Exploring Mothers’ Perspectives About Why Grandparents in Appalachia Give Their Grandchildren Cariogenic Foods and Beverages: A Qualitative Study

BackgroundDental caries is the most common chronic childhood disease. Past studies revealed that grandparents provide their grandchildren with cariogenic foods and beverages (eg, those with free sugars and/or modified starches). Qualitative research can help identify what drives this phenomenon.ObjectiveOur aim was to examine mothers’ explanations for why grandparents in north central and central Appalachia give their grandchildren cariogenic foods and beverages.DesignA qualitative study on children’s oral health in Pennsylvania and West Virginia from 2018 through 2020 was performed. In-person, semi-structured interviews were conducted. Qualitative data from interviews were recorded, transcribed, and then coded using NVivo. Data analysis for this study was performed using thematic analysis with iterative theme development.Participants/settingThe participants were 126 mothers of children aged 3-5 years from West Virginia (n = 66) and Pittsburgh, PA (n = 60).Main outcome measuresMothers’ perspectives about why grandparents give their grandchildren cariogenic foods and beverages were analyzed.ResultsIn the study sample, 85% of mothers (n = 107/126) named at least 1 of their children’s grandparents as a member of their social network responsible for their children’s oral health. From these interviews, 85% of mothers (n = 91/107) discussed that grandparents gave their grandchildren cariogenic foods and beverages. The mothers described the following 4 themes to explain why grandparents gave their grandchildren cariogenic foods and beverages: privilege of the grandparent role; responsibilities of the grandparent role; symbol of care and affection; and limited consideration or understanding of the detrimental impact.ConclusionsGrandparents play a role in giving their grandchildren cariogenic foods and beverages, which could potentially contribute to childhood caries. Research is needed to develop effective social interventions to help some grandparents understand the implications of a cariogenic diet on their grandchildren’s oral health and/or decrease their provision of cariogenic foods and beverages.     

Dietary Practices After Primary Treatment for Ovarian Cancer: A Qualitative Analysis From the OPAL Study

BackgroundLittle is known about the dietary practices of women who have completed primary treatment for ovarian cancer, many of whom will go on to have cancer recurrence and further treatment. Knowledge of dietary practices is needed to optimize care.ObjectiveOur aim was to identify dietary practices after primary treatment for ovarian cancer and evaluate how these practices differ by disease recurrence and treatment status.DesignWomen with invasive epithelial ovarian cancer were provided with the following open-ended question after completing a food frequency questionnaire: “Is there anything we haven’t asked you about your diet in the last 1 to 2 months that you feel is important?”Participants/settingParticipants were from the OPAL (Ovarian Cancer Prognosis and Lifestyle) Study in Australia.Main outcomesThe main outcomes were dietary practices after primary treatment for ovarian cancer and factors affecting these practices.AnalysisParticipants’ responses were analyzed using content analysis. Individual content codes were categorized and reported by recurrence and treatment status at questionnaire completion.ResultsTwo hundred eighty-six women provided responses on 363 questionnaires. Those undergoing further treatment for recurrence commonly reported dietary regimens with clinical indications (eg, low fiber to avoid bowel obstructions, high energy/protein to minimize nutritional deficits). Those not undergoing further treatment frequently reported “popular” diets (eg, organic, plant-based, and alkaline). For women with cancer recurrence, dietary practices were affected by poor appetite and late effects of treatment. For women without recurrence, other comorbidities, geographical location, family, and friends appeared to influence dietary practices. In both groups, nutrition information sources and personal beliefs informed dietary practices. Participant responses that referenced media or online sources often included misinformation.ConclusionsAfter primary treatment for ovarian cancer, women report dietary practices that may not be captured in standard food frequency questionnaires. Dietary practices and factors affecting these practices likely differ by treatment and recurrence status. Improved access to evidence-based dietary information and support is needed.     

Evaluating a Food Pantry–Based Intervention to Improve Food Security,Dietary Intake,and Quality in Midwestern Food Pantries

BackgroundVoices for Food was a longitudinal community, food pantry–based intervention informed by the social ecological model, and designed to improve food security, dietary intake, and quality among clients, which was carried out in 24 rural food pantries across 6 Midwestern states.ObjectiveOur objective was to evaluate changes in adult food security, dietary intake, and quality from baseline (2014) to follow-up (2016), and to assess the role of adult food security on dietary outcomes.DesignA multistate, longitudinal, quasi-experimental intervention with matched treatment and comparison design was used to evaluate treatment vs comparison group changes over time and changes in both groups over time.Participants/settingAdult food pantry clients (n = 617) completed a demographic food security survey, and up to three 24-hour dietary recalls at baseline (n = 590) and follow-up (n = 160).InterventionCommunity coaching served as the experimental component, which only “treatment” communities received, and a food council guide and food pantry toolkit were provided to both “treatment” and matched “comparison” communities.Main outcome measuresChange in adult food security status, mean usual intakes of nutrients and food groups, and Healthy Eating Index-2010 scores were the main outcome measures.Statistical analyses performedLinear mixed models estimated changes in outcomes by intervention group and by adult food security status over time.ResultsImprovements in adult food security score (–0.7 ± 0.3; P = .01), Healthy Eating Index-2010 total score (4.2 ± 1.1; P < .0001), and empty calories component score (3.4 ± 0.5; P <.0001) from baseline to follow-up were observed in treatment and comparison groups, but no statistically significant changes were found for adult food security status, dietary quality, and usual intakes of nutrients and food groups between the 2 groups over time. The intervention effect on dietary quality and usual intake changes over time by adult food security status were also not observed.ConclusionsFood pantry clients in treatment and comparison groups had higher food security and dietary quality at the follow-up evaluation of the Voices for Food intervention trial compared with baseline, despite the lack of difference among the groups as a result of the experimental coaching component.     

Diet and nutrition against inflammatory bowel disease: Trick or treat(ment)?

Even if the relationships between nutrition and inflammatory bowel disease (IBD) remain underexplored, the current literature is providing, day by day, much more evidence on the effects of various diets in both prevention and treatment of such illnesses. Wrong dietary habits, together with other environmental factors such as pollution, breastfeeding, smoke, and/or antibiotics, are among the theoretical pathogenetic causes of IBD, whose multifactorial aetiology has been already confirmed. While some of these risk factors are potentially reversible, some others cannot be avoided, and efficient treatments become necessary to prevent IBD spread or recurrence. Furthermore, the drugs currently available for treatment of such disease provide low-to-no effect against the symptoms, making the illnesses still strongly disabling. Whether nutrition and specific diets will prove to effectively interrupt the course of IBD has still to be clarified and, in this sense, further research concerning the applications of such dietary interventions is still needed.     

Long-term neighborhood ethnic composition and weight-related outcomes among immigrants: The Multi-Ethnic Study of Atherosclerosis

Weight among immigrants in the United States (US) is lower than among the US-born on average, but higher among long-term immigrants than the newly arrived. Neighborhood coethnic concentration—the proportion of neighborhood residents of the same ethnic background—may influence weight among immigrants via behavioral norms and market-driven community resources. However, the relevant exposure timeframe may be far longer than is captured by existing cross-sectional and short-term studies. Using detailed historical residential address information on 1449 older Latino and Chinese long-term immigrants, we investigated associations of 10–20-year neighborhood coethnic concentration trajectories with current waist circumference and weight-related behaviors (diet, physical activity, and sedentary time). Among Chinese participants, compared to persistent low coethnic concentration, increasing coethnic concentration was associated with higher waist circumference (difference = 1.45 cm [0.51, 2.39]). In contrast, both increasing coethnic concentration and persistent high coethnic concentration were associated with a healthier diet. Among Latino participants, trajectories characterized by higher coethnic concentration were associated with higher waist circumference (e.g., difference = 2.11 cm [0.31, 3.91] for persistent high vs. persistent low) and low physical activity. Long-term patterns of neighborhood coethnic concentration may affect weight-related outcomes among immigrants in complex ways that differ by ethnicity and outcome.     

The Influence of Training on New Army Recruits’ Energy and Macronutrient Intakes and Performance: A Systematic Literature Review

BackgroundNew army recruits undertake initial training to develop their skillset and physical and mental preparedness for military service. Recruits experience a range of stressors both physical and psychological, often at extremes, and in combination. These stressors place recruits at risk of suboptimal energy and macronutrient intakes, which may negatively influence their performance.ObjectiveThe objectives of this systematic literature review are to examine, against the Military Recommended Dietary Intakes (MRDIs), the energy, carbohydrate, protein, and fat intakes of army recruits and trainees undertaking initial training internationally, and identify any associated influence on their performance.DesignA systematic literature review was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses guidelines. Information sources were searched from their inception until May 2019.Main outcome measuresOutcome data included dietary intakes of energy, carbohydrate, protein, and fat before, during, and/or after army initial training, as well as measures of physical fitness and performance. A custom tool was used to assess the quality of included studies.ResultsThe results of 14 studies were synthesized. Six were conducted in the United States and four in each of Australia and Israel. Average energy intake represented 69% to 120% of the MRDIs before training commencement, 69% to 106% of the MRDIs in the early weeks of training and 56% to 77% of the MRDIs in the later weeks of training. Average carbohydrate and protein intakes represented 49% to 121% and 64% to 143% of the MRDIs, respectively, across the various time points. Three studies measured physical fitness and/or performance outcomes, with one showing a significant improvement in push-up performance when extra protein was provided.ConclusionsThe novel findings of this systematic literature review are that army recruits, internationally, are likely to be underconsuming energy for extended periods of their initial training, with greater deficits in carbohydrate intake compared with other macronutrients. Only a handful of studies investigated the subsequent influents on performance, with no definitive conclusions drawn in most instances. Further research is needed to understand the influence of suboptimal dietary intake on military relevant performance indicators to help better inform key stakeholders when devising nutrition guidance and strategies for army recruits in the future.