Use of the Nutrition Environment Measures Survey: A Systematic Review.

INTRODUCTION: The Nutrition Environment Measurement Survey (NEMS) measures were developed to assess the consumer food environment in stores and restaurants. NEMS tools have been widely used in research and adapted for diverse settings and populations in the 15 years since they were created. This systematic review examines the use and adaptations of these measures and what can be learned from published studies using NEMS tools. METHODS: A comprehensive search of bibliographic databases was conducted from 2007 to September 2021, supplemented by backward searches and communications with authors, to identify research articles using NEMS tools. Data on purpose, key findings, sample characteristics, NEMS characteristics, and modifications were abstracted. Articles were categorized on the basis of study goals, NEMS tool(s) used, variables measured, and common themes. RESULTS: A total of 190 articles from 18 countries were identified. Most studies (69.5%, n=123) used a modified version of NEMS tools. There were 23 intervention studies that used measures from NEMS tools or adaptations as outcomes, moderators, or process assessments. A total of 41% (n=78) of the articles evaluated inter-rater reliability, and 17% (n=33) evaluated test-retest reliability. DISCUSSION: NEMS measures have played an important role in the growth of research on food environments and have helped researchers to explore the relationships among healthy food availability, demographic variables, eating behaviors, health outcomes, and intervention-driven changes in food environments. The food environment is constantly changing, so NEMS measures should continue to evolve. Researchers should document data quality of modifications and use in new settings.

Tactical Circuit Training Improves Blood Pressure and Vascular Health More Than Resistance Training.

Exercise training is known to reduce CVD risk factors; however, in tactical populations, like veterans and firefighters, the effects of different forms of exercise such as tactical circuit training (CT) or conventional resistance training (RT) is unclear. Thus, the purpose of this study was to compare changes in various CVD risk measures after 4-week tactical CT or RT programs. Thirty-seven firefighters (20 CT, 17 RT), 35% of whom were veterans, participated. Pre- and post-intervention measures included body fat (BF%), carotid artery intima media thickness (IMT), central and brachial BP, and indices of arterial stiffness (augmentation index, Aix@75), myocardial oxygenation (subendocardial viability ratio, SEVR), and endothelial function (flow-mediated dilation, FMD). Estimation of maximum oxygen consumption (VO2peak) for aerobic fitness, balance, muscular endurance, and strength were also compared. For the clinical laboratory values, there were no between group differences and the only within group change was found in triglyceride levels. Tactical CT lowered triglyceride levels by 24.2% (P < 0.05). Only tactical CT exercise lowered BP. Both brachial (4.6% reduction) and central (4.4 % reduction) systolic and diastolic SBP and DBP decreased with CT (all P ≤ 0.01). After training we found improvements in FMD and SEVR with tactical CT only. Percent FMD increased by 28.7% (P < 0.01) while SEVR increased by 4.4% (P < 0.05) in the tactical CT group. Fitness improved in both cohorts (P < 0.05). These data suggest that 4 weeks of a CT program improves several CVD-risk factors and may be more beneficial.

Effects of circuit exercise training on vascular health and blood pressure.

As the global burden of cardiovascular disease (CVD) rises, public health-related interventions aimed at prevention of heart disease have gained medical attention. Clinical research reports that exercise is a protective risk factor associated with CVD and that clinicians need to provide exercise recommendations to patients. Nevertheless, physical inactivity remains a public health problem. In certain populations, like firefighters (FF), increased risk of CVD is especially concerning. The workload FF face is extreme, 50% of line-of-duty deaths (LODD) in FF are cardiac-related, and research on the volunteer FF population is scarce. Government regulations do not require volunteer FF companies to have fitness testing or programming, so exercise intervention studies are necessary to improve the burden of CVD risk in this population. Therefore, this study examined the effects of a 4-week exercise circuit training (CT) intervention on vascular health and fitness in volunteer FF (N = 27) from the Philadelphia PA area compared to a control group of Non-FF (N = 25). Carotid artery intima-media thickness (IMT), brachial artery flow-mediated dilation (FMD), augmentation index, and pulse pressure (PP), brachial and central blood pressure (BP) and fitness were measured pre- and post- intervention. Overall, volunteer FF had more significant improvements (p < 0.05) in vascular health measures (FMD, IMT, and PP). In both groups, we also found that brachial and central BP decreased with exercise. We show that a 4 week CT program can improve vascular structure and function in the volunteer FF population, suggesting that clinicians may be able to reduce or prevent cardiac LODD by exercise.