Nutrition Effects of a Family-Centered Health Promotion Program for Mexican-Heritage Children in the Lower Rio Grande Valley of Texas.

Systemic and social factors, like poverty and food insecurity, negatively influence fruit and vegetable (FV) intake and body mass index (BMI) among Latino/a children. Behavioral programs are needed to support children's nutrition. This study examined program effects on FV intake and BMI outcomes for Mexican-heritage children (9-11 years). The program used a modified stepped-wedge design in the Lower Rio Grande Valley of Texas (2019 and 2020). Promotoras led experiential nutrition education sessions and collected height, weight, and instant skin carotenoid scores (biomarker for FV intake) at pre-test (baseline), post-test (6 weeks), and maintenance (3-4 months after post-test). Mean changes and group differences in skin carotenoid scores, BMI z-scores and percentiles were obtained from analyses of variance. Linear mixed-effects models were used to determine overall program effects. Mexican-heritage children were enrolled (n = 57 and 52.6% female). An overall decrease in skin carotenoid scores was observed at post-test (-15.1; 95% CI: -24.95, -5.33). While scores varied widely (range: 17-498), an increase of 14.8 ± 23.8 points occurred in one intervention group. Compared to the control period, greater reductions in BMI outcomes occurred during the program. These findings provide evidence for the use of strengths-based approaches in behavioral nutrition programs.

Association between diet and symptoms of anxiety and depression in college students: A systematic review.

Objective: To gather research evidence on the association between diet and depression and anxiety among college students. Methods: Systematic searches were performed in CINAHL, PsycINFO, PubMed, and ScienceDirect databases to identify potentially relevant articles published between January 2000 and September 2020. Data were extracted from 21 selected studies. Results: Most of the cross-sectional studies found a positive association between diet and depression and anxiety; however, a few studies found inconsistent results. Moreover, several interventional studies demonstrated that a healthy diet (including consumption of fruit and vegetables) improved depression in the intervention group. Conclusions: The methodological limitations of cross-sectional studies to explain causality and the limited number of prospective interventional studies point to a pressing need to conduct more prospective, longitudinal, and randomized controlled trials to generalize the causal associations between diet and depression and anxiety. Further research is needed to investigate the biological mechanisms of nutrients' actions on anxiety and depression.

The HOME Study: Understanding How College Students at a Hispanic Serving Institution Coped with Food Insecurity in a Pandemic.

College students represent a unique population of adults, who may be more likely to experience food insecurity due to their transient circumstances, limited access to resources, and increased educational expenses. But little is known about how college students and their households mitigate food insecurity, particularly during a crisis like the COVID-19 pandemic. The Household Observations of Meals and Environments (HOME) Study described how college students in the US utilized multilevel resources, including an on-campus food pantry, to maintain food security during the pandemic. A convenience sample of college students (n = 18) were recruited from an on-campus food pantry and provided quantitative and qualitative data through online surveys and in-depth Zoom interviews. Survey data were analyzed to describe sociodemographic characteristics. In-depth interviews were recorded, transcribed, coded, and analyzed thematically to identify emergent themes. Social support and the use of an on-campus food pantry were primary factors in maintaining a food security safety net. Students faced barriers when trying to access federal and state food assistance programs and identified multilevel resources, their food security, and the role of social support as facilitators in their perceptions of food insecurity status and experiences. Findings highlight practical implications for research related to on-campus food insecurity interventions and policies to support food security among college students.

Staff Workshop Improves Child Care Center Menus in South Central Texas: A Best Food for Families, Infants, and Toddlers (Best Food FITS) Intervention.

OBJECTIVE: To assess the efficacy of an educational workshop for child care center staff to improve menus. METHODS: Staff from 18 centers attended a nutrition educational workshop that included an activity that compared center menus to MyPlate standards. Four weeks of menus collected before and after the workshop were imported into SuperTracker; the Food Details report produced menu data clustered by day and center. Changes in pre-post menus were assessed using Healthy Eating Index scores and the SAS software macro, MIXCORR. RESULTS: After the workshop, there was a lower probability that fruit juice (P = .03) and starchy vegetables (P = .004) and a higher probability that non-starchy vegetables (P < .001) and whole grains (P = .004) were on menus; amounts of refined grains (P = .004), savory snacks (P < .001), and cheese (P = .004) were significantly lower. Total Healthy Eating Index scores improved after the workshop (P = .009). CONCLUSIONS AND IMPLICATIONS: Comparing 4 weeks of menus revealed menu changes. Workshop interventions show promise for improving children's health.

User-centered Design of a Texas WIC App: A Focus Group Investigation.

OBJECTIVE: The purpose of this research was to conduct the first stages of a user-centered design of a smartphone app designed to improve health behaviors among participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Texas. METHODS: Focus groups explored facilitators and barriers to health behaviors, current use of apps, and desired features in a WIC app. RESULTS: Facilitators to improve health behaviors included access to information, support from healthcare practitioners and family, and implementation of strategies. Current app use themes included texting/chatting, accessing information, tracking/locating, planning/scheduling, sharing, and gaming. Frequencies of key themes within and across groups were used to inform app prototype design. Mock-ups of 15 prototype features were developed based on themes of facilitators and currently used app features. Participants agreed that having all features combined into a single WIC app would be convenient and provide trustworthy information from WIC. CONCLUSIONS: The enthusiasm of focus group participants for a comprehensive WIC app suggests that this initiative is timely, and that an app has potential to improve health behaviors. Future research should continue the user-centered design process through further evaluation of prototype features, incorporating cultural preferences at every step.

Improving children's menus in community restaurants: best food for families, infants, and toddlers (Best Food FITS) intervention, South Central Texas, 2010-2014.

BACKGROUND: Approximately 32% of US children are overweight or obese. Restaurant and fast food meals contribute 18% of daily calories for children and adolescents aged 2 to 18 years. Changing children's menus may improve their diets. This case study describes Best Food for Families, Infants, and Toddlers (Best Food FITS), a community-based intervention designed to address childhood obesity. The objective of this study was to improve San Marcos children's access to healthy diets through partnerships with local restaurants, removing sugar-sweetened beverages, decreasing the number of energy-dense entrées, and increasing fruit and vegetable offerings on restaurant menus. COMMUNITY CONTEXT: San Marcos, Texas, the fastest growing US city, has more restaurants and fewer grocery stores than other Texas cities. San Marcos's population is diverse; 37.8% of residents and 70.3% of children are Hispanic. Overweight and obesity rates among school children exceed 50%; 40.3% of children live below the poverty level. METHODS: This project received funding from the Texas Department of State Health Services Nutrition, Physical Activity, and Obesity Prevention Program to develop Best Food FITS. The case study consisted of developing a brand, engaging community stakeholders, reviewing existing children's menus in local restaurants, administering owner-manager surveys, collaborating with restaurants to improve menus, and assessing the process and outcomes of the intervention. OUTCOME: Best Food FITS regularly participated in citywide health events and funded the construction of a teaching kitchen in a new community building where regular nutrition classes are held. Sixteen independent restaurants and 1 chain restaurant implemented new menus. INTERPRETATION: Improving menus in restaurants can be a simple step toward changing children's food habits. The approach taken in this case study can be adapted to other communities. Minimal funding would be needed to facilitate development of promotional items to support brand recognition.

Associations between a voluntary restaurant menu designation initiative and patron purchasing behavior.

BACKGROUND: Restaurant initiatives provide an efficient opportunity to impact large numbers of patrons. The purpose of this study is to measure patron purchasing behaviors during the ¡Por Vida! menu designation initiative. METHOD: This study used a cross-sectional design and survey data to assess 23 restaurants throughout Bexar County and 152 restaurant patrons. The Patron Awareness Questionnaire assessed if patrons noticed the logo; believed nutrition, cost, and taste were important in making purchasing decisions; and purchased a ¡Por Vida! item. Descriptive statistics, Spearman correlations, and logistic regression were used to analyze the data. RESULTS: Most (93.4%) patrons considered taste very important when deciding what to eat. Cost was very important to 63.8% and nutrition was very important to 55.9% of the sample. The strongest predictors of purchasing a ¡Por Vida! item were the patrons' ages being between 18 and 35 years (odds ratio = 1.474; confidence interval = 0.017, 0.812; p < .05) and if patrons saw the logo (odds ratio = 4.327; confidence interval = 1.696-11.036; p < .01). DISCUSSION/CONCLUSION: Menu logo designation initiatives can potentially influence patron purchasing behaviors among a segment of the population when the logo is visible.