Infant feeding practices and dietary consumption of US infants and toddlers: National Health and Nutrition Examination Survey (NHANES) 2003-2012.

OBJECTIVE: To compare infant and toddler anthropometric measurements, feeding practices and mean nutrient intakes by race/ethnicity and income. DESIGN: Cross-sectional analysis using general linear modelling. Ten years of survey data (2003-2012) were combined to compare anthropometric measurements, feeding practices and mean nutrient intakes from a nationally representative US sample. SETTING: The 2003-2012 National Health and Nutrition Examination Survey (NHANES). SUBJECTS: Infants and toddlers (n 3669) aged 0-24 months. RESULTS: Rates of overweight were higher among Mexican-American infants and toddlers (P=0·002). There were also several differences in feeding practices among groups based on race/ethnicity. Cessation of breast-feeding occurred earlier for non-Hispanic black and Mexican-American v. non-Hispanic white infants (3·6 and 4·2 v. 5·3 months; P<0·0001; P=0·001). Age at first feeding of solids was earlier for white than Mexican-American infants (5·3 v. 5·7 months; P=0·02). There were differences in almost all feeding practices based on income, including the lowest-income infants stopped breast-feeding earlier than the highest-income infants (3·2 v. 5·8 months, P<0·0001). Several differences in mean nutrient intakes by both race/ethnicity and income were also identified. CONCLUSIONS: Our study indicates that disparities in overweight, feeding practices and mean nutrient intakes exist among infants and toddlers according to race/ethnicity, which cannot be disentangled from income.

Advanced Glycation End Products, Inflammation, and Chronic Metabolic Diseases: Links in a Chain?

Advanced glycation end products (AGEs) are a diverse group of compounds produced when reducing sugars react with proteins or other compounds to form glycosylated molecules. AGEs may form endogenously, and glycation of molecules may negatively affect their function. AGEs may also be consumed in food form with dietary AGEs reported to be particularly high in foods treated with high heat: baked, broiled, grilled, and fried foods. Whether dietary AGEs are absorbed in significant quantities and whether they are harmful if absorbed is a question under current debate. The American Diabetes Association makes no recommendation regarding avoidance of these foods, but many researchers are concerned that they may be pro-inflammatory and way worsen cardiac function, kidney function, diabetes and its complications and may even contribute to obesity.

Contribution of dietary advanced glycation end products (AGE) to circulating AGE: role of dietary fat.

The purpose of this pilot study was to determine whether macronutrient content (low-fat v. high-fat diet) influences an indicator of advanced glycation end products (AGE), N(ε) carboxymethyl-lysine (CML), in the context of a 1-d, high-AGE diet. The effect of the diets on inflammatory markers was also assessed. A total of nineteen overweight and obese adults (nine men and ten women) without known disease were recruited to participate in a crossover challenge of a high-fat, high-AGE (HFHA) and low-fat, high-AGE (LFHA) diet. In each phase patients had fasting blood drawn, followed by consumption of a high-fat or low-fat breakfast test meal, then three postprandial blood draws at 1, 2 and 3 h after consuming the test meal. After consuming high-AGE meals for the remainder of the day, participants returned the next day for a follow-up analysis. A different pattern in the 3-h post-meal CML and soluble receptor for AGE response to the two diets was observed (P=0·01 and 0·05, respectively). No change in serum CML was observed following consumption of a LFHA breakfast (535 (25th-75th percentile 451-790) to 495 (25th-75th percentile 391-682) ng/ml; P=0·36), whereas a rise in CML occurred after the HFHA breakfast (463 (25th-75th percentile 428-664) to 578 (25th-75th percentile 474-865) ng/ml; P=0·05). High sensitivity C-reactive protein and high molecular weight adiponectin were not affected by either diet. These findings suggest that dietary CML may not be as important in influencing serum CML as other dietary factors. In addition, acute exposure to dietary CML may not influence inflammation in adults without diabetes or kidney disease. This is contrary to previous findings.

Serum Cholesterol Differences Between Statin Users Who Take Dietary Supplements and Those Who Do Not: NHANES 2013-2018.

Background: Cardiovascular disease (CVD) is the leading cause of mortality in the United States and statins are the most commonly prescribed medication. It is important to understand the potential impact supplements may have when taken in combination with statins on serum lipid outcomes. Objectives: To evaluate the differences in the concentrations of cholesterol, triacylglycerol (TAG), and HbA1c between adults who use statins alone and those who combine statins and dietary supplements. Methods: A cross-sectional analysis using data from US adults aged ≥20 years who participated in the NHANES (2013-2018). The serum concentrations of lipids and the HbA1c levels were compared using independent sample t-tests. All analyses were adjusted for the complex survey design and used appropriate sample weights. Results: Of 16,327 participants included in this analysis, 13% reported the use of statins alone, and 8.8% used statins and dietary supplements. Statin users who used dietary supplements tended to be women (50.5%), aged 65.8 ± 0.4 years, and were more likely to be White (77.4%). Participants who used statins in combination with dietary supplements were less likely to have higher levels of total cholesterol (5.1% ± 1.4% vs. 15.6% ± 2.7%, P < 0.001), HbA1c (6.0% ± 0.1% vs. 6.3% ± 0.1%, P < 0.05), and HDL cholesterol (50 ± 1.3 vs. 47 ± 0.8 mg/dL, P < 0.05) than those who used statins alone. No significant differences were identified between the two groups for LDL cholesterol and TAG concentrations. Conclusions: Statin users who coingested dietary supplements were less likely to have high levels of total cholesterol and HbA1c and greater HDL levels than statin users who did not take dietary supplements. Dietary intake, lifestyle choices, and other confounders may have influenced the observed outcome differences for those who took dietary supplements with statins and those who did not.

The Baby Bites Text Messaging Project with randomized controlled trial: texting to improve infant feeding practices.

Background: Rapid weight gain and overweight in infancy are associated with childhood obesity. Thus, effective, accessible interventions to promote healthy infant feeding practices to prevent early obesity are essential. Methods: This mixed-methods study involved diverse parents of infants in an urban, low-income pediatric clinic. Qualitative interviews explored parental attitudes towards feeding, early obesity, and communication with the pediatrician. A pilot, randomized controlled trial (RCT) informed by feedback provided by clinic parents compared text messages delivered for 12 months promoting healthy feeding practices to usual care to prevent early pediatric obesity. A computer-generated randomization schedule with balanced distribution for sex was used to place infants into groups. Weight-for-length percentiles and z-scores and feeding practices were measured at 0-2 weeks (baseline), 2-4 months, 6-9 months, and 12 months. Interviews were recorded, transcribed, and coded using thematic analysis. Weight for length percentile, Weight for length z scores, and feeding practices were compared between groups using repeated measures mixed analysis of variance (ANOVA). Results: Participants in the interviews were 15 parents of infants less than 1 month old. RCT participants were 38 parents of newborns (17 control; 21 intervention). Most parents in the qualitative evaluation viewed breastfeeding positively but also discussed barriers. Most also wanted practical information regarding infant feeding. There were no differences in weight-for-length percentile (F=0.52; P=0.60) or z-scores (F=0.7922; P=0.79), breastfeeding persistence χ2[1] =1.45, P=0.23, or age of introduction of solids in the intervention (statistical analysis not possible due to low counts) compared to the control group; however, low response to surveys limited the study's power. Conclusions: Text messaging has potential to extend the healthcare provider's communication beyond clinic. However, texting interventions should be flexible to mitigate barriers such as loss of phone service and challenges customizing messages to parent needs.

Factors associated with food security of Texas Woman's University freshmen.

OBJECTIVE: To investigate what factors are associated with food insecurity (FI) among freshman students and identify potential solutions. PARTICIPANTS: 73 freshman students. METHODS: Cross-sectional, Internet survey-based study. Fisher's Exact tests examined factors associated with food security (FS); Cohen's Kappa assessed the agreement between FI scores and self-assessment; thematic analysis used Nvivo 12. RESULTS: FI was 54.2% among the diverse students (65% non-white). Factors associated with FS included mother with a college degree (p = .018); father employed full-time (p < .001); identifying one's family financial situation as better than others (p = < .001); not obtaining personal student loans (p = 0.022). Students with FI tended to overestimate their FS status. Suggested solutions for FI included: improved finances, improved food accessibility, improved cooking skills. CONCLUSIONS: Future interventions should target freshmen who obtain personal student loans or have parents with less than a college degree or unstable employment status. (148).

College Campus Food Pantry Program Evaluation: What Barriers Do Students Face to Access On-Campus Food Pantries?

The purpose of this study was to explore barriers Texas Woman's University (TWU) students face in accessing on-campus food pantries. This cross-sectional, survey-based study was conducted in Fall 2021. Students' use of the food pantries and barriers to utilization, including qualitative questions, were evaluated using descriptive statistics and thematic analyses. Students (n = 529) completed the survey. Despite a high prevalence of food insecurity (49.2%), most students reported never using the pantries (89.8%). Almost half of the students were unaware that these pantries existed on campus (47.8%). More than one in four students believed there were barriers to accessing the pantries, with time tissues, lack of transportation, limited food pantry hours of operation, and social stigma most commonly cited as major barriers to access. Food insecurity remains an urgent problem at TWU since the prevalence has remained high since 2019 despite the institutions' efforts to reduce it. One of those resources has not been utilized as expected, which might impede improvements in food security among students. TWU on-campus food pantries can use these findings to address major barriers by offering after-hours access through the libraries or campus police, partnering with public transportation, and normalizing accessing food assistance.

Influence of COVID-19 Pandemic Restrictions on College Students' Dietary Quality and Experience of the Food Environment.

The COVID-19 pandemic restrictions sent college students online and off campus, potentially reducing access to healthy food. The objective of this cross-sectional, internet-based study was to use qualitative and quantitative survey methods to evaluate whether COVID-19 pandemic restrictions in Texas, USA affected college students' ability to buy food, how/what they shopped for, how they prepared food, what they ate, how they felt about eating, and overall dietary quality (assessed using Healthy Eating Index [HEI] scores). Survey responses from 502 students (87.5% female; 59.6% nonwhite, mean age 27.5 ± 0.4 years, >50% graduate students) were analyzed. The qualitative analysis of open-ended questions revealed 110 codes, 17 subthemes, and six themes. Almost all students experienced changes in at least one area, the most common being changes in shopping habits. Participants with low or very low food security had lower HEI scores compared to food secure students (p = 0.047). Black students were more likely to report changes in their ability to buy food (p = 0.035). The COVID-19 restrictions varied in their impact on students' ability to access sufficient healthy food, with some students severely affected. Thus, universities should establish procedures for responding to emergencies, including identifying at-risk students and mobilizing emergency funds and/or food assistance.

Parent preferences for text messages containing infant feeding advice.

BACKGROUND: Text-messaging is beneficial in health promotion. Research on impact of message framing (gain- versus loss-framed) has had variable results, depending on type of behavior targeted. There is no research on framing of text-messaging to promote healthful infant feeding practices. METHODS: The purpose of this cross-sectional survey was to examine whether parents of infants aged three months or younger viewed gain- or loss-framed text messages as more helpful and which style was viewed as more likely to affect feeding practices. A secondary purpose was to determine what time of day and frequency of messaging was preferred. Parents were recruited from an urban pediatric medical clinic. PsychData was used to administer the survey. Parents rated message pairs targeting constructs of the Health Belief Model using a five-point Likert scale. Paired t- tests compared overall ratings for helpfulness and likelihood of messages affecting feeding practices between gain- and loss-framed messages. Descriptive and frequency analyses were applied to demographics and questions regarding preferred timing for receiving messages. RESULTS: A total of 34 parents (3 fathers and 31 mothers, mean age 26±5.5 years) completed the survey, with 41% enrolled in WIC and 29% in SNAP. There was no overall difference in helpfulness or likelihood of messages affecting feeding practices between gain- and loss-framed messages. Message style did not affect likelihood of adopting a feeding practice. However, gain framed messages relating to benefits and self-efficacy for breastfeeding were viewed more positively (mean =2.32; P=0.034; mean =1.79; P=0.041, respectively). The greatest proportion of parents (38%) preferred receiving messages once per week, and 50% preferred morning messages. CONCLUSIONS: Framing of text messages appeared to have little effect on parents' acceptance of messages related to infant feeding practices. Parents were receptive to receiving messages from their infant's healthcare provider once per week, in the morning.

Prevalence and Social Determinants of Food Insecurity among College Students during the COVID-19 Pandemic.

The coronavirus disease (COVID-19) pandemic has increased unemployment and food insecurity in the United States (US). Prior to the pandemic, college students exhibited higher rates of food insecurity than nonstudent households. The objectives of this study were to assess the prevalence and determinants of food insecurity among college students during the COVID-19 pandemic. We administered an online survey to 651 students on three diverse campuses at a state-funded university in Texas, US, in May 2020. Food security was assessed using a multistep approach that included the 2-item Food Sufficiency Screener and 6-Item USDA Food Security Survey Module (FSSM). Overall, 34.5% of respondents were classified as food insecure within the last 30 days. The strongest predictors of food insecurity were change in current living arrangement (OR = 2.70, 95% CI: 2.47, 2.95), being furloughed (OR = 3.22, 95% CI: 2.86, 3.64), laid off (OR = 4.07, 95% CI: 3.55, 4.66), or losing part-time work (OR = 5.73, 95% CI: 5.09, 6.46) due to the COVID-19 pandemic. These findings highlight the high prevalence of food insecurity among college students during the COVID-19 pandemic, with students who experienced housing insecurity and/or loss of income due to the pandemic being impacted the most.

Advanced Glycation End Products and Risks for Chronic Diseases: Intervening Through Lifestyle Modification.

Advanced glycation end products (AGEs) are a family of compounds of diverse chemical nature that are the products of nonenzymatic reactions between reducing sugars and proteins, lipids, or nucleic acids. AGEs bind to one or more of their multiple receptors (RAGE) found on a variety of cell types and elicit an array of biologic responses. In this review, we have summarized the data on the nature of AGEs and issues associated with their measurements, their receptors, and changes in their expression under different physiologic and disease states. Last, we have used this information to prescribe lifestyle choices to modulate AGE-RAGE cycle for better health.

Serum soluble receptor for advanced glycation end products correlates inversely with measures of adiposity in young adults.

Advanced glycation end products (AGEs) may promote inflammation by interacting with the receptor for advanced glycation end products. Serum soluble receptor for advanced glycation end products (sRAGE), a form of receptor for advanced glycation end products thought to mediate AGE's inflammatory properties, is decreased in diabetes mellitus and coronary artery disease. Evidence in older adults suggests that sRAGE is depressed in individuals without current disease who are obese; however, 2 studies have failed to find this correlation. We hypothesized that sRAGE would be inversely correlated with adiposity and positively correlated with inflammation, even in apparently healthy, young adults. By considering adults of body mass index (BMI) varying from normal weight to overweight and obese, we aimed to define how closely AGEs and sRAGE correlate with adiposity and other indicators of metabolic stress. Anthropometric measurements and fasting blood samples were obtained from participants (n = 69). Sera were analyzed for sRAGE, n-epsilon carboxy-methyl-lysine, a measure of AGEs, and high sensitivity C-reactive protein. High molecular weight adiponectin, glucose, insulin, total cholesterol, high-density lipoprotein, and triacylglycerol were also assessed (n = 32). Spearman rank correlations were used to evaluate the relationship among indicators of adiposity and biochemical indicators of metabolic health and inflammation. Factors inversely correlated with sRAGE include weight (Rs = -0.397; P = .001), waist circumference (-0.291; P = .015), and BMI (-0.3338; P = .004). High molecular weight adiponectin was positively correlated with sRAGE, and predictors of sRAGE included BMI and total cholesterol. This is the first time these associations have been found in a diverse population of young adults.

Consumption of a diet rich in cottonseed oil (CSO) lowers total and LDL cholesterol in normo-cholesterolemic subjects.

Animal data indicates that dietary cottonseed oil (CSO) may lower cholesterol; however, the effects of a CSO-rich diet have not been evaluated in humans. Thirty-eight healthy adults (aged 18-40; 12 males, 26 females) consumed a CSO rich diet (95 g CSO daily) for one week. Anthropometric measurements were obtained, and blood was drawn pre- and post-intervention. Serum lipids (total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL), triglyceride (TG), and free fatty acids (FFA)) were assayed. There was no change in weight or waist circumference among participants. There was no change in HDL (Pre: 1.27 ± 0.4 mmol/L; Post: 1.21 ± 0.3 mmol/L) or TG (Pre: 0.91 ± 0.6 mmol/L; Post: 1.06 ± 1.0 mmol/L). Total cholesterol and LDL were reduced (TC Pre: 4.39 ± 0.9 mmol/L; Post: 4.16 ± 0.8 mmol/L; LDL Pre: 2.70 ± 0.8 mmol/L; Post: 2.47 ± 0.6 mmol/L). When data were grouped by sex, total cholesterol was reduced in female participants (Pre: 4.34 ± 0.9 mmol/L; Post: 4.09 ± 0.8 mmol/L). Consumption of a high fat, CSO-rich diet for one week reduced total cholesterol in female participants without reducing HDL.