Consumption of 100% Fruit Juice is Associated with Better Nutrient Intake and Diet Quality but not with Weight Status in Children: NHANES 2007-2010

Objective: This study examined the impact of various levels of 100% fruit juice (FJ) consumption on intake of nutrients, diet quality, and weight in children using the more recent national data.Methods: This was a cross-sectional study examining the data from children 2-18 years of age (n=6,090). Intake of nutrients and diet quality were assessed using the 24-hr dietary recall and Healthy Eating Index-2010, respectively. Various consumption levels of 100% FJ were determined. Covariate adjusted linear regression means, and standard errors were determined (p<0.01).Results: Average per capita consumption of 100% FJ consumed was 3.6 fl oz (50 kilocalories; 2.9% energy intake); 30% of children 2-6 years exceeded the recommendation for 100% FJ. Among 100% FJ consumers, the mean amount of 100% FJ consumed was 10.6 fl oz (147 kilocalories; 8.4% energy intake). Intakes of vitamin C, magnesium, and potassium and overall diet quality were higher with more 100% FJ consumed; no difference was found in total fiber intake. No trends were seen in weight with increased amounts of 100% FJ consumed.Conclusions: Consumption of 100% FJ should be recommended as a component of a healthy diet

Relationship between Snacking Patterns, Diet Quality and Risk of Overweight and Abdominal Obesity in Children

Snacking is very common among Americans; the impact of variety of snacking patterns on nutrient intake and weight status is unclear. This study examined the associations of snacking patterns on nutrient intake and weight in U.S. children 2-18 years (n=14,220) participating in the 2001-2008 National Health and Nutrition Examination Survey. Cluster analysis generated 12 distinct snacking patterns, explaining 57% of variance in total calories consumed. Only 8% of the children did not consume snacks on the day of the 24-hour recall. Cakes, cookies and pastries was the most common snacking pattern (16%) followed by miscellaneous snacks (e.g. whole milk, orange juice and meat/fish/poultry; 13%), and crackers and salty snacks (10%). Most snacking patterns resulted in higher total energy intake than the no snack pattern. After controlling for energy intake, most snacking patterns resulted in higher intakes of fiber; vitamins A, C, B12, and K; riboflavin; folate; potassium; calcium; zinc; and magnesium than the no snack pattern. However, most of the snacking patterns resulted in higher total intake of saturated fatty acids, solid fats, added sugars, and sodium (nutrients to limit). Several of the snacking patterns (i.e. cakes/cookies/pastries, crackers/salty snacks, sweets, and other grains) were associated with a reduced risk of overweight and abdominal obesity. Overall, several snacking patterns compared with non-snackers had better diet quality and were less likely to be overweight or obese and less likely to have abdominal obesity. Education is needed to improve snacking patterns in terms of nutrients to limit in the diet

Beverage Consumption in the Diets of Children is Not Consistently Associated with Weight: National Health and Nutrition Examination Survey 2007-2014

Objectives: The objective of this study was to examine whether there was significant risk associated with types of beverages consumed on the weight status in children.Design: Nationally representative cross-sectional sample.Setting: Demographic information was obtained from the NHANES interviews. Dietary intake data were obtained from Day 1, in-person 24-hour dietary recall interviews administered using an automated multiple-pass method. Height and weight were obtained according to NHANES Anthropometry Procedures Manual.Subjects: Children 2-18 years of age.Results: The likelihood of being overweight or obese was not significant for any of the beverages studied between consumers and non-consumers. For the total sample, for every 29.6 mL of water consumed the risk of being obese was 1%. For ages 6-11 years water consumption increased the risk of being obese and in ages 2-5 years, consumption of sugar sweetened beverages (SSB) increased the risk of being obese. The risk of being obese was significant p <0.05 for Hispanic males for every 29.6 mL of water consumed and for 100% fruit juice and SSB for other males; increased risk was ?3%. The risk of being obese increased for White females for every 29.6 mL of flavored milk consumed and water consumption for both Black females and Hispanic females; the significant p<0.05 increased risk of obesity was ?7%.Conclusions: Beverage consumption was not consistently associated with weight status in the diets of a nationally representative sample of children. In some cases the increased risk was very small

Resemblance of Dinner Meal Consumption among Mother and Preschool-Aged Child Dyads from Families with Limited Incomes

Parents’ eating habits are associated with food and nutrient intake of their children; yet, the associations have not always been very strong. The objective of this study was to expand the current literature to include an examination of resemblance in intakes of foods, within the context of a meal, among mother and preschool-aged child dyads from families of limited incomes. Mother-child dyads (n=112; 41% Hispanic and 59% African-American) participated in the study. During the two home observations of each mother-child dyad, a digital photography method plus actual weighing of plate waste was used to assess the amount of food served and consumed by the mothers and children. There were significant correlations between the mother-child dyad intakes of food/beverages consumed at the dinner meal; ranging from 0.298 (total beverages, p<0.01) to 0.687 (100% fruit juice or milk, p<0.01). There was a significant linear association between the amount of total food/beverages served and the amount consumed for both the mothers (R2=0.72, p<0.0001) and the children (R2=0.55, p<0.0001). Mothers-children who were served larger amounts of total food/beverages consumed more. There was a positive association (p<0.05) between the amount of total energy consumed in the mother-child dyads. Portion sizes may be an important strategy that can be used by parents to promote intake of fruits and vegetables and to decrease intake of energy-dense foods. It is important that food and nutrition professionals provide the guidance needed that encourages intake of major food groups in mothers so they can model healthier food consumption behaviors for their children

Trends in Orange Juice Consumption and Nutrient Adequacy in Children 2003-2016

This study aimed to examine secular trends in 100% orange juice (OJ) consumption and trends in nutrient adequacy in children 2-18 years participating in the 2003-2016 National Health and Nutrition Examination Survey. The National Cancer Institute method was used to estimate the usual intake. Ten deciles of OJ consumption were determined based on intakes with non-consumers in the first decile. Nutrient adequacy was determined using the percentage below the Estimated Average Requirement (EAR) or the Adequate Intake (AI) percentage. Linear regression coefficients for changes in intake over time and across deciles of OJ were generated. Approximately 14% of the total sample consumed OJ with a mean intake of 40.0 g/d (77 KJ [0.9% of total energy intake]). Amounts of all 100% fruit juices consumed decreased by 44%, and whole fruit intake increased by approximately 32% from 2003-2016. Consumption of total energy, total carbohydrates, added sugars, and saturated fatty acids decreased. Intakes of folate, riboflavin, zinc, and vitamin C decreased from 2003-2016. The percentage of children below the EAR increased for vitamin C and zinc and decreased for vitamin A from 2003-2016. Percent of children above the AI increased for fiber. Across the deciles of OJ consumption, the percent of children with an inadequate vitamin D intake, calcium, iron, and phosphorus decreased. OJ and other 100% juices were major food sources of many nutrients consumed at levels below recommendations. One strategy to reduce inadequate intake of calcium, phosphorus, and potassium intake is to maintain or increase the consumption of OJ and other 100% juice

Risk stratification for arrhythmic death in an emergency department cohort: a new method of nonlinear PD2i analysis of the ECG

Heart rate variability (HRV) reflects both cardiac autonomic function and risk of sudden arrhythmic death (AD). Indices of HRV based on linear stochastic models are independent risk factors for AD in postmyocardial infarction (MI) cohorts. Indices based on nonlinear deterministic models have a higher sensitivity and specificity for predicting AD in retrospective data. A new nonlinear deterministic model, the automated Point Correlation Dimension (PD2i), was prospectively evaluated for prediction of AD. Patients were enrolled (N = 918) in 6 emergency departments (EDs) upon presentation with chest pain and being determined to be at risk of acute MI (AMI) >7%. Brief digital ECGs (>1000 heartbeats, ∼15 min) were recorded and automated PD2i results obtained. Out-of-hospital AD was determined by modified Hinkle-Thaler criteria. All-cause mortality at 1 year was 6.2%, with 3.5% being ADs. Of the AD fatalities, 34% were without previous history of MI or diagnosis of AMI. The PD2i prediction of AD had sensitivity = 96%, specificity = 85%, negative predictive value = 99%, and relative risk >24.2 (p ≤ 0.001). HRV analysis by the time-dependent nonlinear PD2i algorithm can accurately predict risk of AD in an ED cohort and may have both life-saving and resource-saving implications for individual risk assessment

Proceedings of the 3rd Biennial Conference of the Society for Implementation Research Collaboration (SIRC) 2015: advancing efficient methodologies through community partnerships and team science

It is well documented that the majority of adults, children and families in need of evidence-based behavioral health interventionsi do not receive them [1, 2] and that few robust empirically supported methods for implementing evidence-based practices (EBPs) exist. The Society for Implementation Research Collaboration (SIRC) represents a burgeoning effort to advance the innovation and rigor of implementation research and is uniquely focused on bringing together researchers and stakeholders committed to evaluating the implementation of complex evidence-based behavioral health interventions. Through its diverse activities and membership, SIRC aims to foster the promise of implementation research to better serve the behavioral health needs of the population by identifying rigorous, relevant, and efficient strategies that successfully transfer scientific evidence to clinical knowledge for use in real world settings [3]. SIRC began as a National Institute of Mental Health (NIMH)-funded conference series in 2010 (previously titled the “Seattle Implementation Research Conference”; $150,000 USD for 3 conferences in 2011, 2013, and 2015) with the recognition that there were multiple researchers and stakeholdersi working in parallel on innovative implementation science projects in behavioral health, but that formal channels for communicating and collaborating with one another were relatively unavailable. There was a significant need for a forum within which implementation researchers and stakeholders could learn from one another, refine approaches to science and practice, and develop an implementation research agenda using common measures, methods, and research principles to improve both the frequency and quality with which behavioral health treatment implementation is evaluated. SIRC’s membership growth is a testament to this identified need with more than 1000 members from 2011 to the present.ii SIRC’s primary objectives are to: (1) foster communication and collaboration across diverse groups, including implementation researchers, intermediariesi, as well as community stakeholders (SIRC uses the term “EBP champions” for these groups) – and to do so across multiple career levels (e.g., students, early career faculty, established investigators); and (2) enhance and disseminate rigorous measures and methodologies for implementing EBPs and evaluating EBP implementation efforts. These objectives are well aligned with Glasgow and colleagues’ [4] five core tenets deemed critical for advancing implementation science: collaboration, efficiency and speed, rigor and relevance, improved capacity, and cumulative knowledge. SIRC advances these objectives and tenets through in-person conferences, which bring together multidisciplinary implementation researchers and those implementing evidence-based behavioral health interventions in the community to share their work and create professional connections and collaborations

Whole-genome sequencing reveals host factors underlying critical COVID-19

Critical COVID-19 is caused by immune-mediated inflammatory lung injury. Host genetic variation influences the development of illness requiring critical care1 or hospitalization2,3,4 after infection with SARS-CoV-2. The GenOMICC (Genetics of Mortality in Critical Care) study enables the comparison of genomes from individuals who are critically ill with those of population controls to find underlying disease mechanisms. Here we use whole-genome sequencing in 7,491 critically ill individuals compared with 48,400 controls to discover and replicate 23 independent variants that significantly predispose to critical COVID-19. We identify 16 new independent associations, including variants within genes that are involved in interferon signalling (IL10RB and PLSCR1), leucocyte differentiation (BCL11A) and blood-type antigen secretor status (FUT2). Using transcriptome-wide association and colocalization to infer the effect of gene expression on disease severity, we find evidence that implicates multiple genes—including reduced expression of a membrane flippase (ATP11A), and increased expression of a mucin (MUC1)—in critical disease. Mendelian randomization provides evidence in support of causal roles for myeloid cell adhesion molecules (SELE, ICAM5 and CD209) and the coagulation factor F8, all of which are potentially druggable targets. Our results are broadly consistent with a multi-component model of COVID-19 pathophysiology, in which at least two distinct mechanisms can predispose to life-threatening disease: failure to control viral replication; or an enhanced tendency towards pulmonary inflammation and intravascular coagulation. We show that comparison between cases of critical illness and population controls is highly efficient for the detection of therapeutically relevant mechanisms of disease