Cluster randomized controlled trial of a consumer behavior intervention to improve healthy food purchases from online canteens.

Background: School canteens represent an opportune setting in which to deliver public health nutrition strategies because of their wide reach and frequent use by children. Online school-canteen ordering systems, where students order and pay for their lunch online, provide an avenue to improve healthy canteen purchases through the application of consumer-behavior strategies that have an impact on purchasing decisions.Objective: We assessed the efficacy of a consumer-behavior intervention implemented in an online school-canteen ordering system in reducing the energy, saturated fat, sugar, and sodium contents of primary student lunch orders.Design: A cluster-randomized controlled trial was conducted that involved 2714 students (aged 5-12 y) from 10 primary schools in New South Wales, Australia, who were currently using an online canteen ordering system. Schools were randomized in a 1:1 ratio to receive either the intervention (enhanced system) or the control (standard online ordering only). The intervention included consumer-behavior strategies that were integrated into the online ordering system (targeting menu labeling, healthy food availability, placement, and prompting).Results: Mean energy (difference: -567.25 kJ; 95% CI: -697.95, -436.55 kJ; P < 0.001), saturated fat (difference: -2.37 g; 95% CI: -3.08, -1.67 g; P < 0.001), and sodium (difference: -227.56 mg; 95% CI: -334.93, -120.19 mg; P < 0.001) contents per student lunch order were significantly lower in the intervention group than in the control group at follow-up. No significant differences were observed for sugar (difference: 1.16 g; 95% CI: -0.50, 2.83 g; P = 0.17).Conclusions: The study provides strong evidence supporting the effectiveness of a consumer-behavior intervention using an existing online canteen infrastructure to improve purchasing behavior from primary school canteens. Such an intervention may represent an appealing policy option as part of a broader government strategy to improve child public health nutrition. This trial was registered at www.anzctr.org.au as ACTRN12616000499482.

Time Trends of Dietary and Lifestyle Factors and Their Potential Impact on Diabetes Burden in China.

OBJECTIVE: To examine the secular trends in risk factors, estimate their impact on type 2 diabetes burden from 1991 to 2011, and project trends in the next 20 years. RESEARCH DESIGN AND METHODS: Risk factor distributions were based on data from the China Health and Nutrition Survey 1991-2011. Diabetes cases attributable to all nonoptimal levels of each risk factor were estimated by applying the comparative risk assessment method. RESULTS: In 2011, high BMI was the leading individual attributable factor for diabetes cases in China responsible for 43.8 million diabetes cases with a population-attributable fraction of 46.8%. Low whole-grain intake and high refined grain intake were the leading dietary risk factors in China responsible for 37.8 million and 21.8 million diabetes-attributable cases, respectively. The number of attributable diabetes cases associated with low physical activity, high blood pressure, and current smoking was 29.5, 21.6, and 9.8 million, respectively. Although intakes of low-fat dairy products, nuts, fruit, vegetables, and fish and seafood increased moderately over time, the average intake was below optimal levels in 2011 and were responsible for 15.8, 11.3, 9.9, 6.0, 3.6, and 2.6 million diabetes cases, respectively. Meanwhile, intakes of processed meat, red meat, and sugar-sweetened beverage showed increasing trends over time and were responsible for 2.8, 1.8, and 0.5 million diabetes cases, respectively, in 2011. CONCLUSIONS: A high BMI and low intake of whole grains but high intake of refined grains are the most important individual risk factors related to Chinese diabetes burden; low physical activity and high blood pressure also significantly contributed.

Sociodemographic, lifestyle and behavioural factors associated with consumption of sweetened beverages among adults in Cambridgeshire, UK: the Fenland Study.

OBJECTIVE: We aimed to identify sociodemographic, lifestyle and behavioural determinants of consumption of sugar-sweetened beverages (SSB) and artificially sweetened beverages (ASB) among adults in Cambridgeshire, UK. DESIGN: Cross-sectional data were obtained from a cohort of 9991 adults born between 1950 and 1975. An FFQ was used to assess consumption of beverages and other dietary factors. Multivariable logistic regression was used to examine potential determinants of consuming SSB and ASB (≥1 serving/d). SETTING: Recruitment from general practice surgeries to participate in the ongoing population-based Fenland Study. SUBJECTS: Adults (n 9991) aged 30-64 years from three areas of Cambridgeshire, UK. RESULTS: Prevalence estimates for daily SSB and ASB consumption were 20·4 % (n 2041) and 8·9 % (n 893), respectively. SSB consumption (OR; 95 % CI) was more common in men than women (1·33; CI 1·17, 1·50) and among those reporting lower income (£40 000/year; 1·31; 1·09, 1·58). In contrast, daily ASB consumption was more common among women than men (1·62; 1·34, 1·96), those on weight-loss diets than those who were not (2·58; 2·05, 3·24) and those reporting higher income than lower income (1·53; 1·16, 2·00). Factors associated with higher consumption of each of SSB and ASB included being a younger adult, being overweight/obese, having shorter education, eating meals or snack foods while watching television, and skipping breakfast (P<0·05 each). CONCLUSIONS: Frequent consumers of SSB and ASB differ by several sociodemographic characteristics. However, increased BMI, younger age and unhealthy eating behaviours are common to both groups.

Parental feeding styles, young children's fruit, vegetable, water and sugar-sweetened beverage consumption, and the moderating role of maternal education and ethnic background.

OBJECTIVE: To examine the associations between parental feeding styles and children's dietary intakes and the modifying effect of maternal education and children's ethnicity on these associations. DESIGN: Cross-sectional study of parental feeding styles, assessed by the Parental Feeding Style Questionnaire, and children's dietary intakes. Multiple regression analyses were carried out to assess the associations between the parental feeding styles studied ('control', 'emotional feeding', 'encouragement to eat' and 'instrumental feeding') and children's dietary intakes (consumption of fruit, vegetables, water and sugar-sweetened beverages (SSB)). The modifying effect of maternal education and children's ethnicity on these associations was explored. SETTING: North-western part of the Netherlands. SUBJECTS: Children aged 3-7 years (n 5926). RESULTS: Both 'encouragement' and 'control' were associated with higher consumption of vegetables and lower consumption of SSB, but only 'encouragement' was positively associated with fruit and water intakes. 'Instrumental feeding' showed a positive association with SSB and negative associations with fruit, vegetable and water consumption. No significant associations were found for 'emotional feeding'. Maternal educational level and children's ethnicity moderated some associations; for example, 'control' was beneficial for vegetable intake in all subgroups, whereas the association with SSB was beneficial only in highly educated mothers. CONCLUSIONS: The study shows that both encouraging and controlling feeding styles may improve children's dietary behaviour, while 'instrumental feeding' may have a detrimental effect. Furthermore, maternal educational level and children's ethnicity influence these associations. The study's findings could provide a basis for development of interventions to improve parental feeding styles.

Under 5 Energize: Tracking Progress of a Preschool Nutrition and Physical Activity Programme with Regional Measures of Body Size and Dental Health at Age of Four Years.

To reduce weight gain and encourage healthy eating including reduced sugar intake, Under 5 Energize (U5E) was introduced to 121 early-childhood-centres in the Waikato region of New Zealand in July 2013. Using anonymized data collected from January 2013 to September 2016 through free physical assessments of all 4-year-olds provided by the NZ Ministry of Health, the prevalence of obesity and dental decay children measured in the Waikato region was examined. Data were divided into four periods representing pre-implementation and 3 years of gradual implementation. Obesity was defined according to International Obesity Task Force criteria. Of 18,774 Waikato children included in the analysis, 32% were indigenous Maori, and 32% attended an U5E centre. Pre-implementation prevalences of obesity (4%) and visible dental decay (11%) of children attending and not-attending U5E centres were not different. While obesity prevalence did not change significantly over time, prevalence of dental decay decreased among children at U5E (trend p = 0.003) but not non-U5E (trend p = 0.14) centres, such that prevalences were significantly different between children at U5E vs. non-U5E centres at Year 3 (p = 0.02). The U5E intervention is a small but arguably effective part of the wider system approach that is required to improve children's future health.

Current lifestyle factors that increase risk of T2DM in China.

The Report on the Status of Nutrition and Chronic Diseases of Chinese residents (2015) indicated that the prevalence of diabetes was 9.7% among adults aged ⩾18 years, which markedly increased from 2.6% in 2002 within 10 years. In addition to the social economic factors, transitions in food consumption, behavioral and lifestyle playing the important roles in the fast increase of type 2 diabetes mellitus (T2DM). In 2010-2012, the cereal food consumption of Chinese residents was 337 g/d, vegetables consumption 269 g/d, fruit consumption 41 g/d, legume and legume products 11 g/d, dairy and dairy products consumption 25 g/d, meat consumption 90 g/d, edible oil consumption 42 g/d and dietary fiber 10.8 g/d. The traditional Chinese dietary pattern (high consumption of rice, pork and vegetables) is shifting towards a dietary pattern with high consumption of meats and edible oil but low consumption of cereals and vegetables. Smoking, breakfast omitting and high consumption of sugar-sweetened beverages became popular. Insufficient physical activity rate was 31.7%. Less sleep duration and poorer sleep quality was also common for Chinese residents. Concerning early life factors, residents exposed to the Chinese famine (1959-1961) during fetal life and childhood had an increased risk of hyperglycemia. As a conclusion, current unhealthy lifestyle has inversely effect on the incidence and development of T2DM, especially for the increased intake of fat and carbohydrate, the transition of dietary pattern, the extension of sedentary time and the increasing rate of obesity. Lifestyle management should be taken seriously as a part of diabetes prevention.

The Acute Effects of Simple Sugar Ingestion on Appetite, Gut-Derived Hormone Response, and Metabolic Markers in Men.

This pilot study aimed to investigate the effect of simple sugar ingestion, in amounts typical of common ingestion, on appetite and the gut-derived hormone response. Seven healthy men ingested water (W) and equicaloric solutions containing 39.6 g glucose monohydrate (G), 36 g fructose (F), 36 g sucrose (S), and 19.8 g glucose monohydrate + 18 g fructose (C), in a randomised order. Serum concentrations of ghrelin, glucose dependent insulinotropic polypeptide (GIP), glucagon like peptide-1 (GLP-1), insulin, lactate, triglycerides, non-esterified fatty acids (NEFA), and d-3 hydroxybutyrate, were measured for 60 min. Appetite was measured using visual analogue scales (VAS). The ingestion of F and S resulted in a lower GIP incremental area under the curve (iAUC) compared to the ingestion of G (p < 0.05). No differences in the iAUC for GLP-1 or ghrelin were present between the trials, nor for insulin between the sugars. No differences in appetite ratings or hepatic metabolism measures were found, except for lactate, which was greater following the ingestion of F, S, and C, when compared to W and G (p < 0.05). The acute ingestion of typical amounts of fructose, in a variety of forms, results in marked differences in circulating GIP and lactate concentration, but no differences in appetite ratings, triglyceride concentration, indicative lipolysis, or NEFA metabolism, when compared to glucose.

Dietary Patterns of European Children and Their Parents in Association with Family Food Environment: Results from the I.Family Study.

The aim of this study was to determine whether an association exists between children's  and  parental  dietary  patterns  (DP),  and  whether  the  number  of  shared  meals  or  soft  drink  availability  during  meals  strengthens  this  association.  In  2013/2014  the  I.Family  study  cross-sectionally assessed the dietary intakes of families from eight European countries using 24-h  dietary recalls. Usual energy and food intakes from six- to 16-year-old children and their parents  were estimated based on the NCI Method. A total of 1662 child-mother and 789 child-father dyads  were included; DP were derived using cluster analysis. We investigated the association between  children's and parental DP and whether the number of shared meals or soft drink availability  moderated this association using mixed effects logistic regression models. Three DP comparable in  children and parents were obtained: Sweet & Fat, Refined Cereals, and Animal Products. Children  were more likely to be allocated to the Sweet & Fat DP when their fathers were allocated to the  Sweet & Fat DP and when they shared at least one meal per day (OR 3.18; 95% CI 1.84; 5.47). Being  allocated to the Sweet & Fat DP increased when the mother or the father was allocated to the Sweet  & Fat DP and when soft drinks were available (OR 2.78; 95% CI 1.80; 4.28 or OR 4.26; 95% CI 2.16;  8.41, respectively). Availability of soft drinks and negative parental role modeling are important  predictors of children's dietary patterns.

Does breast-feeding reduce offspring junk food consumption during childhood? Examinations by socio-economic status and race/ethnicity.

OBJECTIVE: To examine whether breast-feeding duration and socio-economic status (SES) interact to predict junk food consumption among offspring and whether the interaction differs across racial/ethnic groups. DESIGN: Survey research using a longitudinal panel design. Hierarchical linear regression was used to analyse the data. SETTING: In-home interviews with the child's parents over a 5-year period across the USA. SUBJECTS: Approximately 10 000 American children from the Early Childhood Longitudinal Study: Birth Cohort (ECLS-B). RESULTS: The findings revealed that longer breast-feeding durations correspond to lower levels of junk food consumption, but that this relationship emerges consistently only among low-SES blacks. CONCLUSIONS: Efforts to promote breast-feeding among low-SES black women may have the added benefit of reducing their children's junk food intake, and may thereby promote their general health and well-being. Future research should seek to explore the mechanisms by which breast-feeding might benefit the dietary habits of low-SES black children.

Family influence on the consumption of sugary drinks by children under two years old / Influência familiar no consumo de bebidas açucaradas em crianças menores de dois anos

ABSTRACT OBJECTIVE To evaluate the influence of family habits and household characteristics on the consumption of sugary drinks by Brazilian children under two years old. METHODS This was a cross-sectional study that used secondary data generated by the National Health Survey (PNS) in 2013. We studied 4,839 pairs of children under two years old and adults living in the same house. We estimated the prevalence of the indicator of sugary drinks consumption for the total sample of children and according to family and household variables. We applied multiple logistic regression analysis to evaluate the influence of family habits and household characteristics on the consumption of sugary drinks by the children. RESULTS The consumption of sugary drinks was identified in 32% of the studied children (95%CI 30.6-33.3) and was independently associated with the following family and household characteristics: regular consumption of sugary drinks by the adult living in the house (OR = 1.78; 95%CI 1.51-2.10), watching TV for more than three hours per day (OR = 1.22; 95%CI 1.03-1.45), older age (OR = 3.10; 95%CI 1.54-6.26), greater education level (OR = 0.70; 95%CI 0.53-0.91), house located in the Northeast region (OR = 0.65; 95%CI 1.54-6.26), and number of family members (OR = 1.05; 95%CI 1.00-1.09). CONCLUSIONS Our findings indicate the high prevalence of sugary drinks consumption by Brazilian children under two years old and show that sociodemographic characteristics and family habits affect this feeding practice not recommended in childhood.

RESUMO OBJETIVO Avaliar a influência de hábitos familiares e características do domicílio sobre o consumo de bebidas açucaradas em crianças brasileiras menores de dois anos. MÉTODOS Estudo transversal que utilizou dados secundários gerados pela Pesquisa Nacional de Saúde (PNS), em 2013. Foram estudados 4.839 pares de crianças menores de dois anos e adultos residentes no mesmo domicílio. Foram estimadas as prevalências do indicador consumo de bebidas açucaradas para a amostra total de crianças e segundo categorias de variáveis familiares e do domicílio. Aplicou-se análise de regressão logística múltipla para avaliar a influência de hábitos familiares e características do domicílio sobre o consumo de bebidas açucaradas pelas crianças. RESULTADOS O consumo de bebidas açucaradas foi identificado em 32% das crianças estudadas (IC95% 30,6–33,3) e esteve independentemente associado com as seguintes caraterísticas familiares e domiciliares: consumo regular de bebidas açucaradas pelo adulto residente no domicílio (OR = 1,78; IC95% 1,51–2,10), hábito de assistir TV por mais de 3 horas diárias (OR = 1,22; IC95% 1,03–1,45), maior idade (OR = 3,10; IC95% 1,54–6,26), maior escolaridade (OR = 0,70; IC95% 0,53–0,91), domicílio localizado na região Nordeste (OR = 0,65; IC95% 1,54–6,26) e número de componentes da família (OR = 1,05; IC95% 1,00–1,09). CONCLUSÕES Os achados apontam a alta prevalência de consumo de bebidas açucaradas em crianças brasileiras menores de dois anos e que características sociodemográficas e hábitos familiares influenciam essa prática alimentar não recomendada na infância.

Adherence to Dietary Recommendations for Food Group Intakes Is Low in the Mexican Population.

BACKGROUND: Given the high prevalence of obesity and noncommunicable diseases in Mexico and the key role of dietary quality in these conditions, it is important to determine Mexicans' adherence to dietary recommendations. OBJECTIVE: Our aim was to estimate the percentage of the Mexican population who adhere to dietary recommendations for key food groups. METHODS: We analyzed 7983 participants aged ≥5 y from the nationally representative Mexican National Health and Nutrition Survey 2012. Dietary intake data were collected by using one 24-h recall and a repeated 24-h recall in 9% of the sample. We used the National Cancer Institute method for episodically consumed foods, which uses a 2-part (probability and amount) mixed regression model to estimate the usual intake distribution and its association with sociodemographic variables. RESULTS: For the food groups that are encouraged, only 1-4% of the population (range across sex and age groups) reached the recommended intake of legumes, 4-8% for seafood, 7-16% for fruit and vegetables, and 9-23% for dairy. For food groups that are discouraged, only 10-22% did not exceed the recommended upper limit for sugar-sweetened beverages, 14-42% for high saturated fat and/or added sugar (HSFAS) products, and 9-50% for processed meats, whereas the majority (77-93%) did not exceed the limit for red meat. A lower proportion of adolescents than children and adults adhered to recommendations for several food groups. Participants with higher socioeconomic status (SES) and living in urban areas consumed more (probability of consuming and/or amount consumed) fruit and vegetables, dairy, and HSFAS products, but they consumed fewer legumes than those of lower SES and living in rural areas. CONCLUSIONS: These results reveal the poor dietary quality of the Mexican population and the urgent need to shift these habits. If current intakes continue, the burden of disease due to obesity and noncommunicable chronic diseases will likely remain elevated in the Mexican population.

Consumption of soft drinks and juices and risk of liver and biliary tract cancers in a European cohort.

PURPOSE: The aim of the study was to assess associations between intake of combined soft drinks (sugar sweetened and artificially sweetened) and fruit and vegetable juices and the risk of hepatocellular carcinoma (HCC), intrahepatic bile duct (IHBC) and biliary tract cancers (GBTC) using data from the European Prospective Investigation into Cancer and Nutrition cohort of 477,206 participants from 10 European countries. METHODS: After 11.4 years of follow-up, 191 HCC, 66 IHBC and 236 GBTC cases were identified. Hazard ratios and 95% confidence intervals (HR; 95% CI) were estimated with Cox regression models with multivariable adjustment (baseline total energy intake, alcohol consumption and intake pattern, body mass index, physical activity, level of educational attainment and self-reported diabetes status). RESULTS: No risk associations were observed for IHBC or GBTC. Combined soft drinks consumption of >6 servings/week was positively associated with HCC risk: HR 1.83; 95% CI 1.11-3.02, p trend = 0.01 versus non-consumers. In sub-group analyses available for 91% of the cohort artificially sweetened soft drinks increased HCC risk by 6% per 1 serving increment (HR 1.06, 95% CI 1.03-1.09, n cases = 101); for sugar-sweetened soft drinks, this association was null (HR 1.00, 95% CI 0.95-1.06; n cases = 127, p heterogeneity = 0.07). Juice consumption was not associated with HCC risk, except at very low intakes (<1 serving/week: HR 0.60; 95% CI 0.38-0.95; p trend = 0.02 vs. non-consumers). CONCLUSIONS: Daily intake of combined soft drinks is positively associated with HCC, but a differential association between sugar and artificially sweetened cannot be discounted. This study provides some insight into possible associations of HCC with sugary drinks intake. Further exploration in other settings is required.

Changes in the Healthy Beverage Index in Response to an Intervention Targeting a Reduction in Sugar-Sweetened Beverage Consumption as Compared to an Intervention Targeting Improvements in Physical Activity: Results from the Talking Health Trial.

The recently developed Healthy Beverage Index (HBI) was designed to evaluate overall beverage intake quality (including total fluid consumption and beverage calories), yet no known intervention studies have assessed longitudinal changes to the HBI. The objective of this investigation was to assess changes in HBI scores in response to a sugar-sweetened beverage (SSB) reduction trial as compared to a physical activity comparison group. Participants were enrolled into a six-month, community-based, controlled behavioral trial and randomized into either a SSB reduction group (SIPsmartER) or a physical activity group (MoveMore). Correlations and multilevel mixed-effects linear regression with intention-to-treat analyses are presented. Total HBI score significantly increased for SIPsmartER (n = 149) (mean increase = 7.5 points (5.4, 9.7), p ≤ 0.001) and MoveMore (n = 143) (mean increase = 3.4 points (1.6, 5.2), p ≤ 0.001) participants, with a significant between group effect (p ≤ 0.05), over the six-month intervention. Other significant changes in HBI components for SIPsmartER included increased SSB and total beverage calorie scores, and decreased low-fat milk and diet soda scores. Changes in total HBI scores were significantly correlated with changes in total Healthy Eating Index-2010 scores (r = 0.15, p ≤ 0.01). Our findings suggest that individual HBI component scores, beyond the SSB component, are influenced by intervention strategies that primarily focus on SSB reduction.

Usual coffee intake in Brazil: results from the National Dietary Survey 2008-9.

Coffee is central to the economy of many developing countries, as well as to the world economy. However, despite the widespread consumption of coffee, there are very few available data showing the usual intake of this beverage. Surveying usual coffee intake is a way of monitoring one aspect of a population's usual dietary intake. Thus, the present study aimed to characterise the usual daily coffee intake in the Brazilian population. We used data from the National Dietary Survey collected in 2008-9 from a probabilistic sample of 34,003 Brazilians aged 10 years and older. The National Cancer Institute method was applied to obtain the usual intake based on two nonconsecutive food diaries, and descriptive statistical analyses were performed by age and sex for Brazil and its regions. The estimated average usual daily coffee intake of the Brazilian population was 163 (SE 2.8) ml. The comparison by sex showed that males had a 12% greater usual coffee intake than females. In addition, the highest intake was recorded among older males. Among the five regions surveyed, the North-East had the highest usual coffee intake (175 ml). The most common method of brewing coffee was filtered/instant coffee (71%), and the main method of sweetening beverages was with sugar (87%). In Brazil, the mean usual coffee intake corresponds to 163 ml, or 1.5 cups/d. Differences in usual coffee intake according to sex and age differed among the five Brazilian regions.

Healthy kids out of school: using mixed methods to develop principles for promoting healthy eating and physical activity in out-of-school settings in the United States.

INTRODUCTION: Widespread practices supporting availability of healthful foods, beverages, and physical activity in out-of-school-time (OST) settings would further obesity prevention efforts. The objective of this article was to describe principles to guide policy development in support of healthy eating and physical activity practices in out-of-school settings to promote obesity prevention. METHODS: The Institute of Medicine's L.E.A.D. framework (Locate Evidence, Evaluate it, Assemble it, and Inform Decisions) was used to identify practices relevant to children's healthful eating in most OST settings: 1) locate and evaluate information from a national survey of children's perceptions of healthful-food access; published research, reports, policies and guidelines; and roundtables with OST organizations' administrators; 2) assemble information to prioritize actionable practices; and 3) inform programmatic direction. RESULTS: Three evidence-informed guiding principles for short-duration OST resulted: 1) drink right: choose water instead of sugar-sweetened beverages; 2) move more: boost movement and physical activity in all programs; and 3) snack smart: fuel up on fruits and vegetables. CONCLUSION: Healthy Kids Out of School was launched to support the dissemination and implementation of these guiding principles in short-duration OST settings, complementing efforts in other OST settings to shift norms around eating and physical activity.

High sugar intake and development of skeletal muscle insulin resistance and inflammation in mice: a protective role for PPAR- δ agonism.

Peroxisome Proliferator Activated Receptor (PPAR)- δ agonists may serve for treating metabolic diseases. However, the effects of PPAR- δ agonism within the skeletal muscle, which plays a key role in whole-body glucose metabolism, remain unclear. This study aimed to investigate the signaling pathways activated in the gastrocnemius muscle by chronic administration of the selective PPAR- δ agonist, GW0742 (1 mg/kg/day for 16 weeks), in male C57Bl6/J mice treated for 30 weeks with high-fructose corn syrup (HFCS), the major sweetener in foods and soft-drinks (15% wt/vol in drinking water). Mice fed with the HFCS diet exhibited hyperlipidemia, hyperinsulinemia, hyperleptinemia, and hypoadiponectinemia. In the gastrocnemius muscle, HFCS impaired insulin and AMP-activated protein kinase signaling pathways and reduced GLUT-4 and GLUT-5 expression and membrane translocation. GW0742 administration induced PPAR- δ upregulation and improvement in glucose and lipid metabolism. Diet-induced activation of nuclear factor-κB and expression of inducible-nitric-oxide-synthase and intercellular-adhesion-molecule-1 were attenuated by drug treatment. These effects were accompanied by reduction in the serum concentration of interleukin-6 and increase in muscular expression of fibroblast growth factor-21. Overall, here we show that PPAR- δ activation protects the skeletal muscle against the metabolic abnormalities caused by chronic HFCS exposure by affecting multiple levels of the insulin and inflammatory cascades.