Food insecurity is inversely associated with positive childhood experiences among a nationally representative sample of children aged 0-17 years in the USA.

OBJECTIVE: We examined the association between food insecurity and positive childhood experiences (PCE). DESIGN: Outcome measure was number of PCE and seven PCE constructs. Food insecurity was assessed with a three-category measure that ascertained whether the respondent could afford and choose to eat nutritious food. We then used bivariate and multivariable Poisson and logistic regressions to analyse the relationship between food insecurity and the outcome measures. The analyses were further stratified by age (≤ 5, 6-11 and 12-17 years). SETTING: The National Survey of Children's Health (NSCH) from 2017 to 2020, a nationally representative sample of children and adolescents in the USA. PARTICIPANTS: Parents/caregivers who reported on their children's experiences of PCE and food insecurity from the 2017-2020 NSCH (n 114 709). RESULTS: Descriptively, 22·13 % of respondents reported mild food insecurity, while 3·45 % of respondents reported moderate to severe food insecurity. On multivariable Poisson regression analyses, there was a lower rate of PCE among children who experienced mild (incidence rate ratio (IRR) = 0·93; 95 % CI 0·92, 0·94) or moderate/severe food insecurity (IRR = 0·84; 95 % CI 0·83, 0·86) compared with those who were food secure. We found an inverse relationship between food insecurity and rate of PCE across all age categories. CONCLUSIONS: Our study finding lends evidence to support that interventions, public health programmes, as well as public health policies that reduce food insecurity among children and adolescents may be associated with an increase in PCE. Longitudinal and intervention research are needed to examine the mechanistic relationship between food insecurity and PCE across the life course.

Adverse childhood experiences and food insecurity in emerging adulthood: findings from the EAT 2010-2018 study.

OBJECTIVE: Low childhood socio-economic status (SES) and adverse childhood experiences (ACE) are associated with poor health outcomes in adulthood. Determining how ACE may be linked to food insecurity among young people from socio-economically diverse households can inform health-protective strategies. This study examined if ACE are associated with food insecurity during the transition to adulthood and investigated prevalence differences across SES strata. SETTING: Participants were recruited from twenty secondary schools in Minneapolis-St. Paul, Minnesota. PARTICIPANTS: The analytic sample (n 1518) completed classroom surveys in 2009-2010 (mean age = 14·5 years) and follow-up surveys in 2017-2018 (mean age = 22·0 years). DESIGN: Past-year food insecurity was reported at both time points, and ACE were reported at follow-up. Logistic regression models were used to estimate emerging adult food insecurity prevalence by ACE exposure; models were stratified by childhood SES (low, middle and high). RESULTS: The adjusted prevalence of food insecurity was 45·3 % among emerging adults who reported three or more ACE compared with 23·6 % among those with one or two ACE and 15·5 % among those with no ACE (P < 0·001). All forms of ACE were related to an elevated prevalence of food insecurity in emerging adulthood. ACE-food insecurity associations were strongest for emerging adults from lower and middle SES households. Among emerging adults from low SES households, childhood experiences of emotional abuse and substance use by a household member were associated with the largest prevalence differences in food insecurity. CONCLUSIONS: Findings suggest a need for trauma-informed services within food assistance programs to better serve individuals with a history of ACE.

Is There a Relationship between County-Level Food Insecurity Rates and Breast Cancer Stage at Diagnosis?

The relationship between county food insecurity (FI) rate and breast cancer stage at diagnosis is not clear. Using 2010-2016 Surveillance Epidemiology and End Results (SEER) and Feeding America data we analyzed the association between county FI rate in quartiles (low, medium, high, very high) and breast cancer stage at diagnosis among adult females (≥18 years). We also analyzed the effect of insurance status and county poverty level on this relationship, and whether this relationship varies among non-elderly (<65 years) and elderly (≥ 65 years) individuals. Bivariate and multivariable multilevel logistic regression were used for analyses. Bivariate analysis showed increased likelihood of late-stage breast cancer with increasing county FI rate. This relationship persisted after adjusting for insurance status but was no longer significant after adjusting for county-level poverty rate. There was a statistically significant association between counties with very high food insecurity rates and late-stage breast cancer diagnosis (OR = 1.07; 95% CI = 1.00, 1.14) among the elderly population. Very high county food insecurity rate was associated with late-stage breast cancer among elderly women. Population-level interventions focused on counties with very high food insecurity rates could reduce disparities in stage at breast cancer diagnosis among elderly women.

Preschoolers' parent and teacher/director perceptions of returning to early childcare education during the COVID-19 pandemic.

BACKGROUND: Early Care and Education (ECE) sites are critical hubs for social, emotional, and physical learning development of preschool children (ages 3-5). The COVID-19 pandemic has impacted ECE enrollment and participation; until June 2022, preschool children in the US were ineligible for COVID-19 vaccines. It is critical to identify perceptions of teachers/directors and parents to enhance safe return-to-school efforts. METHODS: Focus groups (n = 7; 22 participants) were conducted with ECE teachers/directors throughout Arizona to examine perceptions of COVID-19 testing for families and staff at ECE sites, and current and possible COVID-19 mitigation strategies during Summer 2021. Preschool parents from underserved families in Phoenix (n = 41) completed a brief survey on their perceptions of benefits of ECE for themselves and their children, thoughts on COVID-19 mitigation strategies, and timing for safe return to school during Spring 2021. Focus groups were transcribed and analyzed for themes using constant comparison. RESULTS: There were 4 focus group themes: 1) perceptions of saliva-based COVID-19 testing, 2) logistical strategies for COVID-19 testing at ECE sites; 3) successes and challenges with current COVID-19 mitigation strategies; 4) ideas to support improved COVID-19 mitigation, including outdoor gardening. Parents rated peace of mind about the child's education as the most important benefit for themselves of in-person ECE (74.6%), and social development for children as the most important benefit for their children (54.4%). Over 40% of parents reported it would not be safe to send children back until 2022. CONCLUSIONS: COVID-19 continues to impact attendance at ECE sites, despite parents reporting key benefits to attending ECE sites. Teachers/directors supported COVID-19 mitigation strategies including saliva-based testing and gardening education to improve safe return to schools.

Social contexts are related to health behaviors: mEMA findings from the SPARC study.

Understanding how social context is associated with behaviors can indicate circumstances when behaviors are more likely to occur. In this study 29,995 ecological momentary assessment (EMA) surveys from 805 participants were analyzed to determine the social context of when eating, drinking, physical activity behaviors, and none of those behaviors (not eating, drinking, or being physically active, "none") occurred. Within-person results indicated that participants had lower odds of reporting eating (OR = 0.81) and drinking (OR = 0.79), and higher odds of reporting physical activity behaviors (OR = 1.20) and "none" (OR = 1.11) when they were alone, compared to when they were with friends. Within-person results also indicated that when participants were off-campus they were more physically active (OR = 1.73) and had lower odds of being reported "none"(OR = 0.78) than when they were on campus. Surprisingly, within-person results also suggested participants reported less physical activity on the weekend (OR = 0.78) than during weekdays, and instead had higher odds of reporting "none" (OR = 1.11). Between-person results suggested participants who were alone had higher odds of reporting "none"(OR = 1.64). When stratified by demographics the findings were similar. These findings show that student behaviors are different when they are alone vs. not, and that social context matters when understanding student behaviors. Interventions aimed to improve dietary intake and promote physical activity may be more effective if a social context aspect is included in their design.

A New American University Model for Training the Future MCH Workforce Through a Translational Research Team.

OBJECTIVES: To describe the process of developing and implementing experiential learning through translational research teams that engage diverse undergraduate and graduate students. METHODS: After a college redesign, translational research teams were developed to foster multidisciplinary research and better integrate students with faculty research, community, and clinical activities. Three primary approaches were used to engage undergraduate and graduate students in the maternal and child health translational research team (MCH TrT). These included an undergraduate experiential learning course; participation in translational research team meetings and events; and mentorship activities including graduate student theses and supplementary projects. RESULTS: Since 2019, a total of 56 students have engaged with the MCH translational research team. The majority (64%) of students engaging in translational research were undergraduates. Racial and ethnic diversity was evident with 16% Latinx, 14% Black/African American, 12% Asian, 10% two or more races, and 4% Native American or Native Hawaiian. A large proportion (42%) of students indicated that they were first-generation college students, while 24% indicated they had a disability. Five themes emerged from student feedback about their involvement in the experiential learning course: the value of translational research, development of research skills, collaboration, practice development, and value for community partners. CONCLUSIONS FOR PRACTICE: Through an MCH translational research team, we have established a pathway to enhance diversity among the MCH workforce which will increase recruitment and retention of underrepresented groups, and ultimately improve MCH research and practice.

Black-White racial disparities in health care utilization and self-reported health among cancer survivors: The role of food insecurity.

BACKGROUND: Non-Hispanic Blacks continue to have worse cancer outcomes than non-Hispanic Whites. Suboptimal health care utilization and poor self-reported health among non-Hispanic Blacks contribute to these disparities. The relationship between race, food security status (FSS), and health care utilization or self-reported health among cancer survivors is not clear. This study aims to fill this gap in the science. METHODS: The 2011-2018 National Health Interview Survey data were used. Bivariate and multivariable logistic regression analyses were used to examine the relationship between race (non-Hispanic Whites or non-Hispanic Blacks), FSS (high, marginal, low, or very low), health care utilization, and self-reported health among cancer survivors. Analyzed health care utilization measures included cost-related medication underuse (CRMU), cost-related delayed care, cost-related forgone care, seeing/talking to a medical specialist, seeing/talking to a general doctor, and overnight hospital stay. RESULTS: A higher proportion of Blacks reported very low food security in comparison with Whites (10.58% vs 4.24%; P ≤ .0001). Blacks were significantly less likely to report a medical specialist visit and more likely to report fair/poor health in the past 12 months even after adjustments for FSS. There was a dose-response relationship between FSS and CRMU, cost-related delayed care, cost-related forgone care, overnight hospital stay, and self-reported health status for both Whites and Blacks. CONCLUSIONS: Significant disparities in health care utilization and self-reported health across race and FSS persist among cancer survivors. Interventions that target food insecurity have the potential to reduce suboptimal health care utilization and self-reported health among cancer survivors.

Availability, variety and distribution of healthy and unhealthy foods and beverages sold at street food stands in Mexico City.

OBJECTIVE: To examine differences in the availability, variety and distribution of foods and beverages sold at street food stands (SFS) across neighbourhood income levels in Mexico City. DESIGN: Cross-sectional. SETTING: Twenty neighbourhoods representing low-, middle- and high-income levels in Mexico City. PARTICIPANTS: Direct observations of SFS (n 391). RESULTS: The availability of healthy foods such as fruits/vegetables was high in middle- and high-income neighbourhoods, whereas the availability of unhealthy foods such as processed snacks was higher in low-income neighbourhoods. However, statistically significant differences in food availability across neighbourhoods were only observed for dairy and processed snack items (P < 0·05). Similarly, differences in variety were only observed for cereal and processed snacks (P < 0·05). No statistically significant differences were seen for variety of fruits/vegetable across neighbourhood income levels (P > 0·05). No statistically significant differences across neighbourhood income levels were observed for beverage availability and variety (P > 0·05). Although street foods and beverages were often distributed near homes, public transportation centres and worksites, no differences were observed across neighbourhood income levels (P > 0·05). CONCLUSIONS: Findings suggest that SFS can be a source of both unhealthy foods and healthy foods for communities across neighbourhoods in Mexico City. Additional studies are needed to assess the relationship between street food and beverage availability, and consumption.

Relationship between different levels of the Mexican food environment and dietary intake: a qualitative systematic review.

OBJECTIVE: To investigate the possible associations between the food environment and dietary intake in the Mexican population. DESIGN: Four databases (PubMed, PsychInfo, Web of Science and SCIelo) were used to retrieve relevant articles using an open timeframe. Articles were reviewed if they contained a systematic measure (i.e. food checklist) of the food environment (e.g. food availability) and dietary intake. SETTING: Urban and rural communities in Mexico. PARTICIPANTS: Population-based studies of Mexican communities. RESULTS: Twenty studies that assessed at least one food environment level, and at least one dietary outcome, were reviewed. Findings from these studies showed that changes in the Mexican food environment seem to be associated with higher availability of energy-dense foods. Energy-dense foods can be linked to a high consumption in household, environment and community food environments. When both nutrient-dense and energy-dense foods were present, individuals were more likely to consume foods with added sugars, fats and salt options than nutrient-dense items. CONCLUSIONS: The various levels of the food environment (i.e. household, school, community) exposed participants to energy-dense foods. Although nutrient-dense foods were present in all three levels, individuals were more likely to consume energy-dense food items. Not all three levels of the food environment are well represented in the urban and rural settings. Most studies on the community food environment were done in rural areas, whereas most studies on the school food environment were done in urban settings. Additional rigorously designed studies are needed to document the relationship between the food environment and dietary intake in the Mexican population.

Similarity in meal plan use among first-year roommates.

OBJECTIVE: To examine if first-year roommates made similar meal plan decisions. METHODS: Residence information for 1186 first-year students (N = 593 roommate pairs) and 559 floormates was obtained for the 2015-2016 academic year. Linear generalized estimating equations (GEEs) were used to examine if the number of meals students used over the semester was higher if their roommate used their meal plan more frequently. A logistic GEE examined joint meal plan usage between students and roommates for each month of the semester. To determine if residence, rather than roommate, explained the results, a simulation was conducted by randomly assigning the floormates to a same-sex roommate. RESULTS: The number of meals students used in spring was higher if the students' roommate had used more meals in spring, even after controlling for the number of meals students used in fall (Female: ß = 0.07, 99% CI = 0.00, 0.13; Male: ß = 0.10, 99% CI = 0.02, 0.18). Students were more likely to use a meal with their roommate if they were on the same meal plan (Female: OR = 1.61, 99% CI = 1.27, 2.04; Male: OR = 1.57, 99% CI = 1.09, 2.25), and less likely after the first month of being roommates (Female: OR = 0.57-0.25; Male: OR = 0.50-0.22; p < 0.001). The simulation analysis indicated these findings were not due to shared residence. DISCUSSION: Students' meal plan choices were associated with their roommates' meal plan choices. Roommates' joint meal plan usage was highest at the start of the year. Strategic roommate pairings may result in students using their meal plan more. Further research should determine the extent of roommate influence on students' diet.

Trends and disparities in urinary BPA concentrations among U.S. emerging adults.

BACKGROUND: Emerging adulthood (ages 18-25 years) is a key turning point in the life course characterized by particularly poor eating behaviors (e.g., low in fruits and vegetables, and high in fast food) and weight gain. Emerging adults are also prime consumers of personal care and other consumer products that may result in differential exposures to environmental contaminants, such as Bisphenol A (BPA), compared to adults aged 26+ years. This is of concern given BPA has been associated with adverse health outcomes such as obesity, metabolic disorders, miscarriage, infertility and breast cancer. However, no research has examined exposure to BPA among emerging adults. OBJECTIVE: To assess trends of exposure to urinary BPA among a representative sample of emerging adults compared to adults aged 26+ years. Secondarily, we aimed to identify differential associations between BPA concentrations and sociodemographic characteristics and BMI by age group. METHODS: This study uses National Health and Examination Surveys (NHANES) over 2003-2014 to test differences in BPA concentrations comparing emerging adults to adults aged 26+ years. Generalized linear models predicting log BPA by age group and sex, race/ethnicity, education, income, and food security status, and generalized linear models predicting BMI by log BPA, both age group and age as a continuous variable, sex, race/ethnicity, education, income, and food security status were conducted. Interactions with age group (i.e., age group x sex) were examined for the mutually adjusted models. All models controlled for survey year, month, and time of day, and were run with, and without, an adjustment for urinary creatinine. RESULTS: In models adjusted, and not adjusted, for urinary creatinine, emerging adults had a higher log BPA concentration than adults aged 26+ years (ß=0.153, p=0.004; ß=0.544, p<0.001), and a significantly steeper decline in BPA concentration between 2003-2004 and 2013-2014 than adults aged 26+ years (ß=-0.051, p=0.002; ß=-0.071, p=0.001). Males' log BPA concentration were lower than that for females when urinary creatinine was included in the model, and higher when urinary creatinine was excluded from the model (ß=-0.188, p<0.001; ß=0.203, p<0.001). Higher income was significantly associated with lower log BPA concentration (ß=-0.220, p<0.001; ß=-0.166, p<0.001). A significant interaction between emerging adult age group and food security status was observed, which was associated with higher BPA exposures. Log BPA concentration was associated with BMI only when urinary creatinine was excluded from the models (urinary creatinine included: ß=0.031, p=0.747; ß=0.022, p=0.815, urinary creatinine excluded: ß=0.528, p<0.001; ß=0.552, p<0.001). CONCLUSION: Findings indicate that emerging adults had higher BPA exposures than adults aged 26+ years in 2003-2004, and that emerging adults' exposure level has decreased faster than that of adults aged 26+ years. There were suggestions that the BPA concentration of emerging adults in 2013-2014 was lower than that for adults aged 26+ years, and that BPA exposure is associated with higher BMI. Our results highlight the need for additional research to identify the sources and routes of exposure to BPA and BPA replacements among emerging adults and to better characterize the variability in exposure. Intervention studies are needed to assist emerging adults in limiting their exposure to BPA, and potentially also the BPA alternatives.

Diet, physical activity and screen time but not body mass index are associated with the gut microbiome of a diverse cohort of college students living in university housing: a cross-sectional study.

BACKGROUND: Modifiable lifestyle factors (e.g. dietary intake and physical activity) are important contributors to weight gain during college. The purpose of this study was to evaluate whether associations exist between body mass index, physical activity, screen time, dietary consumption (fat, protein, carbohydrates, and fiber), and gut microbial diversity during the first year of college. Racially/ethnically diverse college students (n = 82; 61.0% non-white) at a large Southwestern university completed self-reported physical activity and 24-h recall dietary assessments, height and weight measurements, and provided one fecal sample for gut microbiome analysis. Fecal microbial community composition was assessed with Illumina MiSeq next-generation sequencing of PCR amplified 16S rRNA genes. Post-hoc analyses compared microbial diversity by groups of high and low physical activity and fiber intake using QIIME and LEfSe bioinformatics software. RESULTS: No statistically significant differences were observed between body mass index and gut microbiome abundance and diversity. Median daily consumption of dietary fiber was 11.2 (7.6, 14.9) g/d, while the median self-reported moderate-to-vigorous physical activity (MVPA) was 55.7 (27.9, 79.3) min/d and screen time 195.0 (195.0, 315.0) min/d. Microbial analysis by LEfSe identified Paraprevotellaceae, Lachnospiraceae, and Lachnospira as important phylotypes in college students reporting greater MVPA, while Enterobacteriaceae and Enterobacteriales were more enriched among students reporting less MVPA (p < 0.05). Barnesiellaceae, Alphaproteobacteria, and Ruminococcus were more abundant taxa among those consuming less than the median fiber intake (p < 0.05). Post-hoc analyses comparing weighted UniFrac distance metrics based on combined categories of high and low MVPA and fiber revealed that clustering distances between members of the high MVPA-low fiber group were significantly smaller when compared to distances between members of all other MVPA-fiber groups (p < 0.0001). CONCLUSIONS: Habitual fiber consumption and MVPA behaviors help explain the differential abundance of specific microbial taxa and overall gut microbial diversity differences in first-year college students.

Hungry to learn: the prevalence and effects of food insecurity on health behaviors and outcomes over time among a diverse sample of university freshmen.

BACKGROUND: To examine longitudinal associations between food insecurity (FI) and health behaviors/outcomes among a diverse sample of university freshmen. METHODS: Freshman students (n = 1138; 65% female; 49% non-white) participating in the Social impact of Physical Activity and nutRition in College study completed surveys on health behaviors and had height/weight measured up to 4 times (T1-T4) in Arizona during 2015-2016. Structural equation models were estimated to determine if, after adjusting for covariates, FI predicted concurrent behaviors/outcomes and subsequent behaviors/outcomes. Analyses reported here were conducted in 2017. RESULTS: The prevalence of FI was significantly higher at the end of each semester (35% and 36%, respectively) than at the start of the year (28%). Longitudinally, FI was not related to any health behaviors/outcomes at future time points. However, FI was significantly and inversely associated with concurrent breakfast consumption on most days of the week (OR = 0.67, 99% CI = 0.46, 0.99), daily evening meal consumption (OR = 0.55, 99% CI = 0.36, 0.86) healthy eating habits on campus (OR = 0.68, 99% CI = 0.46, 1.00), healthy physical activity habits on campus (OR = 0.66, 99% CI = 0.44, 1.00), and positively related to the likelihood of experiencing stress (OR = 1.69, 99% CI = 1.16, 2.46) and depressed mood (OR = 1.98, 99% CI = 1.34, 2.91). CONCLUSIONS: Compared with US prevalence rates, the sample FI prevalence was high. FI was related to poorer eating patterns, physical activity behaviors, and mental health, even after adjusting for prior levels of behavior.

The Association among Emotions and Food Choices in First-Year College Students Using mobile-Ecological Momentary Assessments.

BACKGROUND: Studies have examined the associations between emotions and overeating but have only rarely considered associations between emotions and specific food choices. The purpose of this secondary data analysis was to use mobile ecological momentary assessments (mEMAs) to examine associations between emotions and food choices among first-year college students living in residence halls. METHODS: Using an intensive repeated-measures design, mEMAs were used to assess concurrent emotions and food choices in a racially/ethnically diverse sample of first-year college students (n = 663). Emotions were categorized as negative (sad, stressed, tired), positive (happy, energized, relaxed), and apathetic (bored, meh). Assessments were completed multiple times per day on four quasi-randomly selected days (three random weekdays and one random weekend day) during a 7-day period using random prompt times. Generalized estimating equations (GEE) were used to examine between- and within-person associations of emotional status with a variety of healthy and unhealthy food choices (sweets, salty snacks/fried foods, fruits/vegetables, pizza/fast food, sandwiches/wraps, meats/proteins, pasta/rice, cereals), adjusting for gender, day of week, and time of day, accounting for within-person dependencies among repeated measurements of eating behavior. RESULTS: At the between-person level, participants who reported positive emotions more frequently compared to others consumed meats/proteins more often (OR = 1.8; 99% CI = 1.2, 2.8). At the within-person level, on occasions when any negative emotion was reported (versus no negative emotion reported) participants were more likely to consume meats/proteins (OR = 1.5, 99% CI = 1.0, 2.1); on occasions when any positive emotion was reported as compared to occasions with no positive emotions, participants were more likely to consume sweets (OR = 1.7, 99% CI = 1.1, 2.6), but less likely to consume pizza/fast food (OR = 0.6, 99% CI = 0.4, 1.0). CONCLUSIONS: Negative and positive emotions were significantly associated with food choices. mEMA methodology provides a unique opportunity to examine these associations within and between people, providing insights for individual and population-level interventions. These findings can be used to guide future longitudinal studies and to develop and test interventions that encourage healthy food choices among first-year college students and ultimately reduce the risk of weight gain.

Food insecurity and emotional health in the USA: a systematic narrative review of longitudinal research.

OBJECTIVE: To examine the causal directionality in the relationship between food insecurity and emotional well-being among US-based populations. DESIGN: Systematic literature review from January 2006 to July 2016 using MEDLINE (PubMed), PsychInfo, Web of Science and CINHAL. Inclusion criteria were: written in English; examined a longitudinal association between food insecurity and emotional well-being. SETTING: The USA. SUBJECTS: Children and adults. RESULTS: Twelve out of 4161 peer-reviewed articles met inclusion criteria. Three articles examined the effect of emotional well-being on food insecurity, five studies examined the effect of food insecurity on emotional well-being, and four studies examined a bidirectional relationship. Most studies (83 %) reported a positive relationship between negative emotional well-being and food insecurity over time. CONCLUSIONS: Findings suggest a bidirectional association whereby food insecurity increases the risk of poor emotional health, and poor emotional health increases the risk of food insecurity. Better-constructed studies are needed to follow cohorts at risk for both food insecurity and poor emotional health to further understand the mediators and moderators of the relationships. Intervention studies designed to mitigate or reverse risks are also needed to determine best evidence for practice and policy.

Mother and Adolescent Eating in the Context of Food Insecurity: Findings from Urban Public Housing.

Introduction Anecdotal evidence suggests that parents protect their children from food insecurity and its effects, but few studies have concurrently assessed food insecurity among youth and parents. The purpose of this study was to examine food insecurity and eating behaviors among an urban sample of mother-adolescent dyads. Methods Mother-adolescent dyads (n = 55) were from six public housing sites in Phoenix, Arizona who completed surveys during 2014. Multivariate mixed linear and logistic regression models assessed the relationship between mother and adolescent eating behaviors in the context of food insecurity. Results Food insecurity was prevalent with 65.4% of parents and 43.6% of adolescents reporting food insecurity; 34.5% of parents and 14.5% of adolescents reported very low food security. After adjusting for food insecurity status, parents' and adolescents' fruit, vegetable, and sugar-sweetened beverage consumption was not associated. However, significant associations were observed between mothers' and adolescents' fast food intake (ß = 0.52; p < 0.001), family meal intake (ß = 0.52; p = 0.001), mindful eating (ß = 0.51; p = 0.032), and binge eating (OR 8.05; p = 0.011). Discussion Parents may protect their adolescent children against food insecurity given the lower prevalence of food insecurity observed among adolescents. Interventions addressing food insecurity among mothers and adolescents may want to capitalize on shared eating patterns and address issues related to binge eating and leverage site-based strengths of public housing.

Malnutrition coupled with diarrheal and respiratory infections among children in Asia: A systematic review.

OBJECTIVE: The purpose of this systematic literature review was to assess the relationship between malnutrition and respiratory and diarrheal infections among children aged five and under living in Asian countries. DESIGN AND SAMPLE: The design was adapted from the PRISMA method to include case-control, cross-sectional, ecological, and experimental studies. A review of electronic databases identified 144 articles of which 20 met the inclusion criteria. The inclusion criteria were studies of malnourished children under the age of five with respiratory and/or diarrheal infections, admitted to hospitals or residing in villages throughout countries in Asia, and published between 2005 and 2015. MEASURES: Infection was defined as the presence of a respiratory or diarrheal illness. Malnutrition was predominantly measured by WHO standards. RESULTS: Malnutrition is associated with respiratory and diarrheal infections. Children have higher rates of mortality when both malnourished and experiencing a respiratory infection. CONCLUSION: Further research needs to examine the synergetic effect of diarrheal and respiratory infections in malnourished children and rates of mortality. Public health nurses (PHNs) play a critical role in the prevention and treatment of malnutrition and infections in community and national systems. Obtaining better data will allow PHNs to provide critical care in the most underserved areas throughout Asia.

The Role of SNAP in Home Food Availability and Dietary Intake among WIC Participants Facing Unstable Housing.

OBJECTIVE: Little nutrition research has been conducted among families with unstable housing. The objective of this study was to examine the role of food stamps (i.e., Supplemental Nutrition Assistance Program; SNAP) in home food availability and dietary intake among WIC families who experienced unstable housing. DESIGN AND SAMPLE: Cross-sectional study among vulnerable families. Low-income, multiethnic families with children participating in WIC (n = 54). MEASURES: Dietary intake was assessed with 24-hr recalls. Home food availability was assessed with an adapted home food inventory for low-income, multiethnic families. Validation results from adapted home food inventory for these families are also reported. RESULTS: SNAP households had more foods than non-SNAP households; few significant associations were observed between food availability and child dietary intake. CONCLUSIONS: With few exceptions, the home food environment was not related to children's dietary intake among these vulnerable families. More research is needed on food access for families facing unstable housing.

Fit Minded College Edition Pilot Study: Can a Magazine-Based Discussion Group Improve Physical Activity in Female College Freshmen?

OBJECTIVE: Initial efficacy of a magazine-based discussion group for improving physical activity (PA), self-worth, and eating behaviors in female college freshmen. DESIGN: Randomized control trial. SETTING: A large university in southwestern United States. PARTICIPANTS: Thirty-seven female college freshmen were randomized to the intervention (n = 17) and control groups (n = 20) in September 2013. INTERVENTION: Participants completed an 8-week magazine-based discussion group program, Fit Minded College Edition, adapted from Fit Minded, a previously tested theory-based intervention. Education on PA, self-worth, and nutrition was provided using excerpts from women's health magazines. Participants also had access to a Web site with supplementary health and wellness material. The control group did not attend meetings or have access to the Web site but received the magazines. Interventions focusing on concepts of self-worth with less focus on weight and appearance may promote long term PA participation and healthy eating behaviors in college women. MAIN OUTCOME MEASURES: Self-reported PA, global self-worth, knowledge self-worth, self-efficacy, social support, eating behaviors (ie, fruit/veggie/junk food/sugar-sweetened beverage consumption), satisfaction, and Web site usage. RESULTS: Mean age of participants was 18.11 (SD = 0.32) years. Time × Intervention effects were observed for PA minutes per week (Partial η = 0.34), knowledge self-worth (Partial η = 0.02), and daily sugar-sweetened beverage consumption (Partial η = 0.17) (P < .05), with the intervention group reporting greater increases in PA and knowledge self-worth and greater decreases in sugar-sweetened beverage consumption. CONCLUSIONS: A magazine-based discussion group may provide a promising platform to improve health behaviors in female college freshmen.

Longitudinal social networks impacts on weight and weight-related behaviors assessed using mobile-based ecological momentary assessments: Study Protocols for the SPARC study.

BACKGROUND: The transition from the home to college is a phase in which emerging adults shift toward more unhealthy eating and physical activity patterns, higher body mass indices, thus increasing risk of overweight/obesity. Currently, little is understood about how changing friendship networks shape weight gain behaviors. This paper describes the recruitment, data collection, and data analytic protocols for the SPARC (Social impact of Physical Activity and nutRition in College) study, a longitudinal examination of the mechanisms by which friends and friendship networks influence nutrition and physical activity behaviors and weight gain in the transition to college life. METHODS: The SPARC study aims to follow 1450 university freshmen from a large university over an academic year, collecting data on multiple aspects of friends and friendship networks. Integrating multiple types of data related to student lives, ecological momentary assessments (EMAs) are administered via a cell phone application, devilSPARC. EMAs collected in four 1-week periods (a total of 4 EMA waves) are integrated with linked data from web-based surveys and anthropometric measurements conducted at four times points (for a total of eight data collection periods including EMAs, separated by ~1 month). University databases will provide student card data, allowing integration of both time-dated data on food purchasing, use of physical activity venues, and geographical information system (GIS) locations of these activities relative to other students in their social networks. DISCUSSION: Findings are intended to guide the development of more effective interventions to enhance behaviors among college students that protect against weight gain during college.