Childhood Obesity in Florida: A Narrative Review on Current Trends and Interventions

We examine current research on childhood obesity (CO) trends and intervention strategies in Florida. The fiscal, emotional, and health-related costs related to general obesity are staggering. Unfortunately, CO-related publicity, research, policy, and interventions have not been entirely successful in addressing the problem. Florida ranks 35thnationally in prevalence of CO. Data from the Centers for Disease Control and Prevention (CDC) 2013 report a statistically significant decrease in Florida\u27s rate of CO among 2-4 year-olds participating in Florida’s Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) from 2008-2011. Whereas Florida still has significant room for improvement on the issue of CO, its relatively low CO prevalence indicates a step in the right direction. Information provided herein provides valuable insight, resource information, and motivation to healthcare providers, particularly registered dietitian nutritionists (RDNs). As nutrition experts employed in various areas of society, RDNs are advantageously situated to contribute significantly to the CO solution. Florida appears to benefit from interdisciplinary collaborations among healthcare facilities, schools, faith-based organizations, governmental agencies, and grassroots programs that may play a major role in the current fight against CO

Duval County 2009, 2011, and 2013 Fruit and Vegetable Intake by Health Zone: Data from the Youth Risk Behavior Survey

The purpose of this study was to compare the results of fruit and vegetable intake data from the 2009, 2011, 2013 Duval County Youth Risk Surveys (YRBS) by health zone. The survey instrument (questionnaire) is administered using a cluster sample design in all ninth grade classes in public schools (except charter schools) every two (odd) years. The surveys are anonymous and there is parental notification. Oversampling is done to allow for sub-county analysis. There were no statistically significant differences across health zones for any of the fruit and vegetable consumption questions for year 2009 however all health zones were below the recommended level of fruit and vegetable intake. For years 2011 and 2013 despite significant statistical differences by health zone in the frequency of consumption for fruits and vegetables, all health zones had a low mean intake of fruits and vegetables for years 2009, 2011 and 2013. Most respondents indicated consuming fruits, green salad, potatoes (not fried), carrots and vegetables “1 to 3 times during the past 7 days.” Overall intake of fruits and vegetables, however, was low for all health zones

Fruit, Vegetable and Beverage Consumption in Duval County Middle School Students: Youth Risk Behavior Survey 2009-2013

Public health professionals have the opportunity to impact middle school students’ dietary behaviors to combat childhood obesity. The purpose of this study was to investigate the dietary behavior results from the YRBS taken by middle school students in Duval County in 2009, 2011 and 2013. A two-stage cluster design was used and the survey was completed by 6th through 8th grade students following parent notification. Compared to other health zones, Health Zone 1 had the lowest intake of fruits and vegetables in 2009 (2.66 ±1.65) and 2011 (2.77 ± 1.60) and the second lowest intake in 2013 (2.92 ± 1.70). In 2009, 2011 and 2013, Health Zone 1 students’ response for soda intake was consistently higher compared to other health zones (2.39 ±1.54; 2.40 ±1.47; 2.29 ± 1.54 respectively). Health Zone 1, the urban core of Jacksonville, consistently had the lowest intake of fruits and vegetables and the highest intake of soda. Public health strategies should focus on improving fruit and vegetable intake and reducing soda intake within the school environment particularly focusing on Health Zone 1

Dietary Proteins as Determinants of Metabolic and Physiologic Functions of the Gastrointestinal Tract

Dietary proteins elicit a wide range of nutritional and biological functions. Beyond their nutritional role as the source of amino acids for protein synthesis, they are instrumental in the regulation of food intake, glucose and lipid metabolism, blood pressure, bone metabolism and immune function. The interaction of dietary proteins and their products of digestion with the regulatory functions of the gastrointestinal (GI) tract plays a dominant role in determining the physiological properties of proteins. The site of interaction is widespread, from the oral cavity to the colon. The characteristics of proteins that influence their interaction with the GI tract in a source-dependent manner include their physico-chemical properties, their amino acid composition and sequence, their bioactive peptides, their digestion kinetics and also the non-protein bioactive components conjugated with them. Within the GI tract, these products affect several regulatory functions by interacting with receptors releasing hormones, affecting stomach emptying and GI transport and absorption, transmitting neural signals to the brain, and modifying the microflora. This review discusses the interaction of dietary proteins during digestion and absorption with the physiological and metabolic functions of the GI tract, and illustrates the importance of this interaction in the regulation of amino acid, glucose, lipid metabolism, and food intake

Dietary Proteins, Developmental Programming, and Potential Implication in Maternal Obesity

Background: Proteins are known mainly based on their metabolic and nutritional functions including protein synthesis and a source of energy. In spite of various physiological properties attributed to proteins, their functions have neither been addressed by assessing quality of proteins nor by nutrition and dietetic practices. Methods: Studies were included if they were randomized animal studies, clinical trials and systematic reviews/meta-analysis published in English language. Results: The effect of maternal diet in general and dietary proteins in particular during development on health of offspring has been well-studied. Protein content as well as source of protein in the diet consumed during pregnancy and lactation influenced the risk of metabolic syndrome characteristics in offspring. Both high and low protein diets showed detrimental effects on health of offspring. Moreover, comparison of maternal casein-based diet with soy protein-based diet showed more favorable effect on body weight, body composition, blood pressure, and glucose metabolism in offspring. However, the role of maternal dietary proteins in developing the risk of metabolic syndrome characteristics in offspring in gestational obesity is still unclear and needs further study. Conclusions: Dietary proteins are determining factors in developmental programming. Both quantity and source of proteins in maternal diet influenced the development of metabolic syndrome characteristics in offspring. However, whether they have the same function in presence of gestational obesity is still unclear and needs further study

The effect of source of protein fed during pregnancy and lactation on the development of characteristics of metabolic syndrome in male offspring of obese Wistar rats

Gestational obesity has major negative impacts on both mothers and their offspring. More than two-thirds of women of reproductive age in the United States are overweight and/or obese. We previously reported that the source of protein in the maternal diet influences the phenotype of offspring born to normal-weight dams. However, whether it has the same effect in obese mothers was unclear. The casein- and soya protein-based diets were fed to obese pregnant Wistar rats and compared for their effects on characteristics of the metabolic syndrome in male offspring. Dams randomized to either a casein (CD) or soya protein (SD) diet (n 12). Pups were weaned to either a CD or SD for 16 weeks. Offspring of SD dams had higher birthweight (P < 0⋅01). Glucose metabolism was not altered at birth but fasting blood glucose (FBG) (P < 0⋅02), insulin (P < 0⋅0002), insulin/glucose ratio (P < 0⋅03), and HOMA-IR index (P < 0⋅0002) were higher in offspring of SD dams at week 17. The pulse rate was higher in dams (P < 0⋅03). Food intake and body weight of offspring were affected by interactive effects of time and dams’ diet (P < 0⋅05). Food intake was not influenced by maternal diet, but it was higher in pups weaned to SD dams (P < 0⋅03) The results of this study indicate that although the source of protein in the maternal diet is still an influencing factor in the outcome of the pregnancy in obese mothers, gestational obesity may mask this effect possibly by imposing general detrimental effects on measured parameters regardless of the source of protein in maternal diet

The effect of maternal intact protein-and amino acid-based diets on development of food intake regulatory systems and body weight in dams and male offspring of wistar rats

The objective of this study is to examine the effect of maternal and weaning intact protein-and amino acid-based diets on regulation of food intake, intake regulatory hormones, and body weight in dams and their male offspring. Pregnant Wistar rats were allocated to two groups (n = 12) and were fed either an intact protein diet (IPD) or mixed amino acid diet (AAD) from day 3 of gestation throughout gestation and lactation. Male offspring were weaned to either an IPD or AAD for 18 weeks. Food intake (FI) and body weight (BW) were measured weekly. Results: In dams, the AAD group had lower FI and BW in the post-partum period compared with the IPD group. In pups born to AAD dams, birth weight and BW were lower. However, the percentage of fat and lean mass were not affected. Food intake was influenced by maternal diet and was higher in pups born to IPD dams throughout post-weaning. Short-term FI in response to protein preloads was lower in pups born to AAD dams in 1 h. Fasting plasma concentrations of glucose, insulin, and ghrelin were not influenced by either maternal or weaning diet. However, peptide YY (PYY) was higher in pups born to IPD dams at weaning. Conclusions: The physicochemical properties of proteins fed during pregnancy and lactation had determining effects on the body weight and development of food intake regulatory systems in offspring. Maternal AAD resulted in lower BW in dams and lower birth weight and post-weaning BWs in pups compared with maternal IPD which was consistent with their lower FI

Nutritionally Adequate Protein Sources in Diets During Gestation, Lactation and Weaning Influence Food Intake and the Risk of Characteristics of Metabolic Syndrome in Offspring of Wistar Rats

The hypothesis that source of protein in a nutritionally adequate diet during gestation, lactation and weaning alters food intake and characteristics of metabolic syndrome in the offspring was investigated. Pregnant Wistar rats were randomized to either the AIN 93-G casein (C) or soy protein (S) diets (n=12/group) during gestation only or during gestation and lactation. Male offspring in each dams’ diet group were weaned to either C or S diets (n=12/group). Food intake, body weight (BW), fat pad mass, systolic (SBP) and diastolic (DBP) blood pressure, and plasma homocysteine (p<0.05) were higher in offspring born to dams fed the S diet. Fasting blood glucose (BG), BG in response to a glucose gavage and Homeostatic Model of Assessment of Insulin Resistance (HOMA-IR) index were higher only in male offspring born to dams fed the S diet. Moreover, gene expression of Agouti Related Protein (AgRP) was higher in offspring born to dams fed the S diet at weaning. Extending the dams’ diet during gestation and lactation magnified the effect of the gestational S diet on BW and composition and glucose metabolism in male offspring. Although composition of the weaning diets interacted with that of the dams’ diets, the latter was the dominant factor in determining metabolic outcomes in the offspring. In conclusion, the soy protein diet, compared to the casein diet when consumed during gestation or throughout gestation and lactation increased food intake and the presence of characteristics of metabolic syndrome in the offspring.Ph

Association between maternal dietary acid load during the early pregnancy and pregnancy-related complications

Epidemiological studies have suggested that there is an association between dietary acid load (DAL) with complications and outcomes of pregnancy. The current study aimed to explore the impact of DAL on theses parameters through a prospective cohort of Iranian pregnant women. In this prospective cohort study, 812 singleton pregnant women without any medical condition, use of medications, and without following a specific diet were included. Dietary intake of participants was examined using a 117-item semi-quantitative food-frequency questionnaire (FFQ). Net endogenous acid production (NEAP) and potential renal acid load (PRAL) parameters were used to explore potential DAL using the suggested formula. Multinomial logistic regression analysis was used and odds ratio (OR) and 95% corresponding confidence interval (CI) were reported. DAL (NEAP and PRAL) was not associated with pregnancy outcomes including birth weight, birth height and birth head circumference (all P values \u3e.05). NEAP was associated with pre-eclampsia (Model 3: OR = 0.48, 95%CI (0.25, 0.94); Ptrend = 0.05), systolic blood pressure (SBP) (Model 2: OR = 3.99, 95%CI (1.09, 14.53); Ptrend = 0.04), diastolic blood pressure (DBP) (Model 3: OR = 2.45, 95%CI (1.05, 5.72); Ptrend = 0.03), and intra-uterine growth restriction (IUGR) (Model 3: OR = 2.82, 95%CI (1.02, 7.78); Ptrend = 0.01). Moreover, PRAL was related with risk of pre-eclampsia (Model 3: OR = 0.41, 95%CI (0.19, 0.86); Ptrend = 0.003), SBP (Model 2: OR = 6.07, 95%CI (1.23, 29.94); Ptrend = 0.03), DBP (Model 3: OR = 3.62, 95%CI (1.23, 10.65); Ptrend = 0.03), and IUGR (Model 2: OR = 2.63, 95%CI (0.93, 7.44); Ptrend = 0.02). Our study focused on DAL which showed a significant association with pregnancy-related complications including higher SBP, DBP, IUGR, and pre-eclampsia. Further research with larger sample sizes in different populations might be required to evaluate the compatibility of DAL during pregnancy