Karen Chapman-Novakofski

Aim: The purpose of this systematic review was to evaluate robust interventions across seven eating practice outcomes and to consider potential modifiers, including parental involvement, intervention setting, and quality of food practice evaluation. Methods: The search procedure reflected Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Web of Science, PsychInfo, PubMed, and Elton B. Stephens Company (EBSCO) (2004–2019) were searched for studies that aimed to change children’s (2 to 12 years old) diet (one or more eating practice components: fruit, vegetables, whole grains, lower saturated fat, lower sugar-sweetened beverages (SSBs), intake of dairy, diet quality). Of 2316 papers, 22 met inclusion criteria. Results: Fruits ( n = 12) and vegetables ( n = 15) were the most frequent outcomes. Half of fruit-targeted, two-thirds of vegetable-targeted, half of fruit/vegetable-targeted, eight of nine SSB-targeted, and one of two whole grain-targeted outcomes showed significant improvements. The actual food intake change was modest in most cases. Eighteen interventions included parents, although the four that did not also reported significant outcomes. Most studies were conducted in schools, early childcare, or after-school programs ( n = 13) with significant improvements in most settings. Only about half of the studies involving children < 10 years used proxy reporting/direct observation. Eight studies included no reliability, validity, or citation for the method of dietary measurement. Conclusion: Robust studies continue to focus on one or two foods, parental involvement may be beneficial depending on the intervention, and more research is needed to establish best practices across all settings.

BACKGROUND Improving children's fruit and vegetable (FV) preferences may be important as preferences can predict FV consumption. The purpose of this study was to evaluate FV preferences over time, with repeated experience, as part of the Fresh Fruit and Vegetable Program (FFVP). METHODS Fruits (F; N = 28) and vegetables (V; N = 29) were distributed twice a week, over 35 weeks, at a participating FFVP school (N = 236 students, 12 teachers, K-2nd grade). Preference ratings using 3-point Likert scale were analyzed over 35 weeks. RESULTS For 57 FVs rated for preference, ratings revealed that F had higher frequency of children choosing "I like it" than for V (78% F; 38.2% V; p < .05) and liking distribution was different between F and V (p < .001). Significant relations were found between liking and: (1) grade (r = -0.02, p = .02), and (2) time (r = -0.09, p < .001). Models indicated that V served (beta = -0.40), timepoint (beta = -0.07), and grade level (beta = -0.02) accounted for significant variance for preference ratings (R-2 = 0.17, p < .001), indicating that preference ratings declined over time. CONCLUSIONS Fruits were preferred over vegetables. Overall preference ratings were negatively impacted by time, grade level, and vegetables served. Being exposed one time to a variety of FVs did not improve ratings for vegetables.

Background Gastrointestinal symptoms are reported in a large proportion of endurance athletes, with similarities in symptom type and distribution to irritable bowel syndrome (IBS). Aims The objective of this study was to develop and validate a questionnaire to assess IBS diagnoses or fit to IBS diagnostic criteria in this population along with nutritional habits, gastrointestinal symptoms, and symptom management strategies. Methods A 93-item Endurance Athlete Questionnaire was developed to address the objective, targeted at American endurance athletes completing a marathon, ultra-marathon, half-distance triathlon, and/or full-distance triathlon that year. Content validity was established by expert reviewers (n = 6), and face validity was evaluated by endurance athletes (n = 9). Test–retest reliability was assessed by target athletes (n = 51). Participants completed two rounds of the questionnaire, separated by 1–2 weeks. Results were analyzed using Pearson and Spearman correlations and paired comparisons. Results Slight modifications in wording and three demographic questions were added based on the input of expert and athlete reviews. Pearson correlation coefficient of test–retest total questionnaire scores was significant at 0.839 (P < 0.001). Paired comparison of individual questions found significant differences in 10 of 236 analyzed responses; however, these did not affect fit to IBS diagnostic criteria for those without other GI diseases/disorders. Conclusions The Endurance Athlete Questionnaire proved to be a valid and reliable measure of IBS diagnostic criteria, gastrointestinal symptoms, nutritional habits, and symptom management strategies among endurance athletes. Future implementation will help inform gastroenterologists with endurance athlete patients and can elucidate whether certain behaviors could be contributing to athlete gastrointestinal symptoms.

Grassroots stakeholder input results in relevant and timely Extension programs, but presents a challenge for performance measurement using common indicators. A balanced approach to program evaluation and reporting that is adequately valid and reliable while honoring the Extension culture of service is most likely to be successful. This article reviews recent advances in evaluation methodology of food and nutrition programs. It further describes how this evidence base informs the current set of national Extension program outcomes and indicators. Evaluation work is an essential step in documenting the public value of Extension programs.

Because more than half of those participating in a community-based diabetes session expressed experience with hypoglycemia, we sought additional information by conducting focus groups before developing programs or materials for educational support. The objectives of these focus groups were to determine how and to what extent hypoglycemia affected people, and what, if any, methods were used to prevent or treat the condition, to better target education in the future. Four focus groups were held using a tiered discussion script with a moderator and comoderator. Discussions were audiotaped, transcribed, and analyzed by content by independent researchers. Five themes emerged from the discussions: friends, family, and neighbors need hypoglycemia education as well as individuals themselves; leaving home is a concern if you experience hypoglycemia; overeating occurs when treating hypoglycemia; routine is important; and hypoglycemia is a limitation. We found that hypoglycemia had a significant impact on the participants’ quality of life.

Aim and Methods: This study assessed whether distributed interactive learning via web-based modules and grounded in schema and social cognitive theory (treatment group, n = 101) would increase knowledge about diabetes prevention in adolescents from three middle schools to a greater extent than the control group ( n = 80) and examined whether the school environment used to convey the education had an effect. Results: The treatment group showed substantially greater increases in overall and individual modular content knowledge, with 72 voluntarily choosing to retake evaluations that significantly improved their scores. The treatment ( t [3.8], β ≥ 0.30, P < 0.001) and format of delivery (after school, pull out from physical education, or health education curriculum) ( t [3.41], β ≥ 0.24, P < 0.001) influenced knowledge. Conclusions: Thus, distributed interactive learning was more effective than its passive counterpart, and a more structured delivery enhanced knowledge, as did opportunities to self-regulate learning. Attention to these process components will facilitate effective interventions by educators in schools.

Advanced glycation end products (AGEs) are a heterogeneous, complex group of compounds that are formed when reducing sugar reacts in a non-enzymatic way with amino acids in proteins and other macromolecules. This occurs both exogenously (in food) and endogenously (in humans) with greater concentrations found in older adults. While higher AGEs occur in both healthy older adults and those with chronic diseases, research is progressing to both quantify AGEs in food and in people, and to identify mechanisms that would explain why some human tissues are damaged, and others are not. In the last twenty years, there has been increased evidence that AGEs could be implicated in the development of chronic degenerative diseases of aging, such as cardiovascular disease, Alzheimer’s disease and with complications of diabetes mellitus. Results of several studies in animal models and humans show that the restriction of dietary AGEs has positive effects on wound healing, insulin resistance and cardiovascular diseases. Recently, the effect of restriction in AGEs intake has been reported to increase the lifespan in animal models. This paper will summarize the work that has been published for both food AGEs and in vivo AGEs and their relation with aging, as well as provide suggestions for future research.

Bone health is an important issue in aging. Calcium and vitamin D currently have the most focus in published research on nutrition and bone health in aging, although evidence from published research is not conclusive. A systematic review was conducted to determine the impact of dietary and supplemental interventions focused on calcium and vitamin D over the past 10 years. Using key words to search, and search limits (aging population, English), 62 papers were found related to diet, nutrition, and bone; and 157 were found related to calcium and bone. Our review found a positive effect on bone health for supplements; food-based interventions; and educational strategies. Although there may be a publishing bias related to non-significant findings not being published, our results suggest the effectiveness of food based and educational interventions with less economic impact to the individual, as well as less risk of physiological side effects occurring.