Nutrition Sessions Research Articles

Enactment, Evaluation, and Expansion of a Healthy Living Club in an Out of School Setting: A Community-Academic Partnership.

Interventions in community settings, where children spend substantial out of school time, may enhance access to evidence-based lifestyle interventions. The Boys and Girls Club of Lawrence (BGCL) and New Balance Foundation Obesity Prevention Center at Boston Children's Hospital partnered to revise, enact, and evaluate BGCL's existing Healthy Living Club and then flexibly expand the program to increase access. The BGCL is within walking distance of three public housing communities and easily accessible to members, of whom 90% identify as Hispanic. The interventions comprised nutrition sessions and either fitness activity sessions (N+FA Cycle 1, n = 63, 26 hours; N+FA Cycle 2, n = 94, 27 hours) or academic basketball practices (N+AB Cycle 2, n = 99, 72-80 hours), leveraging time already in the schedule where fitness could be intentionally promoted by coaches. Among children aged 8-15 years, mean [95% confidence interval (CI)] changes (beginning to end) in percentage above the BMI median were significant [N+FA Cycle 1: -2.4 (-4.1, -0.8); N+FA Cycle 2: -4.3 (-5.4, -3.1); N+AB Cycle 2: -5.5 (-6.9, -4.1)]. Lifestyle interventions, implemented with flexibility in existing programs, had beneficial impact, indicating potential of community-academic partnerships.

Combined mediterranean diet-based sustainable healthy diet and multicomponent training intervention impact on plasma biomarkers and metabolome in older adults

Background and AimsHealthy dietary patterns and exercise practices have been associated with improved metabolic and inflammatory profiles. However, studies regarding the combined effect of these interventions on plasma biomarkers and metabolome in older adults are sparser. The primary aim of this study was to investigate the impact of a combined Mediterranean Diet-based Sustainable Healthy Diet (SHD) and Multicomponent Training (MT) intervention on the plasma biomarkers and metabolome and how dietary intake and exercise could modulate these effects. MethodsSHD intervention included a weekly supply of Mediterranean Diet-based SHD food and four nutrition sessions involving a Mediterranean-Diet culinary workshop, and the exercise program included 50-minute MT group sessions, held three times a week, lasting both 12 weeks. Plasma biomarkers were obtained through standard biochemical analysis. A proton (1H) nuclear magnetic resonance (NMR) spectroscopy-based metabolomics approach was used to study the metabolome in blood plasma. Repeated measures ANOVA were performed and adjusted for confounders. ResultsSHD+MT intervention significantly decreased HDL-C and calcium. SHD+MT showed some changes in common with the SHD and MT group, namely a significant decrease in citrate levels (p=0.009 for SHD+MT; p=0.037 for SHDT) and an increase in pyruvate (p<0.001 for MT and SHD+MT). The SHD+MT group also revealed specific changes in the levels of some amino acids (decrease in alanine, glutamine and lysine: p=0.026; p<0.001; p=0.038, respectively). Formate (p=0.025) and unsaturated lipids (p=0.011) increase are consistent with changes in energy, amino acid and lipoprotein metabolism. ConclusionOur data show that a combined lifestyle intervention program, including a Mediterranean Diet-based SHD and MT, could modulate biomarker and metabolome and there seems to be a metabolic path associated to these interventions in older adults. Due to its wide-ranging relevance, it is pertinent to assess to what extent combined SHD and MT can contribute to better clinical profiles.

Effectiveness of Educational Nutritional Sessions on Quality of Life, Functional and Nutritional Status among Elderly Patients with Chronic Kidney Diseases

Effectiveness of Educational Nutritional Sessions on Quality of Life, Functional and Nutritional Status among Elderly Patients with Chronic Kidney Diseases

Tobacco cessation in patients with multiple chronic conditions: nutritional strategies as an additional tool in treatment.

To evaluate the impacts of a nutritional education intervention for patients with multiple chronic conditions during smoking cessation. The non-probabilistic sample comprised 18 adults and seniors of both sexes recruited from a smoking cessation treatment group. At the beginning of treatment, smoking history, degree of dependence, and stage of motivation were assessed. Degree of craving was evaluated weekly for the 1st month. Anthropometric and biochemical assessments were conducted at baseline, at 1 month, and at 3 months. Dietary intake was assessed with the "How is your diet?" questionnaire. The nutritional intervention was delivered in three sessions. The themes covered were energy balance and physical activity, healthy eating, and the importance of fruit and vegetables in the diet. Statistical analysis was conducted with the Shapiro Wilk test of normality, the paired t test, and the Wilcoxon or Mann-Whitney U tests (significance ≤ 0.05). Most people (55.6%) in the intervention group had a high degree of smoking dependence, while the frequency in the control group was 22.2%. Degree of craving decreased significantly after 1 month of treatment (p = 0.017). After 3 months, both groups had a positive variation in mean body weight, although below 3%. In both groups, the average percentage of weight gain was less than 3%, suggesting that delivery of the nutritional education sessions and the nutritionist's use of the protocol proposed by the Instituto Nacional de Câncer (INCA) helped to control weight gain. Blood glucose and homeostasis model assessment-insulin resistance (HOMA-IR) both increased significantly in the intervention group (p = 0.15 and p = 0.50, respectively). Greater proximity and more frequent intervention by a nutritionist assists and encourages healthy eating practices during the smoking cessation process, which can benefit individuals' control of chronic diseases over the long term.

Multimodal Prehabilitation for Peripheral Arterial Disease Patients with Intermittent Claudication—A Pilot Randomized Controlled Trial

To establish the feasibility and safety of multimodal prehabilitation (MP), and to obtain pilot data on the change in quality of life, functional walking capacity, and the need for surgery for a full-scale trial. Pilot randomized controlled trial that included patients older than 50years old suffering from moderate to severe intermittent claudication and who were candidates for endovascular revascularization (ER). Participants were excluded if they presented with ischemic rest pain, gangrene or ulceration of the index leg, significant lesions in the iliac vessels, planned surgical bypass, comorbidities in which exercise was contraindicated or if they were unable to speak English or French. Participants were randomized in a 1:1 ratio to 12weeks of MP or institutional standard of care (unsupervised walking advice). MP consisted of i)1 weekly supervised exercise session; ii) home-based exercise prescription; iii) nutritional counseling and supplementation; iv) smoking cessation therapy; and v) psychosocial support. Feasibility and safety were measured with recruitment and retention rates, as well as the occurrence of any adverse events. In addition, barriers to attend supervised sessions and compliance to each component were assessed. Change in functional walking capacity, health-related quality of life, and the rates of patients deciding not to undergo ER were collected and analyzed throughout the follow-up period of 12months. Of the 37 patients referred for eligibility, 27 (73%) accepted to participate in the trial and were randomized. Of the 27 patients included, 24 completed the 12-week program. Adherence to each prehabilitation component was 83% interquartile range [72,93] for supervised exercise, 90% [83,96] for home-based exercise and 69% [45,93] for nutritional sessions. Fifty percent of patients were referred for and underwent psychosocial intervention and 40% of the active smokers enrolled in the smoking cessation program. No adverse events were observed during the program. The 2 main barriers for not fully adhering to the intervention were excessive pain while performing the exercises and the difficulty to keep up with the prescribed exercises. A statistically significant mean change (standard deviation (SD)) was seen in the MP group versus standard of care for functional capacity, mean (SD) 6 Min Walk Test 60 (74) vs. -11 (40) meters P<0.05, and quality of life mean (SD) VascuQol 1.15 (0.54) vs. -0.3 (1.09) points P<0.05. There was no statistically significant difference between groups in the rates of patients deciding to undergo ER during the 1-year follow-up period. The results of this pilot trial demonstrate that MP is safe and feasible. A 12-week MP program seems to improve quality of life and functional walking capacity to a greater extent than unsupervised walking advice. There is a need for a large-scale trial to investigate the effectiveness of MP at improving quality of life and assessing its impact on the rates of patients deciding not to undergo or delay ER. The long-term functional and quality of life outcomes of the patients deciding to undergo ER after prehabilitation also need to be assessed.

Effect of Nutrition Education on Health Science University Students to Improve Cardiometabolic Profile and Inflammatory Status.

The inadequate lifestyle associated with university life may have a negative impact on various cardiometabolic factors. The aim of this study was to evaluate the effect of a one-year nutrition education course on cardiometabolic parameters in undergraduate health science students. During the 2021-22 academic year, 1.30 h nutrition sessions were conducted twice a week. Capillary blood samples were collected and centrifuged to measure cardiometabolic and inflammatory biomarkers in serum. The sample studied consisted of 49 students: 20.4% male and 79.6% female. The nutritional intervention resulted in changes in dietary patterns, with increased consumption of vegetables, nuts and legumes. After the course, females showed an increase in HDL-cholesterol levels (p = 0.007) and no change in LDL-cholesterol levels (p = 0.189). On the other hand, males showed significant changes in HDL-cholesterol (p = 0.001) and LDL-cholesterol (p = 0.043) levels. The atherogenic index was also significantly reduced (p < 0.001) in both males (p = 0.009) and females (p = 0.002). Differences were also observed in the increase in vitamin D levels in both males and females, although the magnitude of the increase was greater in the men (Δ = 7.94, p = 0.016 in men vs. Δ = 4.96, p = 0.001 in women). The monocyte-to-HDL ratio (MHR) showed a significant reduction, although these differences were only significant in males. Students with low vitamin D levels had higher LDL-cholesterol values (p = 0.01) and atherogenic index (p = 0.029). Adjusted linear regression analysis showed a significant association between post-course vitamin D MHR (β = -0.42, IC: -0.29, -0.06, p < 0.01). These findings suggest the importance of including nutrition education programs during the university stage for the prevention of long-term health problems.

Delivering PACE++ curriculum in community settings: Impact of TARA intervention on gender attitudes and dietary practices among adolescent girls in Bihar, India.

Adolescence phase has high intrinsic and instrumental relevance. The Transformative Action for Rural Adolescents intervention delivered PACE++ curriculum with innovations to introduce a) health and nutrition sessions and b) delivery of the content in community settings of rural Bihar. This paper examines impact of the intervention showcasing establishment of intergenerational community connect for empowering and invigorating adolescent girls on gender attitude, empowerment and adolescent health and nutrition. The impact evaluation is based on a two-arm (intervention and comparison groups) cluster randomized controlled design with two rounds of representative cross-sectional surveys. The baseline and endline sample comprised of 2327 and 2033 adolescent girls (15-19 years), respectively. Descriptive statistical, difference-in-differences and propensity score matching methods are used to confirm the program impact. The DID and PSM analyses confirm high significance of impact on gender equity norms, diets and nutritional knowledge and understanding of employee related rights and responsibilities. School-going adolescent girls performed better than those who have discontinued formal education. The intervention showcases the importance of delivering the modified PACE curriculum in rural settings through leveraging community platforms. The findings call for greater policy attention on scaling up of similar initiatives for empowerment and social capital development of adolescent girls.

Using a mobile health app in a weight management program for overweight and obese adolescents and young adults with spina bifida

Context Adolescents and young adults (AYA) with spina bifida (SB) are more susceptible to obesity due to impaired mobility. There is limited access to physical activity for this population. Objective The primary aim of this study was to evaluate the feasibility of a mobile health app in a weight management program for AYA with SB. This was determined by measuring program adherence, active use of the app (defined as ≥3 uses per week), and user rating of the Pt Pal™ mobile app. Secondary outcomes were changes in BMI, quality of life, and health behavior, and the number of active participants over time. Methods Patients from the SB Clinic of a large metropolitan hospital between the ages of 11–21 years and overweight were invited to participate. The program consisted of group nutrition sessions and an individualized exercise plan using a mobile app with coaching. Outcome measures were program adherence, changes in BMI, and validated survey responses. Descriptive statistical analysis was performed. Results Fifteen participants enrolled, and ten participants completed the program. Five of the ten participants attended the nutrition sessions. The number of active app users declined after the first week. Seventy percent of participants decreased their BMI. Most participants reported the program improved their ability to exercise regularly, eat a healthier diet and feel more self-confident. Peds QL™ psychosocial health domains increased postintervention. The YRBS showed increased physical activity and less sedentary time postintervention. Conclusions This mobile app-based weight management program with coaching implemented may not be feasible for adoption in the general population of AYA with SB; however, it was well received by some, and further testing is needed to determine how to improve feasibility. This study provides useful information to guide future programs utilizing digital health and coaching.

Higher Triad Risk Scores Are Associated With Increased Risk for Trabecular-Rich Bone Stress Injuries in Female Runners.

Bone stress injuries (BSIs) in trabecular-rich bone are associated with greater biological risk factors compared with cortical-rich bone. We hypothesized that female runners with high Female Athlete Triad (Triad)-related risk would be at greater risk for trabecular-rich BSIs than runners with low Triad-related risk. Prospective cohort study. Two NCAA institutions. Female runners were followed prospectively for up to 5 years. The intervention consisted of team nutrition presentations focused on optimizing energy availability plus individualized nutrition sessions. Triad Cumulative Risk Assessment (CRA) categories were assigned yearly based on low-energy availability, menstrual status, age of menarche, low body mass index, low bone mineral density, and prior BSI. The outcome was the annual incidence of trabecular- and cortical-rich BSI. Generalized Estimating Equations (GEE, to account for the correlated nature of the observations) with a Poisson distribution and log link were used for statistical modeling. Cortical-rich BSI rates were higher than trabecular-rich BSI rates (0.32 vs 0.13 events per person-year). Female runners with high Triad-related risk had a significantly higher incidence rate ratio of trabecular-rich BSI (RR: 4.40, P = 0.025) and cortical-rich BSI (RR: 2.87, P = 0.025) than women with low Triad-related risk. Each 1-point increase in Triad CRA score was associated with a significant 26% increased risk of trabecular-rich BSI ( P = 0.0007) and a nonsignificant 14% increased risk of cortical-rich BSI ( P = 0.054). Increased Triad CRA scores were strongly associated with increased risk for trabecular-rich BSI. Incorporating Triad CRA scores in clinical care could guide BSI prevention.

Developing a Healthy Lifestyle Program for Recent Kidney Transplant Recipients.

Many kidney transplant recipients experience weight gain in the first year after transplantation. The objective of this research study was to assess the desires of recent kidney transplant patients about the design features of a healthy lifestyle program to counter unnecessary weight gain. In this descriptive study, recent recipients at 2 transplant centers were invited to participate in an online survey. Survey items included sociodemographic information, current medications, health conditions, weight change posttransplant, diet behaviors, physical activity participation, and desired features of a lifestyle program. Fifty-three participants, mean age 60.5 (11.2) years, primarily males, completed surveys. Forty percent gained weight posttransplantation with many indicating struggling with their diet. Physical activity levels stayed the same (17%) or decreased (40%) posttransplantation. Eighty-seven percent of participants indicated they would participate in an online lifestyle program and 76% wanted online physical activity and nutrition sessions to meet at least once weekly. Suggestions about the type of information and activities, included eating strategies (eg, how to eat healthfully at restaurants, grocery shopping tips, and recipes), resources for at-home physical activities, access to cooking classes, and apps to track both activity and food intake. Recent kidney transplant recipients would benefit from and desired to join a lifestyle program featuring tailored nutrition education and physical activity coaching. Gathered information will be used to inform and tailor a lifestyle program. Identifying features for the prevention of unnecessary weight gain with patients' input is essential for promoting and sustaining healthy behaviors.

Mediterranean diet and psychological well-being intervention to reverse metabolic syndrome in Chile (CHILEMED trial)

Psychosocial status and lifestyle are key risk factors of non-communicable diseases (NCDs), which, in turn, are main drivers of healthcare costs and morbimortality worldwide, including Chile. Mediterranean diet (MedDiet) is one of the healthiest dietary patterns under study. However, its impact on high-risk conditions, such as metabolic syndrome (MetS), and NCDs outside the Mediterranean Basin remains mostly unexplored. Even though Central Chile has an environment, food production, and culinary traditions comparable to those present in Mediterranean countries, few studies -some with significant methodological limitations- have evaluated the effect of MedDiet on health and/or disease in Chilean subjects. Importantly, a Mediterranean lifestyle is a modus vivendi that integrates physical health with mental and social well-being. Psychological well-being (PWB) is associated with healthy behaviors, positive health outcomes, and longevity, thereby emerging as a novel healthcare goal. We report here an ongoing randomized controlled clinical trial in Chilean patients with MetS seeking to test whether (1) a PWB theory-based intervention facilitates induction to and increases long-term adherence to a locally adapted MedDiet, and (2) a MedDiet intervention -implemented alone or combined with well-being promotion- is more effective at reversing MetS compared to individuals following a low-fat diet without psychological support. The CHILEan MEDiterranean (CHILEMED) diet intervention study is a 1-year trial including patients with MetS living in Chile. Participants will be assigned randomly by a computer-generated random number sequence to one of the three intervention arms: a) low-fat diet as control group, b) MedDiet alone, and c) MedDiet plus well-being support. Patients will be followed-up by individual and/or group online nutritional sessions or phone cal as well as 6- and 12-month in-person re-assessment of medical history, medication use, food intake, PWB, anthropometrics/physical exam, and blood collection for laboratory analysis. The primary outcome of the trial will be the effect of the MedDiet -with or without PWB intervention- on overall reversal of MetS compared to low-fat diet alone. Based on a statistical superiority trial, expected impact, and patient loss, the estimated study sample is 339 subjects (113 individuals per arm in 3 equal-sized groups). Currently, we have enrolled 179 patients, predominantly women, evenly distributed by age (group means ranging from 45.7 to 48,9 years-old), 3/4 are obese with almost all of them showing abdominal obesity, 70% are hypertensive, whereas <10% exhibit diabetes. If findings turn out as expected (e.g., MedDiet -with or without PWB intervention- is better than the low-fat diet for reversion of MetS at 1-year follow-up), CHILEMED will provide further beneficial evidence of the MedDiet on NCD risk conditions beyond the Mediterranean region.

Healthy Runner Project: a 7-year, multisite nutrition education intervention to reduce bone stress injury incidence in collegiate distance runners

ObjectivesWe evaluated the effect of a nutrition education intervention on bone stress injury (BSI) incidence among female distance runners at two NCAA Division I institutions.MethodsHistorical BSI rates were measured retrospectively...

Multidimensional Health Impact of Multicomponent Exercise and Sustainable Healthy Diet Interventions in the Elderly (MED-E): Study Protocol.

Data concerning the combined effect of diet and exercise interventions on overall health in the elderly are scarce. The MED-E project's primary aim is to assess the effect of the different 3-month sustainable healthy diet (SHD) and multicomponent training (MT) interventions on several health outcomes in the elderly. A quasi-experimental study assigned older adults into four groups: (1) SHD, (2) MT, (3) SHD + MT, or (4) control group (CG). The SHD intervention included a weekly offer of a mixed food supply and individual and group nutritional sessions on the principles of an SHD. The MT groups were submitted to 50-min exercise sessions three times a week. The primary outcomes were blood biomarkers and metabolic profile alterations that were assessed pre- and post-intervention. Additionally, data on dietary intake and nutritional adequacy, physical fitness, body composition and anthropometry, cognitive function, quality of life, and geographical data were assessed at the same time points. The MED-E project's study protocol and future results will add to knowledge about the importance and beneficial contribution of combined SHD and MT interventions on healthy ageing policies.

MoveStrong at home: a feasibility study of a model for remote delivery of functional strength and balance training combined with nutrition education for older pre-frail and frail adults.

Exercise and nutrition interventions are often recommended for frailty; however, effective strategies are required for real-world implementation. Our primary aim was to assess the feasibility and acceptability of telephone and virtual delivery of MoveStrong, an 8-week exercise and nutrition program with a 4-week follow-up for older pre-frail and frail adults. A priori criteria for success included: recruitment (≥25/12 weeks), retention at follow-up (≥80%), and adherence to exercise and nutrition sessions (≥70%). We recruited community-dwelling Ontario residents; ≥60 years, ≥1 chronic condition, ≥1 FRAIL scale score. Participants received mailed materials, a personalized exercise program, 11 remote one-on-one training sessions with an exercise physiologist and 3 online dietitian-led nutrition education sessions. We completed exploratory analyses of secondary outcomes including physical function and dietary protein intake. Semi-structured interviews supported program evaluation. In total, 30 participants were enrolled. 28 (93%) participants completed program and follow-up assessments. Adherence to exercise and nutrition sessions (CI) was 84% (77%-91%) and 82% (70%-93%) respectively. At program end and follow-up [mean change (CI)], significant improvements were measured in 30-second chair stand test [3.50 (1.12-5.86), 4.54 (1.94-7.13) chair stands] and dietary protein intake [12.9 (5.7-20.0), 9.2 (0.4-18.1) g]. Overall, participants were satisfied with program delivery. Trial registration number: NCT04663685.

P131 Pilot Evaluation of Deliciously Healthy Teaching Kitchen Intervention for Chronic Disease Patients

<h3>Objective</h3> This study evaluates behavioral changes reported by participants in Deliciously Healthy, a virtual culinary nutrition program supporting patients with diet-related chronic diseases. <h3>Use of Theory or Research</h3> Six sequential culinary nutrition sessions were informed by Social Cognitive Theory (SCT) theory and the Framework for 10 Experiential Drivers of Behavior Change (Fredericks et al 2020). <h3>Target Audience</h3> Thirty-one patients with diet-related diseases were recruited among 4 cohorts between April and June 2021. Patients were referred from Gouverneur Hospital in NYC. Two cohorts were English speaking and two Spanish speaking. <h3>Program Description</h3> Deliciously Healthy consists of six, 90-minute weekly online virtual sessions where participants learn culinary basics and healthful recipes, practice mindful eating and set SMART GOALS. The recipes consist of low-cost, whole food ingredients. Working together virtually, participants enjoy peer support and bond around the common challenge of making the time to prioritize healthful meals. <h3>Evaluation Methods</h3> Pre- and post-program online surveys about participants' confidence on meal planning, selecting fruits and vegetables, knife skills and dietary habits were conducted. Qualitative data are collected through participant interviews at the 3,6, 9 and 12 month marks. <h3>Results</h3> Of the participants who completed pre- and post- surveys (N = 14) 100% reported improvement in their ratings on a Likert scale of 1-6 for all questions. Despite the small sample size, paired t-tests showed statistical significance for: confidence in adjusting a recipe to make it healthier (<i>P</i> < .001) and confidence in using the recipe templates (<i>P</i> = 0.023). The first participant interviews were conducted in September for the first cohorts who completed the program in June. All 14 participants reported improvements in their food/eating behaviors. <h3>Conclusions</h3> Overall, participants in Deliciously Healthy have reported finding the program beneficial. Despite a small sample size, the finding of statistical significance related to participants selecting fruits and vegetables, adjusting recipes to make it healthier, and use of the recipe templates are encouraging. The remaining interviews will reveal whether the new behaviors are sustainable. <h3>Funding</h3> None

Encouraging older adults with pre-frailty and frailty to "MoveStrong": an analysis of secondary outcomes for a pilot randomized controlled trial.

This 8-week pilot stepped-wedge randomized controlled trial evaluated the MoveStrong program for teaching adults who have frailty/pre-frailty about balance and functional strength training and sufficient protein intake to prevent falls and improve mobility. We recruited individuals aged 60 years and over, with a FRAIL scale score of 1 or higher and at least one chronic condition, who were not currently strength training. The program included 16 exercise physiologist-led hour-long group sessions and two dietitian-led hour-long nutrition sessions. We analyzed secondary outcomes-weight, gait speed, grip strength, physical capacity (fatigue levels), sit-to-stand functioning, dynamic balance, health-related quality of life (HRQoL), physical activity levels and protein intake-using a paired t test and a generalized estimating equation (GEE). Of 44 participants (mean [SD] age 79 [9.82] years), 35 were pre-frail and 9 were frail. At follow-up, participants had significantly improved grip strength (1.63 kg, 95% CI: 0.62 to 2.63); sit-to-stand functioning (2 sit-to-stands, 95% CI: 1 to 3); and dynamic balance (1.68 s, 95% CI: 0.47 to 2.89). There were no significant improvements in gait speed, HRQoL index scores, self-rated health, physical activity levels (aerobic activity and strength training) or protein intake. GEE analysis revealed an interaction between exposure to MoveStrong and gait speed, sit-to-stand functioning, dynamic balance and HRQoL index scores. The total cost to administer the program and purchase equipment was CAD 14 700, equivalent to CAD 377 per participant. Exploratory analyses suggest MoveStrong exercises may improve gait speed, sit-to-stand functioning, dynamic balance and HRQoL index scores in older individuals who are frail and pre-frail.

Integrated Nutrition Education Through the Part C Early Intervention Services for Children With Autism Spectrum Disorder: Material Reviews Involving Providers and Parents

ObjectivesTo collect provider and parent feedback on feasibility of a nutrition education intervention, Autism Eats, for children with ASD through the Part C Early Intervention (EI) Services, and to refine the manual and intervention materials based on the feedback.MethodsA formative survey study was conducted. EI providers (n = 9) and parents of children with ASD (n = 7) reviewed the 10-lessons of Autism Eats intervention and provided their feedback online. The survey consisted of seven Likert-type (1 = strongly disagree to 5 = strongly agree) questions on the following aspects: (1) the amount of preparation time; (2) clarity of instructions; (3) the amount of allocated time for lesson procedure; (4) relevance of activities to the goal and objectives; (5) feasibility of families’ completing activities; (6) satisfaction with provider notes; and (7) relevance to improving nutrition in children with ASD. Additionally, participants completed three open-ended questions to provide written feedback. Descriptive statistics for quantitative data and content analysis for open-ended responses were used.ResultsThe mean of overall scores for all lessons was 4.4 ± 0.5 from the EI providers and 4.1 ± 0.2 from the parent participants, on a 5-point scale, indicating that both providers and parents perceived the intervention materials as feasible and acceptable. The mean of each of seven aspects of the lessons ranged from 3.9 (the amount of allocated time) to 4.5 (relevance to improving nutrition in children with ASD) on a 5-point scale. Common themes for the qualitative analysis included reducing technical terms, condensing instructions, reordering the lesson sequence, improve clarity, more visuals, more elaboration/explanation on certain parts, and positive feedback. One of the parent participants commented, “Introducing anything new to a child with autism could be really hard. This handbook has really helped in way I didn't think of working with my son with ASD.”ConclusionsBased on the findings, Autism Eats intervention materials have been revised. The final intervention includes10-weekly nutrition sessions, two-monthly booster sessions, and social media components. These updates will be utilized for the pilot randomized controlled trial in 2022–2023.Funding SourcesThe Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD).

Effect of early or late nutritional intervention with psychological support on symptoms associated with Anorexia Nervosa: a comparative study

Introduction: Anorexia nervosa (AN) is a disease with increasing incidence and prevalence, favored by biological, psychological, familial, and social factors. Management must be interdisciplinary, involving the intervention of nutritionists and psychologists. Additionally, it is important to evaluate the effect of an early or a late onset of the intervention. Objective: To determine if early nutrition-based intervention along with psychological support leads to a decrease in the symptoms associated with Anorexia Nervosa, when compared with late intervention. Methods: To evaluate the above parameters, an exploratory study was proposed with a design of non-randomized clinical trial and a non-probability purposive sampling of n = 17 women with AN between 12 and 25 years of age (x̄ = 16.8 ± 3.6). According to the moment of the nutritional intervention with psychological support, the 17 women were divided into two groups: Group 1 (n = 10) start the intervention in the first six months after the onset of the disease while Group 2 (n = 7) started 3 years after the disease. The nutritional and psychological carried out consisted of three phases: individualized nutritional assessment, design of the meal plan according to the metabolic needs of each patient and nutritional indications, and an individualized psychological intervention. Both interventions were carried out once a week for six months, for a total of 24 psychological and nutritional sessions. The physical variables of body mass index (BMI) and arm muscle area (AMA) were measured. To assess emotional changes, the body image dissatisfaction subscale of the Eating Disorder Inventory (EDI) was used. Results: Six months after follow-up, the results showed statistically significant changes in the BMI (p &lt;,0.01), AMA (p &lt;,0.01) and body image dissatisfaction (p &lt;,0.01) after the intervention. It was found that the early-intervention group presented lower values in BMI and AMA as compared to the late-intervention patients while both groups showed a marked reduction in body image dissatisfaction values. The late-intervention group presented the sharpest reduction. There was no significant difference in the variables BMI and AMA in the intragroup comparisons. Conclusion: The early-onset nutritional intervention with psychological support decreased the physical and emotional symptoms associated with AN.

Effectiveness of Workplace Mediterranean Diet Interventions on Cardiometabolic Risk Factors: A Systematic Review.

There are numerous health benefits related to high adherence to the Mediterranean diet (MedDiet), providing a protective effect against cardiometabolic diseases, but there are very few MedDiet studies conducted in the workplace. Therefore, the purpose of this systematic review is to analyze the effectiveness of MedDiet workplace interventions on cardiovascular risk factors. Studies were identified in four databases: PubMed, Scopus, Web of Science, and CINAHL, published from the earliest time point until 15 May 2021. The inclusion criteria were (a) adults aged 18 to 70 years; (b) MedDiet intervention only; (c) intervention was conducted in a workplace; and (d) the outcomes included measurement of cardiometabolic biomarkers. Exclusion criteria were (a) abstract not in English; (b) full-text non-available; and (c) review articles. Ninety-five studies were retrieved and assessed for inclusion by two independent reviewers, who also used the Cochrane Collaboration Tool to assess study quality and risk of bias. Five high-quality studies were included (n = 436, 89% male). MedDiet interventions carried out within the workplace were effective in improving cardiovascular risk factors such as lipid profile and insulin sensitivity compared with a low-fat diet, especially among obese participants. Blood pressure and inflammatory markers were not improved after the MedDiet interventions. Worksite occupational health teams should consider promoting MedDiet by conducting regular nutritional sessions and providing tailored menus in workplace cafeterias. However, more high-quality studies are necessary to bring more evidence to this topic.

Effectiveness of Nutritional Strategies on Improving the Quality of Diet of Children from 6 to 12 Years Old: A Systematic Review.

Dietary habits, that are formed during childhood and consolidated in adulthood, are known to influence the development of future chronic diseases such as metabolic syndrome or type 2 diabetes. The aim of this review was to evaluate the effectiveness of nutritional interventions carried out in recent years focused on improving the quality of the diet of the child population. A systematic search of the PubMed and Scopus databases was performed from January 2011 until September 2021. A total of 910 articles were identified and screened based on their title, abstract and full text. Finally, 12 articles were included in the current systematic review. Of those, in six studies the intervention was based on the provision of healthy meals and in the other six studies the intervention focused on modifying the school environment. Six of the studies selected included other components in their intervention such as nutritional education sessions, physical activity and/or families. A wide variety of methods were used for diet assessments, from direct method to questionnaires. The results suggest that interventions that modify the school environment or provide different meals or snacks may be effective in improving children’s dietary patterns, both in the short and long term. Further research is necessary to evaluate the real effectiveness of strategies with multidisciplinary approach (nutritional sessions, physical activity and family’s involvement).