Sarcopenia is a disease of muscle wasting primarily seen in older adults. Although this term was first coined over three decades ago, there is a lack of consensus on a definition, screening criteria, and treatment protocol for sarcopenia. The primary purpose of this study is to determine whether registered dietitian nutritionists (RDNs) in the United States (U.S.) screen for sarcopenia. Study participants were recruited through a randomized email list and included RDNs throughout the U.S. Respondents completed a survey questioning knowledge of sarcopenia, screening tools and company protocols in place, and the need and desire for sarcopenia education. Data revealed a lack of pre-existing protocols in place, a dissonance of validated and unvalidated screening tools used in practice, and substantial need for sarcopenia education.

Understanding how intimate relationships influence physical health has been an important topic of focus; however, research remains unclear on the mechanisms through which this influence occurs. The purpose of this study was to examine how relationship satisfaction relates to diet quality, through mental health (depression and anxiety) and diet self-efficacy. Using a dyadic mediation model with a sample of 234 heterosexual couples, researchers found that women's higher relationship satisfaction was associated with better diet through lower depression and higher diet self-efficacy. Results revealed the same association between women's relationship satisfaction and diet through lower anxiety. Interestingly, rather than mediation through mental health, the association between men's relationship satisfaction and diet was mediated through their partners' diet self-efficacy. This presentation will review the gendered pathways by which relationship satisfaction influences diet in heterosexual couples and discuss the important implications of these findings for tracing how intimate relationships affect overall well-being.

Changing demographics in the United States to a minority-majority culture require health care professionals who are culturally competent to provide appropriate care to patients. In a university in the Mid-Atlantic region of the United States, a gap existed between student education and the culturally competent professional practice of entry-level registered dietitians. Using Freire's notion of social justice and Vygotsky's constructivist theory as the conceptual frameworks, the purpose of this study was to explore educators' instructional strategies that promoted cultural competence in nutrition and dietetics education. The research questions examined how educators described the instructional practices they employed to promote cultural competence in nutrition and dietetics education. Using a qualitative instrumental case study design, 9 educators responded to an open-ended questionnaire, as well as provided documents for analysis in the form of assignments. First-cycle data analysis was conducted using an initial coding protocol followed with a second-cycle phase using axial coding. The key themes for educators included the necessity of cultural competence in nutrition and dietetics instruction, and classroom and experiential learning activities engagement. The key conclusion was cultural competence is necessary to bridge the gap between student education and professional practice. The project study resulted in a position paper that recommended revising the local study site's curriculum to be based in cultural competence instruction through multiple modalities of collaborative and experiential learning activities. Positive social change will be present through enhancing nutrition and dietetics education to better better prepare students to be culturally competent professionals who provide improved health care to their patients.

The purpose of this research was to examine food security for people with prediabetes participating in the Supplemental Nutrition Assistance Program (SNAP), focusing on their food choice decisions and coping strategies over a 30-day benefit cycle that potentially increases the risk of Type 2 diabetes. A cross-sectional, quantitative design based on food choice process model constructs was used. SNAP participants (n = 36) with prediabetes, aged 21-70 years, were recruited as outpatients from Bronx Lebanon Hospital and completed self-reported questionnaires on demographics and health, food security, and food frequency. Descriptive statistics, Pearson chi square tests, and regression analysis were performed using SPSS. Also, independent t test, and Levene's test were used for ad hoc analysis to assess variation of food choice decisions over 30 days. Of the sample, 5% had low and 95% very low food secure status. Food security status did not predict coping strategies (p = .724); however, food security status and type of coping strategy had a moderate relationship (p < 0.01; r =.60). Food choices of 11 food categories changed over a 30-day cycle with greatest variation for Week 1, compared to Weeks 2-4 (p < .005). Use of coping strategies to minimize hunger was limited. Very low food security associated with certain coping strategies disrupted eating patterns. Disrupted eating patterns affect food variation over time, increasing the intake of non-nutrient-dense foods and the risk of obesity and Type 2 diabetes. The implications for positive social change include the potential to change SNAP's benefit allotments, make nutrition education mandatory, and create a nutrition package, thereby lowering food insecurity and the risk of Type 2 diabetes.

Adventists following a plant-based diet have half the prevalence and incidence of type 2 diabetes than nonvegetarian Adventists. This study used a quantitative, correlational study design to assess if there was a significant difference in type 2 diabetes prevalence rate between Adventists and non-Adventists preprogram, and if there were significant differences in biometrics between Adventists and non-Adventists with diabetes pre- and post-Complete Health Improvement Program (CHIP). This study incorporated the social ecological model for its conceptual framework and examined pre- and postprogram changes among Adventists (n=210; 20.1%) and non-Adventists (n=836; 79.9%) with type 2 diabetes. It used secondary data from participants in the volunteer-delivered CHIP intervention from 2006 to 2012 (n=7,172), a whole foods, plant-based, vegan health program. Analysis showed a significant difference in the pre-CHIP diabetic state between the two groups in step one, but not after controlling for covariates in step two (OR=0.96 and 0.91; CI=1.21 and 1.24). A repeated measures MANOVA analysis indicated that religious affiliation (Adventist or non-Adventist) was the determining factor in improved biometric outcomes pre- and post-CHIP for TC (F(1) = 5.65; p = 0.02), and LDL (F(1) = 5.76; p = 0.02) but not for HDL (F(1) = 0.00; p = 0.99), TG (F(1) = 0.19, p = 0.67), FPG (F(1) = 2.71, p = 0.10), SBP (F(1) = 2.25; p = 0.13), DBP (F(1) = 1.20; p = 0.27), and BMI (F(1) = 1.65; p = 0.20). However, both groups improved post-CHIP in all biometrics. The implications for positive social change from this study showed that CHIP is an effective lifestyle model for improving type 2 diabetes outcomes for both Adventists and non-Adventists, a model that does not involve the use of pharmaceuticals.

Childhood obesity rates have increased nationwide, but rates of childhood obesity are higher in Tennessee (TN). The Coordinated School Health (CSH) Program is a multicomponent approach designed to improve academics and health in children in Tennessee; however, researchers have not evaluated the 8 components of the plan and the impact it has on weight in children. The purpose of the study was to determine if a relationship existed between the Coordinated School Health Program and obesity in children. The conceptual framework for this study was Bandura's social cognitive theory. One hundred forty CSH coordinators in TN were surveyed and the results were analyzed using multiple regression to determine the relationship between the 8 components of the CSH program and obesity rates in children in TN. Nutrition service was the only component that was statistically significant. According to study results, many districts had been exposed to the coordinated school health program and had some components in place, but the program was not seen as a priority by school administration, which affected the successful implementation of the program. The findings from this research can be used to help school officials determine how to better integrate the components of the Coordinated School Health program into the existing curriculum, allot time and resources for implementation strategies, hire the appropriate staff, and/or determine which component needs more focus. Determining which component(s) should have more emphasis creates potential for social change by reducing obesity in children, which will likely reduce the chance of those children becoming obese adults.

Nutritional food label understanding (NFLU) in African American Women (AAW) is a philosophy that addresses obesity. Public health efforts have implemented nutritional and caloric information to packaged and restaurant foods to improve nutrient and calorie literacy. Research suggest NFLU might have a minimal effect on reducing obesity. However, it is not known how obese AAW born during the baby-boom era (51 to 64 years of age) perceive NFLU in relation to their dietary behaviors. The purpose of this phenomenological study was to understand the lived experience of obese AAW regarding NFLU from a cognitive and behavioral perspective. Twelve, AAW answered 21-semi-structured questions that were audio recorded and transcribed verbatim. Findings of the study revealed the limited appreciation of NFLU in relation to healthy nutrition behaviors. Reasons for not applying nutritional food label (NFL) information centered on self-help perception, the time to read and understand the content on the NFL, skills required for effective NFL usage (math, organization of content), barriers to overcome while grocery shopping and motivational interest to change their behavior. In addition, the interviews of obese AAW revealed a lack of interest in NFL information while dining out despite understanding the perceived health benefits of knowing such information. Positive social change implications for obese AAW include improved nutrition literacy and nutritional behavior using NFLU as the guide to healthier dietary choice. From an individual, community, societal and nation level, reversing the trajectory of obesity through nutritional health literacy needs further improvement and individual adoption to possibly assist with obesity self-management.

Abstract Type 2 Diabetes Mellitus (T2DM) is the seventh leading cause of death in the United States with a projected increase of 552 million people worldwide who will be affected with this illness by 2030. The need to address this issue is vital to prevent complications and reduce healthcare spending. The DNP project is aimed at planning and designing a nutritional education program tailored toward specific ethnic groups in order to increase knowledge in making healthy food choices. This project is intended to educate Registered Nurses (RNs) on nutrition so that they can offer dietary knowledge to T2DM patients. Additional patients can be reached by educating the RNs rather than patients being limited to consultations with a Certified Diabetes Educator or Registered Dietician. This project focused on whether healthy nutrition tailored toward the individual's own ethnic foods helps to stabilize glycemic values for patients with Type 2 diabetes. A toolkit was utilized to aid with the RNs' learning on healthy nutrition and its impact on the management of blood glucose. It addressed areas such as food groups and calories, grocery shopping, preparation methods, and portion control. The framework for design utilized the basic concepts associated with the systems theory with an intended goal to prevent further complications and improve patients' glycemic value through consuming nutritious foods. The logic model will be used to evaluate the impact of healthy nutrition on blood glucose through pre- and post-program tests of the RNs' nutritional knowledge on healthy eating. The continuation of this program will promote positive social change by helping patients to achieve a healthier lifestyle and reduce healthcare expenditures.

Our study provided an analysis and comparison of specific blood values, dietary intake, body composition, and inflammatory markers (high sensitivity-C-reactive protein (HS-CRP), tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6)) between adults with type 2 diabetes mellitus (T2DM) and prediabetes (PDM) to adults without diabetes. A total of 22 participants (PDM/T2DM n=12, controls n=10) in the San Luis Obispo, CA area completed the study prior to our ending recruitment due to Covid-19. Body composition data were collected through DXA scans. Dietary intake was assessed using a 3-day food record survey and nutritional analysis conducted using ESHA food processing software. In addition, participants completed an overnight fast and early morning blood draw for evaluation of blood glucose regulation, blood lipid profile and inflammatory biomarkers. Analysis included a series of randomization tests that were conducted to determine possible statistical differences between the mean of basic characteristics (age, BMI, weight, HbA1C, fasting plasma glucose, fasting insulin, triglycerides, LDL, HDL, and total cholesterol levels) of the control group and the PDM/T2DM group. Secondly, 2-way ANOVA statistical analyses were conducted to determine the interaction between sex and diabetes status on caloric intake, macronutrient distribution, quality of fat intake, visceral adipose tissue (VAT), and inflammatory biomarkers. We found there was a significant difference in fasting plasma glucose (FPG) and hemoglobin A1C (HbA1C) between the control group and the PDM/T2DM group. We did not find a statistically significant difference in caloric intake, macronutrient distribution, quality of fat intake, visceral adipose tissue (VAT), and inflammatory biomarkers between the PDM/T2DM and control group. Due to the lack of studies that include adults with PDM, we concluded additional future research needs to focus on blood biochemistry values, dietary intake, body composition, and inflammatory markers health-risk factors in both adults with PDM and T2DM since these values can improve diagnosis and treatment of T2DM.

The prevalence of non-alcoholic fatty liver disease (NAFLD) in children has increased over the past decades, creating a need for animal models that recapitulate the features of the pediatric disease. Iberian pigs have a leptin-resistant phenotype characterized by hyperleptinemia, hyperphagia, and extreme adipogenesis. We hypothesized that neonatal Iberian pigs fed a high fat high-fructose (HFF) diet will develop a pattern of liver injury resembling pediatric NAFLD. In addition, we sought to determine if a mixture of probiotics would prevent the disease. Animals were fed 1 of 4 diets containing (g/kg body weight × d) 0 g fructose, 11 g fat and 199 kcal (CON-N; n=8), 22 g fructose, 16 g fat and 300 kcal (HFF2-N; n=8), CON + probiotic (CON-P; n=6), or HFF2 + probiotic (HFF2-P; n=6) every 6 h for 70 d. The probiotic mixture (6.2 × 104 cfu/mL) contained Pediococcus acidilactici, Pediococcus pentosaceus, Lactobacillus plantarum and Bacillus amyloliquefaciens. Body weight was recorded every 3 d. Serum markers of liver injury and dyslipidemia were measured on d 40 and 65 at 2 h post feeding. Fasting leptin, insulin, glucose and homeostatic model assessment (HOMA) values were assessed on d 70. Liver and skeletal muscle (longissimus dorsi) were collected on d 70 for histology, triacylglyceride (TAG) quantification, relative gene expression, and Western blot analysis. Metabolomic analysis was performed on liver tissue and plasma. Body weight was not significantly greater in HFF fed pigs compared to CON. Leptin, alanine and aspartate aminotransferases, alkaline phosphatase, lactate dehydrogenase and total bilirubin were increased (P ≤ 0.001), and high and low density lipoproteins decreased (P ≤ 0.05) in HFF2-N and HFF2-P. Livers in HFF2-P and HFF2-N had higher relative weight and TAG (P ≤ 0.001), micro and macrovesicular steatosis, ballooning degeneration, Mallory-denk bodies, inflammation and necrosis, increased gene expression of TNFα, TGFβ, IL1α and PPARγ (P ≤ 0.001), and decreased ChREBP (P ≤ 0.001). A probiotic affect was seen as pigs fed CON-P and HFF2-P had higher insulin and HOMA values were increased (P ≤ 0.05). Western blot analysis showed dysregulation of autophagy in liver of pigs fed CON-P and HFF2-P, and in skeletal muscle of pigs fed CON-N and HFF2-N. Metabolomic analysis demonstrated dysregulation of one-carbon metabolism, the tricarboxylic acid cycle (TCA), the urea cycle, and amino acid metabolism of pigs fed HFF2 diets compared to CON diets. In conclusion, Iberian pigs fed a HFF diet recapitulate many pediatric NAFLD-associated features, in the absence of obesity and independently of probiotic supplementation, suggesting a potentially suitable model for pediatric NAFLD research. Furthermore, probiotic supplementation did not ameliorate the onset of NAFLD when fed in conjunction with a HFF diet.