A Community Engagement Process Identifies Environmental Priorities to Prevent Early Childhood Obesity: The Children’s Healthy Living (CHL) Program for Remote Underserved Populations in the US Affiliated Pacific Islands, Hawaii and Alaska

Underserved minority populations in the US Affiliated Pacific Islands (USAPI), Hawaii, and Alaska display disproportionate rates of childhood obesity. The region’s unique circumstance should be taken into account when designing obesity prevention interventions. The purpose of this paper is to (a), describe the community engagement process (CEP) used by the Children’s Healthy Living (CHL) Program for remote underserved minority populations in the USAPI, Hawaii, and Alaska (b) report community-identified priorities for an environmental intervention addressing early childhood (ages 2–8 years) obesity, and (c) share lessons learned in the CEP. Four communities in each of five CHL jurisdictions (Alaska, American Samoa, Commonwealth of the Northern Mariana Islands, Guam, Hawai‘i) were selected to participate in the community-randomized matched-pair trial. Over 900 community members including parents, teachers, and community leaders participated in the CEP over a 14 month period. The CEP was used to identify environmental intervention priorities to address six behavioral outcomes: increasing fruit/vegetable consumption, water intake, physical activity and sleep; and decreasing screen time and intake of sugar sweetened beverages. Community members were engaged through Local Advisory Committees, key informant interviews and participatory community meetings. Community-identified priorities centered on policy development; role modeling; enhancing access to healthy food, clean water, and physical activity venues; and healthy living education. Through the CEP, CHL identified culturally appropriate priorities for intervention that were also consistent with the literature on effective obesity prevention practices. Results of the CEP will guide the CHL intervention design and implementation. The CHL CEP may serve as a model for other underserved minority island populations

Physical Chemistry of Milk Fat Globules

Many properties of milk and dairy products are determined by the behaviour and physical chemistry of milk fat globules. Allowed to stand, raw milk quickly separates into fat-enriched and fat-depleted phases, i.e. cream and skim milk, respectively. This is partly due to simple density differences between the emulsified fat globules and milk serum, but gravitational separation occurs at a rate ultimately determined by a complex series of colloidal interactions mediated by the milk fat globule membrane (MFGM) that lead to aggregation of fat globules, particularly at low temperatures (i.e. so-called cold agglutination). Creaming properties of milk differ between mammalian species, and processing of milk can profoundly alter the creaming properties of bovine milk, particularly homogenization and centrifugal separation, but also heat treatment. In this chapter, the principal physical properties of bovine milk fat globules are discussed, along with methods for their analysis and the impact of common dairy processes on their stability