Effectiveness of Behavioral Economics-Informed Strategies and Enhanced Food Preparation Skills to Increase Vegetable Intake and Variety of Vegetables Eaten among Low-Income Children

University of Minnesota Ph.D. dissertation. 2017. Major: Nutrition. Advisors: Marla Reicks, Zata Vickers. 1 computer file (PDF); 285 pages.Obesity prevalence among children continues to be a serious problem, especially for those in low-income households. Inadequate vegetable intake leading to low dietary quality may be a contributing factor to the obesity problem among children. The field of behavioral economics has gained momentum in nutrition interventions for improving vegetable intake, mainly in school and other cafeteria settings, using low-to-no cost modifications to the food environment. Similar strategies have yet to be tested in the home in a large-scale trial. The overall objective of the following dissertation was to determine if an intervention comprised of 6 behavioral economics-informed strategies within a 6-session vegetable-focused cooking skills program, grounded in Social Cognitive Theory, was more effective for improving vegetable intake, vegetable liking, variety of vegetable eaten, BMI-z score, and home availability of vegetables for a diverse sample of low-income children (ages 9-12) than a control condition of the vegetable-focused cooking skills program alone. The 6 strategies tested were: 1) child helping to prepare the vegetables, 2) using a plate that shows the appropriate proportion of food groups within a meal, 3) making the vegetables the most available and visible part of the meal, 4) serving at least 2 vegetables with the meal, 5) serving the vegetables before the meal, and 6) using a bigger spoon to serve the vegetables. The three separate reports included in this dissertation utilized data collected in a longitudinal controlled intervention trial conducted in the Minneapolis-St. Paul metropolitan area from September 2014-June 2017. Outcome measures were collected at 4 time points: baseline, immediate post-course, 6-months post-course, and 12-months post-course. Mixed model regression analyses and t-tests were used to compare outcomes between intervention and control groups. A total of 103 parent/child pairs were enrolled with 91 who completed the weekly cooking skills program. The child outcomes of vegetable intake, vegetable liking, variety of vegetables eaten, and BMI-z score, as well as home availability of vegetables were not improved for the intervention children more than the control children. The immediate impact of the vegetable-focused cooking skills program on parent and child psychosocial measures (e.g. cooking self-efficacy and interest in cooking) was assessed. Baseline and immediate post-course survey data from the intervention and control groups were combined since both groups participated in the cooking skills program. The combined data were used to assess changes in outcome measures from pre- to post-course. Validated parent self-report questionnaires were used to assess changes in the following psychosocial outcomes: cooking confidence, healthy food preparation, cooking barriers, and food resource management. Parents and children were asked if they had ever tried each of 37 different vegetables and if yes, to rate their liking. Changes between pre- and post-course responses were tested using paired t-tests or Wilcoxon signed-rank tests. Improvements were observed for parental cooking confidence, healthy food preparation skills, number of vegetables present in the home, parental vegetable liking, parental variety of vegetables eaten, and confidence in cooking individual vegetables and using several vegetable cooking methods. Improvements were also observed for child cooking self-efficacy and variety of vegetables eaten. Vegetable liking and acceptability for a wide variety of vegetables was measured among a racially and ethnically diverse sample of 9-12 year old children. Child liking data were combined from the present study and another in-home intervention study with a similar study population. Mean liking ratings for each vegetable were calculated. The number of children that found each vegetable acceptable and unacceptable was also tabulated. The most liked vegetables were corn, potatoes, lettuce, and carrots. Artichoke, onion, and beets were the 3 vegetables with the lowest mean liking. Overall, children found a wide variety of vegetables acceptable

Latino adolescent-father discrepancies in reporting activity parenting practices and associations with adolescents’ physical activity and screen time

Latino fathers may play important roles in adolescents’ physical activity and screen time. However, informant discrepancies regarding paternal activity parenting practices may challenge studies supporting evidence-based applications. This study examined Latino adolescent-father discrepancies in reporting paternal activity parenting practices, types of discrepancies by participant characteristics, and associations between discrepancy types and adolescents’ physical activity and screen time.https://doi.org/10.1186/s12889-020-8199-

HPV genotypes and cervical intraepithelial neoplasia in a multiethnic cohort in the southeastern USA

PURPOSE: For poorly understood reasons, invasive cervical cancer (ICC) incidence and mortality rates are higher in women of African descent. Oncogenic human papillomavirus (HPV) genotypes distribution may vary between European American (EA) and African-American (AA) women and may contribute to differences in ICC incidence. The current study aimed at disentangling differences in HPV distribution among AA and EA women. METHODS: Five-hundred and seventy-two women were enrolled at the time of colposcopic evaluation following an abnormal liquid-based cytology screen. HPV infections were detected using HPV linear array, and chi-squared tests and linear regression models were used to compare HPV genotypes across racial/ethnic groups by CIN status. RESULTS: Of the 572 participants, 494 (86 %) had detectable HPV; 245 (43 %) had no CIN lesion, 239 (42 %) had CIN1, and 88 (15 %) had CIN2/3. Seventy-three percent of all women were infected with multiple HPV genotypes. After adjusting for race, age, parity, income, oral contraception use, and current smoking, AAs were two times less likely to harbor HPV 16/18 (OR 0.48, 95 % CI 0.21–0.94, p = 0.03) when all women were considered. This association remained unchanged when only women with CIN2/3 lesions were examined (OR 0.22, 95 % CI 0.05–0.95, p = 0.04). The most frequent high-risk HPV genotypes detected among EAs were 16, 18, 56, 39, and 66, while HPV genotypes 33, 35, 45, 58, and 68 were the most frequent ones detected in AAs. CONCLUSIONS: Our data suggest that while HPV 16/18 are the most common genotypes among EA women with CIN, AAs may harbor different genotypes

Distribution of HPV genotypes in cervical intraepithelial lesions and cervical cancer in Tanzanian women

<p>Abstract</p> <p>Background</p> <p>Infection with human papillomavirus (HPV) is associated with uterine cervical intraepithelial neoplasia (CIN) and invasive cancers (ICC). Approximately 80% of ICC cases are diagnosed in under-developed countries. Vaccine development relies on knowledge of HPV genotypes characteristic of LSIL, HSIL and cancer; however, these genotypes remain poorly characterized in many African countries. To contribute to the characterization of HPV genotypes in Northeastern Tanzania, we recruited 215 women from the Reproductive Health Clinic at Kilimanjaro Christian Medical Centre. Cervical scrapes and biopsies were obtained for cytology and HPV DNA detection.</p> <p>Results</p> <p>79 out of 215 (36.7%) enrolled participants tested positive for HPV DNA, with a large proportion being multiple infections (74%). The prevalence of HPV infection increased with lesion grade (14% in controls, 67% in CIN1 cases and 88% in CIN2-3). Among ICC cases, 89% had detectable HPV. Overall, 31 HPV genotypes were detected; the three most common HPV genotypes among ICC were HPV16, 35 and 45. In addition to these genotypes, co-infection with HPV18, 31, 33, 52, 58, 68 and 82 was found in 91% of ICC. Among women with CIN2-3, HPV53, 58 and 84/83 were the most common. HPV35, 45, 53/58/59 were the most common among CIN1 cases.</p> <p>Conclusions</p> <p>In women with no evidence of cytological abnormalities, the most prevalent genotypes were HPV58 with HPV16, 35, 52, 66 and 73 occurring equally. Although numerical constraints limit inference, findings that 91% of ICC harbor only a small number of HPV genotypes suggests that prevention efforts including vaccine development or adjuvant screening should focus on these genotypes.</p

Associations Between Methylation of Paternally Expressed Gene 3 (PEG3), Cervical Intraepithelial Neoplasia and Invasive Cervical Cancer.

Cytology-based screening for invasive cervical cancer (ICC) lacks sensitivity and specificity to discriminate between cervical intraepithelial neoplasia (CIN) likely to persist or progress from cases likely to resolve. Genome-wide approaches have been used to identify DNA methylation marks associated with CIN persistence or progression. However, associations between DNA methylation marks and CIN or ICC remain weak and inconsistent. Between 2008-2009, we conducted a hospital-based, case-control study among 213 Tanzania women with CIN 1/2/3 or ICC. We collected questionnaire data, biopsies, peripheral blood, cervical scrapes, Human papillomavirus (HPV) and HIV-1 infection status. We assessed PEG3 methylation status by bisulfite pyrosequencing. Multinomial logistic regression was used to estimate odds ratios (OR) and confidence intervals (CI 95%) for associations between PEG3 methylation status and CIN or ICC. After adjusting for age, gravidity, hormonal contraceptive use and HPV infection, a 5% increase in PEG3 DNA methylation was associated with increased risk for ICC (OR = 1.6; 95% CI 1.2-2.1). HPV infection was associated with a higher risk of CIN1-3 (OR = 15.7; 95% CI 5.7-48.6) and ICC (OR = 29.5, 95% CI 6.3-38.4). Infection with high risk HPV was correlated with mean PEG3 differentially methylated regions (DMRs) methylation (r = 0.34 p<0.0001), while the correlation with low risk HPV infection was weaker (r = 0.16 p = 0.047). Although small sample size limits inference, these data support that PEG3 methylation status has potential as a molecular target for inclusion in CIN screening to improve prediction of progression. Impact statement: We present the first evidence that aberrant methylation of the PEG3 DMR is an important co-factor in the development of Invasive cervical carcinoma (ICC), especially among women infected with high risk HPV. Our results show that a five percent increase in DNA methylation of PEG3 is associated with a 1.6-fold increase ICC risk. Suggesting PEG3 methylation status may be useful as a molecular marker for CIN screening to improve prediction of cases likely to progress

Association of cord blood methylation fractions at imprinted insulin-like growth factor 2 (IGF2), plasma IGF2, and birth weight

status: publishe

Improved Mediterranean diet scores by increasing Omega-3 containing foods in U.S. adult diets

Objective: The Mediterranean-Style Diet (MedD) pattern is associated with lower risk for chronic diseases. Key components to the MedD pattern are consumption of olive oil, green leafy vegetables, and fatty fish, all sources of omega-3 (O-3) fatty acids. The purpose of this study is to predict alignment to a MedD pattern using O-3 containing foods. Methods: A sample of 19,978 25-65 year olds with two reliable 24-hour recalls was obtained from the 2007-2018 National Health and Nutrition Examination Surveys. Multiple regression analyses determined differences by adherence level, high scorers (HS) vs. general population (GP), to the MedD pattern for dietary outcomes. Using isocaloric food substitution modeling within the GP, changes in MedD score were measured. Results: The average MedD score in HS was 16.7±0.09 versus 7.1±0.05in GP (p\u3c0.0001).Exclusive olive oil (OO) use was reported at 0.3% in GP; if OO use increased to half of oil as OO, MedD score would increase by2.1 points. MedD score increased by 0.56 when replacing 4 oz. red meat for 4 oz. fish in the GP and 6.26 when replacing 0.67 cups starchy vegetables with 2 cups non-starchy vegetables. Conclusions: Increasing oil consumption to include half of oils from OO, replacing 4 oz of red meat with 4 oz of fatty fish, and replacing 0.67 cups starchy vegetables with 2 cups of non-starchy vegetables would help the GP to achieve better alignment to a MedD pattern

Diet Quality and Eating Practices among Hispanic/Latino Men and Women: NHANES 2011–2016

Dietary quality of Hispanic/Latino adults residing in homes with children may differ by gender, that in turn, may impact youth through role modeling and food availability. Using a nationally representative sample (n = 1039) from the National Health and Nutrition Examination Survey (2011–2016), adjusted regression analyses were used to examine food-related practices, food group intake, and dietary quality among Hispanic/Latino men and women in homes with children (6–17 years). Compared to women, men had lower total 2015 Healthy Eating Index (HEI) scores and component HEI scores for healthy food groups. Men also ate more meals that were not home prepared/week and purchased more foods from non-grocery stores than women. Negative food-related practices and working more hours/week may explain in part the lower dietary quality observed among Hispanic/Latino men than women. Interventions may be improved by targeting gender-specific food-related behaviors that could positively impact dietary quality of youth residing with them