Dietetics students' perceptions of classroom-based learning activities.

BACKGROUND: The Accreditation Council for Education in Nutrition and Dietetics requires that undergraduate dietetics courses utilize a variety of educational approaches to facilitate learning. The aim of this pilot study was to evaluate undergraduate nutrition students' perceptions of 16 classroom-based learning activities before and after taking an upper-level nutrition course. METHODS: A survey was completed by students before and after taking an upper-level nutrition course, Methods in Nutrition Education, at a single university in the southwest region of the United States in fall 2016 and 2017. The survey included demographic questions and assessed students' perceptions of the helpfulness of 16 traditional and active classroom-based activities to learning. Perceptions were measured via Likert scale (1 = strongly disagree to 5 = strongly agree) at baseline and postcourse. Wilcoxon signed rank tests assessed changes in students' perceptions of learning activities from baseline to postcourse (significance = P < 0.05). RESULTS: Ninety-seven completed baseline surveys; 67 (69%) completed postcourse surveys. Observing professionals (median = 5), interviewing professionals (median = 5), and critical thinking (median = 4) were perceived as most helpful to learning postcourse. Students agreed critical thinking, integrating material from other courses, interviewing professionals, case studies, writing short reports and summaries, and group projects and activities were significantly more helpful postcourse compared to baseline (P < 0.05). DISCUSSION: Undergraduate nutrition students perceive a variety of classroom-based activities are helpful to learning including traditional (textbook readings, lectures) and active learning strategies (observation, practice). Instructors may consider implementing a variety of traditional and active learning strategies in upper-level nutrition and health-related courses to facilitate learning.

Associations between Avocado Consumption and Diet Quality, Dietary Intake, Measures of Obesity and Body Composition in Adolescents: The Teen Food and Development Study.

Avocado is a nutrient-rich food that has been shown to benefit the health and diet quality of adults. In this paper, we examined if habitual intake of avocado among adolescents is associated with their diet quality, food and nutrient intake, and measures of obesity and body composition. Participants aged 12-18 years old (n = 534) from selected public and Adventist middle-high schools reported their dietary intake in a web-based food frequency questionnaire (FFQ); anthropometrics were measured during school visits. Diet quality (DQI-I) and avocado intake were calculated from the FFQ; BMI z-scores (BMIz), waist-to-height ratio (WHtR), and fat mass (FM), fat-free mass (FFM), and %body fat (%BF) were determined from the anthropometric data. Compared to non-consumers, avocado consumers had significantly higher covariate-adjusted mean scores on total DQI-I (68.3 vs. 64.6) and energy-adjusted mean scores on variety (18.8 vs. 18.0) and adequacy (36.4 vs. 33.4). Avocado consumption was significantly associated with DQI-I components adequacy (ß [SE] = 0.11 [0.03]) and moderation (ß [SE] = 0.06 [0.03]) but not with BMIz, WHtR, FM, FFM, and %BF. Mean intakes of fruits, vegetables, and plant protein foods, total and vegetable proteins, dietary fiber, retinol, vitamin C, calcium, magnesium, iron, and potassium were significantly higher for avocado consumers; saturated and trans fats intakes were significantly higher for non-consumers. In our adolescent population, avocado consumption was associated with higher diet quality and intake of plant-based foods and shortfall nutrients, but not with measures of obesity and body composition. Studies are needed to determine the optimal amount of avocado that would confer health benefits during adolescence.

Animal Protein Intake Is Associated with General Adiposity in Adolescents: The Teen Food and Development Study.

Protein plays a crucial role in the growth and development of adolescents. However, being a secondary energy source, protein's role in obesity has been sidelined. We examined whether intake of protein (total, animal, plant), branched-chain (BCAAs), and sulfur-containing (SCAAs) amino acids are associated with general body and central obesity and body composition in a cross-sectional study among healthy adolescents. Students aged 12-18 years old (n = 601) in schools near two major Adventist universities in California and Michigan provided dietary data via a validated web-based food frequency questionnaire (FFQ) and anthropometric data during school visits. Intakes of total, animal, and plant proteins, and BCAAs and SCAAs were derived from FFQ data. We defined general body obesity with body-mass-index-for-age (BMIz) z-scores and central obesity with waist-to-height ratios (WHtR). After full adjustment for covariates, multiple regression analyses showed significant positive associations between intakes of total protein (ß = 0.101, 95% CI: 0.041, 0.161), animal protein (ß = 0.118, 95% CI: 0.057, 0.178), BCAAs (ß = 0.056, 95% CI: 0.025, 0.087), and SCAAs (ß = 0.025, 95% CI: 0.012, 0.038) with general body adiposity. Animal protein (ß = 0.017, 95% CI: 0.001, 0.033) and SCAAs (ß = 0.004, 95% CI: 0.000, 0.008) were also associated with central obesity. Total and animal protein and BCAA and SCAA were also significantly associated with fat mass. Our findings suggest that high protein intake may pose a possible detriment to adolescent health. Longitudinal and safety evaluation studies are recommended.

Dietary Intake Among Opioid- and Alcohol-Using Pregnant Women.

BACKGROUND: Substance abuse in nonpregnant adults has been associated with increased intake in calories and decreased intake of nutrient-dense foods; however, studies examining dietary intake in opioid-using and alcohol-using pregnant women are lacking. OBJECTIVE: The objective of this study was to evaluate dietary intake in opioid-using pregnant women with or without concurrent light-to-moderate alcohol use as compared to abstaining controls. METHODS: This prospective birth cohort included 102 pregnant women classified into four study groups: controls (n = 27), medication-assisted treatment (MAT; n = 26), alcohol (ALC; n = 22), and concurrent use of both substances (MAT + ALC; n = 27). Percentage differences in macro- and micronutrient intake were estimated from the food frequency questionnaire and compared among the study groups. Proportions of participants with intakes below the estimated average requirements (EAR) based on diet and diet with supplements were estimated. RESULTS: Three exposed groups had lower prevalence of multivitamin use in periconceptional period (11.5-31.8%) than controls (44.4%). Unadjusted mean energy intake was significantly higher in the MAT + ALC group compared to controls, while micronutrient intake per 1000 kcal was the highest in the control group for almost all of the micronutrients analyzed. After adjustment for energy intake and sociodemographic characteristics, MAT group had lower estimated dietary intake of iron (-15.0%, p = 0.04) and folate (-16.8%, p = 0.04) compared to controls. A high proportion of participants in all study groups had dietary intake below the EAR for vitamin E, iron, and folate. CONCLUSION: Results highlight the need for targeted dietary interventions for opioid-using pregnant women.

Soy isoflavone consumption and age at pubarche in adolescent males.

PURPOSE: Isoflavones have estrogenic properties that may adversely affect pubertal development of boys. We examined if soy isoflavone consumption is associated with age at pubarche (first onset of pubic hair) in a male population with a wide range of soy intake. METHODS: Boys aged 12-18 years (n = 248) who attended schools around Adventist universities in Southern California and Michigan self-reported their age at pubarche. Intake of soy isoflavones was assessed using a validated Web-based food frequency questionnaire; consumption levels were designated as low, moderate, and high. Descriptives, time-to-event analysis, and Cox proportional hazards regression that controlled for confounders were performed. RESULTS: Energy-adjusted mean intakes were 0.8-54.9 mg/d for total isoflavones, 0.4-22.1 mg/d for daidzein, and 0.4-28.0 mg/d for genistein. Moderate and high total soy isoflavone intake were significantly associated with earlier adjusted median age at pubarche: 12.58 years [RR (95% CI): 1.58 (1.06, 2.36)] for moderate and 12.50 years [RR (95% CI): 1.63 (1.03, 2.60)] for high vs. 13.00 years for low consumers. Similarly, daidzein and genistein consumption was also significantly associated with age at pubarche. No significant associations were found for facial hair for any of the isoflavones. CONCLUSIONS: Age at pubarche in this male population widely exposed to soy is within the reported range for boys' pubarcheal age; moderate/high consumers tend to have it earlier compared to low consumers. Further studies are needed to ascertain that substantial exposure to soy isoflavones does not adversely affect pubertal development of boys.

Nutrition Education and Body Mass Index in Grades K-12: A Systematic Review.

BACKGROUND: Overweight and obese body mass index (BMI) status affects an increasing number of children in the United States. The school setting has been identified as a focus area to implement obesity prevention programs. METHODS: A database search of PubMed, Education Search Complete, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) was conducted for peer-reviewed articles published between January 2005 and December 2015 pertaining to programs offered in the school setting to grades K-12 in the United States with a nutrition education component and measured BMI percentile or BMI z-score as an outcome. RESULTS: Seven studies focused on elementary (K-5) populations and 2 studies focused on grades 6-8. Among the 9 identified studies, those with long-term (greater than 1 year) implementation showed more pronounced results with positive impact on reducing overweight/obese BMI measures. CONCLUSIONS: This set of studies suggests that long-term nutrition education delivered in the school setting can provide children with tools to attain a healthy weight status. Additional studies examining participants' BMI status years after the initial study, and studies examining programs in grades 9-12 are needed to determine the most effective delivery time and methods.

Effects of Walnut Consumption on Mood in Young Adults-A Randomized Controlled Trial.

Walnuts contain a number of potentially neuroprotective compounds like vitamin E, folate, melatonin, several antioxidative polyphenols and significant amounts of ω-3 fatty acids. The present study sought to determine the effect of walnuts on mood in healthy volunteers. Sixty-four college students were randomly assigned to two treatment sequences in a crossover fashion: walnut-placebo or placebo-walnut. At baseline mood was assessed using Profiles of Mood States (POMS). Data was collected again after eight weeks of intervention. After six-weeks of washout, the intervention groups followed the diets in reverse order. Data was collected once more at the end of the eight-week intervention period. No significant changes in mood were observed in the analyses with both genders combined and in females. However, we have observed a significant medium effect size improvement in the Total Mood Disturbance score (-27.49%, p = 0.043, Cohen's d = 0.708) in males. In non-depressed healthy young males, walnuts seem to have the ability to improve mood.

Gender differences in exercise dependence and eating disorders in young adults: a path analysis of a conceptual model.

The purpose of our study was to study the prevalence of exercise dependence (EXD) among college students and to investigate the role of EXD and gender on exercise behavior and eating disorders. Excessive exercise can become an addiction known as exercise dependence. In our population of 517 college students, 3.3% were at risk for EXD and 8% were at risk for an eating disorder. We used Path analysis the simplest case of Structural Equation Modeling (SEM) to investigate the role of EXD and exercise behavior on eating disorders. We observed a small direct effect from gender to eating disorders. In females we observed significant direct effect between exercise behavior (r = -0.17, p = 0.009) and EXD (r = 0.34, p < 0.001) on eating pathology. We also observed an indirect effect of exercise behavior on eating pathology (r = 0.16) through EXD (r = 0.48, r2 = 0.23, p < 0.001). In females the total variance of eating pathology explained by the SEM model was 9%. In males we observed a direct effect between EXD (r = 0.23, p < 0.001) on eating pathology. We also observed indirect effect of exercise behavior on eating pathology (r = 0.11) through EXD (r = 0.49, r2 = 0.24, p < 0.001). In males the total variance of eating pathology explained by the SEM model was 5%.

Is soy intake related to age at onset of menarche? A cross-sectional study among adolescents with a wide range of soy food consumption.

BACKGROUND: Early onset of menarche may negatively influence the future health of adolescent girls. Several factors affect the timing of menarche but it is not clear if soy foods consumption around pubertal years plays a role; thus, we examined its relation to age at onset of menarche (AOM) in a high soy-consuming population. METHODS: We conducted a cross-sectional study on 339 girls ages 12-18 years attending middle and high schools near two Seventh-day Adventist universities in California and Michigan using a web-based dietary questionnaire and physical development tool. Soy consumption (categorized as total soy, meat alternatives, tofu/traditional soy, and soy beverages) was estimated from the questionnaire, while AOM was self-reported. Data analyses included descriptive statistics, Cox proportional hazards ratios, Kaplan-Meier curves and Poisson regression with adjustment for relevant confounders. RESULTS: Mean (SD) intakes were: total soy,12.9 (14.4) servings/week; meat alternatives, 7.0 (8.9) servings/week; tofu/traditional soy foods, 2.1 (3.8) servings/week; soy beverages, 3.8 (6.3) servings/week. Mean AOM was 12.5 (1.4) y for those who reached menarche. Consumption of total soy and the 3 types of soy foods was not significantly associated with AOM and with the odds for early- or late-AOM. Adjustment for demographic and dietary factors did not change the results. CONCLUSION: Soy intake is not associated with AOM in a population of adolescent girls who have a wide range of, and relatively higher, soy intake than the general US population. Our finding suggests that the increasing popularity of soy in the US may not be associated with AOM.

Cognition: the new frontier for nuts and berries.

The inclusion of nuts in the diet is associated with a decreased risk of coronary artery disease, hypertension, gallstones, diabetes, cancer, metabolic syndrome, and visceral obesity. Frequent consumption of berries seems to be associated with improved cardiovascular and cancer outcomes, improved immune function, and decreased recurrence of urinary tract infections; the consumption of nuts and berries is associated with reduction in oxidative damage, inflammation, vascular reactivity, and platelet aggregation, and improvement in immune functions. However, only recently have the effects of nut and berry consumption on the brain, different neural systems, and cognition been studied. There is growing evidence that the synergy and interaction of all of the nutrients and other bioactive components in nuts and berries can have a beneficial effect on the brain and cognition. Regular nut consumption, berry consumption, or both could possibly be used as an adjunctive therapeutic strategy in the treatment and prevention of several neurodegenerative diseases and age-related brain dysfunction. A number of animal and a growing number of human studies show that moderate-duration dietary supplementation with nuts, berry fruit, or both is capable of altering cognitive performance in humans, perhaps forestalling or reversing the effects of neurodegeneration in aging.

Food safety attitudes in college students: a structural equation modeling analysis of a conceptual model.

College students are one of the most at-risk population groups for food poisoning, due to risky food safety behaviors. Using the Likert Scale, undergraduate students were asked to participate in a Food Safety Survey which was completed by 499 students ages 18-25. Data was analyzed using SPSS and AMOS statistical software. Four conceptual definitions regarding food safety were defined as: general food safety, bacterial food safety, produce food safety, and politics associated with food safety. Knowledge seems to be an important factor in shaping students attitudes regarding general and bacterial safety. Ethnicity plays a role in how people view the politics of food safety, and the safety of organic foods.

Effects of walnut consumption on cognitive performance in young adults.

Walnuts contain a number of potentially neuroprotective compounds like vitamin E, folate, melatonin, several antioxidative polyphenols and significant amounts of n-3 α-linolenic fatty acid. The present study sought to determine the effect of walnuts on verbal and non-verbal reasoning, memory and mood. A total of sixty-four college students were randomly assigned to two treatment sequences in a crossover fashion: walnuts-placebo or placebo-walnuts. Baseline data were collected for non-verbal reasoning, verbal reasoning, memory and mood states. Data were collected again after 8 weeks of intervention. After 6 weeks of washout, the intervention groups followed the diets in reverse order. Data were collected once more at the end of the 8-week intervention period. No significant increases were detected for mood, non-verbal reasoning or memory on the walnut-supplemented diet. However, inferential verbal reasoning increased significantly by 11.2 %, indicating a medium effect size (P = 0.009; d = 0.567). In young, healthy, normal adults, walnuts do not appear to improve memory, mood or non-verbal reasoning abilities. However, walnuts may have the ability to increase inferential reasoning.

Trends in body fat, body mass index and physical fitness among male and female college students.

There have been many publications in recent years reporting on the quantity of physical activity among college students using indirect indicators such as steps walked per day or time spent on physical activities. The purpose of this study was to describe the trends of physical fitness related to BMI and body fat among university students between 1996 and 2008. The results showed a significant decline in the average fitness levels measured as an estimation of VO(2max) for male and female students (p < 0.001 for both sexes). The linear trend for BMI by years was not significant for both sexes (p for males = 0.772, p for females = 0.253). On average, in the last 13 years, % body fat was increasing 0.513%/year for males and 0.654%/year for females. There is a significant indirect correlation between the student's VO(2max) levels and % body fat, r = -0.489; p < 0.001 for males; and r = -0.416, p < 0.001 for females. Approximately 23.9% of the variance in the VO(2max) levels in males and 17.3% in females can be explained by the variance in % body fat. The results support recent findings that physical fitness among college students is declining and body fatness is increasing.

Beliefs and attitudes toward vegetarian lifestyle across generations.

The objective of the study was to examine whether reasons to adopt vegetarian lifestyle differ significantly among generations. Using a Food Frequency Questionnaire (FFQ), we identified that 4% of the participants were vegans, 25% lacto-ovo-vegetarians, 4% pesco-vegetarians and 67% non-vegetarian. Younger people significantly agreed more with the moral reason and with the environmental reason. People ages 41-60 significantly agreed more with the health reason. There are significant differences across generations as to why people choose to live a vegetarian lifestyle.