Physical Activity Among Native Hawaiians and Pacific Islanders: A Systematic Review and Meta-Analysis.

OBJECTIVE: To examine the proportion of Native Hawaiian and Pacific Islander (NHPI) meeting recommended physical activity guidelines for Americans (PAG) and determine differences in physical activity (PA) by sex and between NHPI and Asians when data are disaggregated. DESIGN: Systematic review and meta-analysis. SETTING: Articles identified in CINAHL, The Cochrane Library, Embase, PsychINFO, PubMed, Scopus, SocINDEX, SPORTDiscus, and Web of Science. PARTICIPANTS: NHPI children and adults, and Asian adults. INTERVENTIONS: Proportion of NHPI meeting PAG and differences in PA involvement by sex and by ethnicity. METHODS: Summary reporting for articles, and meta-analysis using random-effects and inverse-various weighted models. CONCLUSIONS AND IMPLICATIONS: Just over one-third of NHPI children met the PAG (mean = 38.6%, 95% CI [32.43-45.08]), with more males (42.8%) than females (34.7%) meeting the guidelines (t = 6.74, df = 1, P = .02). Less than half met the PAG for combination (mean = 48.7%, 95% CI [34.69-62.97]), moderate (mean = 47.1%, 95% CI [33.62-61.07]), and about one-third met the PAG for vigorous PA (mean = 33.4%, 95% CI [24.55-43.62]). There were no significant differences between Asians and NHPI in PA. Policy, systems, and environmental changes as well as culturally appropriate interventions are needed to increase physical activity among NHPI.

Multilevel approaches to increase fruit and vegetable intake in low-income housing communities: final results of the 'Live Well, Viva Bien' cluster-randomized trial.

BACKGROUND: Fruit and vegetable (F&V) intake can reduce risks for chronic disease, but is much lower than recommended amounts in most Western populations, especially for those with low income levels. Rigorous research is needed on practical, cost-effective interventions that address environmental as well as personal determinants of F&V intake. This paper presents the results of a cluster randomized controlled trial evaluating the efficacy of 'Live Well, Viva Bien' (LWVB), a multicomponent intervention that included discount, mobile fresh F&V markets in conjunction with nutrition education. METHODS: Fifteen subsidized housing sites in Providence County, Rhode Island (8 intervention and 7 control sites) were randomized using a random number generator. Of these, nine housed elderly and/or disabled residents and six housed families. A total of 1597 adult housing site residents (treatment n = 837; control n = 760) were enrolled (73% women, 54% Hispanic, 17% black, Mean age 54 years). A year-long multicomponent intervention including mobile F&V markets plus nutrition education (e.g. campaigns, DVDs, newsletters, recipes, and chef demonstrations) was implemented at intervention sites. Physical activity and stress interventions were implemented at control sites. Follow-up occurred at 6 and 12 months. The main outcome measure was F&V consumption measured by National Cancer Institute's 'Eating at America's Table All Day Screener'. RESULTS: From baseline to 12 months, the intervention group increased total F&V intake by 0.44 cups with the control group decreasing intake by 0.08 cups (p < .02). Results also showed an increased frequency of F&V eating behaviors compared to the control group (p < .01). There was a clear dose response effect of the F&V markets with participants who reported attending all or most of the markets increasing F&V intake by 2.1 cups and 0.86 cups, respectively compared with less than half cup increases for lower levels of market attendance (p < .05). Use of the DVDs, recipes and taste-testings was also associated with greater increases in F&V intake; however, use of other educational components was not. CONCLUSIONS: LWVB is the first cluster, randomized controlled trial to demonstrate the efficacy of year-round F&V markets on improving F&V intake for low-income adults, which provides an evidence-base to bolster the mission of mobile produce markets. Further, the results more broadly support investment in environmental changes to alleviate disparities in F&V consumption and diet-related health inequities. TRIAL REGISTRATION NUMBER: Clinicatrials.gov registration number: NCT02669472.

Associations of neighborhood area level deprivation with the metabolic syndrome and inflammation among middle- and older- age adults.

BACKGROUND: The study examines the association of neighborhood socioeconomic deprivation and metabolic syndrome with inflammation. METHODS: The analysis included 19, 079 black and white participants from the REasons for Geographic And Racial Differences in Stroke Study who were age > 45 years at baseline. Logistic regression examined whether neighborhood deprivation was associated with increased odds of METS and CRP-MetS. RESULTS: Among black adults, residing in the most deprived neighborhoods was associated with increased odds of obesity (p < .01), lower HDL (p < .001), high blood pressure (p < .01), elevated fasting glucose (p < .001), inflammation (p < .01), and CRP-MetS (p < .001). Among white adults, neighborhood deprivation was associated with higher waist circumference (p < .001), lower HDL (p < .001), higher triglycerides (p < .01), higher glucose (p < .001), higher BMI (p < .0001), higher blood pressure (p = .01), METS (p < .001), inflammation (p < .01) and CRP-MetS (p < .001). CONCLUSIONS: These findings highlight the role of neighborhood socioeconomic deprivation on METS and CRP-MetS for black and white adults. Interventions tailored to address the contextual effects of deprived neighborhoods may reduce the observed neighborhood disparities.

Neighborhood perceptions affect dietary behaviors and diet quality.

OBJECTIVE: The primary purpose of this study was to determine if perceived neighborhood disorder affected dietary quality within a multiethnic sample of children. DESIGN: Children were recruited through the use of fliers, wide-distribution mailers, parent magazines, and school presentations from June 2005 to December 2008. SETTING: Birmingham-Hoover, Alabama metropolitan area. PARTICIPANTS: Sample of 100 children aged 7 to 12 years. MAIN OUTCOME MEASURE: Dietary quality was assessed using the average of two 24-hour recalls and analyzed using the Nutrition Data System for Research. ANALYSIS: Multivariate linear regression analyses were conducted to assess the relationship between neighborhood disorder and dietary quality. RESULTS: Perceived neighborhood disorder was associated with increased iron intake (P = .03) and lower potassium levels (P = .04). Perceived neighborhood disorder was not significantly associated with increased energy intake (P = .07) and increased sodium intake (P = .08). CONCLUSIONS AND IMPLICATIONS: Perceived neighborhood disorder was significantly related to differences in dietary quality. This finding indicates that subjective neighborhood characteristics may pose barriers to healthful eating behaviors for children. Future research efforts and policy should address sociostructural factors and ways to manipulate and improve food environments and individuals' perceptions of their neighborhoods.

Neighborhood-level disadvantage is associated with reduced dietary quality in children.

Research has linked neighborhood socioeconomic status to differential dietary quality among adults. However, the relationship between neighborhoods and children's diet remains understudied. The aim of this research was to examine whether neighborhood disadvantage (eg, socioeconomic status, social and physical disorder) affected dietary quality among children. Data for this cross-sectional study were gathered between June 2005 and December 2008. Research participants included 182 children aged 7 to 12 years who were Hispanic (26%), white (28%), and African American (45%). Dietary intake was gathered via two 24-hour recalls and analyzed using the Nutrition Data System for Research. Descriptive statistics and analyses of variance were conducted to determine whether there were significant differences in dietary intakes by quartile grouping of neighborhood disadvantage. Multivariate linear regression analyses were used to determine whether neighborhood disadvantage (as a continuous measure) was associated with dietary quality. Overall, there were no significant differences in total caloric intake; however, children in disadvantaged neighborhoods consumed a greater percentage of calories from fat (P=0.039), trans fat (P=0.018), and had a higher sodium intake (P=0.01). The results suggest that neighborhood factors may contribute to dietary quality among children. Future interventions should assess mechanisms to improve the availability of healthful foods, while taking into account neighborhood-level conditions.