Cross-Sector Partnerships for Improved Cooking Skills, Dietary Behaviors, and Belonging: Findings from a Produce Prescription and Cooking Education Pilot Program at a Federally Qualified Health Center.

Participant engagement, psychosocial factors, and dietary behaviors are important components of "Food as Medicine" and cooking education programs. The purpose of this study is to describe a multidisciplinary cooking program at a Federally Qualified Health Center in central Texas. During biannual harvest seasons (2022-2023), patients participated in four or six weekly 1.5 h hands-on cooking classes with shared meals, education, and produce delivery. Pretest-posttest surveys assessed sociodemographic information, health, psychosocial factors, and dietary behaviors; follow-up assessed group cohesion/sense of community in classes. Survey data were described using means and proportions. Across four cohorts, participants (n = 33; mean age: 45 ± 16 years) were 30% Hispanic/Latino, 18% non-Hispanic Black, and 52% non-Hispanic White; on average, participants attended 66% of sessions. Increases in cooking self-efficacy (p < 0.001) and diet-related self-management strategies (p < 0.001) were observed for those with follow-up data (n = 16); further, 44% reported increased vegetable consumption. All participants (100%) reported feeling like a valued member of their cooking group and 94% reported high levels of belonging. In a diverse community health center serving low-income patients, provision of produce and cooking education classes supported strategies to improve diet-related confidence, skills, and behavior. Cross-sector partnership within a health care setting may help patients and physicians prioritize nutrition and food access.

Sleep Duration and Risks of Incident Cardiovascular Disease and Mortality Among People With Type 2 Diabetes.

OBJECTIVE: People with type 2 diabetes may have insufficient or prolonged sleep that could accelerate cardiovascular disease (CVD) onset, but existing evidence from prospective studies has been limited. We examined the association of sleep duration with CVD incidence and mortality in this high-risk population. RESEARCH DESIGN AND METHODS: This prospective study included 18,876 participants with type 2 diabetes in the UK Biobank who were free of CVD and cancer at baseline. Habitual sleep duration was obtained using a baseline questionnaire. Cox proportional hazards regression models were used to examine the association between sleep duration and CVD events. RESULTS: During an average follow-up of 11.0-12.0 years, we documented 2,570 incident cases of atherosclerotic cardiovascular disease (ASCVD) and 598 CVD deaths. Compared with sleeping for 7 h/day, the multivariable-adjusted hazard ratios of ≤5 and ≥10 h/day were 1.26 (95% CI 1.08, 1.48) and 1.41 (1.16, 1.70) for incident ASCVD, 1.22 (0.99, 1.50) and 1.16 (0.88, 1.52) for coronary artery disease, 1.70 (1.23, 2.35) and 2.08 (1.44, 3.01) for ischemic stroke, 1.02 (0.72, 1.44) and 1.45 (1.01, 2.10) for peripheral artery disease, and 1.42 (1.02, 1.97) and 1.85 (1.30, 2.64) for CVD mortality. Similar results were observed in most sensitivity analyses that aimed to address potential reverse causation and in the joint analyses of sleep duration and metabolic control or diabetes severity status. CONCLUSIONS: Short and long sleep durations were independently associated with increased risks of CVD onset and death among people with type 2 diabetes.

Dietary diversity is associated with nutrient adequacy, blood biomarkers and anthropometric status among preschool children in poor ethnic minority area of Northwest China.

Introduction: This study aimed to evaluate the status of dietary diversity, nutrient adequacy, blood biomarkers of nutrients, and anthropometric status, as well as to determine the predictors of dietary diversity score (DDS) and mean adequacy ratio (MAR) among preschool children in poor ethnic minority areas of northwest China. Methods: A total of 578 healthy preschool children aged 3-6 from 17 kindergartens were selected to assess dietary intake, anthropometric status (height-for-age z-score (HAZ), weight-for-age z-score (WAZ), weight-for-height z-score (WHZ), and blood biomarkers. DDS and nutrient adequacy ratio (NAR) were adopted to assess dietary diversity and micronutrient adequacy, respectively. Results: The mean DDS (ranging from 1 to 9) was relatively low (4.67 ± 1.56). Most participants consumed starchy staples, but few participants consumed organ meat. DDS was associated with serum potassium, serum iron, WAZ, HAZ, all NARs, and MAR (all p < 0.05). Living in urban areas (ß = 0.158), higher household wealth (ß = 0.116), and more caregivers' nutritional knowledge (ß = 0.022) were positively associated with DDS (all p < 0.01), while living in urban areas (ß = 0.031), higher education of caregivers (ß = 0.0.027), and higher DDS (ß = 0.049) were positively associated with MAR (all p < 0.01). Discussion: In conclusion, dietary diversity was associated with nutrient adequacy and other health outcomes. Nutritional education and poverty alleviation are integral to improving the nutritional status of preschool children.

Association between Fresh Fruit and Vegetable Consumption and Purchasing Behaviors, Food Insecurity Status and Geographic Food Access among a Lower-Income, Racially/Ethnically Diverse Cohort in Central Texas.

The aims of this study were to determine if fresh fruit and vegetable consumption and purchasing behaviors were associated with geographic food access and/or food insecurity status, and to explore the role of sociodemographic characteristics among participants of a lower-income, racially/ethnically diverse cohort. This study used a cross-sectional design and baseline survey data from the FRESH-Austin study (N = 393). Associations between fresh produce consumption/purchasing and food insecurity status and geographic access to food were assessed utilizing univariate, bivariate, and multivariate linear regression methods and potential interactions were examined. The sample 40% reported being food insecure and the majority identified as Hispanic. Geographic food access was directly associated with fresh produce consumption (ß = 0.46, p = 0.02); however, the directionality of the relationship between food insecurity and fresh produce consumption varied due to a significant interaction with race/ethnicity. Only utilizing food assistance was associated with purchasing fewer fresh produce (ß= -1.83, p = 0.03). Findings suggest that communities experience food insecurity and limited healthy food access in different ways, and in some situations, are associated with fresh produce consumption and purchasing behaviors. Future research adopting an intersectionality-sensitive approach to better understand how to best support communities at risk is needed.

Dietary Patterns and Obesity in Chinese Adults: A Systematic Review and Meta-Analysis.

Certain dietary patterns are associated with an increased risk of obesity and its comorbidities. However, these associations vary across populations. The prevalence of obesity has been rising amid a drastic nutrition transition in China during the country's rapid economic growth. This systematic review and meta-analysis were conducted to summarize how dietary patterns are associated with obesity in the Chinese population. We searched for articles from 1 January 2000 to 1 February 2022 in PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Scopus that assessed the relationship between dietary patterns and obesity outcomes. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using a random effects model. From the 2556 articles identified from the search, 23 articles were included in the analysis. We found that the traditional Chinese dietary pattern was associated with a lower risk of overweight/obesity (OR = 0.69, 95% CI: 0.57, 0.84, p < 0.001), whereas the Western dietary pattern was associated with a higher OR of overweight/obesity, but not reaching statistical significance (OR = 1.34, 95% CI: 0.98, 1.84, p = 0.07). There were inconsistent results for other dietary patterns, such as meat/animal protein and plant/vegetarian patterns. In conclusion, the traditional Chinese diet characterized by vegetables, rice, and meat was associated with a lower risk of obesity. The heterogeneity in characterizing dietary patterns contributes to the inconsistency of how dietary patterns are associated with obesity in the Chinese population.

Association between electronic cigarette and combustible cigarette use with cardiometabolic risk biomarkers among U.S. adults.

PURPOSE: To determine the association between cigarette use (i.e., never-use - reference group, exclusive e-cigarette users, exclusive cigarette smoking, and dual use of both products) with cardiometabolic risk biomarkers. METHODS: Data came from two cycles (2015-2016 and 2017-2018) of the National Health and Nutrition Examination Survey. We used weighted logistic regression models to determine the association of cigarette use and reduced high-density lipoprotein cholesterol (HDL-C; <40 mg/dL, for men and <50 mg/dL for women), elevated low-density lipoprotein cholesterol (LDL-C; ≥130 mg/dL), elevated triglycerides (TG; ≥150 mg/dL), elevated fasting blood glucose (FBG; (≥100 mg/dL), and high blood pressure (HBP; Systolic ≥130 mm Hg/Diastolic ≥85 mm Hg). RESULTS: Of the 8688 adults 18+ years of age included, 2.7%, 3.2%, and 14.9% self-reported exclusive e-cigarette, dual use, and exclusive cigarette smoking respectively. After adjusting for covariates, exclusive e-cigarette use was significantly associated with increased odds of HBP (adjusted odds ratio [aOR] = 2.05, 95% confidence interval [CI] = 1.03, 4.08). Dual use was associated with increased odds of reduced HDL-C (aOR = 1.64, 95% [CI] = 1.01, 2.70). Exclusive cigarette smoking was significantly associated with reduced HDL-C (aOR=1.80, 95% [CI]=1.45, 2.23) and elevated TG (aOR = 1.59, 95% [CI] = 1.01, 2.52). CONCLUSIONS: Results are preliminary and warrant replication from larger samples with longitudinal follow-up.