The Commit to Be Fit framework: a community case study of a multi-level, holistic school-based wellness initiative in rural Virginia

BackgroundPublic health interventions that target children's physical, mental, and emotional health will enhance their ability to learn and grow. Although more complex, school initiatives that address multiple ecological levels and take a holistic view may be more effective and likely to lead to lasting change.AimsThis article presents the framework of Commit to Be Fit (C2BF) as an example of how schools can integrate multi-level and holistic approaches for health. This innovative school-based intervention includes activities addressing individual, home, school, and community to create a culture of wellness. We describe the implementation of C2BF and its basis in ecological models and give examples of activities across three components: cafeteria, classroom, and community. We discuss challenges and note that leadership engagement and alignment were critical elements for C2BF's success thus far.DiscussionC2BF uses a school-based multi-level approach to creating a culture of wellness and holistic health for students, teachers, and community members. C2BF is unique compared to other school-based programming and includes activities that address all eight domains posited for program sustainability within public health. Built to be flexible and adaptive, C2BF was able to successfully pivot during the COVID pandemic and also follow new science.ConclusionC2BF and other multi-level holistic approaches are more likely to achieve long-term change by utilizing strategies across the multiple levels of the ecological model to improve health and wellbeing

Foods advertised in US weekly supermarket sales circulars over one year: a content analysis

BACKGROUND: The nutritional content of Americans’ shopping carts is suboptimal despite federal dietary guidance, in this case, the MyPlate consumer icon which displays desired proportions of vegetables, fruits, dairy, grains and protein foods for consumption. Consumers mention print advertising—such as weekly sales circulars—frequently as influencing their grocery shopping decisions. METHODS: To examine and describe the relative proportions of advertised foods aggregated into the MyPlate food grouping system, a content analysis of 9 209 foods advertised in 52 weekly supermarket newspaper sales inserts in 2009 from a local grocery chain was conducted in a Midwestern community. RESULTS: Overall, the protein foods group was most often represented in sales circulars (25% of total items), followed by grains (18%); dairy (10%); vegetables (8%) and fruits (7%). Less than 3% of sales advertisements were for dark green and red & orange vegetables. Over twice as much whole fruit versus 100% fruit juice was advertised (70% vs. 30%, respectively; P < 0.001). Significantly fewer protein foods and more grains than expected were advertised in the fall, and slightly more dark green vegetables were advertised in winter and spring than in summer and fall (P = 0.05). CONCLUSIONS: The average American diet, including underconsumption of fruits and vegetables but overconsumption of protein foods, was reflected in the relative frequency of food groups advertised in weekly sales circulars. Modifying sales circulars to represent healthier food groups may preserve retail profits (considering these groups’ higher profit margin) while promoting adherence to federal dietary guidance

Trends in Management of Overweight and Obesity in Obstetrics & Gynecology, Family Medicine and Pediatrics 2011-2015

Purpose: To assess for improvement in the screening and management of overweight and obesity in the past 5 years among Obstetrician-Gynecologists (OB-GYN), Family Physicians (FP), and Pediatricians (Peds). Methods: A retrospective pilot study was conducted, reviewing 150 charts of patients with overweight (body mass index [BMI] 25-29.9 kg/m2) and class I (BMI 30-34.9 kg/m2), class II (BMI 35-39.9 kg/m2), and class III obesity (BMI ≥ 40 kg/m2) between 2011 and 2015. Patients were from OB-GYN (n=50), Family Medicine, adult (FP-A) (n=50) and pediatric (FP-P) (n=28), and Peds (n=22) offices. Results: 75% of patients were female; 35.5% had overweight, 40% had class I obesity, 13.3% had class II obesity, and 11.3% had class III obesity. 100% of clinicians used BMI; none used waist circumference. Peds (91%) and FP-P (96%) visits were more likely to include counseling compared to OB-GYN (30%) and FP-A (30%) visits (p\u3c0.001). A decrease in nutrition counseling (71% vs. 29%, p\u3c0.05) occurred between 2011 and 2015. Conclusions: There remains significant room for improvement among all providers. Peds and FP-Ps may be more sensitive to the need for managing obesity than OBGYNs and FP-As. More efforts are needed to combat the obesity epidemic, starting with accurately identifying and counseling patients with obesity

PCOS from Conception to Menopause: A Review of Our Current Understanding

Polycystic ovary syndrome (PCOS) appears to be a part of a lifelong continuum starting in utero, with progressive signs in the adolescent female. It is recognized as the most common endocrinopathy in reproductive age women, and may have sequelae in the menopausal PCOS woman. PCOS is a disorder characterized by hyperandrogenism and chronic anovulation affecting at least 1 in 15 women or approximately 6-7% of reproductive age women. Metabolic and health complications associated with PCOS include obesity, insulin resistance, dyslipidemia, pancreatic beta-cell dysfunction, type 2 diabetes, cardiovascular disease, endometrial cancer, sleep apnea, inflammation, and infertility

PCOS from Conception to Menopause: A Review of Our Current Understanding

Polycystic ovary syndrome (PCOS) appears to be a part of a lifelong continuum starting in utero, with progressive signs in the adolescent female. It is recognized as the most common endocrinopathy in reproductive age women, and may have sequelae in the menopausal PCOS woman. PCOS is a disorder characterized by hyperandrogenism and chronic anovulation affecting at least 1 in 15 women or approximately 6-7% of reproductive age women. Metabolic and health complications associated with PCOS include obesity, insulin resistance, dyslipidemia, pancreatic beta-cell dysfunction, type 2 diabetes, cardiovascular disease, endometrial cancer, sleep apnea, inflammation, and infertility