The associations of plant-based food and metabolic syndrome using NHANES 2015-16 data.

BACKGROUND: Consuming a diet rich in plant-based foods (PBFs) may be protective for risk of metabolic syndrome (MetS) and chronic disease. However, the impact of consuming healthy versus all types of PBF on MetS is unknown. METHODS: The relationship between consumption of PBF (both healthy and all) was examined using data from the 2015 to 2016 National Health and Nutrition Examination Survey (NHANES). The amount of PBFs consumed was calculated as average daily servings, whereas dichotomous MetS variables were based on the National Cholesterol Education Adult Program Treatment Panel III (2005). After weighting and multiple imputation, adjusted associations were examined using logistic regression and marginal probabilities. RESULTS: Consumption of healthy PBF was significantly associated with reduced risk for elevated waist circumference (P = 0.017; odds ratio, OR 0.96, 95% confidence interval, CI 0.94-0.98) and MetS (P = 0.006; OR 0.96, 95% CI 0.93-0.99). Interactions revealed significant protective effects for females who were $\ge$ 60 years. CONCLUSIONS: In the adjusted model, a 1-unit increase in daily servings of healthy PBF was associated with a 4% lower risk for prevalence of elevated waist circumference and a 4% decrease in risk for prevalence of MetS. Increasing consumption of PBF may offer a viable strategy for reducing risk of MetS.

Validation of the FRESH Austin food frequency questionnaire using multiple 24-h dietary recalls.

OBJECTIVE: The purpose of the current study was to examine the validity of an FFQ utilised in the Food Retail: Evaluating Strategies for a Healthy Austin (FRESH Austin) study, designed to evaluate changes in the consumption of fruits and vegetables (FV) in diverse low-income communities in Austin, TX. DESIGN: The FRESH Austin FFQ was validated against three 24-h dietary recalls (24hDR). All dietary assessments were administered (in-person or by telephone) by trained investigators. SETTING: Recruitment was conducted at sites within the geographic areas targeted in the FRESH Austin recruitment. People at a community health clinic, a local health centre and a YMCA within the intervention area were approached by trained and certified data collectors, and invited to participate. PARTICIPANTS: Among fifty-six participants, 83 % were female, 46 % were non-White, 24 % had income < $25 K/year and 30 % spoke only/mostly Spanish at home. RESULTS: The FFQ and average of three 24hDR produce similar estimates of average total servings/d across FV (6·68 and 6·40 servings/d, respectively). Correlations produced measures from 0·01 for 'Potatoes' and 0·59 for 'Other Vegetables'. Mean absolute percentage errors values were small for all FV, suggesting the variance of the error estimates was also small. Bland-Altman plots indicate acceptable levels of agreement between the two methods. CONCLUSION: These outcomes indicate that the FRESH FFQ is a valid instrument for assessing FV consumption. The validation of the FRESH Austin FFQ provides important insights for evaluating community-based efforts to increase FV consumption in diverse populations.

School-based gardening, cooking and nutrition intervention increased vegetable intake but did not reduce BMI: Texas sprouts - a cluster randomized controlled trial.

BACKGROUND: Although school garden programs have been shown to improve dietary behaviors, there has not been a cluster-randomized controlled trial (RCT) conducted to examine the effects of school garden programs on obesity or other health outcomes. The goal of this study was to evaluate the effects of a one-year school-based gardening, nutrition, and cooking intervention (called Texas Sprouts) on dietary intake, obesity outcomes, and blood pressure in elementary school children. METHODS: This study was a school-based cluster RCT with 16 elementary schools that were randomly assigned to either the Texas Sprouts intervention (n = 8 schools) or to control (delayed intervention, n = 8 schools). The intervention was one school year long (9 months) and consisted of: a) Garden Leadership Committee formation; b) a 0.25-acre outdoor teaching garden; c) 18 student gardening, nutrition, and cooking lessons taught by trained educators throughout the school-year; and d) nine monthly parent lessons. The delayed intervention was implemented the following academic year and received the same protocol as the intervention arm. Child outcomes measured were anthropometrics (i.e., BMI parameters, waist circumference, and body fat percentage via bioelectrical impedance), blood pressure, and dietary intake (i.e., vegetable, fruit, and sugar sweetened beverages) via survey. Data were analyzed with complete cases and with imputations at random. Generalized weighted linear mixed models were used to test the intervention effects and to account for clustering effect of sampling by school. RESULTS: A total of 3135 children were enrolled in the study (intervention n = 1412, 45%). Average age was 9.2 years, 64% Hispanic, 47% male, and 69% eligible for free and reduced lunch. The intervention compared to control resulted in increased vegetable intake (+ 0.48 vs. + 0.04 frequency/day, p = 0.02). There were no effects of the intervention compared to control on fruit intake, sugar sweetened beverages, any of the obesity measures or blood pressure. CONCLUSION: While this school-based gardening, nutrition, and cooking program did not reduce obesity markers or blood pressure, it did result in increased vegetable intake. It is possible that a longer and more sustained effect of increased vegetable intake is needed to lead to reductions in obesity markers and blood pressure. CLINICAL TRIALS NUMBER: NCT02668744 .

Role of Organizational Support on Implementation of an Environmental Change Intervention to Improve Child Fruit and Vegetable Intake: a Randomized Cross-Over Design.

Little is known about the role of organizational or administrative support in implementation of health promotion interventions, particularly outside of school settings. The purpose was to determine the change in fruit and vegetable (FV) intake among children living in residential children's homes (RCHs) and assess the relationships among change in organizational support, intervention implementation, and child nutrition outcomes. Data were collected from 29 RCHs and 614 children living in RCHs, as part of a group randomized design with delayed intervention, at three cross-sectional waves: 2004, 2006, and 2008. RCH staff made environmental changes to increase intake of FV. Implementation and organizational support data were collected from staff at the RCHs. Child FV intake were measured via 24-h dietary recalls. A two-way (condition by time) repeated measures ANOVA was conducted to test whether FV intake increased in response to the intervention. A two-level path analysis with a robust maximum likelihood estimator was used to explore the relationships among organizational support, intervention implementation fidelity, and child FV intake. There was a significant increase in FV intake within all RCHs from 2004 to 2006 (P = 0.022 for the intervention group, P = 0.015 for the control group). This increase was maintained in both groups from 2006 to 2008 (post-intervention mean servings: intervention = 3.2 vs control = 3.4). Increases in organizational support resulted in greater overall implementation fidelity. When RCH staff, supervisors, and the RCH CEO were perceived to be supportive of the intervention, more environmental changes were made to encourage eating FV. Fostering organizational support may improve implementation of interventions.

Five U.S. Dietary Patterns and Their Relationship to Land Use, Water Use, and Greenhouse Gas Emissions: Implications for Future Food Security.

The U.S. agri-food system is a driver of climate change and other impacts. In order to achieve environmental targets that limit global mean temperature rise ≤2 °C, a shift in American dietary patterns is critical. The purpose of this study was twofold: (1) to determine the environmental impact (i.e., land use, water use, and GHG emissions) related to consumption of five U.S. dietary patterns (i.e., Current U.S., the Healthy U.S., Mediterranean, Healthy Vegetarian, and Vegan), and (2) to determine the specific impact of each food group in each dietary pattern on the three environmental indicators. This study utilized existing datasets to synthesize information related to the study's environmental indicators and food production and connected these data to the current U.S. diet and the USDA-defined diets. Results indicate that the three omnivore diets contributed the greatest to GHG emissions, land use and water use. The Vegan diet scored the lowest across all indicators, although the water required for plant-based protein nearly offset other water gains. For the omnivore diets, red meat and dairy milk contributed the most to each environmental indicator. By considering sustainability as well as health outcomes in their recommendations in the Dietary Guidelines, the USDA can have a critical role in shifting diets necessary to alter climate change trends.

Effects of a School-Based Nutrition, Gardening, and Cooking Intervention on Metabolic Parameters in High-risk Youth: A Secondary Analysis of a Cluster Randomized Clinical Trial.

Importance: Although school-based gardening programs for children have consistently been shown to improve dietary behaviors, no cluster randomized clinical trial (RCT) has evaluated the effects of a school-based gardening intervention on metabolic outcomes. Objective: To evaluate the effects of a school-based gardening, nutrition, and cooking intervention (Texas Sprouts) on changes in metabolic outcomes in elementary schoolchildren. Design, Setting, and Participants: This study was a secondary analysis of a cluster RCT, conducted over 3 years from 2016 to 2019, at low-income elementary schools with majority Hispanic students in the greater Austin, Texas, area. Data were analyzed from January to August 2022. Interventions: Texas Sprouts was 1 school year long (9 months) and consisted of (1) Garden Leadership Committee formation; (2) a 0.25-acre outdoor teaching garden; (3) 18 student gardening, nutrition, and cooking lessons taught by trained educators throughout the school year; and (4) 9 monthly parent lessons. The delayed intervention was implemented the following academic year and received an identical intervention. Main Outcomes and Measures: The following measures were obtained at baseline and postintervention (9 months): demographics via survey; measured height, weight, and body mass index parameters; and glucose, insulin, homeostatic model assessment of insulin resistance, and a lipid panel via an optional fasting blood draw. Results: Sixteen elementary schools were randomly assigned to either Texas Sprouts intervention (8 schools) or to delayed intervention (control, 8 schools). A total of 3302 children (aged 7-12 years) were enrolled in Texas Sprouts, and fasting blood samples were obtained from 1104 children (or 33% of those enrolled) at baseline. The final analytic sample included 695 children (307 boys [44.17%]; mean [SE] age, 9.28 [0.04] years; 480 Hispanic children [69.02%]; 452 [65.03%] eligible for free or reduced lunch) with complete demographic data and baseline and postintervention (9-month) fasting blood draws. Compared with control schools, children from Texas Sprouts schools had a 0.02% reduction in mean hemoglobin A1c (95% CI, 0.03%-0.14%; P = .005) and a 6.40 mg/dL reduction in mean low-density lipoprotein cholesterol (95% CI, 3.82-8.97 mg/dL; P = .048). There were no intervention effects on glucose, insulin, homeostatic model assessment of insulin resistance, or other lipid parameters. Conclusions and Relevance: In this cluster RCT, Texas Sprouts improved glucose control and reduced low-density lipoprotein cholesterol in high-risk youth. These findings suggest that elementary schools should incorporate garden-based interventions as a way to improve metabolic parameters in children. Trial Registration: ClinicalTrials.gov Identifier: NCT02668744.

Effects of a School-Based Garden Program on Academic Performance: A Cluster Randomized Controlled Trial.

BACKGROUND: School gardening programs have consistently been found to improve dietary behaviors in children. Although several quasi-experimental studies have also reported that school gardens can enhance academic performance, to date, no randomized controlled trial has been conducted to substantiate this. OBJECTIVE: The objective of the study was to examine the effects of Texas Sprouts (TX Sprouts), a gardening, nutrition, and cooking program vs control on academic performance in primarily low-income, Hispanic children. DESIGN: This is a secondary analysis of the grade-level academic scores from schools that participated in the TX Sprouts program, a school-based cluster randomized controlled trial, consisting of 16 elementary schools that were randomly assigned to either the TX Sprouts intervention (n = 8 schools) or control (delayed intervention; n = 8 schools). PARTICIPANTS/SETTING: Analysis included 16 schools with students in fourth and fifth grade in Austin, TX from 2016 to 2019 that had a majority Hispanic population and a majority of children participating in the free and reduced lunch program. INTERVENTION: The intervention consisted of 18 one-hour gardening, nutrition, and cooking lessons taught in an outdoor teaching garden by trained educators throughout the academic year. MAIN OUTCOME MEASURES: Texas Education Agency grade-level data for the State of Texas Assessments of Academic Readiness were obtained via the Texas Education Agency website for the corresponding year of the intervention or control condition. STATISTICAL ANALYSIS PERFORMED: Repeated measures general linear models with pre- and post-intervention State of Texas Assessments of Academic Readiness scores as the dependent variable were run, adjusting for the percent of free and reduced lunch and school district as covariates. RESULTS: Schools that received the TX Sprouts intervention had a 6.5-percentage-point increase in fourth-grade reading State of Texas Assessments of Academic Readiness scores compared with control schools (P = .047). There were no significant differences in reading scores for fifth grade students or math scores for either fourth- or fifth-grade students between groups. CONCLUSIONS: Study findings provide evidence that school gardening programs may have some modest effects on academic achievement.

Association between Fresh Fruit and Vegetable Consumption and Purchasing Behaviors, Food Insecurity Status and Geographic Food Access among a Lower-Income, Racially/Ethnically Diverse Cohort in Central Texas.

The aims of this study were to determine if fresh fruit and vegetable consumption and purchasing behaviors were associated with geographic food access and/or food insecurity status, and to explore the role of sociodemographic characteristics among participants of a lower-income, racially/ethnically diverse cohort. This study used a cross-sectional design and baseline survey data from the FRESH-Austin study (N = 393). Associations between fresh produce consumption/purchasing and food insecurity status and geographic access to food were assessed utilizing univariate, bivariate, and multivariate linear regression methods and potential interactions were examined. The sample 40% reported being food insecure and the majority identified as Hispanic. Geographic food access was directly associated with fresh produce consumption (ß = 0.46, p = 0.02); however, the directionality of the relationship between food insecurity and fresh produce consumption varied due to a significant interaction with race/ethnicity. Only utilizing food assistance was associated with purchasing fewer fresh produce (ß= -1.83, p = 0.03). Findings suggest that communities experience food insecurity and limited healthy food access in different ways, and in some situations, are associated with fresh produce consumption and purchasing behaviors. Future research adopting an intersectionality-sensitive approach to better understand how to best support communities at risk is needed.

Impact of a School-Based Gardening, Cooking, Nutrition Intervention on Diet Intake and Quality: The TX Sprouts Randomized Controlled Trial.

School gardens have become common school-based health promotion strategies to enhance dietary behaviors in the United States. The goal of this study was to examine the effects of TX Sprouts, a one-year school-based gardening, cooking, and nutrition cluster randomized controlled trial, on students' dietary intake and quality. Eight schools were randomly assigned to the TX Sprouts intervention and eight schools to control (i.e., delayed intervention) over three years (2016-2019). The intervention arm received: formation and training of Garden Leadership Committees; a 0.25-acre outdoor teaching garden; 18 student lessons including gardening, nutrition, and cooking activities, taught weekly in the teaching garden during school hours; and nine parent lessons, taught monthly. Dietary intake data via two 24 h dietary recalls (24 hDR) were collected on a random subsample (n = 468). Dietary quality was calculated using the Healthy Eating Index 2015 (HEI-2015). The intervention group compared to control resulted in a modest increase in protein intake as a percentage of total energy (0.4% vs. -0.3%, p = 0.021) and in HEI-2015 total vegetables component scores (+4% vs. -2%, p = 0.003). When stratified by ethnicity/race, non-Hispanic children had a significant increase in HEI-2015 total vegetable scores in the intervention group compared to the control group (+4% vs. -8%, p = 0.026). Both the intervention and control groups increased added sugar intake; however, to a lesser extent within the intervention group (0.3 vs. 2.6 g/day, p = 0.050). School-based gardening, cooking, and nutrition interventions can result in significant improvements in dietary intake. Further research on ways to scale and sustain nutrition education programs in schools is warranted. The trial is registered at ClinicalTrials.gov (NCT02668744).

Examining food insecurity and areas with unmet food needs during COVID-19: A geospatial, community-specific approach.

Food insecurity is a public health issue that has increased in the U.S. since the 2020 COVID-19 pandemic. Understanding how this increase occurs locally is crucial in informing appropriate food insecurity-related responses. Analyzing 2-1-1 call data is one way to examine food insecurity-related needs at a zip code level. The purpose of this work was to: (1) examine overall call trend data to 2-1-1 from March through July 2019 and March through July 2020, (2) examine changes in food need call volume to 2-1-1 during COVID-19 by zip code, and (3) identify areas with unmet food needs during COVID-19 in central Texas. Data for 2-1-1 calls from Travis County zip codes for March through July 2020 were compared to calls for March through July 2019 and categorized by reason for calling. Descriptive statistics and paired t-tests were used to analyze food need calls by zip code and mapped using ArcGIS. Communities with high food call volume and no emergency food assets located within the zip code were categorized as areas with unmet food needs. Results indicated there were more overall calls to 2-1-1 in 2020 (N=37,572) than in 2019 (N=28,623), and significantly more food need calls in 2020 than in 2019 (p<0.01). Eastern Travis County, a racially and ethnically diverse and lower-income area, had the largest increase in food need calls. Two zip codes were identified as having unmet food needs, which informed the strategic placement of emergency food assets. This study illustrates how 2-1-1 data can result in rapid translation of research to policy and program implementation.

Emergency Food Provision for Children and Families during the COVID-19 Pandemic: Examples from Five U.S. Cities.

As lockdown and school closure policies were implemented in response to the coronavirus, the federal government provided funding and relaxed its rules to support emergency food provision, but not guidance on best practices for effectiveness. Accordingly, cities developed a diverse patchwork of emergency feeding programs. This article uses qualitative data to provide insight into emergency food provision developed in five cities to serve children and families. Based on our qualitative analysis, we find that the effectiveness of local approaches appears to depend on: (i) cross-sector collaboration, (ii) supply chains, and (iii) addressing gaps in service to increased risk populations.

Factors Associated with Use of Recreational Facilities and Physical Activity Among Low-Income Latino Adults.

The purpose of this study was to identify longitudinal correlates of low-income, urban, Latino adults' use of recreational facilities and engagement in physical activity (PA). This secondary data analysis is from a placed-based initiative; the parent study recruited a cohort of parents of kindergarteners from schools in intervention and control communities. Using a self-administered questionnaire, we collected baseline correlates and 1-year follow-up recreational facilities use and PA outcomes. We conducted ordinal logistic regression to assess correlates for recreational facilities use and PA outcomes. Our sample of 273 Latino adults was mostly female and married or living with partners. Meeting PA guidelines at baseline was associated with higher odds of using parks, walking, and moderate- and vigorous-intensity PA. Those who considered PA to be important had higher odds of using trails (adjusted OR = 2.36, 95% CI 1.15-4.84) and of moderate-intensity PA (adjusted OR = 2.68, 95% CI 1.21-5.91). Reported perception that the neighborhood is very safe to walk was associated with higher odds of using trails (adjusted OR 3.45, 95% CI 1.39-8.53) and parks (adjusted OR 2.92, 95% CI 1.19-7.16). Quality of recreational facilities was directly associated with walking (adjusted OR = 1.61 95% CI 1.01-2.57). Speaking English was associated with higher odds of engaging in moderate-intensity PA (adjusted OR = 3.28 95% CI 1.70-6.33). Results from this study of urban, low-income Latinos indicate that promotion is needed not only for sustained use of recreational facilities among current users, but also for concerted efforts to reach less acculturated Latinos and make recreational facilities appealing to currently inactive adults. Both individual-level and neighborhood-level interventions are needed to build positive attitudes towards PA, while also enhancing neighborhood safety and the quality of neighborhood recreational facilities.

Barriers to Preparing and Cooking Vegetables Are Associated with Decreased Home Availability of Vegetables in Low-Income Households.

Knowing which barriers to buying and preparing/cooking vegetables at home are linked with the home availability of vegetables and how food-security status impacts this relationship will facilitate the tailoring of future public health interventions. Baseline data were used from an elementary-school-based intervention. Data on household food-security status, availability of vegetables at home, and barriers to buying and preparing/cooking vegetables were collected from 1942 parents. Differences between food-secure and food-insecure households were examined for barriers to buying and preparing/cooking vegetables. Mixed-effects linear regression was used to estimate the associations between barriers to buying and preparing/cooking vegetables and food-security status on the home availability of vegetables. Food insecurity was reported in 27% of households. Food-insecure households were significantly more likely to report barriers to buying and preparing/cooking vegetables. The barriers to purchasing/cooking vegetables score was associated with a decrease in the home availability of vegetables score (ß = -0.77; 95% CI: -0.88, -0.65; p < 0.001). Compared to food-secure households, food-insecure households were 15% less likely to have home vegetable availability (ß = -1.18; 95% CI: -1.45, -0.92; p < 0.001). Although home availability of vegetables does not guarantee consumption, this study identified specific barriers that were associated with availability that can be targeted in future interventions seeking to improve vegetable consumption in the homes of low-income families.

Coaction Between Physical Activity and Fruit and Vegetable Intake in Racially Diverse, Obese Adults.

PURPOSE: There is minimal understanding of the potential for coaction, defined as action on one behavior increasing the likelihood of taking action on another behavior, between physical activity (PA) and fruit and vegetable (FV) intake. The purpose of this study was to assess the bidirectional coaction between FV intake and PA, as well as self-efficacy for these behaviors, in a racially diverse sample of obese adults. DESIGN: This is a secondary analysis using data collected from the Path to Health study, a randomized controlled trial. ClinicalTrials.gov Identifier: NCT03674229. SAMPLE: Obese adults who completed baseline and 6-month follow-up assessments. MEASURES: For this study, data on FV intake, leisure time PA, and 7-day accelerometer data were analyzed at baseline and 6-month follow-up. ANALYSIS: We interchanged modeling the FV intake and PA change variables as the independent and dependent variables. We conducted multiple imputation and both linear and multinomial regression. RESULTS: The sample (n = 168) was 59% female and mainly split between white (42%) and African American (42%). Change in self-efficacy for PA was predictive of change in self-efficacy for FV intake and vice versa. When compared with participants with no change in FV intake, someone with a positive change in FV intake was more likely to have a positive change in self-reported PA (adjusted risk ratio [RR] = 6.72, 95% confidence interval [CI] = 1.69-26.68). Likewise, when compared with no change, participants with a positive change in self-reported PA were more likely to report a positive change in FV intake (adjusted RR = 6.79, 95% CI = 1.70-27.17). CONCLUSION: Findings suggest coaction between self-efficacy for FV intake and PA as well as between FV intake and PA. Coaction could be capitalized on to more effectively promote both energy-balance behaviors.

Child Compared with Parent Perceptions of Child-Level Food Security.

BACKGROUND: There is a need to directly and accurately conceptualize and measure food insecurity in children as part of surveillance and public health efforts. OBJECTIVE: The aim of this study was to compare parent and child perceptions of child-level food security status via questionnaires within a large, ethnically diverse population. METHODS: Cross-sectional baseline data from a cluster-randomized controlled trial involving primarily low-income, Hispanic third- to fifth-grade students and their parents were used for analysis. The sample consisted of 2408 dyadic (parent and child) pairs. Parents completed the 8-item child-referenced Household Food Security Survey Module and their responses were compared with an adaption of the 5-item Child Food Security Assessment completed by their child. Levels of association between child and parent perceptions within dyads were calculated using Goodman and Kruskal's γ statistic. A mixed-effects binomial logistic regression model was used to model discordance as a function of child, parent, and household sociodemographic characteristics. RESULTS: The child sample was 53% girls, mean age of 9 y, and 63% were Hispanic. The parent sample was 86% women and 65% Hispanic. Child and parent perceptions of child-level food security agreed only 21.7% of the time. There was a weak positive association between child and parent perceptions of child-level food security (γ = 0.162, P < 0.001). Children perceived themselves as less food secure than their parents' perception 70.1% of the time. Household receipt of Supplemental Nutrition Assistance Program benefits was associated with greater odds of discordant food security perceptions, whereas female children, older children, and parents not working were characteristics associated with lower odds of discordant perceptions. CONCLUSIONS: Results, in combination with the existing literature, suggest that parent perceptions of child-level food insecurity may underestimate child-level food insecurity experiences. Inaccurate estimations or underestimations of the true prevalence of child-level food insecurity could be detrimental to maternal and child health efforts. This trial was registered at clinicaltrials.gov as NCT02668744.

Child-Report of Food Insecurity Is Associated with Diet Quality in Children.

Food insecurity (FI) is adversely associated with physical and mental wellbeing in children. The mechanism underlying this association is assumed to be dietary intake; however, evidence has been mixed. This study examined the relationship between self-reported FI and dietary quality among low-income children. Cross-sectional data were used from TX Sprouts, a school-based cooking, gardening, and nutrition intervention. A sample of 598 children completed two 24-h dietary recalls and a questionnaire including an adapted version of the 5-item Child Food Security Assessment (CFSA). Food security was categorized as food secure or FI based on summed CFSA scores. Dietary quality was assessed using the Health Eating Index-2015 (HEI-2015). Mixed effects linear regression models examined associations between FI and dietary quality. Children were 64% Hispanic, 55% female, and were 9.2 years old on average. Adjusting for sociodemographic characteristics, BMI percentile, and energy intake, FI was associated with lower HEI-2015 total scores (ß = -3.17; 95% CI = -5.28, -1.06; p = 0.003). Compared to food secure children, FI children had lower greens and beans (2.3 vs. 1.9, p = 0.016), seafood and plant protein (2.0 vs. 1.6, p = 0.006), and added sugar (7.4 vs. 8.0, p = 0.002) component scores. Interventions targeting low-income and FI children should investigate ways to improve dietary quality.

Design and participant characteristics of TX sprouts: A school-based cluster randomized gardening, nutrition, and cooking intervention.

AIMS: To outline the study design, outcome measures, protocol and baseline characteristics of enrolled participants of Texas (TX) Sprouts, a one-year school-based gardening, nutrition, and cooking cluster randomized trial. METHODS: Eight schools were randomly assigned to the TX Sprouts intervention and eight schools to the delayed intervention over three years (2016-2019). The intervention arm received: formation/training of Garden Leadership Committees; a 0.25-acre outdoor teaching garden; 18 student lessons including gardening, nutrition, and cooking activities, taught weekly during school hours by hired educators throughout one school year; and nine parent lessons taught monthly to families. The delayed intervention was implemented the following academic year and received the same protocol as the intervention arm. Primary outcomes included: dietary intake, dietary-related behaviors, obesity, and metabolic parameters. Child measures included: height, weight, waist circumference, body composition, blood pressure, and dietary psychosocial variables. A subsample of children were measured for glucose, hemoglobin-A1C, and 24-hour dietary recalls. Parent measures included: height and weight, dietary intake, and related dietary psychosocial variables. RESULTS: Of the 4239 eligible students, 3137 students consented and provided baseline clinical measures; 3132 students completed child surveys, with 92% of their parents completing parent surveys. The subsamples of blood draws and dietary recalls were 34% and 24%, respectively. Intervention arm baseline descriptives, clinical and dietary data for children and parents are reported. CONCLUSION: The TX Sprouts intervention targeted primarily low-income Hispanic children and their parents; utilized an interactive gardening, nutrition, and cooking program; and measured a battery of dietary behaviors, obesity and metabolic outcomes.