Scheduling Recess Before Lunch: Perceptions of Washington State Public Elementary School Professionals

Recess Before Lunch (RBL) is a wellness strategy with a purpose of improving the overall health and behavior of school-aged children. While some studies have reported a variety of benefits and challenges by simply scheduling recess prior to the specified lunchtime, few have examined adequate strategies for successful implementation. This mixed-methods study asked elementary school principals and school food service directors within each K-5th grade public school throughout the state of Washington to participate in an online survey assessing their school’s experience using RBL. Schools were placed into three groups based on participants’ stage of RBL adoption: (1) currently using RBL, (2) previously used RBL, or (3) have never implemented RBL. Basic demographic information from each school was collected and matched to the survey responses. Participants from the online survey were asked to provide contact information of a school professional closely involved with the lunch services in their school to complete a semi-structured follow-up interview. Eighteen individuals, six in each of the three stages of RBL adoption, participated in a 10-15-minute phone interview to further investigate perceptions related to RBL. Roughly 75.8% of schools reported having some experience with RBL (N = 74). Benefits most often reported were associated with Nutrition & Food Waste, Behavior & Disruption and Scheduling, respectively; whereas the barriers included Scheduling & Staffing, Logistics, Nutrition & Food Waste and Behavior & Disruption, respectively. However, whether a school reported any benefits had no effect on its history of scheduling the program. A significant correlation was found between student enrollment and a school’s experience with RBL. Schools that never implemented RBL had smaller student enrollments (p \u3c 0.01) and were significantly more likely to report any barriers (p \u3c 0.01), whereas schools currently utilizing the program that had a higher student enrollment (p \u3c 0.05) when compared to all other schools. Telephone interviewees reported the significance of gaining support from all involved parties and encouraged finding solutions to challenges prior to implementing the program

Green tea improves metabolic biomarkers, not weight or body composition: a pilot study in overweight breast cancer survivors

Abstract Background: Overweight status after breast cancer treatment may increase a woman's risk for recurrent disease and/or early onset cardiovascular disease. Green tea has been proposed to promote weight loss and favourably modify glucose, insulin and blood lipids. This pilot study tested the effect of daily decaffeinated green tea consumption for 6 months on weight and body composition, select metabolic parameters and lipid profiles in overweight breast cancer survivors. Methods: The effect of daily decaffeinated green tea intake on weight, body composition and changes in resting metabolic rate, energy intake, glucose, insulin, homeostasis model assessment -insulin resistance (HOMA-IR) and lipids was evaluated in overweight breast cancer survivors. Participants had a mean weight of 80.2 kg; body mass index (BMI) 30.1 kg m )2 ; and body fat 46.4%. Participants (n = 54) were randomised to 960 mL of decaffeinated green or placebo tea daily for 6 months. Results: Mean (SD) tea intake among study completers (n = 39) was 5952 (1176) mL week )1 and was associated with a significant reduction in energy intake (P = 0.02). Change in body weight of )1.2 kg (green tea) versus +0.2 kg (placebo) suggests a weight change effect, although this was not statistically significant. Decaffeinated green tea intake was associated with elevated high-density lipoprotein (HDL) levels (P = 0.003) and nonsignificant improvements in the HDL/LDL ratio and HOMA-IR ()1.1 ± 5.9: green tea; +3.2 ± 7.2: herbal). Conclusions: Intake of decaffeinated green tea for 6 months was associated with a slight reduction in body weight and improved HDL and glucose homeostasis in overweight breast cancer survivors

Diet or exercise, or both, for weight reduction in women after childbirth

Background: Weight retention after pregnancy may contribute to obesity. It is known that diet and exercise are recommended components of any weight loss programme in the general population. However, strategies to achieve healthy body weight among postpartum women have not been adequately evaluated. Objectives: The objectives of this review were to evaluate the effect of diet, exercise or both for weight reduction in women after childbirth, and to assess the impact of these interventions on maternal body composition, cardiorespiratory fitness, breastfeeding performance and other child and maternal outcomes.: Search methods: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 January 2012) and LILACS (31 January 2012). We scanned secondary references and contacted experts in the field. We updated the search of the Cochrane Pregnancy and Childbirth Group's Trials Register on 30 April 2013 and added the results to the awaiting classification section of the review. Selection criteria: All published and unpublished randomised controlled trials (RCTs) and quasi‐randomised trials of diet or exercise or both, among women during the postpartum period. Data collection and analysis: Both review authors independently assessed trial quality and extracted data. Results are presented using risk ratio (RR) for categorical data and mean difference (MD) for continuous data. Data were analysed with a fixed‐effect model. A random‐effects model was used in the presence of heterogeneity. Main results: Fourteen trials were included, but only 12 trials involving 910 women contributed data to outcome analysis. Women who exercised did not lose significantly more weight than women in the usual care group (two trials; n = 53; MD ‐0.10 kg; 95% confidence interval (CI) ‐1.90 to 1.71). Women who took part in a diet (one trial; n = 45; MD ‐1.70 kg; 95% CI ‐2.08 to ‐1.32), or diet plus exercise programme (seven trials; n = 573; MD ‐1.93 kg; 95% CI ‐2.96 to ‐0.89; random‐effects, T² = 1.09, I² = 71%), lost significantly more weight than women in the usual care group. There was no difference in the magnitude of weight loss between diet alone and diet plus exercise group (one trial; n = 43; MD 0.30 kg; 95% CI ‐0.06 to 0.66). The interventions seemed not to affect breastfeeding performance adversely. Authors' conclusions: Evidence from this review suggests that both diet and exercise together and diet alone help women to lose weight after childbirth. Nevertheless, it may be preferable to lose weight through a combination of diet and exercise as this improves maternal cardiorespiratory fitness and preserves fat‐free mass, while diet alone reduces fat‐free mass. This needs confirmation in large trials of high methodological quality. For women who are breastfeeding, more evidence is required to confirm whether diet or exercise, or both, is not detrimental for either mother or baby

Coffee and tea consumption in relation to inflammation and basal glucose metabolism in a multi-ethnic Asian population: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Higher coffee consumption has been associated with a lower risk of type 2 diabetes in cohort studies, but the physiological pathways through which coffee affects glucose metabolism are not fully understood. The aim of this study was to evaluate the associations between habitual coffee and tea consumption and glucose metabolism in a multi-ethnic Asian population and possible mediation by inflammation.</p> <p>Methods</p> <p>We cross-sectionally examined the association between coffee, green tea, black tea and Oolong tea consumption and glycemic (fasting plasma glucose, HOMA-IR, HOMA-beta, plasma HbA1c) and inflammatory (plasma adiponectin and C-reactive protein) markers in a multi-ethnic Asian population (N = 4139).</p> <p>Results</p> <p>After adjusting for multiple confounders, we observed inverse associations between coffee and HOMA-IR (percent difference: - 8.8% for ≥ 3 cups/day versus rarely or never; <it>P_trend</it>= 0.007), but no significant associations between coffee and inflammatory markers. Tea consumption was not associated with glycemic markers, but green tea was inversely associated with plasma C-reactive protein concentrations (percent difference: - 12.2% for ≥ 1 cup/day versus < 1 cup/week; <it>P_trend</it>= 0.042).</p> <p>Conclusions</p> <p>These data provide additional evidence for a beneficial effect of habitual caffeinated coffee consumption on insulin sensitivity, and suggest that this effect is unlikely to be mediated by anti-inflammatory mechanisms.</p

The Diet Study in Lactating Women: A Mediterranean-Style Diet Intervention and its Effects on Postpartum Weight Loss, Body Composition and Select Biomarkers of Inflammation

Obesity-related diseases account for the majority of morbidity and mortality in U.S. adults. An estimated 4 million women in the United States deliver an infant annually, of which approximately 34% are overweight/obese prior to pregnancy. More than 30% of these women gain weight that exceeds the IOM’s recommendations; increasing their risk of postpartum weight retention and possibly increasing their risk of greater weight gain and retention over time. This research sought to test the efficacy of a traditional MED diet for 4-months on weight loss/control and biomarkers of inflammation in breastfeeding women compared to women randomized to the USDA’s MyPyramid diet for Pregnancy and Breastfeeding (control diet). At baseline, the women (N=129) were 29.7±4.6 years, overweight (BMI: 27.2±4.9 kg/m2), and primarily non-Hispanic white (75.2%). The majority of women were exclusively breastfeeding (73.6%) and a mean 17.5 weeks postpartum. Adherence to the MED diet was evaluated via calculation of the MED diet score from validated FFQs administered pre- and post- the diet intervention. Anthropometric measurements (body weight, body fat, and waist and hip circumference) and biosamples (blood, urine, and breast milk) were collected at baseline and 4-months (diet completion). Biomarkers of inflammation (IL-6 and TNF-α) were assessed via standard ELISA kits. The MED diet score was increased by 0.68±2.74 and 0.27±1.57 for the MED and control group, respectively. Increases in fish and dairy intake and a decrease in meat/poultry intake were significantly different between diet groups (P<0.05). Participants in both diet groups demonstrated significant (P=0.002) reductions in all anthropometric measurements; no significant between group differences were shown. A significant decrease in TNF-α, but not IL-6, was demonstrated in both diet groups. There were no significant between group differences. Both the MED diet and the USDA’s MyPyramid diet were effective in reducing anthropometric measurements and inflammation in postpartum breastfeeding women

The Effects of a Nutrition Education Intervention on Third- and Fifth- Grade Students’ Fruit and Vegetable Knowledge, Preference and Consumption

Purpose/Objectives Most American school children fail to meet recommended intakes of fruits and vegetables (F/V). Possible solutions to increase intake include nutrition education interventions paired with access to a cafeteria salad bar (SB). The aim of this research was to determine if a F/V-targeted nutrition education intervention would increase F/V knowledge, preference, and consumption among elementary school-aged students. Methods This repeated measures experimental design examined the effects of a nutrition education intervention among third- and fifth-grade students (n=149). Pre- and post-intervention surveys, as well as pre and post SB specific plate waste analyses, were used to measure change in F/V knowledge, preference, and consumption. Participants received eight weekly 20-minute nutrition education lessons focused on the benefits of consuming F/V. A series of two-way ANOVA models with interactions were used to examine changes in F/V knowledge, preference, and consumption in each grade. Results A few significant improvements in nutrition knowledge and F/V preference were observed. There were slight differences in overall nutrition knowledge and F/V preference between grades but not a change post-intervention within grades. Fifth-grade students generally possessed a better understanding about the benefits of consuming F/V and a greater preference for F/V. Non-significant increases in F/V consumption were noted post-intervention. Application to Child Nutrition Professionals The results of this study suggest that targeted nutrition interventions may be effective in increasing F/V intake among elementary school-aged students. Positive outcomes seem to depend on several factors, including the existence and duration of other F/V promotional programs like SB, as well as peer- and adult-modeling of F/V consumption. This study as well as previous research indicates exposure and modeling are powerful tools in order to increase pre-adolescent F/V consumption

School Breakfast Programs With Implementation of Farm to School Have No Influence on Body Weight Among 3rd and 4th Grade Students

Objectives To examine the association between frequency of breakfast consumption and body mass index (BMI) among elementary students participating in a traditional School Breakfast Program (SBP) in a school district that is implementing a Farm to School (F2S) program compared to those participating in a traditional SBP without F2S. Methods This cross-sectional study matched ten schools with a traditional SBP, five with F2S (A) and five without F2S (B). Third- and fourth-grade students (n=1031) were recruited for study participation. Demographic information, frequency of breakfast participation, and anthropometric data were collected. BMI and frequency of breakfast consumption over a ten-day period, excluding non-school days, were stratified by frequent eaters (7-10), occasional eaters (3-6), and skippers (0-2). Results No significant difference in BMI-for-age between F2S (A) and traditional SBP (B) was observed. There was also no significant correlation between BMI or BMI-for-age and breakfast participation observed. This data suggests that there is no relationship between F2S participation and BMI-for-age and no correlation between breakfast consumption and BMI-for-age among third- and fourth-grade students. Hispanic and Latino students were more likely to qualify for free and reduced lunch (p\u3c0.001). Free and reduced school meals students were more likely to be overweight or obese than students that qualify for paid school meals (p\u3c0.001). In both districts, students that were offered breakfast in the classroom were 30% more likely to participate than students offered breakfast in the cafeteria. Applications to Child Nutrition Professionals Based on this limited study, a F2S program alone is unlikely to be an effective strategy to prevent/reduce childhood overweight and obesity unless fully implemented. Future strategies should focus on lower socio-economic status students and minority groups due to their increased rates and predisposition of overweight and obesity. Offering breakfast in the classroom may be a positive method of increasing breakfast participation in all types of school breakfast programs