Harnessing the Magic of the Dairy Matrix for Next-Level Health Solutions: A Summary of a Symposium Presented at Nutrition 2022.

An emerging body of scientific evidence demonstrates that the food matrix-the interaction among nutrients, bioactive components, and physical structure of a food-can affect health in significant, unexpected ways beyond its individual nutrients. In particular, research suggests that consumption of dairy foods such as milk, yogurt, and cheese may affect human health in a matrix-dependent fashion. To disseminate and discuss the growing body of evidence surrounding the role of the dairy food matrix on cardiometabolic health, 3 expert researchers on the topic of the food matrix shared the latest science in a session entitled "Next-Level Health Solutions: The Magic of the Matrix" at the American Society for Nutrition's 2022 LIVE ONLINE Conference. This article is a summary of the literature presented and discussed during that session. A substantial body of literature demonstrates that full-fat dairy foods, particularly fermented dairy foods, may beneficially modulate cardiometabolic outcomes depending on an individual's health status. These findings have important implications for current authoritative dietary guidance that recommends the consumption of low-fat or fat-free dairy foods. Furthermore, this evidence may inform practical applications of harnessing dairy's unique profile of bioactives for health promotion and disease prevention at the individual and community levels.

Green schoolyard renovations in low-income urban neighborhoods: Benefits to students, schools, and the surrounding community.

Green schoolyards may buffer against the effects of urbanization through increasing access to nature and its benefits. The present study was a community-academic partnership that examined the effects of green schoolyard renovations on utilization, physical activity (PA), and social interactions as well as perceptions of safety, neighborhood climate, and social cohesion among those living in low-income, urban neighborhoods. Utilizing behavioral mapping techniques and multi-informant surveys (i.e., caregivers, teachers, and community members), changes from pre- to postrenovation were assessed at two low-income, urban schools. Behavioral mapping results demonstrated increases in utilization and prosocial interactions among youth from pre- to postrenovation. Levels of moderate-to-vigorous PA also increased from pre- to postrenovation at one school. Survey data from community stakeholders revealed improvements in the perception of schoolyard safety and school-community relationships as well as reductions in bullying postrenovation. Green schoolyards may offer a safe space for children and adults to engage in social, outdoor activities, particularly in low-income, urban neighborhoods.

Green Schoolyards in Low-Income Urban Neighborhoods: Natural Spaces for Positive Youth Development Outcomes.

Children from low-income families are increasingly growing up in urban areas with limited access to nature. In these environments, strategies that promote access to natural outdoor spaces, such as green schoolyards, may enhance positive youth development outcomes by promoting physical activity (PA) and prosocial behavior, as well as increasing perceptions of safety. The current study examines children's PA and social interactions, as well as caregiver and teacher perceptions of safety, injuries, teasing/bullying, and gang activity on three newly renovated green schoolyards in low-income urban neighborhoods. A multi-method strategy, including behavioral mapping and caregiver- and teacher-reported surveys, was utilized at three time points to examine positive youth development outcomes and maintenance of effects over time. Analyses revealed that children evidenced a range of PA on the green schoolyards and demonstrated significant decreases in sedentary activity over time. The majority of children were engaged in social interactions with peers on the green schoolyards when observed. Less than 3% of interactions were negative and follow-up analyses found significant increases in positive interactions on the green schoolyards up to 24 months post-renovation. Caregivers and teachers reported increased perceptions of safety, fewer injuries, less teasing/bullying, and less gang-related activity on the renovated green schoolyards in comparison to the pre-renovation schoolyards, and these effects were maintained up to 32 months post-renovation. Overall, the study suggests that green schoolyards may promote positive development outcomes among youth living in urban, low-income neighborhoods by providing natural and safe spaces for PA and prosocial behavior.

Energy Balance 4 Kids with Play: Results from a Two-Year Cluster-Randomized Trial.

BACKGROUND: Identifying sustainable approaches to improving the physical activity (PA) and nutrition environments in schools is an important public health goal. This study examined the impact of Energy Balance for Kids with Play (EB4K with Play), a school-based intervention developed by the Academy of Nutrition and Dietetics Foundation and Playworks, on students' PA, dietary habits and knowledge, and weight status over 2 years. METHODS: This cluster-randomized, controlled trial took place in four intervention and two control schools over 2 years (n=879; third- to fifth-grade students). PA (fourth and fifth grades only), dietary knowledge and behaviors, school policies, and BMI z-score were assessed at baseline (fall 2011), midpoint (spring 2012), and endpoint (fall 2012 for accelerometers; spring 2013 for all other outcomes). RESULTS: At endpoint, there were no group differences in change in PA or dietary behaviors, although BMI z-score decreased overall by -0.07 (p=0.05). Students' dietary knowledge significantly increased, as did the amount of vegetables schools served. Post-hoc analyses stratified by grade revealed that, relative to control students, fourth-grade intervention students reduced school-day sedentary time by 15 minutes (p=0.023) and third-grade intervention students reduced BMI z-score by -0.2 (0.05; p<0.05). There were no significant differences for older students. CONCLUSIONS: EB4K with Play, which leverages the existing infrastructure of two national programs, increases children's dietary knowledge and may improve weight status and decrease sedentary behaviors among younger children. Future iterations should examine programming specific for different age groups.

Energy Balance 4 Kids with Play: Results from a Two-Year Cluster-Randomized Trial.

BACKGROUND: Identifying sustainable approaches to improving the physical activity (PA) and nutrition environments in schools is an important public health goal. This study examined the impact of Energy Balance for Kids with Play (EB4K with Play), a school-based intervention developed by the Academy of Nutrition and Dietetics Foundation and Playworks, on students' PA, dietary habits and knowledge, and weight status over 2 years. METHODS: This cluster-randomized, controlled trial took place in four intervention and two control schools over 2 years (n=879; third- to fifth-grade students). PA (fourth and fifth grades only), dietary knowledge and behaviors, school policies, and BMI z-score were assessed at baseline (fall 2011), midpoint (spring 2012), and endpoint (fall 2012 for accelerometers; spring 2013 for all other outcomes). RESULTS: At endpoint, there were no group differences in change in PA or dietary behaviors, although BMI z-score decreased overall by -0.07 (p=0.05). Students' dietary knowledge significantly increased, as did the amount of vegetables schools served. Post-hoc analyses stratified by grade revealed that, relative to control students, fourth-grade intervention students reduced school-day sedentary time by 15 minutes (p=0.023) and third-grade intervention students reduced BMI z-score by -0.2 (0.05; p<0.05). There were no signicifant differences for older students. CONCLUSIONS: EB4K with Play, which leverages the existing infrastructure of two national programs, increases children's dietary knowledge and may improve weight status and decrease sedentary behaviors among younger children. Future iterations should examine programming specific for different age groups.

Energy balance for kids with play: design and implementation of a multi-component school-based obesity prevention program.

BACKGROUND: Improving nutrition and physical activity behaviors associated with childhood obesity are significant national public health goals. Energy Balance for Kids with Play (EB4K with Play), developed through a partnership between the Academy of Nutrition and Dietetics Foundation and Playworks, is a multi-component school-based intervention designed to address youth's nutrition and physical activity behaviors. This article describes the EB4K with Play intervention and evaluation study and presents the baseline data. METHODS: The evaluation is a 2-year cluster-randomized design targeting third- to fifth-grade students enrolled in a low-income, urban school district in northern California. Six schools were recruited to participate. Four were randomized to the intervention group and two into a control group. Baseline student-level data pertaining to nutrition, physical activity, fitness, and BMI were collected in the fall of 2011. The EB4K with Play program, which includes direct-to-student nutrition and physical activity interventions, a school wellness component, and parent/community partner outreach components, began immediately after baseline data collection. RESULTS: An ethnically diverse sample of students (n=844) was recruited to participate in the study. Baseline data showed a higher percent of eligibility for free and reduced-price school lunch and higher rates of obesity/overweight than the California state averages. Fitness levels and levels of moderate-to-vigorous physical activity were comparable to state averages. CONCLUSIONS: End-point data will be collected after 2 years of the intervention. The findings from this study should help guide future efforts to design effective intervention programs to support the prevention of pediatric obesity.

Using learner-centered education to improve fruit and vegetable intake in California WIC participants.

OBJECTIVE: To examine the effectiveness of learner-centered education in conveying the message to change participants' fruit and vegetable consumption. DESIGN: Focus groups were conducted with sites participating in the Finding the Teacher Within (FTW) program and comparison sites 4-6 months after participants attended the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) fruit and vegetable class. SETTING: Six California WIC agencies. PARTICIPANTS: Sixty predominantly Latina mothers with young children, 30 from 3 participating intervention agencies and 30 from 3 comparison agencies, participated in focus groups. Each agency independently recruited mothers for participation. Apart from selecting only mothers, no other exclusion criteria were applied. INTERVENTION: An FTW learner-centered fruit and vegetable class. ANALYSIS: An analytic team independently reviewed transcripts and coded themes. The long-table analytic approach was used to categorize results. Results from intervention and comparison groups were compared and ranked to create a textual summary. RESULTS: The most significant difference between the intervention and comparison groups' reports was that intervention participants identified more value, importance, and relevance of the fruit and vegetable information and adopting new fruit and vegetable practices after attending the class. CONCLUSIONS AND IMPLICATIONS: California WIC demonstrated that messages delivered through this process can be retained and integrated into family life practices.

Preventing obesity: a life cycle perspective.

Traditional approaches to treating overweight and obese adults by focusing on individual weight loss have not been effective in stemming the tide of obesity in the population. Recent research has identified critical factors that, as they accumulate and interact over an individual's life span, may put a person at risk for obesity. These factors include rapid weight gain in infancy and childhood, early puberty, and excessive weight gain in pregnancy. Based on this research, a life cycle perspective can be used to develop comprehensive interventions that address the multiple determinants of obesity. Because obesity tracks across generations, it is essential to adopt effective obesity prevention measures now to prevent even higher rates of obesity in future generations. Dietetics professionals can reduce individual risks by providing nutritional services that support appropriate weight gain in childhood and pregnancy. We can also advocate for policies in communities, schools, and worksites that support breastfeeding, ensure access to health-promoting foods, and provide opportunities to be physically active.

Family environment and pediatric overweight: what is a parent to do?

Although the causes of pediatric overweight are many and the levels of intervention required to prevent overweight in children extend from the child's immediate environment to the larger societal level, one critical intervention target is the parent. Scientific evidence points to specific dietary and physical activity/inactivity behaviors that families can adopt to encourage healthful weight status. Dietary recommendations include providing children with ample access to nutrient-dense foods and beverages and high-fiber foods, both at meals and snack times, reducing children's access to high-calorie, nutrient-poor beverages and foods both when eating at home and at restaurants, avoiding excessive food restriction or use of food as a reward, and encouraging children to eat breakfast on a daily basis. Physical activity recommendations include providing opportunities and encouragement for children to be physically active while reducing children's television and video game time. Parental modeling of healthful eating and physical activity practices is recommended to reinforce these patterns in youth. Dietetics professionals, physicians, and other health care professionals can assist parents in their efforts to prevent pediatric overweight by providing information and supporting these key behaviors, while working to create environments that support healthful lifestyle changes.

Clarifying concepts about macronutrients' effects on satiation and satiety.

It seems that many people, including dietetics professionals and other nutrition experts, are unclear about some of the fundamental yet complex concepts behind the influence of dietary macronutrients (ie, protein, carbohydrate, and fat) on appetite regulation. Recent research has begun to unravel some of the more complicated physiological processes of appetite control and regulation generated by hormones such as leptin, ghrelin, and the gut hormone peptide YY3-35. Although the processes by which the macronutrients in our foods influence appetite regulation have been a topic of study for decades, they remain confusing and are often misunderstood. The objective of this article is to define the terminology commonly used to discuss the macronutrients' roles in appetite regulation and to discuss the interrelated concepts and roles of taste, palatability, and energy density.