ABSTRACT
Background. Physical activity (PA) has been conclusively shown to reduce the incidence of diabetes in prior research. A 2,000 steps/day increment yielded hazard ratio (HR) 0.88 for incidence of diabetes 95% CI 0.78-1.00;p = 0.046 (Garduno, 2022). Despite this, the role of different factors associated with higher adolescent after-school PA is understudied after the coronavirus pandemic, during which a greater proportion of parents worked remotely. This study aimed to evaluate statistically significant factors that are associated with higher adolescent PA versus sedentary behavior with the goal of identifying effective diabetes prevention interventions. Method(s): Study participants from Florida, U.S., aged 13-19 were enrolled and categorized into three groups based on the number of days of after-school exercise completed each week: 0 days of after-school exercise (No PA, n=214), 1-4 days of after-school exercise (moderate PA, n=245), and 5-7 days of after-school exercise (high PA, n=252). The statistical significance of the study factors associated with each PA group was assessed using two-tailed t-tests with a 95% confidence level. Result(s): The participants' mean age was 15.6+/-1.2 years. Among participants with high PA, moderate PA, and no PA, 19.4%, 26.4%, and 30.9% were affected by overweight or obesity respectively (p<0.05). PA was influenced by gender (81.7% of males had high PA, versus 59.5% of females, p<0.01). The incidence of high PA levels was greater among those participants whose parents were married (77.7% vs 58,8%, p<0.05) or those who were the oldest children in the family (85.1% vs 58.1%, p<0.05). In terms of modifiable factors, possibly due to a role-modeling parenting effect, high PA levels were more among participants who exercised together with parents (94.2% vs 49.1%, p<0.01), and if one of the parents had a healthy diet (74.1% vs 55.9%, p<0.05). High PA levels were also more prevalent in adolescents who read nutrition labels (86.6% vs 54.6%, p<0.01), who were concerned about protein content in food choices (90.5% vs 56.1%, p<0.05), who considered fiber (95.8% vs 64.4%, p<0.05), sugar (85.1% vs 62.8%, p<0.05), or whole food content (80.1% vs 65.8%, p<0.05). Conclusion(s): A deeper understanding of the factors associated with physical activity can help design more effective interventions. Study findings provide insight into environmental and behavioral factors associated with physical activity and provide the rationale for family-level interventions aimed at improving modifiable variables that will assist in the reduction of diabetes burden.
ABSTRACT
Introduction: A 10% increase in the diet's proportion of ultra-processed foods is associated with a higher risk of abdominal obesity (OR 1. 07, 95% CI 1. 01 to 1.13) as well as visceral obesity (OR 1. 07, 95% CI 1. 02 to 1.13) (Neri, 2022). Given that ultra-processed food intake now comprises 67% of the adolescent diet (Wang, 2021), there is growing interest in the impact of COVID-19 on obesity and ultra-processed food intake in adolescents and young adults. Methods: This paper presents an interim analysis of the Processed Intake Evaluation (PIE) study enrolling 1800 participants, aged 13-19 years, in the US. The interim data is presented for the first 452 participants in the PIE study. For these participants, we calculated a composite PIE score (Processed Intake Evaluation) score, a scale of 0-100) averaged for consumption of different ultra-processed foods (1) before COVID-19 prior to 2020 (2) during COVID-19 restrictions 2020-2021 (3) after easing of COVID-19 restrictions in 2022. Results: The participants’ mean age was 16.6±1.1 years, with 53% females. The processed food intake (PIE score) decreased from 56.2 (before COVID-19) to 52.6 (during COVID-19 restrictions) to 48.1 (now with COVID-19 restrictions eased). The respective decrease was 57.9 to 55.5 to 49.1 in male participants and 54.1 to 50.6 to 47.4 in female participants. Next, the study analyzed a panel of 23 behavioral nutritional factors and identified that less processed food stocked at home and fewer opportunities to eat processed food with peers had the highest association with this decrease during COVID-19. Next, we analyzed participants in high/low-risk groups based on obesity and diabetes in the participant or family. The high-risk group showed a muted decrease in ultra-processed food consumption from 57.7 (prior COVID) to 53.3 (COVID restrictions) to 53. 0 (now). In contrast, the low-risk group showed a higher sustained decrease from 55.9 to 52.5 to 47.1. The differential decrease between the two groups was significant (-4.7 vs. -8.8 for the high/low-risk group, p<0. 01). Conclusion: This study suggests that the ultra-processed food consumption in adolescents has decreased markedly during COVID-19. Further, the decrease has been sustainable and continued its downward trend even after easing pandemic restrictions. This downward trend related to COVID-19 will be confirmed in the final analysis of 1800 patients, however, this early data provides an encouraging signal that expanded research into COVID-19 impact on reduction in ultra-processed foods consumption and obesity may be warranted, and presents a window of opportunity to strengthen further nutritional and behavioral interventions targeted at adolescents and young adults for reducing obesity-related risk factors.Presentation: No date and time listed
ABSTRACT
Background: During COVID-19, this study examined data on adolescents' eating habits. It proposes a new 'gateway food model' for ultra-processed foods (UPF). This model shows that certain UPFs when increased (decreased) drive consumption of other UPFs as well. This has important implications for managing hypertension risk factors since studies show that those in the highest tertile of UPF consumption have a higher risk of hypertension (adjusted HR, 1.21;CI, 1.06, 1.37;p = 0.004) (Mendonca, 2016). Method(s): The study enrolled 315 participants aged 13-19 years in Florida, U.S. Participants' PIE scores (Processed Intake Evaluation scores, scale 0-100), were calculated based on averaged consumption of 12 ultra-processed food products. PIE scores, before COVID-19 in 2019, and after COVID-19 restrictions were eased in 2022, were assessed in the study. Result(s): The participants' mean age was 16.2+/-1.4 years. The study classified participants into UPF+ (n=135) and UPF- (n=180) groups according to whether they increased or decreased their UPF intake during COVID-19. For both groups, a stepwise regression was employed to identify significant factors for change in UPF intake. In the UPF+ group, increased intake of candy, store pastries, or frozen desserts was associated with increased UPF intake across all other UPFs as well (+31.2, +12.0, or +10.5 respective change in PIE score, p<0.01). Correspondingly, in the UPFgroup, reduced intake of biscuits, white bread, or processed meat was associated with decreased overall UPF intake across all other UPFs as well (-9.6, -9.4, -8.6 respective change in PIE score, p<0.01). Conclusion(s): Hypertension can begin during childhood and may be mediated by a focus on modifiable risk factors such as high UPF intake. These results indicate that for adolescents whose consumption of UPFs has not yet been established, certain gateway UPFs (candy, store pastries, and frozen desserts) should be given priority for preventive dietary interventions since increased intake in these UPFs leads to consumption of all other UPFs as well. In contrast, if an adolescent's UPF eating is already established, other UPFs (biscuits, white bread, or processed meat) can be targeted by dietary interventions as they decrease intake across all other UPFs.