Evaluating the Effects of Corn Flour Product Consumption on Cardiometabolic Outcomes and the Gut Microbiota in Adults with Elevated Cholesterol: A Randomized Crossover.

BACKGROUND: Consumption of whole grains is associated with a reduction in chronic diseases and offers benefits for cardiovascular health and metabolic regulation. The relationship between whole-grain corn and corn bran with the gut microbiota (GM) remains an area of growing interest, particularly regarding their influence on cardiometabolic health. OBJECTIVES: To investigate the effects of different corn flours on cardiometabolic outcomes and GM changes in adults with elevated low-density lipoprotein cholesterol (LDL cholesterol) concentrations. METHODS: In this crossover study, 36 adults with LDL cholesterol above 110 mg/dL consumed 48 g/d of 3 corn flour types for 4 wk: whole-grain corn meal, refined corn meal (RCM), and a blend of RCM and corn bran (RCM + B). We assessed the impact on cardiometabolic markers [LDL cholesterol, high-density lipoprotein cholesterol (HDL cholesterol), total cholesterol, and triglycerides)] and GM composition and estimated function. Statistical analyses included mixed-effects modeling and responder (>5% decrease in LDL cholesterol) analysis to evaluate changes in GM related to lipid profile improvements. RESULTS: Of the 3 corn flour types, only RCM + B significantly decreased LDL cholesterol over time (-10.4 ± 3.6 mg/dL, P = 0.005) and marginally decreased total cholesterol (-9.2 ± 3.9 mg/dL, P = 0.072) over time. There were no significant effects on HDL cholesterol or triglyceride concentrations. No significant changes were observed in GM alpha diversity, whereas beta diversity metrics indicated individual variability. Two genera, unclassified Lachnospiraceae and Agathobaculum (Padj ≤ 0.096), differed significantly by treatment, but only Agathobaculum remained significantly elevated in the whole-grain corn meal, compared to RCM and RCM + B, after adjustment for multiple comparisons. CONCLUSIONS: The type of corn flour, particularly RCM + B, notably influenced LDL cholesterol concentrations in adults with elevated LDL cholesterol. This study suggests that incorporating milled fractions (e.g., bran) of whole-grain corn with refined corn flour may be a viable alternative to supplementing manufactured grain products with isolated or synthetic fibers for improved metabolic health. This trial was registered at clinicaltrials.gov as NCT03967990.

Determinants of tap water mistrust among Phoenix, Arizona Latinx adults.

The purpose of this investigation was to characterize factors that predict tap water mistrust among Phoenix, Arizona Latinx adults. Participants (n = 492, 28 ± 7 years, 37.4% female) completed water security experience-based scales and an Adapted Survey of Water Issues in Arizona. Binary logistic regression determined odds ratios (OR) with 95% confidence intervals (95% CI) for the odds of perceiving tap water to be unsafe. Of all participants, 51.2% perceived their tap water to be unsafe. The odds of mistrusting tap water were significantly greater for each additional favorable perception of bottled compared to tap water (e.g., tastes/smells better; OR = 1.94, 95% CI = 1.50, 2.50), negative home tap water experience (e.g., hard water mineral deposits and rusty color; OR = 1.32, 95% CI = 1.12, 1.56), use of alternatives to home tap water (OR = 1.25, 95% CI = 1.04, 1.51), and with decreased water quality and acceptability (OR = 1.21, 95% CI = 1.01, 1.45; P < 0.05). The odds of mistrusting tap water were significantly lower for those whose primary source of drinking water is the public supply (municipal) (OR = 0.07, 95% CI = 0.01, 0.63) and with decreased water access (OR = 0.56, 95% CI = 0.48, 0.66; P < 0.05). Latinx mistrust of tap water appears to be associated with organoleptic perceptions and reliance on alternatives to the home drinking water system.

Cardiometabolic Risk Factors Among Insufficiently Active African American Women With Obesity: Baseline Findings From Smart Walk.

BACKGROUND: Low moderate-to-vigorous physical activity (MVPA) levels and obesity are associated with increased cardiometabolic disease risk. OBJECTIVE: The aim of this study was to describe MVPA and cardiometabolic risk characteristics of insufficiently active African American women with obesity (N = 60) enrolled in a culturally tailored MVPA intervention. METHODS: We assessed accelerometer-measured and self-reported MVPA, blood pressure, serum lipid profiles, cardiorespiratory fitness (VO 2 peak), and aortic pulse wave velocity. RESULTS: Participants (mean age, 38.4; mean body mass index, 40.6 kg/m 2 ) averaged 15 min/d of accelerometer-measured MVPA and 30 min/wk of self-reported MVPA. Systolic and diastolic blood pressure levels were elevated (135.4 and 84.0 mm Hg, respectively). With the exception of low-density lipoprotein cholesterol (121.4 mg/dL) and high-density lipoprotein cholesterol (47.6 mg/dL), lipid profiles were within reference ranges. Compared with normative reference values, average VO 2 peak was low (18.7 mL/kg/min), and pulse wave velocity was high (7.4 m/s). CONCLUSIONS: Our sample of insufficiently active African American women with obesity was at an elevated risk for cardiometabolic disease.

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.

Effects of a lifestyle intervention on markers of cardiometabolic risk and oxidized lipoproteins among obese adolescents with prediabetes.

OBJECTIVE: Obesity and hyperglycaemia contribute to the atherosclerotic process in part through oxidative modifications to lipoprotein particles. The present study aimed to evaluate the effects of a lifestyle intervention on markers of oxidized lipoproteins in obese Latino adolescents with prediabetes. DESIGN: Pre-post design. SETTING: Participants were enrolled into a 12-week lifestyle intervention. Measurements pre- and post-intervention included anthropometrics and body composition, lipid panel, oxidized LDL (oxLDL), oxidized HDL (oxHDL), intake of fresh fruits and vegetables, and cardiorespiratory fitness. PARTICIPANTS: Thirty-five obese Latino adolescents (seventeen females, eighteen males; mean age 15·5 (sd 1·0) years; mean BMI percentile 98·5 (sd 1·2)) with prediabetes. RESULTS: Intervention participation resulted in significant reductions in weight (-1·2 %, P = 0·042), BMI and BMI percentile (-2·0 and -0·4 %, respectively, P < 0·001), body fat (-7·0 %, P = 0·025), TAG (-11·8 %, P = 0·032), total cholesterol (-5·0 %, P = 0·002), VLDL-cholesterol (-12·5 %, P = 0·029), and non-HDL-cholesterol (-6·7 %, P = 0·007). Additionally, fitness (6·4 %, P < 0·001) and intake of fruits and vegetables (42·4 %, P = 0·025) increased significantly. OxLDL decreased significantly after the intervention (51·0 (sd 14·0) v. 48·7 (sd 12·8) U/l, P = 0·022), while oxHDL trended towards a significant increase (395·2 (sd 94·6) v. 416·1 (sd 98·4) ng/ml, P = 0·056). CONCLUSIONS: These data support the utility of lifestyle intervention to improve the atherogenic phenotype of Latino adolescents who are at high risk for developing premature CVD and type 2 diabetes.

Nutrition Facts Panel use is associated with diet quality and dietary patterns among Latinos with type 2 diabetes.

OBJECTIVE: The study aims were to (i) identify determinants of Nutrition Facts Panel (NFP) use and (ii) describe the association between NFP use and dietary intake among Latinos with type 2 diabetes. DESIGN: Baseline cross-sectional data from a clinical trial were used to assess the association between NFP use and dietary intake. Diet was measured using two methods: (i) a diet quality score (the Healthy Eating Index-2010) derived from a single 24 h recall and (ii) dietary pattern (exploratory factor analyses) from an FFQ. Multivariable logistic and non-parametric quantile regressions were conducted, as appropriate. Settings Hartford County, Connecticut, USA. SUBJECTS: Latino adults (n 203), ≥21 years of age, with diagnosed type 2 diabetes, glycosylated Hb≥7 %, and without medical conditions limiting physical activity. RESULTS: Participants' education level, diabetes-related knowledge and English speaking were positively associated with NFP use. At the higher percentiles of diet quality score, NFP use was significantly associated with higher diet quality. Similarly, NFP users were more likely to consume a 'healthy' dietary pattern (P=0·003) and less likely to consume a 'fried snack' pattern (P=0·048) compared with NFP non-users. CONCLUSIONS: The association between reported NFP use and diet quality was positive and significantly stronger among participants who reported consuming a healthier diet. While NFP use was associated with a healthier dietary pattern, not using NFP was associated with a less-healthy, fried snack pattern. Longitudinal studies are needed to understand whether improving NFP use could be an effective intervention to improve diet quality among Latinos with type 2 diabetes.

Effects of Food Label Use on Diet Quality and Glycemic Control Among Latinos With Type 2 Diabetes in a Community Health Worker-Supported Intervention.

OBJECTIVES: To determine the impact of an intervention led by community health workers (CHWs) on food label use and to assess whether food label use and diet quality mediate the intervention's impact on glycemic control. METHODS: From 2006 to 2010, 203 Latinos (intervention group, n = 100; control group, n = 103) in Hartford County, Connecticut, with type 2 diabetes were randomized to an intervention that included 17 CHW-led home-based sessions over a 12-month period in addition to the standard of care available in both study arms. Data on food label use, diet quality, covariates, and glycated hemoglobin (HbA1c) were collected at baseline and at 3, 6, 12, and 18 months. Data were analyzed via mixed effects and multilevel structural equation modeling. RESULTS: Food label use in the intervention (vs control) group was significantly higher at 3, 12, and 18 months (odds ratio = 2.99; 95% confidence interval = 1.69, 5.29). Food label use and diet quality were positive mediators of improved HbA1c levels. CONCLUSIONS: Culturally tailored interventions led by CHWs could increase food label use. Also, CHW-delivered food label education may lead to better diet quality and improve glycemic control among Latinos with type 2 diabetes.

Comparison and evaluation of dietary quality between older and younger Mexican-American women.

OBJECTIVE: To compare and evaluate the dietary quality of young and older sedentary Mexican-American women. Understanding key dietary concerns, while considering developmental transition periods and cultural relevance, can provide insight for developing appropriate nutrition interventions. DESIGN: Cross-sectional dietary data were collected using unannounced 24 h diet recalls to assess nutrient intake adequacy (Estimated Average Requirement cut-point method) and dietary quality (Healthy Eating Index (HEI) 2010). SETTING: Mujeres en Acción and Madres para la Salud, two community-based physical activity interventions. SUBJECTS: Participants were 139 young (28 (sd 6) years) and 124 older (55 (sd 7) years) overweight/obese sedentary Mexican-American women (BMI=25·0-35·0 kg/m2) of low socio-economic status. RESULTS: Older women consumed less Ca, Fe, folate, empty calories and energy from carbohydrate, but more fruit, vegetables, greens and beans, and fibre than younger women (all P<0·05). Over 60 % of all participants had an intake below recommendations for fibre, Ca, vitamin E, vitamin C and folate. Both groups had low total HEI-2010 scores (62 for older and 63 for younger women; NS), with 57 % of older and 48 % of younger women classified as having a poor diet. CONCLUSIONS: Despite differences in nutrient requirements according to developmental transition periods (childbearing v. perimenopausal), overall, older and younger Mexican-American women generally had low-quality diets and may benefit from dietary quality improvement.

Correlates of depressive symptoms after birth for Latinas who are overweight or obese.

Depression symptoms and overweight/obesity are common concerns during childbearing. Both conditions are associated with poor outcomes at birth and can have long-lasting consequences. Predictors of depressive symptoms among overweight and obese low-income and ethnically diverse women are not known. Data are from the Madres para la Salud trial with 139 postpartum Latinas. Depressive symptoms during a prior pregnancy were positively related, while social support and moderate intensity physical activity (PA) were negatively related to depressive symptoms after birth. Social support and PA may be effective interventions, particularly for women who have experienced depressive symptoms in a prior pregnancy.

Influence of exercise on the metabolic profile caused by 28 days of bed rest with energy deficit and amino acid supplementation in healthy men.

OBJECTIVE: Muscle loss and metabolic changes occur with disuse [i.e. bed rest (BR)]. We hypothesized that BR would lead to a metabolically unhealthy profile defined by: increased circulating tumor necrosis factor (TNF)-α, decreased circulating insulin-like-growth-factor (IGF)-1, decreased HDL-cholesterol, and decreased muscle density (MD; measured by mid-thigh computerized tomography). METHODS: We investigated the metabolic profile after 28 days of BR with 8 ± 6% energy deficit in male individuals (30-55 years) randomized to resistance exercise with amino acid supplementation (RT, n=24) or amino acid supplementation alone (EAA, n=7). Upper and lower body exercises were performed in the horizontal position. Blood samples were taken at baseline, after 28 days of BR and 14 days of recovery. RESULTS: We found a shift toward a metabolically unfavourable profile after BR [compared to baseline (BLN)] in both groups as shown by decreased HDL-cholesterol levels (EAA: BLN: 39 ± 4 vs. BR: 32 ± 2 mg/dL, RT: BLN: 39 ± 1 vs. BR: 32 ± 1 mg/dL; p<0.001) and Low MD (EAA: BLN: 27 ± 4 vs. BR: 22 ± 3 cm(2), RT: BLN: 28 ± 2 vs. BR: 23 ± 2 cm(2); p<0.001). A healthier metabolic profile was maintained with exercise, including NormalMD (EAA: BLN: 124 ± 6 vs. BR: 110 ± 5 cm(2), RT: BLN: 132 ± 3 vs. BR: 131 ± 4 cm(2); p<0.001, time-by-group); although, exercise did not completely alleviate the unfavourable metabolic changes seen with BR. Interestingly, both groups had increased plasma IGF-1 levels (EAA: BLN:168 ± 22 vs. BR 213 ± 20 ng/mL, RT: BLN:180 ± 10 vs. BR: 219 ± 13 ng/mL; p<0.001) and neither group showed TNFα changes (p>0.05). CONCLUSIONS: We conclude that RT can be incorporated to potentially offset the metabolic complications of BR.

A comparison of a social support physical activity intervention in weight management among post-partum Latinas.

BACKGROUND: Weight gain during the childbearing years and failure to lose pregnancy weight after birth contribute to the development of obesity in postpartum Latinas. METHODS: Madres para la Salud [Mothers for Health] was a 12-month, randomized controlled trial exploring a social support intervention with moderate-intensity physical activity (PA) seeking to effect changes in body fat, fat tissue inflammation, and depression symptoms in sedentary postpartum Latinas. This report describes the efficacy of the Madres intervention. RESULTS: The results show that while social support increased during the active intervention delivery, it declined to pre-intervention levels by the end of the intervention. There were significant achievements in aerobic and total steps across the 12 months of the intervention, and declines in body adiposity assessed with bioelectric impedance. CONCLUSIONS: Social support from family and friends mediated increases in aerobic PA resulting in decrease in percent body fat. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01908959.

Social marketing: approach to cultural and contextual relevance in a community-based physical activity intervention.

We report the social marketing strategies used for the design, recruitment and retention of participants in a community-based physical activity (PA) intervention, Madres para la Salud (Mothers for Health). The study example used to illustrate the use of social marketing is a 48-week prescribed walking program, Madres para la Salud (Mothers for Health), which tests a social support intervention to explore the effectiveness of a culturally specific program using 'bouts' of PA to effect the changes in body fat, fat tissue inflammation and postpartum depression symptoms in sedentary Hispanic women. Using the guidelines from the National Benchmark Criteria, we developed intervention, recruitment and retention strategies that reflect efforts to draw on community values, traditions and customs in intervention design, through partnership with community members. Most of the women enrolled in Madres para la Salud were born in Mexico, largely never or unemployed and resided among the highest crime neighborhoods with poor access to resources. We developed recruitment and retention strategies that characterized social marketing strategies that employed a culturally relevant, consumer driven and problem-specific design. Cost and benefit of program participation, consumer-derived motivation and segmentation strategies considered the development transition of the young Latinas as well as cultural and neighborhood barriers that impacted retention are described.

Postprandial lipid responses to standard carbohydrates used to determine glycaemic index values.

Prior studies assessing the metabolic effects of different types of carbohydrates have focused on their glycaemic response. However, the response of postprandial cardiometabolic risk indicators has not been considered in these studies. The present study assessed postprandial lipid responses to two forms of carbohydrates used as reference foods for glycaemic index determinations, white bread (50 g available carbohydrate) and glucose (50 g), under controlled conditions and with intra-individual replicate determinations. A total of twenty adults (20­70 years) underwent two cycles of challenges with each pair of reference foods (four challenges/person), administered in a random order on separate days under standard conditions. Serum lipids (total cholesterol, LDL-cholesterol, HDL-cholesterol, TAG and NEFA), glucose and insulin were monitored for 5 h post-ingestion. Oral glucose resulted in greater glycaemic and insulinaemic responses than white bread for the first 90 min and a greater subsequent decline after 120 min (P =0·0001). The initial decline in serum NEFA concentrations was greater after the oral glucose than after the white bread challenge, as was the rebound after 150 min (P = 0·001). Nevertheless, the type of carbohydrate had no significant effect on postprandial total cholesterol, LDL-cholesterol and HDL-cholesterol concentrations. Following an initial modest rise in TAG concentrations in response to both challenges, the values dropped below the fasting values for oral glucose but not for the white bread challenge. These data suggest that the type of carbohydrate used to determine the glycaemic index, bread or glucose, has little or modest effects on postprandial plasma cholesterol concentrations. Differences in TAG and NEFA concentrations over the 5 h time period were modest, and their clinical relevance is unclear.

Adaptation process of a culturally congruent parenting intervention for parents of Hispanic adolescents to an online synchronous format.

Adaptations to interventions for specific settings or communities are critical for facilitating successful implementation. The Dynamic Adaptation Process model was applied to systematically assess the adaptation process made to an in-person parenting intervention (FPNG+) prior to its implementation online. This qualitative case study design included meeting notes and interviews completed with project team members. Meeting notes were analyzed using content analysis. Semi-structured interviews regarding project team members' roles on FPNG+ and processes and activities they identified as critical for the adaptation of FPNG+ to an online intervention were analyzed using a deductive-inductive approach. In the formative phase, three primary processes were identified: information gathering to determine if the environment existed for the implementation of an online program; considerations to support the facilitation process of FPNG+ to an online environment, and decision-making to support modifications to FPNG+. The pre-implementation phase consisted of three processes: information shared by the instructional designer to facilitate the delivery of the FPNG+ content online; modifications made to the format of the intervention to meet the cultural needs of Hispanic families and address contextual issues; and iterative efforts to tailor the intervention by the project team. This study used implementation science to distinguish the dynamic processes that occurred across different systems and multiple levels in the project team's effort to modify FPNG+ to an online intervention. The contribution of this study underscores the importance of identifying the processes that facilitate the modifications made to an intervention and the capacity to implement the modified intervention with Hispanic families.

Adaptations to interventions for specific settings or communities are critical for facilitating successful implementation. The Dynamic Adaptation Process model was used to systematically assess the adaptation process made to an in-person parenting intervention (FPNG+) prior to its implementation online. Using a qualitative case study design, meeting notes were analyzed using content analysis; and semi-structured interviews were analyzed using a deductive-inductive approach. In the formative phase, three processes were identified: information gathering to determine if the environment existed for the implementation of an online program; considerations to support the facilitation process of FPNG+ to an online environment, and decision-making to support modifications to FPNG+. The pre-implementation phase consisted of three processes: information shared by the instructional designer to facilitate the delivery of the FPNG+ content online; modifications made to the format of the intervention to meet the cultural needs of Hispanic families and address contextual issues; and iterative efforts to tailor the intervention by the project team. The contribution of this study underscores the importance of identifying the processes that facilitate the changes made to an intervention and the capacity to implement the modified intervention with Hispanic families.

Smart Walk: A Culturally Tailored Smartphone-Delivered Physical Activity Intervention for Cardiometabolic Risk Reduction among African American Women.

This article reports the results of Smart Walk: a randomized pilot trial of an 8-month culturally tailored, smartphone-delivered physical activity (PA) intervention for African American women with obesity. Sixty participants (age range = 24−49 years; BMI range = 30−58 kg/m2) were randomized to the Smart Walk intervention (n = 30) or a wellness comparison intervention (n = 30). Results supported the acceptability and feasibility of the intervention, as demonstrated by participant retention (85% at 4 months and 78% at 8 months), Smart Walk app use, and intervention satisfaction (i.e., 100% of PA participants completing the intervention [n = 24] reported they would recommend it to friend). Smart Walk participants also reported greater increases in moderate-to-vigorous PA (4-month between-arm difference in change [b] = 43.3 min/week; p = 0.018; Cohen's d = 0.69; 8-month b = 56.6 min/week; p = 0.046; d = 0.63) and demonstrated clinically relevant, although not statistically significant (p-values > 0.05), baseline to 4 months improvements in cardiorespiratory fitness (b = 1.67 mL/kg/min; d = 0.40), systolic blood pressure (b = −3.33 mmHg; d = 0.22), diastolic blood pressure (b = −4.28 mmHg; d = 0.37), and pulse wave velocity (b = −0.46 m/s; d = 0.33). Eight-month cardiometabolic outcomes followed similar trends, but had high rates of missing data (45−53%) due to COVID-19 restrictions. Collectively, findings demonstrated favorable outcomes for acceptability and feasibility, while also highlighting key areas for refinement in future research.

Diet Outcomes from a Randomized Controlled Trial Assessing a Parenting Intervention Simultaneously Targeting Healthy Eating and Substance Use Prevention among Hispanic Middle-School Adolescents.

Parents play a significant role in adolescent health behaviors; however, few nutrition interventions for Hispanic adolescents involve parents. This study assessed the effects of a 10-week parenting intervention simultaneously targeting nutrition and substance use prevention. Hispanic parent/6th-8th-grade adolescent dyads (n = 239) were randomized to Families Preparing the New Generation Plus (FPNG+; nutrition/substance use prevention), FPNG (substance use prevention only), or Realizing the American Dream (RAD; academic success control). Surveys assessed diet, alcohol use, substance use intentions, and substance use norms at baseline (T1), immediately post-intervention (T2), and at 16 weeks post-intervention (T3). Latent change modeling assessed diet changes; adolescent substance use outcomes were assessed using effect sizes. Among adolescents, those in FPNG+ increased fruit (+0.32 cup equivalents, p = 0.022) and fiber intake (+1.06 g, p = 0.048) and did not change added sugars intake at T2; those in FPNG and RAD reduced their intake of fruit and fiber (p < 0.05 for both). FPNG+ parents marginally increased fruit/vegetable intake (+0.17 cup equivalents, p = 0.054) and increased whole grains intake (+0.25-ounce equivalents, p < 0.05), in contrast to the reduction among RAD and FPNG parents (p < 0.05). Reductions in added sugar intake at T2 were greater among FPNG and FPNG+ parents relative to RAD parents (p < 0.05). FPNG+ and FPNG had comparable substance use outcomes (i.e., both had lower alcohol use and intentions to use substances relative to RAD). Engaging parents in a nutrition and substance use prevention parenting intervention yielded positive changes in dietary intake and maintained substance use prevention outcomes among their adolescent children.

Associations between parent-adolescent health-related conversations and mealtime media use among Hispanic families.

INTRODUCTION: Whereas parents play an important role in shaping the home environment, it is unknown whether health-related parent-adolescent conversations may be associated with different health-promoting parenting practices, such as limiting adolescent mealtime media use in Hispanic families. METHOD: For this cross-sectional analysis, Hispanic parents (n = 344; 40.4 ± 6.6 years; 89.2% female) of sixth- to eighth-grade adolescents self-reported the frequency of having health- or weight-related conversations with their adolescent child, and the frequency of adolescent mealtime media device use. Spearman's rank correlations were used to assess whether parent-adolescent health-related conversations are associated with mealtime media device use by adolescents. RESULTS: Over 75% of parents reported having conversations about healthy eating and being physically active at least a few times per week. Fewer parents reported having frequent weight-related conversations. Frequency of mealtime media use was low, except for television/movie watching (only 30% of parents reported their child rarely/never watching television during family meals). Having conversations related to the adolescent weighing too much was correlated with the mealtime use of television (r = .207; p < .001), cellphones (r = .134; p = .018), and headphones for music listening (r = .145; p = .010). Conversations about exercising to lose weight were correlated with television/movie watching during mealtimes (r = .129; p = .035). DISCUSSION: Findings suggest the co-occurrence of less health-promoting parenting behaviors, such as focusing on weight-related conversations and allowing the use of media devices during mealtimes. Focusing on health- rather than weight-related parent-adolescent conversations and implementing mealtime media use rules may have the potential to shape a home food environment which ultimately could improve an adolescent's overall health outcomes. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Inflammatory Mediators and Type 2 Diabetes Risk Factors before and in Response to Lifestyle Intervention among Latino Adolescents with Obesity.

Obesity is associated with chronic inflammation that may contribute to T2D among youth. We examined the association between inflammatory biomarkers and insulin sensitivity and ß-cell function and response to lifestyle intervention among Latino youth with obesity. Latino youth (n = 64) were randomized to six months of lifestyle intervention (INT, n = 40) or usual care (UC, n = 24). INT included nutrition education and physical activity. UC involved meeting with a pediatric endocrinologist and registered dietitian to discuss healthy lifestyles. At baseline, multiple linear regression assessed fasting serum interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), monocyte chemoattractant protein-1 (MCP-1), high-molecular weight adiponectin (HMW Adpn), IL-10, IL-1 receptor antagonist (IL-1ra) as predictors of insulin sensitivity (whole-body insulin sensitivity index, WBISI) and ß-cell function (oral disposition index, oDI). Changes in outcomes between groups were assessed using covariance pattern models. At baseline, MCP-1 (ß ± SE, -0.12 ± 0.05, p = 0.027) and IL-1ra (-0.03 ± 0.01, p = 0.005) were negatively associated with WBISI. Treatment effects were not observed for inflammatory markers. WBISI was significantly increased among both INT (from 1.8 ± 0.2 to 2.6 ± 0.4, p = 0.005) and UC (from 1.6 ± 0.2 to 2.8 ± 0.5, p = 0.002) with no significant differences between the groups. Obesity-related inflammatory mediators were associated with T2D risk factors but were unaffected by lifestyle intervention among Latino youth.

Qualitative Research on the Perceptions of Factors Influencing Diet and Eating Behaviors Among Primarily Latinx Seventh-Grade Students.

BACKGROUND: Latinx youth are a population of concern, at elevated risk for chronic diseases and with poor adherence to dietary recommendations. OBJECTIVES: To examine Latinx seventh-grade students' perceptions of the factors that influence their diet and eating behaviors. DESIGN: This qualitative research used focus groups and an inductive content analysis approach. PARTICIPANTS/SETTING: Five sex-stratified focus groups (three groups with females) with 35 primarily Latinx seventh-grade students were conducted at two local Title 1 public middle schools in a large metropolitan area of the Southwestern United States. MAIN OUTCOME MEASURES: The discussion protocol included questions about participants' food choices, the role of their parents in their diet, and healthy body-related concerns among their peers. ANALYSES: Verbatim transcripts were coded in NVivo 12 on the basis of specificity, extensiveness, and frequency. Themes emerged from group dialogue, detailed conversations, and predominant topics of discussion, and aligned with ecological systems theory. RESULTS: Participants referred to factors influencing Latinx seventh-grade students' eating behaviors at the individual, family, household, and school levels. At the individual level, participants described their eating as unhealthy and perceived it as determined by taste, convenience, ease of preparation, and home availability. Participants expressed concerns about diabetes because of their body weight and family history, and identified those concerns as reasons for acceptance of healthy foods and the desire for parents to model healthy eating behaviors. Family-level factors perceived as influencing dietary behaviors included the role of parents as providers of food and models of unhealthy eating, budget constraints, and availability (or lack thereof) of healthy foods at home. Similarly, the identified school-level factors aligned with availability and quality of foods in that environment. CONCLUSIONS: Family- and household-related factors emerged as important influences on seventh-grade students' dietary behaviors. Future diet interventions should incorporate strategies targeting these multiple-level factors that influence dietary intake for Latinx youth and that address the concerns related to disease risk.

Promotoras' roles in integrative validity and treatment fidelity efforts in randomized controlled trials.

Promotoras from the communities in which interventions are implemented can be effective contributors to validity and fidelity efforts. This article describes a 48-week randomized controlled trial Madres para la Salud (Mothers for Health) and illustrates the use of promotoras as collaborative members of the research team to contribute to attaining integrative validity and treatment fidelity. Madres para la Salud implements a culturally tailored physical activity program to effect changes in body fat, systemic and fat tissue inflammation, and depression symptoms. The significance of Madres para la Salud treatment validity and fidelity processes includes cultural tailoring of a social support intervention, and a promotora model to incorporate initial and ongoing fidelity monitoring.