Julie Kennel

Camp NERF: methods of a theory-based nutrition education recreation and fitness program aimed at preventing unhealthy weight gain in underserved elementary children during summer months

BackgroundThe number of obese children in the US remains high, which is problematic due to the mental, physical, and academic effects of obesity on child health. Data indicate that school-age children, particularly underserved children, experience unhealthy gains in BMI at a rate nearly twice as fast during the summer months. Few efforts have been directed at implementing evidence-based programming to prevent excess weight gain during the summer recess.MethodsCamp NERF is an 8-week, multi-component (nutrition, physical activity, and mental health), theory-based program for underserved school-age children in grades Kindergarten - 5th coupled with the USDA Summer Food Service Program. Twelve eligible elementary school sites will be randomized to one of the three programming groups: 1) Active Control (non-nutrition, physical activity, or mental health); 2) Standard Care (nutrition and physical activity); or 3) Enhanced Care (nutrition, physical activity, and mental health) programming. Anthropometric, behavioral, and psychosocial data will be collected from child-caregiver dyads pre- and post-intervention. Site-specific characteristics and process evaluation measures will also be collected.DiscussionThis is the first, evidence-based intervention to address the issue of weight gain during the summer months among underserved, school-aged children. Results from this study will provide researchers, practitioners, and public health professionals with insight on evidence-based programming to aid in childhood obesity prevention during this particular window of risk.Trial RegistrationNCT02908230/09-19-2016

Determining the Feasibility and Acceptability of a Nutrition Education and Cooking Program for Preschoolers and Their Families Delivered Over the Dinner Hour in a Low-Income Day Care Setting

Objective. To test the feasibility and acceptability of a nutrition education/cooking program aimed at teaching positive eating behaviors to parents and their preschool children. Methods. A monthly program was delivered over the dinner hour at a child care facility. Questionnaires were completed at baseline, midway, and study end (10 month). Outcomes were program feasibility (retention, attendance) and acceptability (satisfaction); child food preparation skills, dietary intake, and body mass index percentile; parent self-efficacy regarding healthy eating practices; and family meal frequency. Results. Eleven families were recruited, and 10 families completed (91% retention). On average, 74% attended the program. All reported high satisfaction. Certain child diet outcomes improved (increased fruits and vegetables; decreased sugar-sweetened beverages) (P < .05). No gain in child body mass index percentile was observed. Parent self-efficacy regarding healthy eating practices improved (planning and encouraging...

Feasibility and acceptability of technology-based caregiver engagement strategies delivered in a summertime childhood obesity prevention intervention: results from an internal pilot of the Camp NERF (Nutrition, Education, Recreation, and Fitness) study

BackgroundThe most efficacious childhood obesity prevention interventions have involved caregivers directly or indirectly. Due to the high reliance on technology, research examining technological intervention approaches is warranted, particularly during the summer when parents may be more difficult to engage and the risk for excess weight gain among children is high.MethodsThe feasibility and acceptability of a multi-component childhood obesity prevention intervention incorporating a caregiver component utilizing technology-based approaches—texting and social media—was explored. This was an internal pilot of the Camp Nutrition Education Recreation and Fitness (NERF) study, a group RCT for school-age children coupled to the USDA Summer Food Service Program. Feasibility and acceptability of the technology caregiver engagement component were assessed via process outcomes (participation rates) and in-depth interviews.ResultsParticipants (n = 37) were 91.9% female, 91.8% Black, 58.7% low-income, and 75.0% overweight/obese. Participation rates in texting and social media were 62.2% and < 3%, respectively. Themes emerged from the in-depth interviews were texting provides connection; desire more involvement with program; fear social media privacy intrusion.ConclusionsResults will be used to inform changes to technology-based caregiver engagement strategies to be tested in future interventions.Trial registrationClinical Trials, NCT02908230/09-19-2016. Registered 20 September 2016

Unaccompanied homeless youth have extremely poor diet quality and nutritional status

ABSTRACT A lack of in-depth assessment of the nutritional status of homeless youth precludes interventions that achieve nutritional adequacy. We enrolled 118 unaccompanied homeless youth to obtain sociodemographic and health data along with dietary, anthropometric, biochemical, and clinical assessments. As a reference, homeless youth data were compared to a convenience sample of 145 college students. Obesity was prevalent among homeless youth than among college students (29% vs. 8% respectively (CI: 11.2, 29.9). Among homeless youth, 74% of females versus 41% of males were overweight/obese (CI: 14.9, 51.2). Homeless youth also had poor diet quality (44.37 (SD: 12.64)). Over 70% of homeless youth had inadequate intakes of vitamins A, C, D3 and E, as well as calcium and magnesium. Our findings show increased weight, adiposity, and suboptimal intakes of essential nutrients among unaccompanied homeless youth. Further studies are needed to inform evidence-based nutrition interventions that will aid in improving their nutritional health.

Milk Vending Does Not Improve College Students’ Milk and Calcium Intakes

In the transition from adolescence to young adulthood, overall diet quality decreases, including a reduction in both dairy and calcium consumption. The objective of this pilot study was to determine the impact of milk vending on milk and calcium intakes in college students. Participants were 124 college students living in dorms at a large public university (Fall 2012). Milk vending machines were installed in two campus dorms. Before and 2 months after installation, students were surveyed about milk and calcium intakes, as well as attitudes regarding milk vending. Sales data for the newly installed machines were also collected between the pre- and posttest surveys. Students reported similar milk and calcium consumption before and after the intervention. Mean calcium intakes were lower than the recommended dietary allowance for students in either life stage group (18 years old or 19 years and older). Milk vending sales data showed that during the study period, approximately nine bottles of milk were bought each day from the two dorms combined. Results from this study suggest that milk vending alone may not be an effective strategy for preventing the commonly observed decrease in milk and calcium intakes among college students.

Health and Wellness Coaching Improves Weight and Nutrition Behaviors

Most Americans have an eating pattern inconsistent with the Dietary Guidelines, putting them at risk for obesity and chronic disease. Health and wellness coaching (HWC) for lifestyle behavior change is emerging as a potentially effective tool to prevent and treat chronic disease. A systematic literature review identified 11 randomized controlled trials studying the use of HWC for improving nutrition-related biomarkers and eating behaviors. These trials demonstrate efficacy of HWC across diverse populations and treatment modalities. Almost all (82%) of the trials showed an improvement in at least one outcome. The most commonly studied outcomes were weight, blood pressure, and fruit, vegetable, and fat intake. There are several gaps in the research. The assessment of nutrition-related behaviors can be expanded to include assessment of diet quality and eating patterns associated with chronic disease prevention. Research is needed to evaluate HWC for nutrition-related biomarkers and behaviors in understudied populations with known health disparities. In addition, the health coaching dosage for long-term maintenance of changed outcomes and behaviors is inconsistent or unknown. These gaps will be important to address to determine policies and best practices for future application of HWC.

Patterns in Vegetable Consumption: Implications for Tailored School Meal Interventions.

BACKGROUND Vegetable consumption is a challenging behavioral target; consumption rates are below recommended levels and when interventions produce improvements, increases in vegetable consumption are typically a fraction of the change in fruit consumption. We describe vegetable consumption within Ohio school meals and examine how fruit selection, the more popular item, impacts vegetable consumption. METHODS Fruit and vegetable waste was collected on 11,250 trays from 17 elementary and 16 middle/high schools, using the quarter-waste visualization method. RESULTS One in 4 students ate at least a one-fourth of a cup of vegetables with their school lunch. Consumption was the highest (30.8%) in elementary school buildings with a majority of regular priced meals. Fruit selection was associated with vegetable consumption (p < .001). Middle/high school students who consumed a fruit were 88% more likely to consume a vegetable as oppose to waste it (95% CI: 1.45-2.42). Fruit selection was also associated with not selecting a vegetable, but the association was of a lower magnitude (odds ratio 1.32; 95% CI: 1.06-1.64). Trends were similar in elementary schools. CONCLUSIONS Fruit and vegetable consumption should be approached as 2 distinct behaviors with particular attention given to vegetables. Fruit items can be leveraged, though, as a means to encourage vegetable selection.