The Society of Behavioral Medicine urges passage of the PLANT (Peas, Legumes, And Nuts Today) Act.

Current US diets negatively impact human health and the environment, while shifting toward increased intake of plant-based foods could mitigate these issues. Current food policies exacerbate these problems, necessitating a reevaluation and the implementation of new policies. The Society of Behavioral Medicine urges legislators to support the PLANT Act (H.R.5023), which would enhance production, research, and development of plant-based foods and address both health and environmental concerns.

Introduced to the House by Congressman James McGovern, the PLANT Act would expand opportunity for agricultural producers and would make it easier for consumers to afford and access plant-based foods.

Effect of mobile food environments on fast food visits.

Poor diets are a leading cause of morbidity and mortality. Exposure to low-quality food environments saturated with fast food outlets is hypothesized to negatively impact diet. However, food environment research has predominantly focused on static food environments around home neighborhoods and generated mixed findings. In this work, we leverage population-scale mobility data in the U.S. to examine 62M people's visits to food outlets and evaluate how food choice is influenced by the food environments people are exposed to as they move through their daily routines. We find that a 10% increase in exposure to fast food outlets in mobile environments increases individuals' odds of visitation by 20%. Using our results, we simulate multiple policy strategies for intervening on food environments to reduce fast-food outlet visits. This analysis suggests that optimal interventions are informed by spatial, temporal, and behavioral features and could have 2x to 4x larger effect than traditional interventions focused on home food environments.

Conceptualization and Assessment of 24-H Timing of Eating and Energy Intake: A Methodological Systematic Review of the Chronic Disease Literature.

Timing of eating (TOE) and energy intake (TOEI) has important implications for chronic disease risk beyond diet quality. The 2020 Dietary Guidelines Advisory Committee recommended developing consistent terminology to address the lack of TOE/TOEI standardization. The primary objective of this methodological systematic review was to characterize the conceptualization and assessment of TOE/TOEI within the chronic disease literature (International Prospective Register of Systematic Reviews registration number: CRD42021236621). Literature searches in Cumulative Index to Nursing and Allied Health Literature (CINAHL) Plus, Embase, PubMed, and Scopus were limited to English language publications from 2000 to August 2022. Eligible studies reported the association between TOE/TOEI and obesity, cardiovascular disease, type 2 diabetes mellitus, cancer, or a related clinical risk factor among adults (≥19 y) in observational and intervention studies. A qualitative synthesis described and compared TOE/TOEI conceptualization, definitions, and assessment methods across studies. Of the 7579 unique publications identified, 259 studies (observational [51.4 %], intervention [47.5 %], or both [1.2 %]) were eligible for inclusion. Key findings indicated that most studies (49.6 %) were conducted in the context of obesity and body weight. TOE/TOEI variables or assigned conditions conceptualized interrelated aspects of time and eating or energy intake in varying ways. Common TOE/TOEI conceptualizations included the following: 1) timepoint (specific time to represent when intake occurs, such as time of breakfast [74.8 %]); 2) duration (length of time or interval when intake does/does not occur, such as "eating window" [56.5 %]); 3) distribution (proportion of daily intake at a given time interval, such as "percentage of energy before noon" [29.8 %]); and 4) cluster (grouping individuals based on temporal ingestive characteristics [5.0 %]). Assessment, definition, and operationalization of 24-h TOE/TOEI variables varied widely across studies. Observational studies most often used surveys or questionnaires (28.9 %), whereas interventions used virtual or in-person meetings (23.8 %) to assess TOE/TOEI adherence. Overall, the diversity of terminology and methods solidifies the need for standardization to guide future research in chrononutrition and to facilitate inter-study comparisons.

Prioritize "Food is Medicine" initiatives in the 2024 Farm Bill for human and planetary health.

The Society of Behavioral Medicine (SBM) supports increased funding for policies in the 2024 Farm Bill that align with a Food is Medicine (FIM) framework and address multiple dimensions of human and planetary health.

The Society of Behavioral Medicine (SBM) supports funding for policies in 2024 Farm Bill that align with a Food is Medicine (FIM) framework and address multiple dimensions of human and planetary health. Recommendations include increasing funding for produce prescription programs, establishing systems to align federal- and state-funded initiatives, and the allocation of funding for financial incentives when sustainable agricultural practices are utilized in government-funded local and regional farm-to-institution programs.

Population mobility data provides meaningful indicators of fast food intake and diet-related diseases in diverse populations.

The characteristics of food environments people are exposed to, such as the density of fast food (FF) outlets, can impact their diet and risk for diet-related chronic disease. Previous studies examining the relationship between food environments and nutritional health have produced mixed findings, potentially due to the predominant focus on static food environments around people's homes. As smartphone ownership increases, large-scale data on human mobility (i.e., smartphone geolocations) represents a promising resource for studying dynamic food environments that people have access to and visit as they move throughout their day. This study investigates whether mobility data provides meaningful indicators of diet, measured as FF intake, and diet-related disease, evaluating its usefulness for food environment research. Using a mobility dataset consisting of 14.5 million visits to geolocated food outlets in Los Angeles County (LAC) across a representative sample of 243,644 anonymous and opted-in adult smartphone users in LAC, we construct measures of visits to FF outlets aggregated over users living in neighborhood. We find that the aggregated measures strongly and significantly correspond to self-reported FF intake, obesity, and diabetes in a diverse, representative sample of 8,036 LAC adults included in a population health survey carried out by the LAC Department of Public Health. Visits to FF outlets were a better predictor of individuals' obesity and diabetes than their self-reported FF intake, controlling for other known risks. These findings suggest mobility data represents a valid tool to study people's use of dynamic food environments and links to diet and health.

Advocacy efforts of the Society of Behavioral Medicine: a 6-year update.

Six years ago, we published a paper describing the Society of Behavioral Medicine's (SBM) health policy organizational leadership structure and policy initiatives. The purpose of the current paper is to provide an update on changes in the infrastructure and new policy initiatives that have been developed since 2017. We review each of the policy leadership arms of SBM including details of the work of each and goals for the future. The SBM engages in several health policy advocacy efforts through their Advocacy Council and Position Statements Committee. The Advocacy Council launched the Health Policy Ambassador Program in 2020. The Ambassador Program serves to train members to develop longer-term relationships with legislative staff around key policy priority areas. The Position Statements Committee is responsible for overseeing the development and dissemination of health policy position statements. Both groups work together and with partner organizations to increase the impact of our science. Over the last 6 years, developing a stronger infrastructure and implementing metrics for progress such as tracking social media engagement has helped to move SBM's policy agenda forward. The work of the policy-related leadership teams can serve as a model for other organizations who are interested in further developing their policy advocacy efforts.

The Society of Behavioral Medicine (SBM) engages in several health policy advocacy efforts through their Advocacy Council and Position Statements Committee. The Advocacy Council launch the Health Policy Ambassador Program in 2020. The Ambassador Program serves to train members to develop longer-term relationships with legislative staff around key policy priority areas. The Position Statements Committee is responsible for overseeing the development and dissemination of health policy position statements. Both groups work together and with partner organizations to increase the impact of our science. Over the last 6 years, developing a stronger infrastructure and implementing metrics for progress has helped to move SBM's policy agenda forward. The work of the policy-related leadership teams can serve as a model for other organizations who are interested in further developing their policy advocacy efforts.

Measurement of diets that are healthy, environmentally sustainable, affordable, and equitable: A scoping review of metrics, findings, and research gaps.

Introduction: Research on the impacts of dietary patterns on human and planetary health is a rapidly growing field. A wide range of metrics, datasets, and analytical techniques has been used to explore the role of dietary choices/constraints in driving greenhouse gas (GHG) emissions, environmental degradation, health and disease outcomes, and the affordability of food baskets. Many argue that each domain is important, but few have tackled all simultaneously in analyzing diet-outcome relationships. Methods: This paper reviews studies published between January 2015 and December 2021 (inclusive) that examined dietary patterns in relation to at least two of the following four thematic pillars: (i) planetary health, including, climate change, environmental quality, and natural resource impacts, (ii) human health and disease, (iii) economic outcomes, including diet cost/affordability, and (iv) social outcomes, e.g., wages, working conditions, and culturally relevant diets. We systematically screened 2,425 publications by title and abstract and included data from 42 eligible publications in this review. Results: Most dietary patterns used were statistically estimated or simulated rather than observed. A rising number of studies consider the cost/affordability of dietary scenarios in relation to optimized environmental and health outcomes. However, only six publications incorporate social sustainability outcomes, which represents an under-explored dimension of food system concerns. Discussion: This review suggests a need for (i) transparency and clarity in datasets used and analytical methods; (ii) explicit integration of indicators and metrics linking social and economic issues to the commonly assessed diet-climate-planetary ecology relationships; (iii) inclusion of data and researchers from low- and middle-income countries; (iv) inclusion of processed food products to reflect the reality of consumer choices globally; and (v) attention to the implications of findings for policymakers. Better understanding is urgently needed on dietary impacts on all relevant human and planetary domains simultaneously.

Nosotros mismos nos estamos matando/We are the ones killing ourselves: Unraveling individual and network characteristics associated with negative dietary acculturation among Mexican Americans in New York City.

BACKGROUND: Research on negative dietary acculturation among Mexican-Americans has mostly focused on individual-level processes and has largely ignored the role of social networks. METHODS: This mixed-method study used an egocentric network approach and derived 1620 personal ties of self-identified Mexican adults in New York. 24-hour dietary recalls were used to derive a total Healthy Eating Index (HEI) and subscores. The qualitative portion generated narratives around who helps or hinders their efforts to eat healthfully. RESULTS: At the individual level, age at which participants migrated to the U.S. was negatively associated with total HEI (ß = -0.39, p < .01). An annual income below $30,000 was positively associated with total HEI (ß = 0.25, p < .05) and with HEI fruit subscores (ß = 0.25, p < .05). Acculturative stress was negatively associated with HEI fruit (ß = -0.29, p < .05) and refined grain subscores (ß = -0.34, p < .01). At the network level, the proportion of network members who consumed traditional Latino diets was negatively associated with total HEI and HEI refined grains subscores (ß = -0.39, p < .001; and ß = -0.23, p < .05; respectively). In contrast, the proportion of alters who lived in another country was positively associated with HEI dairy subscores (ß = 0.25, p < .05). Juxtaposing qualitative participants' visual representation of their total HEI scores with their lay interpretations of healthy and unhealthy eating matched public health messages of reducing sugar, red meat intake, and processed foods. However, participants felt that this could only be achieved through restriction rather than balance. Qualitative narratives also elucidated how dietary acculturation and income could help shape dietary quality in unexpected ways. CONCLUSIONS: This study found evidence of negative dietary acculturation and showcases the complex ways in which both individual- and network-level processes help shape dietary choices for Mexican-Americans.

The climate crisis is here: a primer and call to action for public health nutrition researchers and practitioners in high-income countries.

Dietary behaviours and the food systems in which they occur have a significant impact on climate change. The 2022 Intergovernmental Panel on Climate Change (IPCC) reports and other major climate reports have identified population-level dietary shifts towards balanced, sustainable healthy diets as an important mitigation (i.e. prevention) solution for climate change. Thus, public health nutrition researchers and practitioners have a crucial role to play in combatting the climate crisis. They have the content expertise, interdisciplinary training and technical skills needed to facilitate wide-scale dietary behaviour changes at multiple levels of influence and ultimately improve both human and planetary health. This commentary article: (i) summarises how dietary behaviours and food systems contribute to climate change, with a particular focus on high-income countries; (ii) reviews food-system-related climate change mitigation solutions most relevant to public health nutrition researchers and practitioners; and (iii) identifies key gaps in the literature and future research directions for the field.

The mediating role of emotional eating in the relationship between perceived stress and dietary intake quality in Hispanic/Latino adolescents.

Obesity rates have steadily increased over the past three decades, and large racial/ethnic disparities in childhood obesity rates-specifically for Hispanic/Latino youth-highlight the major need for identifying and examining key mechanisms of obesogenic behaviors for this at-risk population. This study investigates the relationship between stress and dietary quality in Hispanic/Latino adolescents and seeks to determine the mediating role of emotional eating as a behavioral mechanism. Baseline data from 169 adolescents enrolled in the Imagine HEALTH trial were used to investigate these relationships. Perceived stress and emotional eating were assessed with age-validated questionnaires, and dietary quality was measured via 24-hour recall dietary assessments (later calculated as individual Healthy Eating Index-2015 scores). Nonparametric bootstrapping was used to test the primary hypothesis that emotional eating partially or fully mediates the relationship between perceived stress and dietary quality in this sample, and to test the significance of the mediating effect. Results indicate that emotional eating partially mediates the relationship between perceived stress and dietary quality. The total effect of perceived stress scores on dietary quality scores was -0.24 (p = .006); the direct effect of perceived stress scores on dietary quality scores (controlling for emotional eating scores) was -0.16 (p = .107), and the mediating (indirect) effect of emotional eating was -0.09 (p = .001). The proportion of mediation was 0.36 (36%) (p = .008). This study identifies an important mechanism of obesogenic behavior and can be used to inform future obesity prevention and intervention strategies tailored for the Hispanic/Latino adolescent population.

Society of Behavioral Medicine (SBM) position statement: provide funding for incentive programs to expand healthy food offerings in SNAP-authorized small food stores.

Individuals and families with limited access to healthy foods often experience increased risk for poor diet and chronic disease. Low-income communities are more likely to have a large number of small food stores (e.g., corner stores and dollar stores) compared to higher-income communities. Since many of these small food stores participate in the Supplemental Nutrition Assistance Program (SNAP), increasing healthy food offerings in these stores may expand healthy food retail in low-income communities. We recommend the provision of funding for incentive programs that encourage SNAP-authorized small food stores in low-income communities to expand their healthy food offerings. This programming should (a) provide seed grants to store owners to develop or reconfigure store infrastructure, (b) offer store owners technical assistance and educational materials on marketing strategies for promoting healthy food items to customers, and (c) give a tax break to SNAP-authorized small food stores in low-income communities that maintain a predetermined minimum stock of U.S. Department of Agriculture-recognized staple foods.

Automatic, wearable-based, in-field eating detection approaches for public health research: a scoping review.

Dietary intake, eating behaviors, and context are important in chronic disease development, yet our ability to accurately assess these in research settings can be limited by biased traditional self-reporting tools. Objective measurement tools, specifically, wearable sensors, present the opportunity to minimize the major limitations of self-reported eating measures by generating supplementary sensor data that can improve the validity of self-report data in naturalistic settings. This scoping review summarizes the current use of wearable devices/sensors that automatically detect eating-related activity in naturalistic research settings. Five databases were searched in December 2019, and 618 records were retrieved from the literature search. This scoping review included N = 40 studies (from 33 articles) that reported on one or more wearable sensors used to automatically detect eating activity in the field. The majority of studies (N = 26, 65%) used multi-sensor systems (incorporating > 1 wearable sensors), and accelerometers were the most commonly utilized sensor (N = 25, 62.5%). All studies (N = 40, 100.0%) used either self-report or objective ground-truth methods to validate the inferred eating activity detected by the sensor(s). The most frequently reported evaluation metrics were Accuracy (N = 12) and F1-score (N = 10). This scoping review highlights the current state of wearable sensors' ability to improve upon traditional eating assessment methods by passively detecting eating activity in naturalistic settings, over long periods of time, and with minimal user interaction. A key challenge in this field, wide variation in eating outcome measures and evaluation metrics, demonstrates the need for the development of a standardized form of comparability among sensors/multi-sensor systems and multidisciplinary collaboration.

The role of maternal social networks on the outcomes of a home-based childhood obesity prevention pilot intervention.

BACKGROUND: Despite evidence that obesity and related behaviors are influenced by social networks and social systems, few childhood obesity initiatives have focused on social network factors as moderators of intervention outcomes, or targets for intervention strategies. OBJECTIVES: This pilot study examines associations between maternal social network characteristics hypothesized to influence health behaviors, and the target outcomes of a family-centered childhood obesity prevention initiative. The pilot intervention entailed the provision of healthy eating and activity components as part of an existing home visiting program (HVP) delivered to mothers and infants, to test the feasibility of this approach for improving mother diet, physical activity, and weight status; and infant diet and weight trajectory. METHODS: Mothers and their infants (N=50 dyads) receiving services from our HVP partner were recruited and randomized to receive the HVP core curriculum with or without a nutrition and physical activity enhancement module for six months. Assessments of mothers' social network characteristics, mother/infant food intake and mother physical activity, and mothers' postpartum weight retention and children's growth velocity were conducted at baseline and post-intervention. RESULTS: Several features of mothers' social networks, including the receipt of health-related social support, were significantly associated with the focal intervention outcomes (p < .05) at follow-up, controlling for study condition. CONCLUSIONS: Integrating childhood obesity prevention into HVPs appears promising. Future family-based interventions to prevent childhood obesity may be enhanced by including social network intervention strategies. For example, by addressing family network characteristics that impede healthy behavior change, or enhancing networks by fostering social support for healthy behavior and weight change.

Sensing eating mimicry among family members.

Family relationships influence eating behavior and health outcomes (e.g., obesity). Because eating is often habitual (i.e., automatically driven by external cues), unconscious behavioral mimicry may be a key interpersonal influence mechanism for eating within families. This pilot study extends existing literature on eating mimicry by examining whether multiple family members mimicked each other's bites during natural meals. Thirty-three participants from 10 families were videotaped while eating an unstructured family meal in a kitchen lab setting. Videotapes were coded for participants' bite occurrences and times. We tested whether the likelihood of a participant taking a bite increased when s/he was externally cued by a family eating partner who had recently taken a bite (i.e., bite mimicry). A paired-sample t-test indicated that participants had a significantly faster eating rate within the 5 s following a bite by their eating partner, compared to their bite rate at other times (t = 7.32, p < .0001). Nonparametric permutation testing identified five of 78 dyads in which there was significant evidence of eating mimicry; and 19 of 78 dyads that had p values < .1. This pilot study provides preliminary evidence that suggests eating mimicry may occur among a subset of family members, and that there may be types of family ties more prone to this type of interpersonal influence during meals.

Society of Behavioral Medicine position statement: increase funding for fruits and vegetables production in The Farm Bill reauthorization.

The Society of Behavioral Medicine (SBM) recommends that Congress increase funding for fruit and vegetable production and intake in The Farm Bill reauthorization. Analysis of the U.S. Department of Agriculture's databases indicates that the availability of fruits and vegetables in the food supply is at half or less than half of what is needed to meet federal dietary recommendations for Americans. Based on the extant literature, SBM supports including funding allocations for fruit and vegetable production, including fruits and vegetables in commodity programs, providing additional insurance subsidies for producing fruits and vegetables, and maintaining or increasing funding for initiatives that promote fruit and vegetable intake. To avoid some of the unintended consequences of increasing support for fruit and vegetable production, new insurance products should be developed in collaboration with groups representing fruit and vegetable producers.

Advances and Controversies in Diet and Physical Activity Measurement in Youth.

Technological advancements in the past decades have improved dietary intake and physical activity measurements. This report reviews current developments in dietary intake and physical activity assessment in youth. Dietary intake assessment has relied predominantly on self-report or image-based methods to measure key aspects of dietary intake (e.g., food types, portion size, eating occasion), which are prone to notable methodologic (e.g., recall bias) and logistic (e.g., participant and researcher burden) challenges. Although there have been improvements in automatic eating detection, artificial intelligence, and sensor-based technologies, participant input is often needed to verify food categories and portions. Current physical activity assessment methods, including self-report, direct observation, and wearable devices, provide researchers with reliable estimations for energy expenditure and bodily movement. Recent developments in algorithms that incorporate signals from multiple sensors and technology-augmented self-reporting methods have shown preliminary efficacy in measuring specific types of activity patterns and relevant contextual information. However, challenges in detecting resistance (e.g., in resistance training, weight lifting), prolonged physical activity monitoring, and algorithm (non)equivalence remain to be addressed. In summary, although dietary intake assessment methods have yet to achieve the same validity and reliability as physical activity measurement, recent developments in wearable technologies in both arenas have the potential to improve current assessment methods. THEME INFORMATION: This article is part of a theme issue entitled Innovative Tools for Assessing Diet and Physical Activity for Health Promotion, which is sponsored by the North American branch of the International Life Sciences Institute.

Virtual Sprouts: A Virtual Gardening Pilot Intervention Increases Self-Efficacy to Cook and Eat Fruits and Vegetables in Minority Youth.

OBJECTIVE: To examine the effect of the Virtual Sprouts intervention, an interactive multiplatform mobile gardening game, on dietary intake and psychosocial determinants of dietary behavior in minority youth. MATERIALS AND METHODS: In this quasi-experimental pilot intervention, 180 third-, fourth-, and fifth-grade students in Los Angeles Unified School District participated in a 3-week program that included three Virtual Sprouts gaming sessions, three in-school lessons, and three in-home activities, using a nutrition- and gardening-focused curriculum. Pre- and postintervention questionnaires were used to assess psychosocial determinants of dietary behavior, including knowledge about and self-efficacy to eat fruits and vegetables (FV). Data were collected on FV, whole grains, fiber, total sugar, added sugar, and energy from sugary beverages through the Block Kids Food Screener ("last week" version) for Ages 2-17. Repeated measures analysis of covariance models was used for continuous outcomes, controlling for age, sex, ethnicity, school, and free school lunch. RESULTS: After the intervention, the intervention group (n = 116) compared with the control group (n = 64) had a significantly improved self-efficacy to eat FV score (+1.6% vs. -10.3%, P = 0.01), and an improved self-efficacy to cook FV score (+2.9% vs. -5.0%, P = 0.05). There were no significant differences in dietary intake or self-efficacy to garden scores between intervention and control groups. CONCLUSION: The results from this 3-week pilot study suggest that an interactive mobile game with a nutrition- and gardening-focused curriculum can improve psychosocial determinants of dietary behavior in minority youth.