Consumption of Health-Related Content on Social Media Among Adolescent Girls: Mixed-Methods Pilot Study

Background: Consumption of health- and fitness-related social media content is a predominant behavior among teenage girls, which puts them at risk for consuming unreliable health-related information. Objective: This mixed-methods study (qualitative and quantitative) assessed health behavior attitudes and practices as well as social media use among adolescent girls. Additionally, similar practices and behaviors of adults who regularly interact with this population were studied. Methods: Girls aged 12-18 years were recruited to complete a 28-item survey and participate in a 45- to 60-minute focus group. Adults who regularly interact with adolescent girls, including parents, teachers, and healthcare professionals, were recruited from the local community and given a link to provide online consent and complete a survey. Results: A total of 27 adolescent girls participated in one of nine focus groups. Participants included 18 high school (age: mean 16.1 years; SD 1.3 years) and 9 middle school (age: mean 12.4 years; SD 0.7 years) girls. Eleven adults completed the online survey. Adolescents used social media to communicate and connect with friends, rather than as a source of health information. Although adolescents may see health-related content, most do not follow health-related pages or share such pages themselves, and fewer are actively searching for this information. Adolescents tend to trust information from familiar sources, and the participants reported that they do not follow official news accounts. Adults considered modeling and discussing healthy behaviors important and reportedly expected adolescents to see some level of health-related, especially fitness-related, content on social media. Conclusions: Education interventions are warranted for both adolescents and adults with whom adolescent girls regularly interact, in the areas of sedentary behavior to guide them to access reliable online health-related information and be judicious consumers of online health information

The “Motor of the Day”: Parent and School-Age Children’s Cognitions, Barriers, and Supports for Breakfast

Despite the many benefits of regular breakfast consumption few parents and children consume this meal every day and research examining the determinants of breakfast consumption is limited. Thus, the purpose of this study was to examine breakfast-related cognitions (i.e., beliefs, attitudes, facilitators, barriers) of parents and school-age children (ages 6–11 years) using the constructs of Social Cognitive Theory as a guide. Parents (n = 37) and children (n = 41) participated in focus group discussions held in community settings in 3 states (FL, NJ, WV). Data were qualitatively content analyzed to detect trends. Parents felt breakfast was important for numerous reasons. Parents expressed concern about the healthfulness of some traditional breakfast options, preferring breakfasts containing mostly fruits, vegetables, and protein and fewer carbohydrates. Parents identified lack of time as the greatest barrier to breakfast consumption. To overcome this barrier, they utilized grab-and-go foods, prepared breakfast ahead of time, and got up earlier. Utilizing the school breakfast program was another strategy mentioned, however some were concerned about the nutritional quality of this option. Children recognized the importance of breakfast and cited several benefits. The greatest barrier to breakfast identified by children was feeling rushed in the morning. To overcome barriers, children suggested having a morning routine, selecting or preparing breakfast foods ahead, and relying on parents to encourage breakfast consumption. The effectiveness of interventions aiming to improve breakfast intake may be improved by addressing parent and child breakfast-related cognitions and tailoring interventions to address their needs

Neck Circumference Positively Relates to Cardiovascular Risk Factors in College Students

The objective of this study was to determine the relationship between neck circumference (NC) and other anthropometric measures and examine cut-off points for males and females according to existing waist circumference cut-off levels in this age group. Across 8 universities, 1562 students underwent a physical assessment. Spearman rho correlations (ρ) were calculated to determine associations between NC and other continuous variables of health. Receiving operating characteristic curves were constructed to assess the optimal cut-off levels of NC of males and females with central obesity. Participants were predominantly Caucasian (67%), female (70%), and outside of Appalachia 2 (82%). Forty-one percent of males and 34% of females had a BMI ≥ 25 kg/m . In both sexes, significant positive correlations were seen between NC and body weight, BMI, waist circumference, hip circumference, and systolic blood pressure (all p-values \u3c 0.0001). NC ≥ 38 cm for males and ≥33.5 cm for females were the optimal cut-off values to determine subjects with central obesity. NC has been identified to closely correlate with other anthropometric measurements related to disease and could be used as a convenient, low-cost, and noninvasive measurement in large-scale studies

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Service-Learning or Internship: A Mixed-Methods Evaluation of Experiential Learning Pedagogies

Experiential learning pedagogies, including internship and service-learning experiences, are becoming increasingly popular in higher education. An internship engages students with hands-on experiences that enhance their learning or skills within their fields of study. In contrast, service-learning is a type of experiential education in which students participate in service, typically within the community, and reflect on their involvement to gain further understanding of the discipline as well as its relationship to societal needs. To date, no study has directly compared these teaching modalities. Therefore, the present study systematically evaluated a service-learning experience against an internship experience using a mixed-methods model with the primary outcome being student self-efficacy. Sixteen exercise physiology students (13 females) completed a community-based wellness internship with a subgroup (nine students, 7 females) allocated to a service-learning component of internship designed to improve self-efficacy. At the end of the semester, students completed a 15-item online self-efficacy and satisfaction survey. Three focus groups were conducted in which 3-4 participants responded to a series of nine questions that explored their experience. Overall responses to the self-efficacy and satisfaction survey were favorable for both groups, but the internship group was more likely to agree or strongly agree with statements of self-efficacy. Focus groups found that the internship experience reinforced classroom learning, but the ability to work with different populations and ability levels was mentioned only by the service-learning group. Themes from reflective assignments, such as engaging with community members and professional exploration, were evident only in the service-learning group responses. Therefore, the findings indicate that service-learning reflection assignments successfully connect the service experience to relevant course outcomes promoting student development but may not improve self-reported self-efficacy beyond that of a typical internship experience

Non-fat milk attenuates acute hypertriglyceridemia in obese individuals who consume a high fat diet: A randomized control trial

BACKGROUND: Repeated exposure to elevated postprandial triglycerides, as seen with typical Western diets, contributes to atherosclerosis and vascular disease. We determined if a single serving of non-fat milk added to a high fat tolerance test could attenuate postprandial hypertriglyceridemia in individuals who consume a high fat diet. METHODS: In this placebo-controlled, randomized, crossover experimental study, 30 overweight/obese adults consumed a high-fat tolerance test meal combined with either non-fat milk, carbohydrate control drink, or caloric control drink. RESULTS: Plasma triglycerides increased over time with no significant differences between interventions. Peak plasma triglyceride levels during HFTT were significantly related to dietary fat intake (r = 0.30, p < 0.05). When participants were divided into tertiles based on habitual dietary fat intake, the higher fat diet group exhibited reduced triglyceride net integrated area under the curve when supplemented with non-fat milk. No significant differences in hemodynamic measures (brachial flow-mediated dilation and femoral vascular conductance) were observed between the milk and caloric control trials for either the low fat or high fat diet groups. CONCLUSIONS: A single serving of non-fat milk may attenuate acute hypertriglyceridemia in individuals who chronically consume a high fat diet, offering a simple and easily implemented option for managing elevations in postprandial triglycerides

Nonfat milk attenuates acute hyperglycemia in individuals with android obesity: A randomized control trial

BACKGROUND Elevated android body fat increases the risk of developing cardiometabolic diseases. Postprandial hyperglycemia contributes to the proatherogenic metabolic state evident in android adiposity. Due to the insulinotropic effect of milk‐derived proteins, postprandial hyperglycemia has been shown to be reduced with the addition of dairy products. The purpose of this study was to determine whether one serving of nonfat milk added to an oral glucose tolerance test (OGTT ) could attenuate postprandial hyperglycemia in individuals with elevated android adiposity and whether these improvements would be associated with metabolic and/or peripheral hemodynamic effects. METHODS In this placebo‐controlled, randomized, crossover experimental study, 29 overweight/obese adults (26 ± 1 year) consumed an OGTT beverage (75 g glucose) combined with either nonfat milk (227 g) or a placebo control (12 g lactose + 8 g protein + 207 g water) that was matched for both carbohydrate and protein quantities. RESULTS In the whole sample, blood glucose and insulin concentrations increased over time in both trials with no significant differences between trials. Relative increases in peak blood glucose response were significantly related to android body fat (p < 0.05). The subjects in the highest tertiles of android body fat displayed attenuated hyperglycemic responses as well as improvements in flow‐mediated dilation (FMD) after milk intake. CONCLUSIONS A single serving of nonfat milk may attenuate acute hyperglycemia in individuals with elevated android body fat offering a simple and convenient option for managing elevations in blood glucose

Neck Circumference Positively Relates to Cardiovascular Risk Factors in College Students

The objective of this study was to determine the relationship between neck circumference (NC) and other anthropometric measures and examine cut-off points for males and females according to existing waist circumference cut-off levels in this age group. Across 8 universities, 1562 students underwent a physical assessment. Spearman rho correlations (ρ) were calculated to determine associations between NC and other continuous variables of health. Receiving operating characteristic curves were constructed to assess the optimal cut-off levels of NC of males and females with central obesity. Participants were predominantly Caucasian (67%), female (70%), and outside of Appalachia (82%). Forty-one percent of males and 34% of females had a BMI ≥ 25 kg/m2. In both sexes, significant positive correlations were seen between NC and body weight, BMI, waist circumference, hip circumference, and systolic blood pressure (all p-values < 0.0001). NC ≥ 38 cm for males and ≥33.5 cm for females were the optimal cut-off values to determine subjects with central obesity. NC has been identified to closely correlate with other anthropometric measurements related to disease and could be used as a convenient, low-cost, and noninvasive measurement in large-scale studies