Integrating Health Education into Clinical Settings

In the United States, health concerns such as food insecurity and obesity continue to rise among American households (Centers for Disease Control and Prevention, 2003). Poor dietary intake can result in poor health outcomes as well as negatively impact student academic performance (Sigman-Grant, 2003). Despite the growing health concerns among the youth, limited studies have examined the dietary patterns of the Mexican-American adolescent population. This study aims to fill that void by describing the dietary intake of predominantly Mexican-American adolescents 13-18 years of age (n=532). The study design was cross-sectional and randomly selected high school participants based on their enrollment in physical education classes. Results of a one day 24-hour dietary recall showed both males and females in this study were below the national recommendations for total calories per day and reported poor eating behaviors. Further research is needed to investigate food insufficiency in this population who has high prevalence of overweight.

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Low Caloric Intake Among Mexican – American High School Students May Suggest Food Insecurity and/or Insufficiency in the Household

Californian Journal of Health Promotion ◽

10.32398/cjhp.v5i2.1230 ◽

2007 ◽

Vol 5 (2) ◽

pp. 29-44

Author(s):

Liset Leal-Vasquez ◽

Tammy Wyatt ◽

Ashley Love

Keyword(s):

High School ◽

High School Students ◽

Dietary Intake ◽

Food Insecurity ◽

Mexican American ◽

Caloric Intake ◽

The United States ◽

School Students ◽

Cross Sectional ◽

Health Concerns

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Association between Ready-to-Eat Cereal Consumption and Nutrient Intake, Nutritional Adequacy, and Diet Quality in Adults in the National Health and Nutrition Examination Survey 2015–2016

Nutrients ◽

10.3390/nu11122952 ◽

2019 ◽

Vol 11 (12) ◽

pp. 2952

Author(s):

Yong Zhu ◽

Neha Jain ◽

Vipra Vanage ◽

Norton Holschuh ◽

Anne Hermetet Agler ◽

...

Keyword(s):

United States ◽

Dietary Intake ◽

National Health ◽

Diet Quality ◽

The United States ◽

Healthy Eating Index ◽

Nutrition Examination Survey ◽

Food Groups ◽

Dietary Recall ◽

Health And Nutrition

This study examined differences in dietary intake between ready-to-eat cereal eaters and non-eaters in adults from the United States. Participants (n = 5163) from the National Health and Nutrition Examination Survey 2015–2016 were included. One-day dietary recall was used to define ready-to-eat cereal consumption status and estimate dietary intake in eaters and non-eaters. Data from Food Patterns Equivalent Database 2015–2016 were used to compare intakes of food groups by consumption status. Diet quality was assessed by Healthy Eating Index 2015. Nineteen percent of US adults were ready-to-eat cereal eaters; they had a similar level of energy intake as non-eaters, but they had significantly higher intake of dietary fiber, and several vitamins and minerals, such as calcium, iron, magnesium, potassium, zinc, vitamin A, thiamin, riboflavin, niacin, vitamin B6, folate, vitamin B12, and vitamin D. They were also more likely to meet nutrient recommendations. Compared to non-eaters, ready-to-eat cereal eaters had the same level of added sugar intake but they had significantly higher intake of whole grains, total fruits, and dairy products. The diet quality of ready-to-eat cereal eaters was significantly higher than that of non-eaters. The study supports that ready-to-eat cereal eaters have better dietary intake with a healthier dietary pattern than non-eaters in the United States.

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Association of HIV-1 Infection and Antiretroviral Therapy With Type 2 Diabetes in the Hispanic Population of the Rio Grande Valley, Texas, USA

Frontiers in Medicine ◽

10.3389/fmed.2021.676979 ◽

2021 ◽

Vol 8 ◽

Author(s):

Juan Carlos Lopez-Alvarenga ◽

Dora A. Martinez ◽

Alvaro Diaz-Badillo ◽

Liza D. Morales ◽

Rector Arya ◽

...

Keyword(s):

Type 2 Diabetes ◽

Mexican American ◽

Robust Regression ◽

Rio Grande Valley ◽

Rio Grande ◽

The United States ◽

Cross Sectional ◽

Mean Values ◽

Cell Counts

The Rio Grande Valley (RGV) in South Texas has one of the highest prevalence of obesity and type 2 diabetes (T2D) in the United States (US). We report for the first time the T2D prevalence in persons with HIV (PWH) in the RGV and the interrelationship between T2D, cardiometabolic risk factors, HIV-related indices, and antiretroviral therapies (ART). The PWH in this study received medical care at Valley AIDS Council (VAC) clinic sites located in Harlingen and McAllen, Texas. Henceforth, this cohort will be referred to as Valley AIDS Council Cohort (VACC). Cross-sectional analyses were conducted using retrospective data obtained from 1,827 registries. It included demographic and anthropometric variables, cardiometabolic traits, and HIV-related virological and immunological indices. For descriptive statistics, we used mean values of the quantitative variables from unbalanced visits across 20 months. Robust regression methods were used to determine the associations. For comparisons, we used cardiometabolic trait data obtained from HIV-uninfected San Antonio Mexican American Family Studies (SAMAFS; N = 2,498), and the Mexican American population in the National Health and Nutrition Examination Survey (HHANES; N = 5,989). The prevalence of T2D in VACC was 51% compared to 27% in SAMAFS and 19% in HHANES, respectively. The PWH with T2D in VACC were younger (4.7 years) and had lower BMI (BMI 2.43 units less) when compared to SAMAFS individuals. In contrast, VACC individuals had increased blood pressure and dyslipidemia. The increased T2D prevalence in VACC was independent of BMI. Within the VACC, ART was associated with viral load and CD4+ T cell counts but not with metabolic dysfunction. Notably, we found that individuals with any INSTI combination had higher T2D risk: OR 2.08 (95%CI 1.67, 2.6; p < 0.001). In summary, our results suggest that VACC individuals may develop T2D at younger ages independent of obesity. The high burden of T2D in these individuals necessitates rigorously designed longitudinal studies to draw potential causal inferences and develop better treatment regimens.

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“I Feel like I’m Eating Rice 24 Hours a Day, 7 Days a Week”: Dietary Diversity among Asylum Seekers Living in Norway

Nutrients ◽

10.3390/nu11102293 ◽

2019 ◽

Vol 11 (10) ◽

pp. 2293 ◽

Cited By ~ 1

Author(s):

Sigrun Henjum ◽

Bess L. Caswell ◽

Laura Terragni

Keyword(s):

Dietary Intake ◽

Asylum Seekers ◽

Dietary Diversity ◽

Dietary Quality ◽

Limited Information ◽

Food Groups ◽

Cross Sectional ◽

Dietary Recall ◽

Vegetables And Fruits ◽

Inadequate Dietary Intake

Food insecurity is widespread among asylum seekers resettled in Western countries. Limited information exists on the quality of food intake in this population. The aim of this study was to investigate dietary quality among asylum seekers living in Norwegian reception centers. This study has a cross-sectional research design. Dietary intake was assessed through a qualitative 24-hour dietary recall, and the dietary diversity score (DDS) was calculated. This study was conducted in eight Norwegian reception centers. A total of 205 adult asylum seekers (131 men and 74 women) participated in the study. The asylum seekers ate on average two meals per day, and one-third ate their first meal after noon. Mean (SD) DDS was 4.0 (1.6) and 2/3 had low dietary diversity, eating from fewer than five food groups. Women had a significantly higher mean DDS (4.5) than men (3.8) (β (95% CI): 0.47 (0.00, 0.95) and a higher consumption of vegetables and fruits. The longer the period of residence in Norway, the higher the DDS, β (95% CI): 0.01 (0.00, 0.02). The asylum seekers’ inadequate dietary intake reveals new forms of poverty and social exclusion in Europe. An inadequate dietary intake may increase the magnitude of difficulty involved in the settlement process and contribute to poorer health.

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Dietary intake of adults with and without diabetes: results from NHANES 2013–2016

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2020-001681 ◽

2020 ◽

Vol 8 (1) ◽

pp. e001681

Author(s):

Scott T McClure ◽

Haley Schlechter ◽

Susan Oh ◽

Karen White ◽

Beiwen Wu ◽

...

Keyword(s):

Dietary Intake ◽

Representative Sample ◽

Tolerance Test ◽

Serum Glucose ◽

Healthy Eating Index ◽

Oral Glucose ◽

Dietary Intakes ◽

Cross Sectional ◽

Dietary Recall ◽

Nationally Representative

IntroductionDiet is a critical aspect of the management of adults with diabetes. This paper aims to compare dietary intakes of key macronutrients and micronutrients of US adults with and without diabetes and across the spectrum of diabetes.Research design and methodsWe compared absolute and energy-adjusted dietary intake of major macronutrients and micronutrients among those with and without diabetes and across the spectrum of glycemic control using a 24-hour dietary recall from a cross-sectional, nationally representative sample of 9939 US adults, 20+ years old (National Health and Nutrition Examination Survey 2013–2016). Diabetes was defined as an glycohemoglobin A1c (HbA1c)≥6.5%, fasting glucose ≥126 mg/dL, serum glucose at 2 hours following a 75 g glucose load (oral glucose tolerance test) ≥200 mg/dL, any diagnosis of diabetes or use of diabetes medication (self-reported).ResultsPercent of calories from macronutrients was similar for those with and without diabetes (p>0.05, energy adjusted and adjusted for age, race, and sex). In both groups, sugar accounted for about 20% of calories. Those with diabetes consumed about 7% more calcium (p=0.033), about 5% more sodium (p=0.026), and had lower diet quality (Healthy Eating Index-2015, p=0.021) than those without diabetes. Among those with diabetes, those with an HbA1c>9.0% consumed about 4% less magnesium (p-analysis of variance=0.007) than those with an HbA1c<6.5%. Results were similar within strata of age, race, and sex. Macronutrient intake did not vary consistently by HbA1c level.ConclusionsIn this nationally representative sample, there were no substantial or consistent differences in the dietary intake of macronutrients or micronutrients between US adults with and without diabetes. Improving the diets of those with diabetes will likely require enhanced targeted efforts to improve the dietary intake of persons with diabetes, as well as broad efforts to improve the dietary intake of the general population.

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Trends in Vitamin C Consumption in the United States: 1999–2018

Nutrients ◽

10.3390/nu13020420 ◽

2021 ◽

Vol 13 (2) ◽

pp. 420

Author(s):

Mary Brauchla ◽

Mark J. Dekker ◽

Colin D. Rehm

Keyword(s):

United States ◽

Vitamin C ◽

Fruits And Vegetables ◽

Fruit Juice ◽

The United States ◽

Cross Sectional Study ◽

P Value ◽

Cross Sectional ◽

Dietary Recall ◽

Health And Nutrition

Low intakes of fruits and vegetables have resulted in suboptimal intakes of several micronutrients, including vitamin C. This cross-sectional study used data from 84,902 children/adults (≥1 y) who completed a 24-h dietary recall as part of the United States National Health and Nutrition Examination Survey (1999–2018). Mean vitamin C intakes from foods/beverages were calculated as were trends in major food/beverage sources of vitamin C. Percentages below the Estimated Average Requirement (EAR) were estimated. Overall, mean vitamin C consumption declined by 23% (97–75 mg/d; p-value for trend < 0.001). 100% fruit juice was the leading source of vitamin C (25.6% of total or 21.7mg/d), but this declined by 48% (25–13 mg/d; p-value for trend < 0.001). Whole fruit increased among children/adolescents (+75.8%;10–17 mg/d; p-value for trend < 0.001), but not adults, while the vegetable contribution was generally unchanged. The proportion of the population below the EAR increased by 23.8% on a relative scale or 9 percentage points on an absolute scale (38.3–47.4%). Declines in vitamin C intake is driven largely by decreases in fruit juice coupled with modest increases in whole fruit. Due to associations between vitamin C intake and numerous health outcomes these trends warrant careful monitoring moving forward.

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Dietary intake patterns among adults with inflammatory bowel disease in the United States, 2015

PLoS ONE ◽

10.1371/journal.pone.0250441 ◽

2021 ◽

Vol 16 (4) ◽

pp. e0250441

Author(s):

Fang Xu ◽

Sohyun Park ◽

Yong Liu ◽

Kurt J. Greenlund

Keyword(s):

Inflammatory Bowel Disease ◽

Dietary Intake ◽

Dietary Fiber ◽

Bowel Disease ◽

The United States ◽

Processed Meat ◽

Cross Sectional ◽

Added Sugars ◽

Supplement Use ◽

Inflammatory Bowel

Background Dietary behavior and nutrient intake patterns among U.S. men and women with inflammatory bowel disease (IBD) are unclear at the population level. Methods This cross-sectional study compared dietary intake patterns among U.S. adults (aged ≥18 years) with and without IBD in the 2015 National Health Interview Survey (N = 33,626). Age-standardized weighted prevalences for intake of fruits, vegetables, dairy, whole grain bread, dietary fiber, calcium, total added sugars, sugar-sweetened beverages (SSBs), processed meat, and supplement use were compared between adults with and without IBD by sex. Results In 2015, an estimated 3 million adults (1.3%) reported IBD. Compared with adults without IBD, adults with IBD were more likely to be older, non-Hispanic white, not currently working, former smokers, and former alcohol drinkers. Overall, dietary behaviors were similar among adults with and without IBD. However, adults with IBD were more likely to take vitamin D supplements (31.5% vs 18.8%) and consume dietary fiber <16.7 grams(g)/day, the amount that 50% of U.S. adults consumed (51.8% vs 44.1%), than those without IBD. Compared with their counterparts, men with IBD were more likely to consume vegetables ≥1 time/day (84.9% vs 76.0%) and take any supplement (59.6% vs 46.0%); women with IBD were more likely to have SSBs ≥2 times/day (26.8% vs 17.8%) and total added sugars ≥14.6 teaspoons(tsp)/day, the amount that 50% of U.S. adults consumed (55.3% vs 46.7%). Conclusions Adopting a healthy diet, especially limiting added sugars intake among women with IBD, might be important for the overall health.

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The Public’s Perception of the Severity and Global Impact at the Start of the SARS-CoV-2 Pandemic: A Crowdsourcing-Based Cross-Sectional Analysis (Preprint)

10.2196/preprints.19768 ◽

2020 ◽

Author(s):

Orr Shauly ◽

Gregory Stone ◽

Daniel Gould

Keyword(s):

Age Groups ◽

The United States ◽

Cross Sectional Study ◽

Amazon Mechanical Turk ◽

Cross Sectional ◽

The Us ◽

Control And Prevention ◽

Novel Coronavirus ◽

Study Participants ◽

Sectional Analysis

BACKGROUND COVID-19 is a rapidly developing threat to most people in the United States and abroad. The behaviors of the public are important to understand, as they may have a tremendous impact on the course of this novel coronavirus pandemic. OBJECTIVE This study intends to assess the US population’s perception and knowledge of the virus as a threat and the behaviors of the general population in response. METHODS A prospective cross-sectional study was conducted with random volunteers recruited through Amazon Mechanical Turk, an internet crowdsourcing service, on March 24, 2020. RESULTS A total of 969 participants met the inclusion criteria. It was found that the perceived severity of the COVID-19 pandemic significantly differed between age groups (<i>P</i><.001) and men and women (<i>P</i><.001). A majority of study participants were actively adhering to the Centers for Disease Control and Prevention guidelines. CONCLUSIONS Though many participants identified COVID-19 as a threat, many failed to place themselves appropriately in the correct categories with respect to risk. This may indicate a need for additional public education for appropriately defining the risk of this novel pandemic.

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Anxiety is associated with undesirable eating behaviors in university students during the COVID-19 pandemic

10.21203/rs.3.rs-148637/v1 ◽

2021 ◽

Author(s):

Kathryn E Coakley ◽

Huyen Le ◽

Spirit Rae Silva ◽

Aspen Wilks

Keyword(s):

Eating Behaviors ◽

The United States ◽

Eating Attitudes ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Professional Students ◽

The Past ◽

Severe Anxiety ◽

Satiety Responsiveness ◽

Food Fussiness

Abstract Background COVID-19 has impacted mental health globally, however, relationships between anxiety and eating behaviors during the pandemic have not been explored. This study evaluated anxiety, eating attitudes and behaviors, and associations between anxiety and eating behaviors in students at a large public University in the United States during the COVID-19 pandemic. Methods Current undergraduate and graduate/professional students completed a cross-sectional survey in fall 2020. Demographic information, indicators of anxiety in the past two weeks assessed by the Generalized Anxiety Disorder Screener (GAD-7), and eating behaviors assessed by the Adult Eating Behavior Questionnaire (AEBQ) were evaluated. A score ≥ 10 on the GAD-7 indicated anxiety (≥ 15 indicated severe anxiety). Eating behaviors were reported via Likert scale and combined into eight AEBQ subscales; subscale mean and standard deviation were reported. Differences in mean AEBQ subscale scores were examined between participants with and without anxiety via Mann-Whitney U tests. Multivariate linear regression was utilized to examine associations between GAD-7 score and individual AEBQ subscale scores, adjusting for age, gender, race/ethnicity, and student status. Results The final sample included 1243 students (57% undergraduates). In the full sample, 51.9% experienced anxiety in the past two weeks; 24.6% had severe anxiety. Subgroups with the highest prevalence of anxiety included non-cisgender participants (73.6%), the youngest age group [18–20 years of age (62%)], undergraduate students (60.7%), and Hispanic/Latino participants (57.5%). Participants with anxiety had significantly lower AEBQ scores for enjoyment of food and significantly higher scores for emotional over and under-eating, food fussiness, food and satiety responsiveness, and hunger than those with no anxiety (p < 0.01). In adjusted analyses, GAD-7 score was significantly and positively associated with hunger, food responsiveness, emotional over-eating, satiety responsiveness, and food fussiness and negatively associated with enjoyment of food. Conclusions The prevalence of anxiety is overwhelming in undergraduate and graduate/professional students amidst the COVID-19 pandemic. Eating behaviors differ significantly in those with anxiety; increasing anxiety severity was associated with undesirable eating behaviors including hunger and emotional over-eating. Universities and health professionals must consider strategies to address anxiety, particularly in younger students, non-cis-gender students, and across race/ethnicities keeping in mind associations between anxiety and eating behaviors.

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Sources of Medical Information for Oncology Physicians During the COVID-19 Pandemic: Results From a National Cross-Sectional Survey

JNCI Cancer Spectrum ◽

10.1093/jncics/pkaa095 ◽

2020 ◽

Vol 4 (6) ◽

Author(s):

Helen M Parsons ◽

Rachel I Vogel ◽

Anne H Blaes ◽

Emil Lou ◽

Heather Beckwith ◽

...

Keyword(s):

Disease Control ◽

Online Survey ◽

Medical Information ◽

Care Delivery ◽

The United States ◽

Sources Of Information ◽

Cross Sectional ◽

Professional Societies ◽

Control And Prevention ◽

Centers For Disease Control

Abstract Because the coronavirus disease 2019 (COVID-19) has completely transformed the accepted norms and approaches to cancer care delivery in the United States, we sought to understand the sources of medical information that oncology physicians seek and trust. We recruited 486 oncology physicians to an anonymous cross-sectional online survey through social media from March 27, 2020, to April 10, 2020, with 79.2% reporting their sources of medical information during the COVID-19 pandemic. We found a diverse array of reported sources for COVID-19 information that most commonly included professional societies (90.7%), hospital or institutional communications (88.6%), and the Centers for Disease Control and Prevention (69.9%); however, trust in these sources of information varied widely, with professional societies being the most trusted source. These results highlight the important role that professional societies, hospitals, and the Centers for Disease Control and Prevention play in ensuring dissemination of consistent, high-quality practice recommendations for oncology physicians.

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