The effectiveness of an eight-week nutrition and physical activity intervention at a summer camp to prevent obesity, and promote healthy eating habits and physical activity among children in Kuwait was studied. Two summer camps were recruited for intervention and comparison groups. Convenient sampling was used (N= 79). Pre-test/post-test assessment were used for the participants in the intervention and comparison groups. Modified Healthy Habits Survey (HHS) was used to measure children’s knowledge, behavior and attitude about nutrition, screen time and physical activities, BMI-for age percentile were collected. Statistical analysis included independent t-test, paired t-test, chi-squared test, McNemar's test, and multiple regression. Results indicated that there was a significant increase in nutrition knowledge score (Pp= 0.013, p = 0.007, p = 0.002, and p = 0.012, respectively). There was no significant decrease in the number of servings of unhealthy foods for french-fries and chips, fruit flavored drinks or soft drinks. The only significant decrease in the unhealthy food intake was seen in the number of servings of sweets and candies. Thirty-three-point-three percent of participants in the intervention group decreased their consumption of sweets and candies to 1 time or less per day (P=0.001). There was a significant increase in the intervention group in both physical activity and screen time knowledge (Pp

Vitamin A nutrition status was evaluated in 110 pairs of women and their preschool children at rural health posts in two different ecological regions of Northeast Brazil. Serum retinol and carotene, weight, height, tricep skinfold and mid-arm circumference were measured from each mother and child. Nutrition knowledge of mothers, socioeconomic living conditions and consumption of retinol and carotene food sources were assessed. Nine children (8 percent) and one mother had less than acceptable serum retinol (less than 20 μg/dl). Additionally, 21 percent of the children and six percent of the mothers had "low" serum carotene levels. Thirty-seven percent and 57 percent of the children were at or below the tenth percentile for height and weight, respectively, when compared to Brazilian standard tables, and 30 percent were below the tenth percentile of weight for height. When compared to NCHS standard tables, 34 percent were below the tenth percentile for weight/height. Nutrition knowledge was very limited, but opportunities for nutrition education are great as mothers wanted more nutrition and feeding information. Squash, carrots and mangoes were more common sources of vitamin A than were animal sources. Multiple regression models indicated statistical significance among mothers' serum retinol, survey site, and mothers' weight/height percentile and among mothers' vitamin A intake, survey site, and mothers' ages. The data indicate that vitamin A nutrition status is suboptimal in Northeast Brazil, but appropriate food sources exist. Long-term intervention projects need to focus on increasing the production, distribution, and consumption of preformed vitamin A- and carotene-rich foods.

Osteoporosis is responsible for approximately 1.3 to 1.5 million fractures per year in the United States. The risk of osteoporosis increases with age, especially among postmenopausal women, and with lifestyle factors such as the use of certain drugs, heavy alcohol consumption, cigarette smoking, high caffeine intake, and sedentary living. Genetic factors that may influence susceptibility to osteoporosis include a positive family history of the disease, or a low weight - for-height ratio. In some cases, race and geographic location may increase or decrease the risk of osteoporosis. Known protective factors include obesity, estrogen replacement therapy, weight bearing exercise, and possibly calcium, fluoride, and Vitamin D. Although several studies have examined multiple factors in single populations, few comparisons have been made between populations within the same country. Recent epidemiological studies have shown that the Utah population has lower rates of some chronic diseases than the national average. In this study, we used a questionnaire approach to relate the incidence of osteoporotic fracture to 28 lifestyle, dietary, physical, and geographic factors in postmenopausal women between a Utah population and a combined population from North Dakota, South Dakota, and Colorado. Logistic regressions were used to determine the probability of osteoporosis for these two populations and to determine which factors significantly (P ≤ 0.05) increased or decreased the incidence of osteoporosis. The following factors were significantly related to the occurrence of osteoporosis: age, race, arthritis, cortisone, and fluoridated water. Dietary factors, including calcium, were not significantly related to osteoporosis in this study. The model successfully predicted the occurrence of an osteoporotic event in 72% of the cases.

A dietary nutrient intake study of ninety-five residents of a nursing home in rural community was conducted. Nutrient intakes were determined for seven consecutive days using the method of weighing food served and weighing food left by subjects. Patients on in the study. Snacks consumed between meals and vitamin and mineral supplements were included in the nutrient intakes. Height, weight, body mass index, tricep skinfold measurement and serum blood laboratory data were obtained for each subject. Activity levels were also determined. Results showed the mean caloric intake of the men was 2152+331. For the women the mean caloric intake was 1869+251. Nutrients less 100 percent standard (RDA 1974) were energy, calcium, thiamin, riboflavin, niacin, vitamin C, potassium, fiber and fat for the men and for the women energy, calcium, iron, thiamin, niacin, vitamin C, potassium, fiber and fat. Mean Index of Nutritional Quality values for selected nutrients indicated that for men protein, vitamins A, C, thiamin, riboflavin, niacin, iron, calcium and phosphorus and INQ ratios of 1.0 or greater. INQ ratios for the women indicated that protein, vitamin A, C, riboflavin, niacin, iron, calcium, and phosphorus were greater than 1.0. Correlations were found between BMI and tricep skinfold measurement and a weak correlation between kilocalories and BMI for both men and women. All of the mean serum blood values were within normal limits except for albumin. Further studies using these methods will need to be done to determine whether high caloric intake of both men and women compared to other studies of nutrient intake of elderly subjects was possibly the result of more careful analysis or because subjects were more active.

This study presents a formative evaluation of an afterschool program that combined youth development and school garden curricula. This program used a novel approach to teach elementary school children about fruits and vegetables and to engage them in advocacy for the physical activity and nutrition environments in their community. The youth development curriculum included sessions on team building, community pride, healthy eating and physical activity, and advocacy. Photovoice was used as a method to allow participants to assess their community and communicate findings with leaders. Participants selected community leaders to invite to their school and shared their findings via a presentation of the photographs and a plan for action. The school garden curriculum included lessons on plant parts, plant nutrients, site evaluation, and pollination. Participants planted and harvested vegetables in a raised bed constructed at their school. Formative evaluation was conducted through the use of an evaluation form to collect information about each session. Evaluations were examined to provide recommendations to strengthen future program design and implementation. Themes of the evaluation were: successful methods for engaging youth, issues within the social environment, and implications for program management. Successful methods for engaging youth included creative activities, working in pairs, and experiential activities. Issues in the social environment were behavioral problems, shyness, gender groups, and competition. Areas of concern for program management included recruitment, attendance, volunteer training, team building activities, and survey administration.

Diabetes is increasing globally and nationally. Diabetes complications and costs can be reduced through modification of lifestyle risks and diabetes self-management education (DSME). The Cooperative Extension System (CES) is uniquely positioned to implement DSME. This study assessed the role and impact of the Cooperative Extension System (CES) in DSME. A survey was sent to CES professionals throughout the U.S. a total of 43 participants provided information on 73 DSME programs. Most participants were from the South (n=22, 51.16%) and Midwest (n=12, 27.91%) and most programs targeted adults with and at risk for type 2 diabetes. Most programs were developed and taught by registered dietitians and family and consumer science agents and were focused on healthy eating and cooking techniques. Few programs addressed medications, mental and physical health, influenza and pneumococcal vaccinations. Implementation challenges were related to recruitment, attrition, and funding and most suggestions for the future of CES in DSME were related to funding. CES has a wide reach in terms of DSME with over 29 states. Future CES efforts should target children with type 2 diabetes and should form/continue partnerships with health care professionals.

Obesity, diabetes, cardiovascular disease, and poor dietary habits are major healthcare problems in the United States. These issues are especially prevalent in the state of Kentucky and among at-risk populations such as Women, Infants, and Children (WIC) participants. Studies have found that whole grains play a role in weight maintenance, protection against type 2 diabetes, and lowering cholesterol. Interventions aimed at improving WIC participant dietary behavior and intake has been successful as well. This study assessed Kentucky WIC participants’ knowledge of the benefits of consuming grains, attitudes and beliefs regarding food purchasing and grains, and identified grains consumed in a two-week period. A survey, created with the input of Registered Dietitians and WIC staff, examined these factors. Results from the survey found that WIC participants might benefit from education on: purchasing nutrient-dense foods (especially whole grains), the nutrition facts panel, types of grains, nutrients such as calories, fat, sugar, and fiber, serving sizes, and how to get children to eat whole grains.

Childhood obesity has increased significantly in the past decade. The same factors putting adults at risk for obesity apply to children as well. For children, the family environment may be one of the largest factors. Obesity affects both adults and children of low socioeconomic status. It also affects families living in the Appalachian region of the United States more frequently than other regions. The purpose of this study was to examine the relationships between obesity related behaviors and nutrition education among Appalachian participants in the Expanded Food and Nutrition Education Program (EFNEP). For this study eleven educators from the Appalachian region who work with the EFNEP/SNAP-Education program were interviewed by telephone. Their responses to questions were coded according to a pre-prepared answer guide. From answers provided by staff there are some areas that the EFNEP program could focus on more. Some of these areas include educating participants on budgeting and family finance, cooking skill, parenting skills and physical activity. Answers provided by participants in this study suggest that educators feel fairly successful with making changes related to healthy eating but less successful with making changes in participant’s physical activity.

The prevalence of obesity is rising in the United States and one factor that contributes to it is the lack of cooking at home and planning out meals. Since text messaging is now a main avenue of communication, it could be used to motivate people to plan out their meals and cook at home instead of consuming fast food. Current research on how weekly nudges might relate to peoples’ goals about meal preparation and dietary intake is very limited. The purpose of this study was to examine if sending weekly nudges, focusing on specific dietary goals, improves meal planning and dietary intake in an online meal planning group. A Facebook group was used to send weekly nudges to the participants throughout six weeks. It was found that meal planning appears to have a significant effect on meal preparation at home and thus may help improve dietary intake. The results found can also be utilized in other aspects of leading to healthier lifestyles and motivation-need situations such as weight loss.

The Live Well Springfield (LWS) movement is a collaborative effort of partner organizations in Springfield, Massachusetts. The project promotes healthy living by increasing knowledge and awareness of food and physical activity. A key LWS strategy was the creation of a website to function as an information hub. In addition to local event and health information, the website features 16 narratives depicting residents practicing healthy lifestyle choices, designed to encourage community engagement. To date, there has been no evaluation of the website’s reach and effect. A mixed methods approach, surveys and focus group discussions, was designed to collect data from people who live, work, or attend school in Springfield. Focus group participants were recruited in person at Springfield Community College, via recruitment posters (distributed at STCC), and through email requests from a previously compiled list of residents willing to be contacted. A website evaluation survey was developed using eHealth research constructs and the Expectation-Confirmation Model (ECM). This survey measured users’ perceived quality and satisfaction with the website. The survey was accessible via the livewellspringfield.org homepage, the LWS Facebook page, and emailed directly to potential respondents. The validated eHealth Literacy Scale (eHEALS) was incorporated into the survey and focus group sessions to assess self-reported skills for using eHealth resources. Each hour-long focus group (n=5 and n=6, respectively) was video/audio recorded and fully transcribed. Focus group transcripts were analyzed to thematically organize responses to narratives and fact-based health messages and assess the appeal, relevance, effectiveness, perceived purpose, and appropriateness. Survey data was analyzed to produce frequencies, descriptive statistics, and correlations. A mean eHEALS score of 4.22 of 5.00 (SD=0.83) was calculated from 36 responses, suggesting this sample felt very knowledgeable and confident using eHealth resources. Health Literacy Advisor (HLA) software was used to analyze an aggregate of all narratives, resulting in a Fry-based reading grade level of 8.4. On a five-point Likert scale, mean satisfaction with the website was 4.71 (SD=0.53), and mean likelihood to return was 4.76 (SD=0.51). Content analysis of focus group transcripts resulted in 184 responses coded for one or more themes. The largest proportion of responses (40.2%) related to effectiveness. One third of these effectiveness-related responses were negative toward the fact-based examples. Although the narratives were greatly preferred in both groups, all respondents made comments or agreed with suggestions to have both affective narratives and strictly fact-based health messages accessible, regardless of initial preferences. Results and interpretations will be reported to LWS partners to inform potential revisions of the website revisions and contribute to ongoing activities of the LWS initiative.