Knowledge, Attitudes, and Practices Regarding Dietary Sodium in College Students.

OBJECTIVE: Test a dietary sodium survey in a US adult population of college students using a survey previously validated in a non-US adult population. METHODS: Cross-sectional study of a convenience sample of college students from a Midwest (n = 168) and Pacific Island (n = 152) university. Main outcome measures were knowledge, attitudes, and practices regarding dietary sodium (38 items). Sum scores and percentages for constructs were calculated. A score <75% was considered unfavorable; t test or ANOVA were used to examine group differences. RESULTS: Midwest students were primarily non-Hispanic White individuals (81%) and 65% female. Pacific Island students were predominantly Asian (51%) and 66% female. Mean ± SD construct scores (percentage) for knowledge, attitudes, and practices were 58.69 ± 10.62, 63.96 ± 16.18, 66.00 ± 12.34 (Midwest) and 57.54 ± 10.93, 64.84 ± 14.96, 64.94 ± 13.18 (Pacific Island), respectively; there were no significant differences between schools or race. CONCLUSIONS AND IMPLICATIONS: College students scored low in knowledge, attitudes, and practices regarding sodium. Results from this formative study may inform assessment strategies in future dietary sodium interventions.

Youth Mentor Dietary Outcomes and Waist Circumference Improvement: Camp NERF Study Findings.

Background. The health impact of youth mentors serving in the delivery of child nutrition and physical activity (PA) interventions on youth mentors themselves has been understudied. Objective. The primary objective of the current study was to examine the impact of engaging youth mentors in the delivery of a summertime childhood obesity prevention intervention on youth mentors' behavioral health. Method. Data were collected at baseline and postintervention. A survey of validated nutrition, mental health, PA, and psychosocial questionnaires was administered. Diet was assessed via 24-hour recall. Height, weight, and waist circumference (WC) were measured. In-depth interviews were conducted with youth mentors. Results. Eleven youth mentors enrolled: 60% were female, mean age was 16.1 ± 0.38 years, and 100% were Black. Mean kilocalories (p = .05), sugar-sweetened beverage intake (p = .08), and waist circumference (p = .04) decreased. In-depth interviews were conducted with 11 youth mentors, and three themes emerged: perceived improvement in nutrition, PA, and mental health-related behaviors; formation of a positive role modeling relationship with the child campers; and strengthening of higher education goals and future career aspirations. Conclusions. Youth mentor staffing may be an important intervention strategy for changing health behaviors among youth mentors. Results from this study can be used to inform utilization of youth mentors in the delivery of this and similar health behavior interventions in the future.

Examination of the relationship of diet quality with cardiometabolic risk factors in apparently healthy college students.

BACKGROUND: Preliminary evidence indicates that subclinical cardiometabolic abnormalities are present in apparently healthy nonobese young adults. Poor dietary habits may be a contributing factor. OBJECTIVE: The objective of this study was to examine the presence of cardiometabolic abnormalities in apparently healthy college students and to assess the relationship between diet quality and cardiometabolic risk factors. METHODS: Cross-sectional anthropometric, lipidemia, and glucose tolerance, blood pressure, and dietary Healthy Eating Index (HEI) data were collected (April 2015). Participants were undergraduate students. Ordinary least squares regression was used to examine associations between diet quality and cardiometabolic risk factors. RESULTS: Participants (n = 147) were primarily nonHispanic Caucasian between 18 and 22 years and largely nonobese (95.0% of females, 85.1% of males). Total HEI score was 56.1 ± 16.1 for females and 53.2 ± 15.0 for males. Mean biochemical and clinical outcomes fell within normal limits. However, 71.0% of females and 80.9% of males met ≥1 or more metabolic syndrome criteria. HEI was not related to health outcomes. CONCLUSIONS: Cardiometabolic abnormalities are present in a large proportion of apparently healthy undergraduates which may place them at risk for future cardiometabolic complications. There was no relationship between diet quality and cardiometabolic health.

Participation in structured programming may prevent unhealthy weight gain during the summer in school-aged children from low-income neighbourhoods: feasibility, fidelity and preliminary efficacy findings from the Camp NERF study.

OBJECTIVE: Evaluate the feasibility, fidelity and preliminary efficacy of Camp NERF to prevent unhealthy weight gain and promote healthy behaviours in children during the summer. DESIGN: Camp NERF was an 8-week, multicomponent, theory-based programme coupled with the US Department of Agriculture's Summer Food Service Program. Twelve eligible elementary-school sites were randomized to one of three treatment groups: (i) Active Control (non-nutrition, -physical activity (PA), -mental health); (ii) Standard Care (nutrition and PA); or (iii) Enhanced Care (nutrition and PA, plus cognitive behavioural techniques) programming. Efficacy was determined by assessing mean change by group in child outcomes using hierarchical linear regression models. SETTING: Low-income, urban neighbourhoods in Columbus, OH, USA.ParticipantsEconomically disadvantaged, racial minority children of elementary school age (kindergarten-5th grade). RESULTS: Eighty-seven child-caregiver dyads consented; eighty-one completed pre- and post-intervention assessments resulting in a 93·10 % retention rate. Delivery of the intended lesson occurred 79-90 % of the time. Of the children, 56·98 % (n 49) were female; 89·53 % (n 77) were Black. Overall mean change in BMI Z-score from baseline to post-intervention was -0·03 (se 0·05); change in BMI Z-score did not differ significantly between treatment group. Change in nutrition, PA, mental health or psychosocial outcomes did not differ between groups. CONCLUSIONS: Results from the current study demonstrate feasibility and fidelity, yet no intervention effect of Camp NERF. Instead, findings suggest that participation in structured programming of any type (health behaviour-related or not) may prevent unhealthy summer weight gain. Additional studies are needed to confirm findings. Results have implications for child nutrition policy addressing the issue of summer health.

Feasibility and acceptability of technology-based caregiver engagement strategies delivered in a summertime childhood obesity prevention intervention: results from an internal pilot of the Camp NERF (Nutrition, Education, Recreation, and Fitness) study.

BACKGROUND: The most efficacious childhood obesity prevention interventions have involved caregivers directly or indirectly. Due to the high reliance on technology, research examining technological intervention approaches is warranted, particularly during the summer when parents may be more difficult to engage and the risk for excess weight gain among children is high. METHODS: The feasibility and acceptability of a multi-component childhood obesity prevention intervention incorporating a caregiver component utilizing technology-based approaches-texting and social media-was explored. This was an internal pilot of the Camp Nutrition Education Recreation and Fitness (NERF) study, a group RCT for school-age children coupled to the USDA Summer Food Service Program. Feasibility and acceptability of the technology caregiver engagement component were assessed via process outcomes (participation rates) and in-depth interviews. RESULTS: Participants (n = 37) were 91.9% female, 91.8% Black, 58.7% low-income, and 75.0% overweight/obese. Participation rates in texting and social media were 62.2% and < 3%, respectively. Themes emerged from the in-depth interviews were texting provides connection; desire more involvement with program; fear social media privacy intrusion. CONCLUSIONS: Results will be used to inform changes to technology-based caregiver engagement strategies to be tested in future interventions. TRIAL REGISTRATION: Clinical Trials, NCT02908230/09-19-2016. Registered 20 September 2016.

Determining attitudinal and behavioral factors concerning milk and dairy intake and their association with calcium intake in college students.

BACKGROUND/OBJECTIVES: Average intake of calcium among college students is below the recommended intake, and knowledge surrounding the attitudinal and behavioral factors that influence milk and dairy intake, a primary food source of calcium, is limited. The purpose of this study was to evaluate college students' attitudes and behaviors concerning milk and dairy consumption and their association with calcium intake. SUBJECTS/METHODS: Participants were 1,730 undergraduate students who completed an online survey (SurveyMonkey) as part of baseline data collection for a social marketing dairy campaign. The online survey assessed attitudes and behaviors concerning milk and dairy intake, and calcium intake. Questions about milk- and dairy-related attitudes and behaviors were grouped into 14 factors using factor analysis. Predictors of calcium intake were then evaluated. RESULTS: Median calcium intake across all participants was 928.6 mg/day, with males consuming higher calcium intakes than females (P < 0.001). Adjusted for gender, calcium intakes were most strongly (and positively) correlated with associating milk with specific eating occasions and availability (i.e., storing calcium-rich foods in one's dorm or apartment) (both P < 0.001). Other correlates of calcium intake included: positive-viewing milk as healthy (P = 0.039), having family members who drink milk) (P = 0.039), and taking calcium supplements (P = 0.056); and negative-parent rules concerning milk (P = 0.031) and viewing milk in dining halls negatively (P = 0.05). CONCLUSIONS: Calcium intakes among college students enrolled in the current study was below the recommended dietary allowance of 1,000 mg/day, reinforcing the need for dietary interventions in this target population, especially females. Practitioners and researchers should consider the factors found here to impact calcium intake, particularly associating milk with specific eating occasions (e.g., milk with breakfast) and having calcium-rich foods available in the dorm room or apartment, as intervention strategies in future efforts aimed at promoting milk and dairy foods and beverages for improved calcium intake in college students.

Milk Vending Does Not Improve College Students' Milk and Calcium Intakes.

In the transition from adolescence to young adulthood, overall diet quality decreases, including a reduction in both dairy and calcium consumption. The objective of this pilot study was to determine the impact of milk vending on milk and calcium intakes in college students. Participants were 124 college students living in dorms at a large public university (Fall 2012). Milk vending machines were installed in two campus dorms. Before and 2 months after installation, students were surveyed about milk and calcium intakes, as well as attitudes regarding milk vending. Sales data for the newly installed machines were also collected between the pre- and posttest surveys. Students reported similar milk and calcium consumption before and after the intervention. Mean calcium intakes were lower than the recommended dietary allowance for students in either life stage group (18 years old or 19 years and older). Milk vending sales data showed that during the study period, approximately nine bottles of milk were bought each day from the two dorms combined. Results from this study suggest that milk vending alone may not be an effective strategy for preventing the commonly observed decrease in milk and calcium intakes among college students.

Camp NERF: methods of a theory-based nutrition education recreation and fitness program aimed at preventing unhealthy weight gain in underserved elementary children during summer months.

BACKGROUND: The number of obese children in the US remains high, which is problematic due to the mental, physical, and academic effects of obesity on child health. Data indicate that school-age children, particularly underserved children, experience unhealthy gains in BMI at a rate nearly twice as fast during the summer months. Few efforts have been directed at implementing evidence-based programming to prevent excess weight gain during the summer recess. METHODS: Camp NERF is an 8-week, multi-component (nutrition, physical activity, and mental health), theory-based program for underserved school-age children in grades Kindergarten - 5th coupled with the USDA Summer Food Service Program. Twelve eligible elementary school sites will be randomized to one of the three programming groups: 1) Active Control (non-nutrition, physical activity, or mental health); 2) Standard Care (nutrition and physical activity); or 3) Enhanced Care (nutrition, physical activity, and mental health) programming. Anthropometric, behavioral, and psychosocial data will be collected from child-caregiver dyads pre- and post-intervention. Site-specific characteristics and process evaluation measures will also be collected. DISCUSSION: This is the first, evidence-based intervention to address the issue of weight gain during the summer months among underserved, school-aged children. Results from this study will provide researchers, practitioners, and public health professionals with insight on evidence-based programming to aid in childhood obesity prevention during this particular window of risk. TRIAL REGISTRATION: NCT02908230/09-19-2016.