates of food insecurity among program participants (57.5% vs. 18.1%; p < 0.001), an association that persisted even when we compared similar households using matching techniques (p ≤ 0.001). From matched analyses, we found that, compared to low-income non-participants, low-income program participants were less likely to meet fruit intake recommendations (p = 0.048) and that low-income SNAP and WIC participants were less likely to meet vegetable intake recommendations (p = 0.035). We also found lower rates of perceived stress among low-income school meal participant households compared to low-income non-participants (p = 0.039). Despite these mixed outcomes, participants broadly valued federal nutrition assistance programs, characterizing them as helpful or easy to use.ConclusionsWe found that federal nutrition assistance programs as a group were not sufficient to address food insecurity and stress or increase fruit and vegetable intake in the state of Vermont during the early months of the COVID-19 pandemic. Nonetheless, participants perceived benefits from participation in these programs. Optimizing the utility of nutrition assistance programs depends on critical examination of their functioning under conditions of great stress.

Effects of Nudge Strategy-Based Dietary Education Intervention in Patients with Type 2 Diabetes Mellitus: A Cluster Randomized Controlled Trial

ObjectivesWe aimed to assess the clinical effects of dietary education intervention utilizing the nudge strategy in individuals with type 2 diabetes mellitus (T2DM). BackgroundThe global prevalence of T2DM and its associated complications presents a significant health challenge. While the benefits of dietary education intervention for blood glucose management are widely acknowledged, patients often struggle to adhere to dietary recommendations. The implementation of the nudge strategy may offer a promising solution to change unhealthy dietary behavior and enhance diabetes control among individuals with T2DM. MethodsThis is a sub-study within a broader cluster-randomized trial that evaluated the effects of nudge-based dietary education and traditional dietary education intervention. Measurements of HbA1c, fasting blood glucose (FBG), body mass index (BMI), blood lipid levels, blood pressure, dietary behavior, and diabetes distress were assessed at baseline and 3 months after the intervention in 147 individuals with T2DM from six primary care practices in Beijing, China. ResultsAll outcome measurements were complete at two time points for 134 participants. Results showed that compared to the control group, the intervention group achieved a significantly greater reduction in HbA1c, FBG, BMI, total cholesterol, low-density lipoprotein cholesterol, blood pressure, total energy intake, carbohydrate intake, fat intake, and protein intake and had lower diabetes distress. The intervention group also maintained HDL-C levels and had a significantly greater increase in vegetable intake, while changes in triglycerides were similar in the two groups . ConclusionThe present study provides evidence that nudge strategy-based dietary education intervention is effective in improving blood glucose, BMI, blood lipid levels, and blood pressure and facilitating changes in patients' dietary behavior and diabetes distress. These findings suggest that implementing nudge strategies can contribute to the optimization of T2DM dietary management and overall patient well-being.

Seeds of change: fostering nutritional education through school kitchen gardens

Dear Sir / Madam Eighty-two percent of adolescents are at risk of developing Non-Communicable Diseases (NCDs) due to physical inactivity and low fruit and vegetable intake Research has consistently shown that vegetable consumption in children is well below recommended amounts. According to a recent study in Karachi, consumption of discretionary food items such as food that is not necessary to fulfil the nutrient requirement and is consumed for enjoyment such as sugar-sweetened beverages was more than vegetable intake in school children. A key aspect of addressing the issue lies in promoting dietary diversification, which is to increase the type of foods consumed to ensure that children receive a wide range of nutrients essential for their growth and development. One effective strategy to promote dietary diversification and increase vegetable intake among school children is the establishment of a school kitchen garden. The concept of school kitchen gardens holds tremendous potential to improve health and well-being in school-going children. Interventions in this area have predominantly been used to influence school-aged children’s knowledge, attitudes, and/or behaviours toward diet and nutrition, particularly in connection to increasing vegetable consumption. School gardens serve as interactive and educational platform for children to learn about different types of vegetables, how they grow, and their nutritional benefits. Children actively engage in planting, tending, and harvesting the produce, which creates a sense of ownership and excitement about consuming what they have cultivated. A recent systematic review has shown promising effects in improving children’s knowledge of food, nutrition, gardening, and science. Acquisition of knowledge is the basis for behavioural. This is a holistic approach that not only educates but also serves to familiarize students with a variety of vegetables, making it more likely for them to include these vegetables in their dietary choices. In conclusion, school kitchen gardens offer an excellent, practical solution that integrates nutrition education into the extra curriculum while ensuring that students are actively consuming nutrient-rich vegetables. As a result, we can potentially witness healthier, more well-informed generations who understand the significance of dietary diversification. By increased exposure to a variety of vegetables through school kitchen gardens, children are not only learning about healthy eating but are also actively engaged in the cultivation and consumption of nutrient-rich produce. ---Continue

Cooking with the Seasons for Health (CwS4H): An Innovative Intervention That Links Nutrition Education, Cooking Skills, and Locally Grown Produce to Increase Vegetable Intake among Limited-Resource Parent-Child Dyads in Rural Washington.

Although children from limited-resource families in rural areas are at great risk for nutrition-related chronic diseases, few hands-on programs have been implemented that simultaneously engage both parents and children and include local produce in a single program. This study reports on the development, implementation, and evaluation of Cooking with the Seasons for Health (CwS4H). Parent-child pairs participated in six sessions (two weekly sessions during each of three growing seasons), which included food tasting, a spotlight vegetable, interactive mini nutrition lesson, a child-focused cooking lesson, hands-on meal preparation, distribution of materials as family guides, and a take-home bag of fresh produce. Pre- and postprogram survey data were collected from 23 parents and 22 children. Children reported improvements in nutrition knowledge, vegetable preference, and self-efficacy in food preparation and cooking. Parents reported gains in nutrition knowledge, nutritional behaviors, vegetable preference, attitude toward food preparation/cooking, involvement of the child in food preparation/cooking, confidence in preparing vegetables, and the child's vegetable intake. Parents commented on the value children placed on food preparation and produce selection and how the program enhanced the parent-child relationship. By focusing CwS4H on a variety of fresh vegetables, this intervention helped to impact children's vegetable intake behaviors by engaging children in preparing and choosing the food they eat.

Working together to increase Australian children's liking of vegetables: a position statement by the Vegetable Intake Strategic Alliance (VISA).

Children need to be repeatedly and consistently exposed to a variety of vegetables from an early age to achieve an increase in vegetable intake. A focus on enjoyment and learning to like eating vegetables at an early age is critical to forming favourable lifelong eating habits. Coordinated work is needed to ensure vegetables are available and promoted in a range of settings, using evidence-based initiatives, to create an environment that will support children’s acceptance of vegetables. This will help to facilitate increased intake and ultimately realise the associated health benefits. The challenges and evidence base for a new approach are described.

School Health Education Program in Pakistan (SHEPP): findings from a feasibility trial in pre-adolescent school children from a lower middle-income country

BackgroundThe school environment plays an essential role in promoting health education and physical activity for children and adolescents. We aim to assess the feasibility of threefold health education program in children and its potential efficacy on physical activity and diet and cardiometabolic risk factors including blood pressure, body mass index (BMI), and waist circumference.MethodsThe SHEPP was a parallel group feasibility intervention trial conducted in two schools over 23 months. All children aged 9–11 years enrolled in the schools were included. The SHEPP intervention comprised of health education on healthy lifestyle and physical activity sessions for children, training of teachers, and awareness sessions for parents conducted over 10 months. One school received the intervention of SHEPP while the other school continued routine activity. The primary outcome was the feasibility of SHEPP in terms of recruitment, retention, and treatment fidelity. Secondary outcomes were physical activity levels, dietary intake (of fruits and vegetables), and cardiometabolic risk factors (blood pressure, BMI, and waist circumference (WC)).ResultsA total of 1280 preadolescent children were assessed for eligibility and 1191 were found eligible. The overall recruitment n (%) was 982/1191(82.5%) with 505(51.4) from SHEPP intervention school and 477(48.6) in routine activity school. The overall retention rate n (%) at 10-month follow-up was 912/982(92.8), with 465/505(92) in SHEPP intervention school and 447/477(93.7) in routine activity school. In treatment fidelity, 132/144(92) %). Physical activity sessions and all (100%) health education sessions were conducted for each of the twelve classes. Mean (SD) Seven-day Physical activity increased by 134 (196) min in the SHEPP intervention school v 29.8(177) in the routine activity school (P value < 0.001) from baseline to follow-up. Overall, there was an increase in vegetable intake (> 3 serving /day) in SHEPP intervention school of 5.5 to 21.4% from baseline to follow-up compared to 7.5 to 14.9% in routine activity school. The mean change (SD) in systolic blood pressure was 1.3(12) mmHg, 2.2(19.0) mm Hg in in diastolic blood pressure, − 0.09(5.4) kg/m2 in BMI and 6.2 cm in waist circumference in the intervention arm versus − 3.4(11.1) mm Hg in SBP, − 4.3(9.9) mm Hg in DBP, − 0.04((4.6) kg/m2 in BMI, and 3.8 cm in WC in the control arm.ConclusionWe found that intervention using SHEPP is feasible in schools and may help children to adopt a healthy lifestyle as they age by increasing physical activity. However, the potentially beneficial effect on diet, MI, and BP needs further exploration and a longer follow-up, more specifically at the juncture of teenage and adulthood.Trial registrationNCT03303287.

Vegetable Intake, but Not Fruit Intake Is Inversely Associated With Fasting Plasma Glucose in Kidney Transplant Recipients

The association between dietary intake and glycemic control has been extensively investigated in type 2 diabetes. However, little is known about this association in kidney transplant recipients (KTRs). We performed an observational study involving 263 adult KTRs with a functioning allograft for at least 1 year at the outpatient clinic of the Hospital from November 2020 to March 2021. Dietary intake was assessed by food frequency questionnaire. Linear regression analyses were performed to evaluate the association between fruit and vegetable intake and fasting plasma glucose. The vegetable and fruit intake were 238.24 g/d (102.38-416.67) and 511.94 g/d (321.19-849.05), respectively. The fasting plasma glucose was 5.15 ± 0.95 mmol/L. The linear regressions revealed that vegetable intake, but not fruit intake was inversely associated with fasting plasma glucose in KTRs (adjusted R2=0.203, P < .001). The clear dose-response relation was observed. Moreover, each 100 g increase in vegetable intake was associated with 11.6% reduction of fasting plasma glucose. Vegetable intake, but not fruit intake, is inversely associated with fasting plasma glucose in KTRs.

47-LB: Inverse Association of Vegetable Consumption with Nonalcoholic Fatty Liver Disease in Chinese Patients with Type 2 Diabetes Mellitus

Objective: We aimed to investigate the association of fruit and vegetable consumption with nonalcoholic fatty liver disease (NAFLD) in Chinese patients with type 2 diabetes mellitus (T2DM). Methods: This cross-sectional study included 2667 Chinese patients with T2DM aged 18 to 76 years. Dietary intake was assessed by food frequency questionnaire, and prevalent NAFLD was diagnosed with abdominal ultrasonography. The primary outcome measurement was multivariate-adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for the prevalence of NAFLD in relation to the highest fruit and (or) vegetable intake compared with the lowest. Secondary analyses were conducted to assess the effects of either fruit or vegetable intake on the fatty liver index (FLI) using multivariable linear regressions. Results: There were 1445 (54.06%) participants had prevalent NAFLD in this study. Patients with high fruit-vegetable intake (≥500 g/day) had a lower prevalence of NAFLD (52.04% vs. 56.48%), but this difference was not statistically significant (p = 0.065). Vegetable intake had a significantly inverse association with NAFLD (OR: 0.68, 95% CI: 0.52-0.90), but this association was not pronounced with fruit intake (OR: 1.23, 95% CI: 0.89-1.69) or fruit-vegetable intake (OR: 0.90, 95% CI: 0.73-1.10). Additional analyses showed that an increase in vegetable intake was linearly associated with a significant reduction in FLI (β: −1.028, 95% CI: −1.836, −0.219). Conclusions: Higher vegetable consumption was associated with lower odds of NAFLD in Chinese patients with T2DM, which suggested that increased vegetable intake might protect patients with diabetes against NAFLD. Disclosure X. Gu: None.

Changes in dietary habits during Covid-19 lockdown in Egypt: the Egyptian COVIDiet study

PurposeCOVID-19 lockdown changed social habits and lifestyle, including dietary habits, of people worldwide. However, limited information is available about these changes in Egypt. This cross-sectional study investigates the effects of COVID-19 lockdown on dietary habits among the Egyptian populations.MethodsAn online questionnaire, based on sociodemographic data and dietary adherence in accordance with the validated PREDIMED MedDiet Adherence Screener (MEDAS), was used all over the Egyptian governorates. The dietary changes were statistically evaluated for significance in relation to age, gender, body mass index (BMI), education level and governorates.ResultsA total of 1010 participants (76% aged below 36 years, 77% female, 22% obese, and 62% university-level education) answered the questionnaire. Respondents ≤ 20 years had a significant increase in weight and consumption of carbonated beverages, commercial pastries, fried and fast food. Egyptians > 50 years old had a significant decrease in physical activity. Underweight people (less than 3% of participants) increased their fast food intake with a prominent rise in weight. However, obese people increased cooking frequency and increased eating times with a decrease in physical activity. Male participants reported increased intake of carbonated beverages and fast food, while female participants increased the intake of homemade pastries with a significant decrease in physical activity. Approximately 50% of participants with postgraduate education reported decreased intake of fast food and carbonated beverages as well as decreased body weight. Residents of Cairo showed a significant increase in vegetable intake, and fried food intake with a decrease in seafood consumption. Participants from the Delta region had a significant increase in pastries intake.ConclusionThe findings of this study explored the need for increasing awareness about healthy lifestyle in future lockdown periods.

Changes in diet and physical activity after a pilot intervention to tackle childhood obesity in a deprived inner-London community: an observational cohort study

BackgroundLocal authorities in England are uniquely positioned to modify obesogenic local environments contributing to childhood obesity. Evaluating the effects of local authority-led, community-wide approaches is challenging. This study examines changes in diet and physical activity in children aged 6–11 years after a 4-year, complex, community-based, pilot intervention in Golborne, one of the most deprived areas in London. MethodsThe Go-Golborne intervention aimed to shape the local environment by building on local assets, connecting stakeholders in local government and the community, and synchronising existing activities. Activities focused on six themes to make changes to local environments and reduce the consumption of sugary snacks and beverages, increase fruit and vegetable intake, promote healthy snacks, increase active play and travel, and reduce screen time. We analysed changes in self-reported diet and physical activity, collected annually in 2016–19, from children from six local schools. Results were compared with the data collected at baseline. We used multilevel, linear (for dietary outcomes), and logistic (for physical activity) random-slope regression models to examine changes in diet and physical activity by time on study, adjusting for baseline age, sex, ethnicity, deprivation quintile, school, and baseline weight status. Dietary outcomes were calculated by summing the total occasions a participant indicated they ate or drank a certain food or drink (reported as portions per day, expressed as a β coefficient). The physical activity outcomes were developed by creating six binary variables to distinguish those who were most active from those who were least active. Findings1650 children (mean age 7·9 years [SD:1·6]; 808 [49%] girls and 842 [51%] boys) were included. After 3 years of follow-up, we noted reductions in sugary beverage consumption (adjusted β –0·43 portions [95% CI –0·55 to –0·32]; p<0·0001) and car travel to and from school (adjusted odds ratio [OR] 0·19 [95% CI 0·06 to 0·66]; p<0·0001), whereas screen time increased (high vs moderate or low; 2·30 [1·36 to 3·90]; p=0·0021). For other dietary and physical activity outcomes, no evidence of changes and no variation by subgroups were noted. InterpretationLocal authorities can make changes to the obesogenic environment, and mixed results from the Go-Golborne intervention show that collaboration is possible between academics, local authorities, and the community, highlighting the need for robust intervention design in real-world settings, where the need for practical community interventions are met alongside academic rigour. FundingRoyal Borough of Kensington and Chelsea. CB is funded by the School for Public Health Research of the National Institute for Health and Care Research (grant reference PD-SPH-2015). CJ is partly funded by Public Health at the Royal Borough of Kensington and Chelsea and by the National Institute for Health and Care Research Applied Research Collaborative. The views expressed are those of the authors and not necessarily those of the National Institute for Health and Care Research or the Department of Health and Social Care.

EFFECT OF RESTRICTING SWEETENED CARBONATED BEVERAGES AND PROMOTING VEGETABLE CONSUMPTION IN PUBLIC SCHOOLS ON CALORIC INTAKE AND OBESITY RATE AMONG STUDENTS

Consumption of high-caloric sugar-sweetened beverages can promote childhood obesity and limit consumption of healthy foods. The Texas Public School Nutrition Policy is a mandate promoting healthy school environments by prohibiting sales of sweetened beverages and restricting portion sizes of high-fat foods. This study examined the possible effects of applying the Texas Public School Nutrition Policy in Saudi Arabian schools on students caloric intake and obesity rates. The average weekly sweetened carbonated beverage, caloric, and vegetable consumption of 162,147 Saudi public school students were determined based on the literature. Thereafter, according to prior pre-/post-studies, the effect of the Texas Public School Nutrition Policy on students food selection was estimated. This study found that the policy would decrease students consumption of sweetened carbonated beverages during school days from 5.3 to 3.9 servings/week, increase vegetable intake from 4.25 to 4.7 servings/week, and decrease total average caloric intake from 1,871 to 1,792 kcal/week. Although the reduction in caloric consumption is small (79 kcal/week/student), this policy can be a general strategy for increasing physical activity, improving nutrition, and managing obesity and overweight among Saudi students.

Inverse Association of Fruit and Vegetable Consumption with Nonalcoholic Fatty Liver Disease in Chinese Patients with Type 2 Diabetes Mellitus.

We aimed to investigate the association of fruit and vegetable consumption with nonalcoholic fatty liver disease (NAFLD) in Chinese patients with type 2 diabetes mellitus (T2DM). This cross-sectional study included 2667 Chinese patients with T2DM aged 18 to 76 years from March 2017 to October 2021. Dietary intake was assessed using a food frequency questionnaire, and prevalent NAFLD was diagnosed with abdominal ultrasonography. High fruit-vegetable consumption was determined using ≥500 g/day consumption of both fruit and vegetable, and both fruit and vegetable consumption were divided into three categories of &lt;200 g/day (low), 200-400 g/day (median) and &gt;400 g (high). The primary outcome measurement was multivariate-adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for the prevalence of NAFLD in relation to the highest fruit and (or) vegetable intake compared with the lowest. Secondary analyses were conducted to assess the effects of either fruit or vegetable intake on the fatty liver index (FLI) using multivariable linear regressions. There were 1694 men and 973 women in this study, and 1445 (54.06%) participants had prevalent NAFLD. Patients with high fruit-vegetable intake had a lower prevalence of NAFLD than those with low fruit-vegetable intake (52.04% vs. 56.48%), but this difference was not statistically significant (p = 0.065). Vegetable intake had a significantly inverse association with NAFLD (OR: 0.68, 95% CI: 0.52-0.90), but this association was not pronounced with fruit intake (OR: 1.23, 95% CI: 0.89-1.69) or fruit-vegetable intake (OR: 0.90, 95% CI: 0.73-1.10). Additional analyses showed that an increase in vegetable intake was linearly associated with a significant reduction in FLI (β: -1.028, 95% CI: -1.836, -0.219). In conclusion, higher vegetable consumption was associated with lower odds of NAFLD in Chinese patients with T2DM, which suggested that increased vegetable intake might protect patients with diabetes against NAFLD.

SCHOOL HEALTH EDUCATION PROGRAM IN PAKISTAN (SHEPP)-FINDINGS FROM A FEASIBILITY TRIAL IN SCHOOL CHILDREN FROM A LOWER MIDDLE-INCOME COUNTRY

Objective: The school environment plays an essential role in promoting health education and physical activity for children and adolescence, which they adapt into their adulthood. We aim to test feasibility of threefold health education program in children and its potential efficacy on physical activity and diet and cardio metabolic risk factors by including BP, BMI, and waist circumference. Design and method: The SHEPP was a parallel group feasibility intervention trial conducted in 2 schools over a 23 month period. All children aged 9–11 years enrolled from the above-mentioned schools were included. The SHEPP Intervention comprised of health education on healthy lifestyle and physical activity sessions for children, training of teachers and awareness sessions for parents conducted over 10 months. Primary outcome was feasibility of SHEPP in terms of recruitment, retention, and treatment fidelity. Secondary outcomes were physical activity levels, dietary intake (of fruits, vegetable), and cardio metabolic risk factors (blood pressure, BMI, and waist circumference (WC) Results: Results: A total of 1280 preadolescent children were assessed for eligibility and 1191 were found eligible. The overall recruitment n (%) was 982/1191(82.5 %) with 505(51.4) from SHEPP intervention school and 477(48.6) in Routine Activity school. The overall retention rate n (%) at 10 month follow up was 912/982(92.8), with 465/505(92) in SHEPP intervention school and 447/477(93.7) in routine activity school. In treatment fidelity 132/144(92) %) Physical activity sessions and all (100%) health education sessions were conducted for each of the 12 classes. There was increase by134(196) minutes in the SHEPP intervention school v 29.8(177) in the routine activity school (P value &lt; 0.001).The increase in out of school physical activity component of physical activity was more compared to in In school Physical activity from baseline to follow-up (101.0(187) v 33(27)). Overall, there was increase in vegetable intake n (%) (&gt;3 serving /day) in SHEPP intervention school (28(5.5) to 108(21.4)) from baseline to follow-up compared to routine activity school (36(7.5) to 71(14.9)). Conclusions: We found that intervention using SHEPP is feasible in schools and may help children to carry healthy lifestyle in adulthood by increasing physical activity.

An eHealth Intervention, Called Healthy Online Parental Education (HOPE), Improves Vegetable Intake and Active Play Among Toddlers From Low-Income Families in West Texas

ObjectivesThe objective of this study was to evaluate a parent-focused eHealth intervention aimed at improving fruit and vegetable intake and active play among toddlers in West Texas.MethodsA randomized controlled trial was conducted among 73 parents with toddlers between August and December 2021. Intervention group participants (n = 37) completed weekly videos and biweekly online cooking activities through the Healthy Online Parental Education (HOPE) website for a total of 8 weeks. The HOPE intervention curriculum was informed by the Social Cognitive Theory. Control group participants (n = 36) received printed materials about dietary recommendations for children. The primary outcomes were fruit and vegetable intake and physical activity among children. Secondarily, parents completed an assessment in nutritional knowledge, self-efficacy, and feeding practices. There were two data collection points at baseline and post-intervention. A linear mixed model was performed to compare intervention with control group effects over time on study outcomes.ResultsMore than half of the children were male (56%) with a mean age of 27 months. Children in the intervention group showed a small but significant increase in vegetable intake by 0.75 servings (P < 0.05) than in the control group. There was a significant increase in active playtime by 19.88 minutes in the intervention group (P < 0.05). Parents in the intervention group significantly increased their scores in nutritional knowledge (p = 0.01), self-efficacy around feeding (p = 0.02), and healthy modeling practices (P < 0.05) at post-intervention. There was no significant difference in child fruit intake between the intervention and control group at post-intervention.ConclusionsThe HOPE program was successful in improving vegetable intake and active playtime among toddlers, but not fruit intake at post-intervention. Parent-focused eHealth interventions may have the potential to address child health disparities in areas where the communities are underserved. The HOPE trial was registered at clinicaltrials.gov as NCT05085041.Funding SourcesThis study was partially funded by the Graduate School at Texas Tech University.

Potential Effects of Prolonged Water-Only Fasting Followed by a Whole-Plant-Food Diet on Salty and Sweet Taste Sensitivity and Perceived Intensity, Food Liking, and Dietary Intake.

The overconsumption of calorie-dense foods high in added salt, sugar, and fat is a major contributor to current rates of obesity, and methods to reduce consumption are needed. Prolonged water-only fasting followed by an exclusively whole-plant-food diet free of added salt, oil, and sugar may reduce the consumption of these hyper-palatable foods, but such effects have not been quantified. Therefore, we conducted a preliminary study to estimate the effects of this intervention on salty and sweet taste detection and recognition thresholds and perceived taste intensity after at least five days of fasting and at refeed day three. We also assessed the effects on sweet, salty, and fatty food preference and overall dietary consumption 30 days after the day three refeed visit. Based on this data, we estimated that 10 days after the start of the fasting, salty taste recognition, sweet taste detection, and sweet taste recognition thresholds decreased significantly, salty taste intensity ratings increased significantly, and sweet taste intensity ratings decreased significantly. We also have preliminary data that prolonged water-only fasting followed by refeeding on an exclusively whole-food-plant diet may reduce salty/fatty and sweet/fatty food liking, reduce sugar intake, and increase vegetable intake. These results support further research into the effects of fasting and diet on taste function and food likability and consumption.

Fasting-Mimicking Diet Reduces Trimethylamine N-Oxide Levels and Improves Serum Biochemical Parameters in Healthy Volunteers.

Elevated plasma levels of trimethylamine N-oxide (TMAO) have been proposed as a diet-derived biomarker of cardiometabolic disease risk. Caloric restriction is the most common dietary intervention used to improve cardiometabolic health; however, novel trends suggest a fasting-mimicking diet (FMD) as a more feasible alternative. FMD is a variation of intermittent fasting, based on caloric restriction and limitation of protein sources of animal origin, applied in daily cycles during a 5-day period. As TMAO is intensively produced by gut microbiota after the consumption of animal-derived products, we aim to investigate whether a 5-day FMD affects plasma TMAO levels and markers of metabolic health. To investigate whether an increase in vegetable intake possesses similar effects on TMAO levels and metabolic parameters, healthy volunteers (n = 24) were subjected to a 5-day FMD and 19 volunteers served as a reference group (VEG). This group of volunteers consumed an additional four servings of vegetables per day, but otherwise stayed on their usual diet. FMD resulted in a twofold decrease in plasma TMAO levels, which was not evident in the volunteers from the VEG group. Moreover, FMD led to a weight loss of 2.8 ± 0.2 kg and a subsequent reduction in BMI compared to baseline. The FMD group exhibited a significant elevation in plasma ketone bodies (14-fold compared to baseline) and a decrease in IGF-1 levels by 37 ± 8 ng/mL. Since fasting glucose and C-peptide levels decreased, all volunteers in the FMD group showed improved insulin sensitivity and a decreased HOMA-IR index. In contrast, in the VEG group, only a slight reduction in plasma levels of fasting glucose and triglycerides was noted. In conclusion, we show that FMD is a viable strategy to reduce plasma levels of TMAO by limiting caloric intake and animal-derived protein consumption. The reduction in the level of TMAO could be an additional benefit of FMD, leading to a reduced risk of cardiometabolic diseases.

Design and Methods of a Participatory Healthy Eating Intervention for Indigenous Children: The FRESH Study.

ObjectiveTo increase vegetable and fruit intake, reduce body mass index (BMI), and improve parental blood pressure among American Indian families.DesignRandomized, wait-list controlled trial testing a multi-level (environmental, community, family, and individual) multi-component intervention with data collection at baseline and 6 months post-intervention.SettingTribally owned and operated Early Childhood Education (ECE) programs in the Osage Nation in Oklahoma.ParticipantsAmerican Indian families (at least one adult and one child in a ECE program). A sample size of 168 per group will provide power to detect differences in fruit and vegetable intake.InterventionThe 6-month intervention consisted of a (1) ECE-based nutrition and gardening curriculum; (2) nutrition education and food sovereignty curriculum for adults; and (3) ECE program menu modifications.Main Outcome MeasuresThe primary outcome is increase in fruit and vegetable intake, assessed with a 24-h recall for adults and plate weight assessments for children. Secondary outcomes included objective measures of BMI among adults and children and blood pressure among adults.

A Review of Experiential School-Based Culinary Interventions for 5-12-Year-Old Children.

Cooking is an essential skill and the acquisition of cooking skills at an early age is associated with higher diet quality. This review aimed to describe the characteristics of school-based experiential culinary interventions and to determine the value of these to child (5–12 years) health outcomes. Interventions were eligible for inclusion if they took place in school during school hours, included ≥3 classes, and had a control group. Interventions published up to May 2021 were included. The databases searched were PubMed, CINAHL, and EMBASE, and the grey literature was searched for published reports. The search strategy yielded 7222 articles. After screening, five published studies remained for analysis. Four studies targeted children aged 7–11 years, and one targeted children aged 5–12 years. The interventions included food tasting, food gardening, and/or nutrition education alongside experiential cooking opportunities. Improvements were evident in self-reported attitudes toward vegetables, fruits, and cooking, and two studies reported small objective increases in vegetable intake. School-based experiential cookery interventions have the potential to positively impact health-related aspects of the relationship children develop with food. However, a greater number of long-term methodologically rigorous interventions are needed to definitively quantify the benefits of such interventions.

Abstract 10560: Reducing Cardiovascular Risk Among Participants in a Community Supported Agriculture Program

Introduction: Eating a diet high in vegetables translates to lower risk for cardiovascular disease. Only 10% of Americans consume the recommended servings of vegetables per day. Community supported agriculture (CSA) programs support local farmers while promoting increased consumption of vegetables. At the University of Kentucky (UK), employees receive vouchers to encourage CSA program participation while giving financial support to local farms that allow them to operate in an economically sustainable manner. Our objective was to examine the effect of participation in a CSA voucher program on CVD risk factors as a new approach to CVD risk management. Methods: Participants self-selected in the UK employee Health and Wellness CSA voucher program. Biometric measurements (blood pressure, lipid levels, and noninvasive dermal carotenoid levels via Veggie Meter) and vegetable intake via six-question BRFSS were collected pre- and post- CSA program participation. Descriptive statistics, independent t-tests, paired t-tests and cluster analysis were used to analyze the data. Results: Among 204 eligible individuals, 85 enrolled pre-program and 52 completed post program for a 61.2% retention rate. Average participant age was 42 + 10 years, predominantly Caucasian females. Systolic blood pressure was significantly reduced from pre- to post program (125.8 compared to 120.6 mmHg, p = 0.012). Carotenoid levels significantly increased from pre- to post program (286.3 ± 110 to 295.9 ± 124,) while controlling for age and sex (p = &lt;0.001). Frequency of total vegetable, red/orange vegetables, dark green vegetables and other vegetable intake also increased from pre- to post- program while controlling for age and sex (p = 0.003, 0.004, 0.013, &lt; 0.001 and 0.011 respectively). Conclusion: Our data identifies participation in a CSA employer incentivized program can effectively reduce blood pressure and increase vegetable intake (dermal carotenoids) and self-reported quantity and variety of vegetable consumption thereby reducing CVD risk.

Improvements in Diet and Physical Activity-Related Psychosocial Factors Among African Americans Using a Mobile Health Lifestyle Intervention to Promote Cardiovascular Health: The FAITH! (Fostering African American Improvement in Total Health) App Pilot Study.

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