Lacey McCormack

Weight-Related Teasing in a Racially Diverse Sample of Sixth-Grade Children

Negative outcomes are associated with weight-based teasing. Among children, little research to date has explored the extent to which teasing occurs, the effects of teasing, or differences among sources of teasing. The purpose of this secondary data analysis was to assess the prevalence and frequency of weight-related teasing by peers and families in a low-income, multiracial/ethnic sample of children; to determine how bothered children were by the teasing; to evaluate whether teasing varied by overweight status and sex; and to see whether body satisfaction varied based on teasing history. In 2007, baseline data were obtained from 148 children (aged 11 to 12 years) in a classroom intervention pilot study in four public schools serving low-income communities in St Paul, MN. Participants completed a classroom survey assessing body satisfaction and weight-related teasing. Height and weight were measured. Forty percent of children reported being teased by peers and 36% reported being teased by family members about their weight. Significantly more overweight/obese children reported being teased by peers (P<0.01) and family members (P<0.05) than normal weight children. No significant differences were seen between weight status and the degree to which children were bothered by teasing. Body satisfaction was lower among children teased by family members or peers than those who were not teased (P<0.05). These results suggest that weight-related teasing is a problem for children, especially those who are overweight or obese. A better understanding is needed of the long-term effects of teasing on behavioral and psychosocial outcomes in racially/ethnically diverse samples of children.

Impact of dietary resistant starch type 4 on human gut microbiota and immunometabolic functions.

Dietary modulation of the gut microbiota impacts human health. Here we investigated the hitherto unknown effects of resistant starch type 4 (RS4) enriched diet on gut microbiota composition and short-chain fatty acid (SCFA) concentrations in parallel with host immunometabolic functions in twenty individuals with signs of metabolic syndrome (MetS). Cholesterols, fasting glucose, glycosylated haemoglobin, and proinflammatory markers in the blood as well as waist circumference and % body fat were lower post intervention in the RS4 group compared with the control group. 16S-rRNA gene sequencing revealed a differential abundance of 71 bacterial operational taxonomic units, including the enrichment of three Bacteroides species and one each of Parabacteroides, Oscillospira, Blautia, Ruminococcus, Eubacterium, and Christensenella species in the RS4 group. Gas chromatography–mass spectrometry revealed higher faecal SCFAs, including butyrate, propionate, valerate, isovalerate, and hexanoate after RS4-intake. Bivariate analyses showed RS4-specific associations of the gut microbiota with the host metabolic functions and SCFA levels. Here we show that dietary RS4 induced changes in the gut microbiota are linked to its biological activity in individuals with signs of MetS. These findings have potential implications for dietary guidelines in metabolic health management.

Recruitment of Women in the National Children's Study Initial Vanguard Study

The initial Vanguard Study of the National Childrens Study was conducted during 2009-2010 in 7 locations in the United States. A goal was to evaluate the feasibility and yield of a household-based sampling design to recruit pregnant women. A multistage area probability sampling design was used to identify study locations (generally, counties) that were subsequently divided into smaller geographical units, termed segments. Between 7 and 18 segments were selected in each location, and dwelling units within segments were listed. A household-based recruitment process was implemented, which included enumeration of households to identify age-eligible women, pregnancy screening to identify pregnant women eligible for immediate enrollment and nonpregnant women for telephone follow-up, and administration of informed consent to eligible women. After a recruitment period of 17-20 months, 67,181 (89%) households were enumerated, which identified 34,172 (88%) age-eligible women to whom the pregnancy screener was administered. Among those who completed the screener, 2,285 women became eligible for enrollment, of whom 1,399 (61%) enrolled. Although response rates were fairly high at initial contact and among pregnant women, the overall yield was lower than anticipated. In particular, telephone follow-up of nonpregnant women was not a practicable strategy for prospective recruitment of newly pregnant women.

Photovoice: Engaging School Communities in Wellness Efforts

Children spend the majority of weekday waking hours at school. Schools provide students with food and opportunities for physical activity, and serve as a key environment to facilitate healthy behaviors.1,2 In 2004, the US Federal Government passed the Child Nutrition and Women, Infants and Children (Special Supplemental Nutrition Program for Women, Infants, and Children) Reauthorization Act, mandating all schools participating in the National School Lunch Program to develop and implement a school wellness policy by the 2006–2007 school year.3 The Healthy, Hunger-Free Kids Act4 and the Final Rule of 20165 added requirements to support school wellness efforts. During the 2010–2011 school year, 55% of students were enrolled in a school district whose wellness policy did not meet all federal requirements.6 Two barriers to writing and implementing effective wellness policies noted by school board members, school wellness advocates, and state public health nutrition directors were the need to educate and gain support from non-staff stakeholders and the lack of adequate tools to assist schools in their wellness efforts.2 PhotoVoice was a participatory research methodology that used photography to document and showcase strengths and weaknesses to advocate for change.7,8 PhotoVoice was used to advocate for neighborhood safety, rural childhood obesity prevention, and smoking policies.8-11 This GEM focuses on the PhotoVoice: School Wellness curriculum,12 which was developed to raise awareness of and engagement in school wellness efforts.

Bigger ≠ Better: The Comprehensiveness and Strength of School Wellness Policies Varies by School District Size.

BACKGROUND District size has been shown to impact the anticipated barriers to wellness policy creation and implementation. Therefore, the purpose of the present study was to determine if strength and comprehensiveness of wellness policies differs among school districts of varying size. METHODS Wellness policies were collected from 10 large, 29 medium, and 31 small school districts in a rural Midwest state. District size was categorized by the average daily membership in grades 9-11. Polices were coded using the Wellness School Assessment Tool (WellSAT). Strength and comprehensiveness of the full policy and policy sections were compared among small, medium, and large districts using 1-way analyses of variance (ANOVAs). Data are presented as mean ± SD. Statistical significance was set at p ≤ .05. RESULTS There was a difference in the total combined (p = .041), total comprehensiveness (p = .043), and total strength scores (p = .031) based on school district size, such that small districts had stronger, more comprehensive wellness policies than large districts. Section comparisons revealed the section focused on Standards for United States Department of Agriculture School Meals was primarily responsible for these differences. CONCLUSIONS These data suggest smaller districts write policies that are more comprehensive to governmental standards and use more definitive language than larger districts.

Associations Between Sedentary Time, Physical Activity, and Dual-Energy X-ray Absorptiometry Measures of Total Body, Android, and Gynoid Fat Mass in Children

Negative health outcomes are associated with excess body fat, low levels of physical activity (PA), and high sedentary time (ST). Relationships between PA, ST, and body fat distribution, including android and gynoid fat, assessed using dual-energy X-ray absorptiometry (DXA) have not been measured in children. The purpose of this study was to test associations between levels of activity and body composition in children and to evaluate if levels of activity predict body composition by DXA and by body mass index percentile in a similar manner. PA, ST, and body composition from 87 children (8.8-11.8 yr, grades 3-5, 44 boys) were used to test the association among study variables. Accelerometers measured PA and ST. Body composition measured by DXA included bone mineral content (BMC) and fat and lean mass of the total body (TB, less head), android, and gynoid regions. ST (range: 409-685 min/wk) was positively associated with TB percent fat (0.03, 95% confidence interval [CI]: 0.00-0.05) and android fat mass (1.5 g, 95% CI: 0.4-3.0), and inversely associated with the lean mass of the TB (-10.7 g, 95% CI: -20.8 to -0.63) and gynoid regions (-2.2 g, 95% CI: -4.3 to -0.2), and with BMC (-0.43 g, 95% CI: 0.77-0.09). Moderate-to-vigorous PA was associated with lower TB (-53 g, 95% CI: -87 to -18), android (-5 g, 95% CI: -8 to -2]), and gynoid fat (-6 g, 95% CI: -11 to -0.5). Vigorous activity results were similar. Light PA was associated with increased TB (17.1 g, 95% CI: 3.0-31.3) and gynoid lean mass (3.9 g, 95% CI: 1.0-6.8) and BMC (0.59 g, 95% CI: 0.10-1.07). In boys, there were significant associations between activity and DXA percent body fat measures that were not found with the body mass index percentile. Objective measures of PA were inversely associated with TB, android, and gynoid fat, whereas ST was directly associated with TB percent fat and, in particular, android fat. Activity levels predict body composition measures by DXA and, in particular, android fat distribution.

The Impact of a Fruit and Vegetable Intervention on Children and Caregivers

Background: Fruit and vegetable consumption is important; however, intake remains low among children. Simple, effective classroom-based interventions are needed. Purpose: To assess the impact of South Dakota Harvest of the Month (SD HOM) on child fruit and vegetable knowledge and consumption and to determine caregiver reach. Methods: Educators delivered 8 classroom-based nutrition education lessons, which included produce taste-testing. Cross-sectional assessment data were collected pre- and postintervention in over 1200 children and postintervention in caregivers (N = 142). Results: Program awareness and fruit and vegetable knowledge increased among children. Postintervention, children were less likely to be in the low fruit and vegetable consumption groups and more likely to be in the high consumption groups. Over 80% of caregivers who responded indicated they were aware of HOM and many (55%) used the handouts brought home. Caregivers indicated that children asked for more fruits and vegetables (72.7%) and seemed more willing to taste or eat them (83.5%). Discussion: Utilizing fewer components than other successful fruit and vegetable interventions, SD HOM positively influenced childrens fruit and vegetable consumption and knowledge and reached their caregivers. Translation to Health Education Practice: Health educators are encouraged to access freely available SD HOM materials and implement the program as appropriate.

Daily Dietary Intake Patterns Improve after Visiting a Food Pantry among Food-Insecure Rural Midwestern Adults

Emergency food pantries provide food at no cost to low-resource populations. The purpose of this study was to evaluate single-day dietary intake patterns before and after visiting a food pantry among food-secure and food-insecure pantry clients. This observational cohort study comprised a paired, before-and-after design with a pantry visit as the intervention. Participants (n = 455) completed a demographic and food security assessment, and two 24-h dietary recalls. Adult food security was measured using the U.S. Household Food Security Survey Module. Dietary intake patterns were assessed using Automated Self-Administered 24-h Recall data and classified by Healthy Eating Index (HEI-2010) scores, dietary variety, number of eating occasions, and energy intake. Paired t-tests and Wilcoxon signed-rank tests compared outcomes before and after a pantry visit. Mean dietary variety increased after the pantry visit among both food-secure (p = 0.02) and food-insecure (p < 0.0001) pantry clients. Mean energy intake (p = 0.0003), number of eating occasions (p = 0.004), and HEI-2010 component scores for total fruit (p < 0.001) and whole fruit (p < 0.0003) increased among food-insecure pantry clients only. A pantry visit may improve dietary intake patterns, especially among food-insecure pantry clients.

Use of a Model Wellness Policy May Not Increase the Strength and Comprehensiveness of Written School Wellness Policies.

BACKGROUND Many state agencies have developed model wellness policies (MWPs) to serve as examples for schools when writing their own school wellness policy (SWP). The purpose of this study was to evaluate if a MWP aids schools in writing stronger, more comprehensive SWPs. METHODS For this cross-sectional study, 91 school districts submitted their current SWP and completed a survey that classified districts into either districts that utilized the state MWP (N = 56; 61.5%) or those that did not (NMWP, N =35; 38.5%). The Wellness School Assessment Tool (WellSAT) was used to assess the strength, comprehensiveness, total overall score, and subsection scores of each policy. Dependent variables were compared between groups using t tests. Statistical significance was set at p ≤ .05. Data are presented as mean ±SD. RESULTS No significant differences were found between groups in total overall (MWP 76.8 ± 37.9; NMWP 62.1 ± 34.3), strength (MWP 25.3 ± 17.6; NMWP 19.1 ± 12.8), or comprehensiveness scores (MWP 51.5 ± 21.2; NMWP 43.0 ± 22.1). The only subsection score difference identified between groups was the Nutrition Standards comprehension score (p = .02). CONCLUSIONS These data suggest MWPs may not improve the quality of written SWPs. Further research is needed to better understand the needs of school districts in SWP development.

The Healthfulness of Entrées and Students' Purchases in a University Campus Dining Environment

The purpose of this study is to determine the availability of “more healthful” (MH) versus “less healthful” (LH) entrée items in the campus dining and if students’ purchases are reflective of what is offered. This is an observational study in which purchases of the available entrée items in the campus dining at South Dakota State University in one academic year were collected and categorized as either MH or LH according to the American Heart Association guidelines. Chi-square tests were used to determine the differences between the proportion of purchased MH and LH versus those available. Odds ratio estimates with 95% confidence limits were used to determine the associations between the demographics and MH and LH purchases. Of the total entrée items available, 15.0% were MH and 85.0% were LH. In the fall, 8.0% of purchases were MH and 92.0% purchases were LH as compared to 8.9% MH and 91.1% LH in the spring. Whites were less likely than non-whites to purchase a MH entrée. Females were two times more likely to choose MH entrées than males. The campus dining offerings and students’ purchases of entrees were primarily LH. Work with campus dining providers to create profitable, yet healthful, dining entrees is needed to improve the healthfulness of offerings.