scholarly journals Foods for Health: An Integrated Social Medical Approach to Food Insecurity Among Patients With Diabetes

2020 ◽  
pp. 089011712096414
Author(s):  
Jonathan L. Blitstein ◽  
Danielle Lazar ◽  
Kathleen Gregory ◽  
Colleen McLoughlin ◽  
Linda Rosul ◽  
...  
Keyword(s):  
Food Security ◽  
Glycemic Control ◽  
Food Insecurity ◽  
Nutrition Education ◽  
Repeated Measures ◽  
Repeated Measure ◽  
Care Practice ◽  
Mixed Effect ◽  
Repeated Measures Design ◽  
Patients With Diabetes

Purpose: Examine a clinic-based approach to improve food security and glycemic control among patients with diabetes. Design: One-group repeated-measures design. Setting: Federally Qualified Health Centers in a large Midwest city. Sample: Of the 933 patients with diabetes who consented at baseline, 398 (42.66%) returned during the follow-up period for a visit that included Hemoglobin A1c (HbA1c) results. Intervention: Integrated social medicine approach that includes food insecurity screening, nutrition education, and assistance accessing food resources as a standard-of-care practice designed to minimize disruptions in how patients and providers experience medical care. Measures: HbA1c collected as part of a standard blood panel. Analysis: Repeated-measure, mixed-effect linear regression models. Results: There was a decrease in mean HbA1c (Δ = −0.22, P = 0.01) over the study period. The model examining change over time, glycemic control (GC), and food security status (F1, 352 = 5.80, P = 0.02) indicated that among participants with poor GC (33.12%), food secure (FS) participants exhibited significantly greater levels of improvement than food insecure (FI) participants (Δ = −0.55, P = 0.04). Among participants with good GC, changes in HbA1c were not significantly different between FS and FI participants (Δ = 0.23, P = 0.21). Conclusion: Providing nutrition education and food assistance improved HbA1c profiles among FS and FI participants, but FI participants may face social and structural challenges that require additional support from health care teams.

scholarly journals Food Insecurity, Food “Deserts,” and Glycemic Control in Patients With Diabetes: A Longitudinal Analysis

Diabetes Care ◽  
2018 ◽  
Vol 41 (6) ◽  
pp. 1188-1195 ◽  
Author(s):  
Seth A. Berkowitz ◽  
Andrew J. Karter ◽  
Giselle Corbie-Smith ◽  
Hilary K. Seligman ◽  
Sarah A. Ackroyd ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Food Insecurity ◽  
Longitudinal Analysis ◽  
Food Deserts ◽  
Patients With Diabetes

scholarly journals Do Smallholder Farmers Need Nutrition Education? A Case Study from KwaZulu Natal, South Africa

2021 ◽  
Vol 28 (3) ◽  
pp. 14-27
Author(s):  
Sarahi Moralles ◽  
Abdukladir Egal ◽  
Wilna Oldewage-Theron
Keyword(s):  
South Africa ◽  
Food Security ◽  
Food Insecurity ◽  
Nutrition Education ◽  
Smallholder Farmers ◽  
Dietary Guidelines ◽  
Nutritional Knowledge ◽  
Household Level ◽  
Balanced Diet ◽  
Kwazulu Natal

South Africa (SA) is considered as the second largest economies in Africa with well-developed agricultural food production system. But food security is still a challenge at household level. Currently, in Africa, smallholder agriculture is recognized to contribute food security at household level. This study investigates the prevalence of food insecurity and nutritional knowledge of 78 local smallholder farmers in KwaZulu Natal (KZN) province of South Africa. The results from this study indicated that nutrition knowledge was poor and food insecurity was prevalent at >40% at the household level. It is therefore recommended that future agricultural training should include nutrition education based on FBDG (Food Based Dietary Guidelines) in their respective programs so as to attain a balanced diet for healthy and productive smallholder farmer communities

Abstract 15980: Effects of a Concurrent Strength and Endurance Training Program in Diabetes Patients a Randomized Controlled Trial

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Daniela Bassi ◽  
Vivian M Arakelian ◽  
Renata G Mendes ◽  
Flavia C Caruso ◽  
José C Bonjorno Júnior ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Repeated Measures ◽  
Functional Performance ◽  
Controlled Trial ◽  
Intervention Strategy ◽  
Peak Torque ◽  
Peak Oxygen Consumption ◽  
Significant Difference ◽  
Patients With Diabetes ◽  
The Impact

Background: The prevalence of diabetes have increased globally to epidemic proportions; glycemic control and treatment remains a challenge. Concurrent aerobic and resistance training programs (CART) have been widely recommended as an important strategy to improve physiologic and functional performance. Objective: The impact of CART programs on metabolic profile, glycemic control and exercise capacity status in patients with diabetes requires additional study, which is the primary aim of the current study. Materials and Methods: We evaluated 41 patients (15 female and 19 male, 50.8±7 years) with a confirmed diagnosis of diabetes. The subjects were randomized in two groups: sedentary group (SG) and CART group (CART-G). CART was performed 12 weeks, 3 times a week for approximately 1 hour per session (30 minutes aerobic and 30 minutes resistance). Body habitus was assessed by body mass index, waist circumference, and skinfolds. Peripheral muscular strength was evaluated by an isokinetic dynamometer and pulmonary gas exchange was measured breath-by-breath, using a portable telemetric system during maximal incremental exercise testing on a cycle ergometer. Statistical analysis included Shapiro-Wilk test follow by ANOVA two way repeated measures. Results: We observed a decrease in HbA1c (8.1±1.6 to 7.3±1.2%), cholesterol (198.38.1±50.3 to 186.8±35.1 mg/dL) and HOMA IR (6.4±6.8 to 5.0±1.4) in the CART-G compared to the SG. There was no significant difference in fasting plasma glucose. Although body weight did not significantly change after training, skinfold measurements indicated decreased body fat in the CART-G only. CART significantly enhanced muscle strength (p<0.05) (peak torque: 135.5±4 to 159.7±47.7 N.m) compared to the SG (Peak torque: 145.3±47.9 to 143±42.2 N.m). CART was also associated with a significant increase in peak oxygen consumption, from 22.9±6.1 to 27.2±4.7 ml•kg –1 •min –1 compared to the SG, from 21.7±4.5 to 21±3.3 ml•kg –1 •min –1 as well as the maximal workload (124.6±29.1 to 149.9±29 watts) compared to the SG (123.6±36.9 to 122.1±32.9 watts). Conclusion: We concluded that CART is an important intervention strategy, producing both physiologic and functional improvements, in patients with diabetes.

Food Insecurity and Mental Health Trajectories During the COVID-19 Pandemic: Longitudinal Evidence

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 408-409
Author(s):  
Dexia Kong ◽  
Peiyi Lu ◽  
Elissa Kozlov ◽  
Mack Shelley
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Longitudinal Data ◽  
Health Outcomes ◽  
Food Insecurity ◽  
Repeated Measures ◽  
Mental Health Outcomes ◽  
Mixed Effect ◽  
Health Trajectories ◽  
Over Time

Abstract The extent to which food insecurity impacts changes in mental health outcomes over time in the context of Covid-19 remains unknown. Using longitudinal data from a nationally representative survey, the objectives of the present study were to: (1) assess the prevalence of food insecurity among U.S. adults amid the Covid-19 pandemic; and (2) investigate the relationships between food insecurity statuses and changes in mental health outcomes over time as the pandemic unfolds. Longitudinal data from the Internet-based Understanding Coronavirus in America survey collected bi-weekly between April and December 2020 were used (n=4,068, 15 repeated measures). Adult respondents (aged ≥18) were asked about their food insecurity experiences and stress/anxiety/depressive symptoms. Linear mixed-effect models examined changes in mental health outcomes over time among groups with various food insecurity statuses. Overall prevalence of food insecurity was 8%. Food insecurity was consistently associated with higher levels of stress/anxiety/depressive symptoms (p&lt;0.001). Stress/anxiety/depressive symptoms declined over time among food-secured U.S adults. However, mental health trajectories of respondents with various food insecurity categories, including food insecurity status, persistent food insecurity, and food insecurity of higher severity and longer duration, remained stable or worsened over time. Moreover, the mental health gap between food-secured and food-unsecured participants widened over time. Food insecurity represents a pressing public health problem during the Covid-19 pandemic with substantial mental health implications. Persistent and severe food insecurity may contribute to mental health disparity in the long term. Food insecurity reduction interventions may alleviate the estimated alarming mental health burden as the pandemic unfolds.

Visual Word Recognition in Two Facial Motion Conditions: Full-Face Versus Lips-Plus-Mandible

1995 ◽  
Vol 38 (6) ◽  
pp. 1387-1394 ◽  
Author(s):  
Lynn K. Marassa ◽  
Charissa R. Lansing
Keyword(s):  
Repeated Measures ◽  
Visual Recognition ◽  
Repeated Measure ◽  
Video Sequences ◽  
Exposure Condition ◽  
Repeated Measures Design ◽  
Open Set ◽  
Full Face ◽  
Face Exposure ◽  
Exposure Conditions

The present study used a new method to develop video sequences that limited exposure of facial movement. A repeated-measures design was used to investigate the visual recognition of 60 monosyllabic spoken words, presented in an open set format, for two face exposure conditions (full-face vs. lips-plus-mandible). Twenty-six normal hearing college students and 4 adults with bilateral sensorineural hearing loss speechread a video laserdisc presentation of a male talker under the two face exposure conditions. Percent phoneme correct scores were similar in the part-face and full-face conditions. However, scores significantly improved for the repeated measure independent of the face exposure condition observed. The results suggested that speechreaders (a) can recognize monosyllabic words in video sequences that provide information only about movements of the lips-plus-mandible region and (b) are sensitive to practice effects.

scholarly journals Effectiveness of a Problem-Solving Program in Improving Problem-Solving Ability and Glycemic Control for Diabetics with Hypoglycemia

2021 ◽  
Vol 18 (18) ◽  
pp. 9559
Author(s):  
Fei-Ling Wu ◽  
Chia-Hung Lin ◽  
Chia-Ling Lin ◽  
Jyuhn-Huarng Juang
Keyword(s):  
Problem Solving ◽  
Glycemic Control ◽  
Usual Care ◽  
Repeated Measures ◽  
Control Group ◽  
Diabetic Patients ◽  
Repeated Measures Design ◽  
Weekly Session ◽  
Quasi Experimental ◽  
Experimental Group

The purpose of this study was to evaluate the effects of a hypoglycemia problem-solving program (HPSP) on problem-solving ability and glycemic control in diabetics with hypoglycemia. This was a prospective, quasi-experimental study with two groups, using a pre- and post-repeated measures design. A total of 71 diabetic patients with hypoglycemia were purposively assigned to an experimental group (n = 34) and a control group (n = 37). The experimental group participated in an 8-week HPSP, and each weekly session lasted approximately 90 min, while the control group received usual care. Participants were assessed at baseline, 1, 3, and 6 months after intervention care. In the experimental group, 6 months after the HPSP intervention, HbA1c was superior to that before the intervention. In both groups, the score obtained using the hypoglycemia problem-solving scale (HPSS) was low before the intervention. In the experimental group, HPSS tracking improved at all stages after the intervention compared to before the intervention. In the control group, the HPSS score improved slightly in the first month and sixth months after usual care. There were significant differences between and within groups in HbA1c levels and HPSS score over time. The intervention based on the HPSP effectively improves HbA1c level and hypoglycemia problem-solving ability in patients with hypoglycemia.

scholarly journals Nutritional Education and Its Effects on Household Food Insecurity in Southeastern Iran

2021 ◽  
Author(s):  
Zinat Mortazavi ◽  
Ahmad Reza Dorosty ◽  
Mohammad Reza Eshraghian ◽  
Mohtasham Ghaffari ◽  
Alireza Ansari-Moghaddam
Keyword(s):  
Food Security ◽  
Food Insecurity ◽  
Nutrition Education ◽  
Educational Intervention ◽  
Intervention Group ◽  
Household Food Security ◽  
Household Food Insecurity ◽  
Nutritional Education ◽  
Household Food ◽  
Food Insecure Households

Background: Food insecurity can affect health directly or indirectly through its impact on nutritional status. We aimed at determining the effects of nutrition education intervention on household food insecurity in Zahedan, southeast Iran. Methods: The study was conducted using multi-stage sampling method. The first stage was a cross-sectional investigation whereby 2,160 households were studied in Zahedan in 2015. The prevalence of food insecurity was determined and food-insecure households were identified. Household food security status was assessed through the 18-item US Household Food Security Survey Module. In the second stage, based on the determined sample size of 150 households in each group, eligible households were randomly divided into the intervention and control groups. Before the educational intervention, questionnaires including demographic and socioeconomic information were completed for both groups. Then, data analysis was performed and the intervention was conducted on the intervention group. Six months post-intervention, a final assessment was made by interviewing the two groups to complete demographic, socioeconomic, and household food security questionnaires. Results: The prevalence of food insecurity in the 2,160 households was 58.8%. After the intervention, the number of food-insecure households diminished by 22% in the intervention group, and these households were assigned to the food secure category. After controlling the confounding variables, the educational intervention was significantly effective in reducing food insecurity score (P<0.001). Conclusion: The findings demonstrated the beneficial role of nutritional education and the skills of resource management in modifying nutritional behaviors and improving food security in the study population.

scholarly journals Predictors of Food Insecurity Before and During COVID-19 Among Middle-Aged and Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 956-956
Author(s):  
Emily Nicklett ◽  
Jianjia Cheng
Keyword(s):  
Older Adults ◽  
Food Security ◽  
Food Insecurity ◽  
Repeated Measures ◽  
Community Dwelling ◽  
Future Research ◽  
Median Income ◽  
Middle Aged ◽  
Increased Risk ◽  
The Impact

Abstract The indirect impact of COVID-19 on food security of middle aged and older adults is not well understood. This study examines changes in risk factors for food security from 2018-2020 in a population-based sample. Using data from the Health and Retirement Study (2018 and 2020 waves), we utilized generalized estimating equations (GEE) with repeated measures to examine factors associated with food insecurity among US adults aged 50 and older (n=3170) before COVID-19 and since COVID-19. The prevalence of food insecurity doubled from 2018 (4.83%) to 2020 (9.54%). In multivariate analyses, the population-averaged odds of experiencing food insecurity was 81% higher in 2020 compared to 2018. Other factors significantly associated with higher odds of food insecurity included being female (OR: 1.29), Black (OR: 1.46), lowest quintile for wealth (OR: 1.82), not working due to a disability (OR: 3.29), renting (OR: 2.04), greater IADL limitations (OR: 1.32), and greater number of chronic illness comorbidities (OR: 1.14). Factors significantly associated with lower odds of food insecurity included older age (65-74: OR: 0.73; 75+: OR: 0.56) and being above the median income level (OR: 0.47). Partnership status, education level, and ADL limitations were not significantly associated with the population-averaged odds of experiencing food insecurity. This study identified factors related to food insecurity among a community-dwelling sample of middle aged and older adults in the U.S. Future research should examine the impact of policies and intervention strategies to address the disproportionate impact of COVID-19 on populations at increased risk of experiencing food insecurity.

scholarly journals Concordance in reports of food insecurity associated with environmental factors among Latino fathers and mothers

2020 ◽  
Author(s):  
Sayaka Nagao-Sato ◽  
Stephanie Druziako ◽  
Aysegul Baltaci ◽  
Alejandro Omar Peralta Reyes ◽  
Youjie Zhang ◽  
...  
Keyword(s):  
Food Security ◽  
Food Insecurity ◽  
Nutrition Education ◽  
Predictor Variables ◽  
Household Food Security ◽  
Fruit And Vegetable ◽  
Neighborhood Safety ◽  
Factors Associated ◽  
Household Food ◽  
Food Security Status

Abstract Background: Food assistance and nutrition education are strategies used to address the high prevalence of food insecurity among U.S. Latino households. Assessment of food security status is necessary to implement these strategies. However, similarities and differences in perceptions of food security status have not been reported among Latino fathers and mothers who may have different home food acquisition and preparation responsibilities. This study aimed to 1) determine demographic characteristics and/or food-related factors associated with perceptions of food security status among Latino fathers and mothers, and 2) identify those factors correlated with concordance in perceptions of food insecurity between fathers and mothers.Methods: Baseline data were used from a Latino-family, community-based program to improve paternal parenting practices and youth energy balance-related behaviors (Padres Preparados, Jóvenes Saludables), including 106 father and mother couples. Food security was assessed with two questions from the U.S. Department of Agriculture 18-item Household Food Security Survey. Logistic regression models were used to evaluate associations between food security and predictor variables in fathers or mothers and between couple discordant responses in food security status and predictor variables.Results: The prevalence of household food insecurity was reported by 39% of fathers and 55% of mothers. Food security status was associated with neighborhood safety (odds ratio (OR): 3.7, p < 0.05) and household income (OR: 3.2, p < 0.05) in fathers, and with neighborhood safety (OR: 4.1, p < 0.01) and home fruit and vegetable availability (OR: 5.5, p < 0.01) in mothers. Couple discordance in reporting food security status occurred in 24% of the couples and was related to higher discordance among couples where fathers reported a lower frequency of participation in nutrition education than mothers (OR: 3.4, p < 0.05) and different perceptions of home fruit and vegetable accessibility (OR: 3.1, p < 0.05).Conclusions: Among Latino fathers and/or mothers, factors associated with perceptions of food insecurity differed, possibly related to fathers versus mothers having access to information about different household aspects related to food insecurity. Nutrition education for fathers may support an improvement in couple discordance in assessment of food security.

scholarly journals Message Framing and Exercise Effects in Mobile Fitness Application: Repeated Measure Design and Playtest Experimental Study (Preprint)

2018 ◽  
Author(s):  
Keyword(s):  
Repeated Measures ◽  
Message Framing ◽  
Repeated Measure ◽  
Persuasive Messages ◽  
Exercise Behaviors ◽  
Repeated Measures Design ◽  
Perceived Benefit ◽  
The Difference ◽  
Experimental Treatments ◽  
Self Administered Questionnaire

BACKGROUND The ultimate goals of exercise contents in the form of apps are to manage and nurture users’ exercise habits. To promote and maintain their desire for exercise, app developers focus not only on the utilization of various media characteristics for fitness apps, but also on the composition and effects of messages that stimulate and reward users’ exercise behaviors. OBJECTIVE This study sought to verify differences in user experiences and exercise experiences depending on the message framing provided by a mobile fitness app, based on evaluation of the variables of perceived benefit, exercise interest, exercise flow, and exercise attitude. METHODS The research was designed following the repeated measures design and the playtest method, in which experiments were repeated multiple times for the same group based on the type of message on the fitness app (male 50, female 50). This enabled effective verification of the difference between experimental treatments. Participants were instructed to use two types of fitness app that presented gain or loss messages about exercise outcomes while performing exercises. Thereafter, they were surveyed with a self-administered questionnaire. RESULTS Users who were exposed to gain-framed messages in the mobile fitness app showed higher perceived benefit, exercise interest, and exercise flow than those who were exposed to loss-framed messages. Furthermore, gain-framed messages also led to a positive attitude toward exercise. CONCLUSIONS The present study is meaningful due to its investigation of the influences and persuasive effects of gain- and loss-framed messages given by a health fitness app. This study, which demonstrated that gain-framed messages enhanced the exercise experiences of users compared to loss-framed messages when persuasive messages were presented through a health functional app, provides a theoretical foundation for health message framing in exercise apps.

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