Dietary fats and the APOE-e4 risk allele in relation to cognitive decline: a longitudinal investigation in a biracial population sample.

BACKGROUND: APOE-e4 is the strongest genetic risk factor for Alzheimer's disease. However, the influence of APOE-e4 on dietary fat intake and cognition has not been investigated. OBJECTIVE: We aim to examine the association of types of dietary fat and their association to cognitive decline among those with and without the APOE-e4 allele. METHODS: The study included 3,360 Chicago Health and Aging Project (CHAP) participants from four Southside Chicago communities. Global cognition was assessed using a composite score of episodic memory, perceptual speed, MMSE, and diet using a 144-item food frequency questionnaire. APOE genotype was assessed by the hME Sequenom mass-array platform. Longitudinal mixed-effect regression models were used to examine the association of dietary fat and the APOE-e4 allele with cognitive decline, adjusted for age, sex, education, smoking status, and calorie intake. RESULTS: The present study involved 3,360 participants with a mean age of 74 at baseline, 62% African Americans, 63% females, and a mean follow-up of 7.8 years. Among participants with the APOE-e4 risk allele, higher intakes of total and saturated fat (SFA) were associated with a faster decline in global cognition. Among individuals with the APOE-e4 risk allele, a 5% increase in calories from SFA was associated with a 21% faster decline (ß = -0.0197, P = 0.0038). In contrast, a higher intake of long-chain n-3 polyunsaturated fatty acids (LC-n3 PUFA) was associated with a slower rate of decline in global cognition among APOE-e4 carriers. Specifically, for every 1% energy increment from LC-n3 PUFA, the annual rate of global cognitive decline was slower by 0.024 standardized unit (SD 0.010, P = 0.023), about 30.4% slower annual cognitive decline. Higher SFA or other types of dietary fat were not associated with cognitive decline among APOE-e4 non-carriers. CONCLUSIONS: Our study found a significant association between SFA and faster cognitive decline, LC-n3 PUFA and slower cognitive decline among those with the APOE-e4 allele. Our findings suggested that higher intake of SFA might contribute faster cognitive decline in combination with APOE-e4 whereas LC-n3 PUFA might compensate the adverse effects of APOE-e4. The interaction between intakes of different types of dietary fat and APOE-e4 on cognitive function warrants further research.

Study design and methods: U.S. study to protect brain health through lifestyle intervention to reduce risk (U.S. POINTER).

INTRODUCTION: The U.S. study to protect brain health through lifestyle intervention to reduce risk (U.S. POINTER) is conducted to confirm and expand the results of the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) in Americans. METHODS: U.S. POINTER was planned as a 2-year randomized controlled trial of two lifestyle interventions in 2000 older adults at risk for dementia due to well-established factors. The primary outcome is a global cognition composite that permits harmonization with FINGER. RESULTS: U.S. POINTER is centrally coordinated and conducted at five clinical sites (ClinicalTrials.gov: NCT03688126). Outcomes assessments are completed at baseline and every 6 months. Both interventions focus on exercise, diet, cognitive/social stimulation, and cardiovascular health, but differ in intensity and accountability. The study partners with a worldwide network of similar trials for harmonization of methods and data sharing. DISCUSSION: U.S. POINTER is testing a potentially sustainable intervention to support brain health and Alzheimer's prevention for Americans. Impact is strengthened by the targeted participant diversity and expanded scientific scope through ancillary studies.

Cognitive performance in relation to MIND and MEPA III dietary pattern accordance of NHANES participants.

BACKGROUND: There is growing evidence that Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) and Mediterranean-like diets are associated with better cognitive performance. METHODS: In this cross-sectional sample from two NHANES cycles (2011-2014), scores for the MIND dietary pattern (maximum score = 14) and for the Mediterranean Eating Pattern for Americans (MEPA) III (maximum score = 22) were calculated based on the reported foods consumed on two nonconsecutive 24-h dietary recalls. Only adults with two completed recalls and cognitive testing were studied (n = 2598). Cognitive assessments included the word learning and recall components from the Consortium to Establish a Registry for Alzheimer's Disease (CERAD), Animal Fluency test (AFT) and Digit Symbol Substitution Test. RESULTS: The ages of participants were (mean ± SD) 69.2 ± 0.3 years, with almost equal proportions of men and women. MIND score was 5.0 ± 0.0, and MEPA III score was 8.6 ± 2.1. Positive associations between continuous MIND scores and education-dependent standardised cognitive scores for each test and global cognition were observed, unadjusted or adjusted for covariates; no such associations were observed for MEPA III. Compared to adults in the lowest MIND tertile, those in the highest were less likely to exhibit low cognitive performance on the AFT [0.45 (0.29-0.69)], CERAD Delayed Recall [0.52 (0.32-0.83)] and global cognition [0.50 (0.27-0.94)]. Similar observations were noted with MEPA III with AFT [0.58 (0.43-0.79)] and CERAD Delayed Recall [0.66 (0.46-0.94)]. CONCLUSIONS: Older Americans were generally non-accordant to MIND and MEPA III patterns. However, those who reported greater MIND or MEPA III diet accordance exhibited better cognitive performance.

Association of Whole Grain Consumption and Cognitive Decline: An Investigation From a Community-Based Biracial Cohort of Older Adults.

BACKGROUND AND OBJECTIVES: To examine the association of whole grain consumption and longitudinal change in global cognition, perceptual speed, and episodic memory by different race/ethnicity. METHODS: We included 3,326 participants from the Chicago Health and Aging Project who responded to a Food Frequency Questionnaire (FFQ), with 2 or more cognitive assessments. Global cognition was assessed using a composite score of episodic memory, perceptual speed, and the Mini Mental State Examination (MMSE). Diet was assessed by a 144-item FFQ. Linear mixed-effects models were used to estimate the association of intakes of whole grains and cognitive decline. RESULTS: This study involved 3,326 participants (60.1% African American [AA], 63.7% female) with a mean age of 75 years at baseline and a mean follow-up of 6.1 years. Higher consumption of whole grains was associated with a slower rate of global cognitive decline. Among AA participants, those in the highest quintile of whole grain consumption had a slower rate of decline in global cognition (ß = 0.024, 95% CI [0.008-0.039], p = 0.004), perceptual speed (ß = 0.023, 95% CI [0.007-0.040], p = 0.005), and episodic memory (ß = 0.028, 95% CI [0.005-0.050], p = 0.01) compared with those on the lowest quintile. Regarding the amount consumed, in AA participants, those who consumed >3 servings/d vs those who consumed <1 serving/d had a slower rate of decline in global cognition (ß = 0.021, 95% CI [0.005-0.036], p = 0.0093). In White participants, with >3 servings/d, we found a suggestive association of whole grains with global cognitive decline when compared with those who consumed <1 serving/d (ß = 0.025, 95% CI [-0.003 to 0.053], p = 0.08). DISCUSSION: Among AA participants, individuals with higher consumption of whole grains and more frequent consumption of whole grain had slower decline in global cognition, perceptual speed, and episodic memory. We did not see a similar trend in White adults.

Trial of the MIND Diet for Prevention of Cognitive Decline in Older Persons.

BACKGROUND: Findings from observational studies suggest that dietary patterns may offer protective benefits against cognitive decline, but data from clinical trials are limited. The Mediterranean-DASH Intervention for Neurodegenerative Delay, known as the MIND diet, is a hybrid of the Mediterranean diet and the DASH (Dietary Approaches to Stop Hypertension) diet, with modifications to include foods that have been putatively associated with a decreased risk of dementia. METHODS: We performed a two-site, randomized, controlled trial involving older adults without cognitive impairment but with a family history of dementia, a body-mass index (the weight in kilograms divided by the square of the height in meters) greater than 25, and a suboptimal diet, as determined by means of a 14-item questionnaire, to test the cognitive effects of the MIND diet with mild caloric restriction as compared with a control diet with mild caloric restriction. We assigned the participants in a 1:1 ratio to follow the intervention or the control diet for 3 years. All the participants received counseling regarding adherence to their assigned diet plus support to promote weight loss. The primary end point was the change from baseline in a global cognition score and four cognitive domain scores, all of which were derived from a 12-test battery. The raw scores from each test were converted to z scores, which were averaged across all tests to create the global cognition score and across component tests to create the four domain scores; higher scores indicate better cognitive performance. The secondary outcome was the change from baseline in magnetic resonance imaging (MRI)-derived measures of brain characteristics in a nonrandom sample of participants. RESULTS: A total of 1929 persons underwent screening, and 604 were enrolled; 301 were assigned to the MIND-diet group and 303 to the control-diet group. The trial was completed by 93.4% of the participants. From baseline to year 3, improvements in global cognition scores were observed in both groups, with increases of 0.205 standardized units in the MIND-diet group and 0.170 standardized units in the control-diet group (mean difference, 0.035 standardized units; 95% confidence interval, -0.022 to 0.092; P = 0.23). Changes in white-matter hyperintensities, hippocampal volumes, and total gray- and white-matter volumes on MRI were similar in the two groups. CONCLUSIONS: Among cognitively unimpaired participants with a family history of dementia, changes in cognition and brain MRI outcomes from baseline to year 3 did not differ significantly between those who followed the MIND diet and those who followed the control diet with mild caloric restriction. (Funded by the National Institute on Aging; ClinicalTrials.gov number, NCT02817074.).

A healthy plant-based diet was associated with slower cognitive decline in African American older adults: a biracial community-based cohort.

BACKGROUND: African American (AA) adults have about twice the risk of developing dementia compared with white adults. However, evidence on dietary modification in preventing cognitive decline from diverse populations focusing on AA adults is minimal. OBJECTIVES: We aimed to evaluate the association between a plant-based diet and the rate of cognitive decline in a population-based sample of AA and white adults. METHODS: This study consisted of 3337 participants from the Chicago Health and Aging Project (60% AA participants, 64% female). Plant-based diet quality was evaluated by the overall plant-based diet index (PDI), the healthful PDI (hPDI), and the unhealthful PDI (uPDI). Global cognition was assessed using a composite score of 4 individual tests of cognition. We used mixed models to examine the associations of PDI, hPDI, and uPDI with the rates of decline in global cognition, perceptual speed, and episodic memory. Models were adjusted for age, sex, presence of apoE e4 allele, lifestyle factors including education, cognitive activities, smoking status, calorie intake, risk factors for cardiovascular disease, time, and the interaction terms of time × each covariate. RESULTS: AA and white participants had various dietary patterns. Higher hPDI was associated with a slower rate of decline in global cognition, perceptual speed, and episodic memory in AA participants but not white participants. AA study participants in the highest quintile of hPDI had significantly slower rates of global cognitive decline (ß: 0.0183 ± 0.0086; P = 0.032), perceptual speed (ß: 0.0179 ± 0.0088; P = 0.04), and episodic memory (ß: 0.0163 ± 0.0118; P = 0.04) than individuals in the lowest quintile of hPDI. There were no associations of either PDI or uPDI with the rate of cognitive decline in either racial group. CONCLUSIONS: A healthy plant-based diet was associated with a slower rate of decline in global cognition, perceptual speed, and episodic memory in AA adults.

Alcohol Consumption and Cardiovascular Health.

BACKGROUND: Studies evaluating alcohol consumption and cardiovascular diseases have shown inconsistent results. METHODS: We performed a systematic review of peer-reviewed publications from an extensive query of Ovid MEDLINE, Ovid Embase, Ovid Cochrane Database of Systematic Reviews, Scopus, and Web of Science from database inception to March 2022 for all studies that reported the association between alcohol consumption in terms of quantity (daily or weekly amounts) and type of beverage (wine, beer or spirit) and cardiovascular disease events. RESULTS: The study population included a total of 1,579,435 individuals based on 56 cohorts from several countries. We found that moderate wine consumption defined as 1-4 drinks per week was associated with a reduction in risk for cardiovascular mortality when compared with beer or spirits. However, higher risk for cardiovascular disease mortality was typically seen with heavier daily or weekly alcohol consumption across all types of beverages. CONCLUSIONS: It is possible that the observational studies may overestimate the benefits of alcohol for cardiovascular disease outcomes. Although moderate wine consumption is probably associated with low cardiovascular disease events, there are many confounding factors, in particular, lifestyle, genetic, and socioeconomic associations with wine drinking, which likely explain much of the association with wine and reduced cardiovascular disease events. Further prospective study of alcohol and all-cause mortality, including cancer, is needed.

Development and Feasibility of an Obesity Prevention Intervention for Black Adolescent Daughters and Their Mothers.

Black female adolescents and women have disproportionately higher rates of obesity than their racial/ethnic counterparts. There is an urgent need to address obesity prevention in Black adolescent females through interventions that enhance lifestyle physical activity and improve dietary behaviors. Middle adolescence presents an important opportunity to strengthen the daughter-mother bond and improve healthy behaviors such as physical activity and dietary intake. Because of the intersection of adolescent development, culture and structural racism, it is essential to include mothers; however, this approach is understudied in the literature. This pre-pilot proof of concept study, Black Girls Move, was conducted using a 12-week pre-post within-subjects design to assess feasibility of conducting and delivering the BGM intervention, program satisfaction, and ability to obtain outcome measures in Black ninth and tenth grade daughters and their mothers. Twenty-two dyads were recruited and 14 dyads completed baseline assessments; however, only eight daughters and their mothers attended the first session and remained for the entire study. All dyads had valid objective and self-reported physical activity data. However, two of eight daughters and one mother provided self-reported dietary data that were considered invalid. All individual sessions were rated highly. Excellent attendance, retention, and satisfaction among participants suggest that we succeeded in developing an accepted, culturally relevant intervention. This lifestyle intervention would be strengthened by modifications to recruitment and retention, as well as incorporation of a computerized dietary assessment tool, a tailored dietary app for self-monitoring, and increased photo-based and group homework activities.

Dietary quality differs among cannabis use groups: data from the National Health and Nutrition Examination Survey 2005-16.

OBJECTIVE: To describe diet quality (Healthy Eating Index 2010 (HEI-2010) and Healthy Eating Index 2015 (HEI-2015)) according to self-reported cannabis use among the National Health and Nutrition Examination Survey (NHANES) adult participants. DESIGN: Utilizing cross-sectional data, we assessed diet quality with up to two 24-h diet recalls from NHANES participants. Usual intakes were estimated via the multivariate Markov Chain-Monte Carlo method. Diet quality scores were compared among never users, previous users and current users of cannabis. SETTING: NHANES surveys from 2005 to 2016. PARTICIPANTS: Adult NHANES participants (17 855) aged 20-59 years with valid data for dietary recalls and drug use questionnaires. RESULTS: Current adult cannabis users (ages 20-59 years) had significantly lower total diet quality (HEI-2010) scores (51·8 ± 0·7) compared with previous (56·2 ± 0·4) and never users (57·7 ± 0·4). Similar differences in total and individual HEI-2015 scores were observed. For the HEI-2015 scores, cannabis users had a significantly higher (better) sodium scores (4·1 ± 0·2) compared with never users (3·3 ± 0·1) and previous users (3·2 ± 0·1). Cannabis users scored lower compared with never users on total vegetables (3·1 ± 0·1 v. 3·7 ± 0·0), total fruit (2·1 ± 0·1 v. 3·0 ± 0·1) and whole fruit (2·2 ± 0·1 v. 3·3 ± 0·1) for the HEI-2015 index. CONCLUSIONS: Current cannabis users' usual intakes reflect lower diet quality compared with never or previous users, particularly lower subcomponent scores of total vegetables, greens and beans, total fruit and whole fruit. Cannabis users should increase their intake of fruit and vegetables to improve overall diet quality.

A Small-Changes Weight Loss Programfor African-American Church Members.

OBJECTIVE: To test whether a previously tested, small-changes weight loss program could be translated for use in African American churches. METHODS: The program consisted of 12 group sessions held weekly at a partner church. Key intervention messages were disseminated via Facebook. A single-arm pretest-posttest evaluation included assessments at baseline, program completion (3-month), and after three months with no contact (6-month). RESULTS: Participants (N = 17; 16 women, age 57.5±12.1 years, body mass index 36.5 kg/m2±5.4, hemoglobin A1c 6.3±0.5, blood pressure 132±14/82±7) attended an average of 77% (mdn=9) of treatment sessions and 94% and 100% completed the 3- and 6-month assessment visits. All participants reported they were "somewhat" or "very satisfied" with the program. There was minimal interaction with Facebook with an average of 0.5 comments and 3.9 reactions per post. Three- and six-month reductions (all p's≤.01) were observed for weight (mdn=-2.7 kg; mdn=-2.6 kg), waist circumference (mdn=-3.8cm; mdn=-5.1cm), and hemoglobin A1c (mdn=-0.5; mdn=-0.3). At 3-months, there were significant reductions in systolic (mdn=-10.7 mmHg) and diastolic blood pressure (mdn=-8.0) but not at 6 months. CONCLUSIONS: This study suggests that a faith-based, faith-placed intervention utilizing a small-changes approach in African American churches may achieve sustained weight loss in parishioners with obesity.

MIND food and speed of processing training in older adults with low education, the MINDSpeed Alzheimer's disease prevention pilot trial.

BACKGROUND: Multiple national organizations and leaders have called for increased attention to dementia prevention in those most vulnerable, for example persons with limited formal education. Prevention recommendations have included calls for multicomponent interventions that have the potential to improve both underlying neurobiological health and the ability to function despite neurobiological pathology, or what has been termed cognitive reserve. OBJECTIVES: Test feasibility, treatment modifier, mechanism, and cognitive function effects of a multicomponent intervention consisting of foods high in polyphenols (i.e., MIND foods) to target neurobiological health, and speed of processing training to enhance cognitive reserve. We refer to this multicomponent intervention as MINDSpeed. DESIGN: MINDSpeed is being evaluated in a 2 × 2 randomized factorial design with 180 participants residing independently in a large Midwestern city. Qualifying participants are 60 years of age or older with no evidence of dementia, and who have completed 12 years or less of education. All participants receive a study-issued iPad to access the custom study application that enables participants, depending on randomization, to select either control or MIND food, and to play online cognitive games, either speed of processing or control games. METHODS: All participants complete informed consent and baseline assessment, including urine and blood samples. Additionally, up to 90 participants will complete neuroimaging. Assessments are repeated immediately following 12 weeks of active intervention, and at 24 weeks post-randomization. The primary outcome is an executive cognitive composite score. Secondary outcomes include oxidative stress, pro-inflammatory cytokines, and neuroimaging-captured structural and functional metrics of the hippocampus and cortical brain regions. SUMMARY: MINDSpeed is the first study to evaluate the multicomponent intervention of high polyphenol intake and speed of processing training. It is also one of the first dementia prevention trials to target older adults with low education. The results of the study will guide future dementia prevention efforts and trials in high risk populations.

Delay discounting and household food purchasing decisions: The SHoPPER study.

OBJECTIVE: Delay discounting is a neurocognitive trait that has been linked to poor nutritional health and obesity, but its role in specific dietary choices is unclear. This study tested whether individual differences in delay discounting are related to the healthfulness of household food purchases and reliance on nonstore food sources such as restaurants. METHOD: The food purchases of 202 primary household food shoppers were objectively documented for 14 days through a food receipt collection and analysis protocol. The nutrient content of household food purchases was derived for each participant, and the overall diet quality (Healthy Eating Index-2015) and energy density (kcal/g) of foods and beverages were calculated. The proportion of energy from nonstore food sources was also derived. Delay discounting was assessed with a choice task featuring hypothetical monetary rewards. RESULTS: Data were available for 12,624 foods and beverages purchased across 2,340 shopping episodes. Approximately 13% of energy was purchased from restaurants and other nonstore food sources. Steeper discounting rates were associated with lower overall Healthy Eating Index-2015 scores and a higher energy density (kcal/g) of purchased foods. Associations were attenuated but remained statistically significant when accounting for body mass index and sociodemographic variables. Discounting rates were unrelated to reliance on nonstore food sources or the energy density of purchased beverages. CONCLUSIONS: Delay discounting is related to the healthfulness of food purchases among primary household shoppers. As food purchasing is a key antecedent of dietary intake, delay discounting may be a viable target in dietary and weight management interventions. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Nutrition quality of food purchases varies by household income: the SHoPPER study.

BACKGROUND: Lower household income has been consistently associated with poorer diet quality. Household food purchases may be an important intervention target to improve diet quality among low income populations. Associations between household income and the diet quality of household food purchases were examined. METHODS: Food purchase receipt data were collected for 14 days from 202 urban households participating in a study about food shopping. Purchase data were analyzed using NDS-R software and scored using the Healthy Eating Index 2010 (HEI 2010). HEI total and subscores, and proportion of grocery dollars spent on food categories (e.g. fruits, vegetables, sugar sweetened beverages) were examined by household income-to-poverty ratio. RESULTS: Compared to lower income households, after adjusting for education, marital status and race, higher income households had significantly higher HEI total scores (mean [sd] = 68.2 [13.3] versus 51.6 [13.9], respectively, adjusted p = 0.05), higher total vegetable scores (mean [sd] = 3.6 [1.4] versus 2.3 [1.6], respectively, adjusted p < .01), higher dairy scores (mean [sd] = 5.6 [3.0] versus 5.0 [3.3], p = .05) and lower proportion of grocery dollars spent on frozen desserts (1% [.02] versus 3% [.07], respectively, p = .02). CONCLUSIONS: Lower income households purchase less healthful foods compared with higher income households. Food purchasing patterns may mediate income differences in dietary intake quality. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT02073643.

Evaluation of a Brief Sodium Screener in Two Samples.

The Sodium Screener© (SS©), as developed by NutritionQuest (Berkeley, CA, USA), was designed to reduce the burden of repeated dietary or urinary sodium measurements, but the accuracy of daily sodium intake estimates has not been reported. Associations were examined between sodium intakes derived from the SS© scores and repeated 24-h recalls (24DR) in two studies with different administration modes. In one study, 102 registered dietitians (RD) completed three Automated Self-Administered 24DRs (ASA24©), version 2014, followed by the SS©; both were self-administered and web-based. In the second sample, (the Study of Household Purchasing Patterns, Eating, and Recreation or SHoPPER), trained dietitians conducted 24DR interviews with 69 community-dwelling adults in their homes; all the community adults then completed a paper-based SS© at the final visit. In the RD study, SS© -predicted sodium intakes were 2604 ± 990 (mean ± Standard deviation (SD)), and ASA24© sodium intakes were 3193 ± 907 mg/day. In the SHoPPER sample, corresponding values were 3338 ± 1310 mg/day and 2939 ± 1231 mg/day, respectively. SS©-predicted and recall sodium estimates were correlated in the RD study (r = 0.381, p = 0.0001) and in the SHoPPER (r = 0.430, p = 0.0002). Agreement between the SS© and 24-h recalls was poor when classifying individuals as meeting the dietary sodium guidelines of 2300 mg/day or not (RD study: kappa = 0.080, p = 0.32; SHoPPER: kappa = 0.207, p = 0.08). Based on repeated 24DR either in person or self-reported online as the criterion for estimating daily sodium intakes, the SS© may require additional modifications.

Gender Comparison of the Diet Quality and Sources of Food Purchases Made by Urban Primary Household Food Purchasers.

OBJECTIVE: To compare food purchasing behaviors and diet quality of foods purchased between men and women who were the primary food purchaser for their households. METHODS: Food purchasing was measured via itemized receipts. The dietary composition of purchased foods was derived using the Nutrition Data System for Research and quality was assessed using the Healthy Eating Index-2010. RESULTS: Men comprised 17.2% of the household primary food purchasers in the sample (n = 204). There were no differences by gender in the number of items purchased or the number of receipts. Men made fewer purchases at stores (74.0%) than did women (81.4%; P < .001). There were no gender differences in the quality of foods purchased overall or by source of purchase. CONCLUSIONS AND IMPLICATIONS: In primary purchasers, purchasing behaviors varied by gender but not purchases did not. Food purchasing interventions should include both genders for greatest impact.

Demographic Correlates of Infant Feeding Practices and Growth Performance in the First Year of Life.

The aims of this study are (1) to assess changes in infant WHO growth indicators (weight-for-age, weight-for-length, and head circumference z-scores) from birth to 12 months of age as a function of feeding practices (FP) and (2) to describe the proportion of infants experiencing rapid weight gain (RWG; defined as change in weight-for-age z-score of ≥0.67 between birth and six months) among different FP. The modified Infant Feeding Practices Study II questionnaire was administered to 149 diverse caretakers/mothers of infants who were less than six months of age in a pediatric outpatient clinic. Growth as a function of FP was assessed using repeated measures ANOVA, while logistic regression was used to describe the correlates of RWG. The largest proportion of caretakers was African American (37%), 46% completed college, and 48% were enrolled in the Women, Infants, and Children (WIC) program. Regarding FP, 32% of infants were formula fed, and 18% were breastfed, with the remaining being either mixed fed or complementary fed, with nearly 40% of infants demonstrating RWG. While changes in weight-for-age z-scores differed among FP across time (p<0.05), observed patterns for head-circumference-for-age and weight-for-length z-scores did not. Various demographic correlates (caretaker race-ethnicity, education, and WIC enrollment) were associated with FP. Only the patterns of change in weight-for-age z-scores at 9 and 12 months differed among FP (with breastfeeding being the lowest at both time points). Further study is needed to adequately characterize the correlates of infant growth performance and growth patterns among different FP in such diverse samples. Continued research will allow for the development of an easy-to-use, succinct questionnaire that will allow healthcare providers to individualize feeding recommendations for caretakers of infants.

Effects of green tea on miRNA and microbiome of oral epithelium.

Consumption of green tea (GT) extracts or purified catechins has shown the ability to prevent oral and other cancers and inhibit cancer progression in rodent models, but the evidence for this in humans is mixed. Working with humans, we sought to understand the source of variable responses to GT by examining its effects on oral epithelium. Lingual epithelial RNA and lingual and gingival microbiota were measured before and after 4 weeks of exposure in tobacco smokers, whom are at high risk of oral cancer. GT consumption had on average inconsistent effects on miRNA expression in the oral epithelium. Only analysis that examined paired miRNAs, showing changed and coordinated expression with GT exposure, provided evidence for a GT effect on miRNAs, identifying miRNAs co-expressed with two hubs, miR-181a-5p and 301a-3p. An examination of the microbiome on cancer prone lingual mucosa, in contrast, showed clear shifts in the relative abundance of Streptococcus and Staphylococcus, and other genera after GT exposure. These data support the idea that tea consumption can consistently change oral bacteria in humans, which may affect carcinogenesis, but argue that GT effects on oral epithelial miRNA expression in humans vary between individuals.

Favorable Outcomes Using an eHealth Approach to Promote Physical Activity and Nutrition Among Young African American Women.

BACKGROUND: Internet and mobile devices are widely used and provide alternative approaches for promoting healthy lifestyles, yet less information is available describing outcomes of these approaches when used with young African American (AA) women at risk for developing hypertension. OBJECTIVE: In this study, we evaluated a Web-based, culturally relevant lifestyle change intervention targeting AA women (referred to as the eHealth study). METHODS: African American women, aged 18 to 45 years, with untreated prehypertension and Internet access were eligible for a 12-week study that incorporated social cognitive theory strategies. Participants were randomized to (1) lifestyle physical activity (PA) or (2) Dietary Approaches to Stop Hypertension (DASH) online education modules. RESULTS: The 14 DASH and 12 PA participant attributes were similar at baseline. The DASH participants had a significant change in total DASH score (P = .001) and large effect sizes for DASH components (vegetables, 0.84; nonfat dairy, 0.71; fruit, 0.62). The PA participants had a favorable change (+39%) in pedometer steps (P = .055). With respect to weight change, a large effect size was observed for PA (0.84) and smaller for DASH participants (0.18). Seventy-one percent of DASH and 48% of PA participants completed program activities, corresponding to a moderate difference in program engagement between groups (d = 0.58). CONCLUSION: Our eHealth platform provides an alternative approach for reaching young AA women and was successful with respect to improving PA and dietary behaviors. Furthermore, the eHealth approach has the potential as a powerful program for changing health behaviors for other at-risk populations.