Social media behaviors and body type ideals predict weight loss and food tracking behaviors among recreational climbers.

Introduction: Elite and recreational climbers may be at risk for disordered eating, low energy availability (LEA), and increased injury as a result. Social media use among athlete and non-athletes can lead to body image disturbances resulting in unhealthy weight loss practices exacerbating LEA and injury risk. Therefore, the objective of this study was to examine relationships between social comparative behaviors on social media, body type ideals and outcomes, and health behaviors among adult recreational climbers. Methods: Participants (n = 324) were adult recreational climbers from the U.S. (29.30 ± 9.99 years old and 50% female). Participants answered a 66-item questionnaire comprised of demographics, climbing characteristics, social media behaviors, body type ideals, training and nutrition-seeking behaviors, and weight and food tracking behaviors. Results: Most participants (78.7%) indicated strength-to-weight ratio was important for climbing performance. Many participants perceived they could perform better at rock climbing if their body proportions were different (59.3%). These body type ideals were found to be significant predictors of performing weight loss and food-tracking behaviors (all p < 0.001). Higher amounts of social comparative behaviors on social media and social physique anxiety independently and significantly predicted attempting weight loss to improve climbing ability (p < 0.001 and p = 0.001 respectively). Those who followed climbing influencers, used Instagram frequently for training and nutrition information, perceived they could perform better at rock climbing if their body proportions were different, or were female and college-aged had significantly higher mean social comparative behavior scores (all p < 0.01). Discussion: This study expands on prior work with elite climbers by providing a possible explanation for how climbing-related body type ideals and certain social media behaviors can perpetuate negative body image and compensatory behaviors among a general climbing population. Because unhealthy weight management behaviors can lead to injury and health disturbances, broad education programming and social media campaigns should be developed to shift body ideals and nutrition behaviors among recreational climbers.

A Pilot Fruit and Vegetable Prescription (FVRx) Program Improves Local Fruit and Vegetable Consumption, Nutrition Knowledge, and Food Purchasing Practices.

Fruit and Vegetable Prescription (FVRx) programs rely on diverse community and clinic partnerships to improve food security and fruit and vegetable consumption among medically underserved patient populations. Despite the growth in these programs, little is known about the feasibility or effectiveness of the unique partnerships developed to implement FVRx programs conducted in both community and free safety-net clinic settings. A 6-month nonrandomized controlled trial of an FVRx program was pilot tested with 54 Supplemental Nutrition Assistance Program (SNAP)-eligible adults with diet-related chronic conditions. The intervention combined monthly produce prescriptions for local produce at a farmers market, SNAP-Ed direct nutrition education, and health screenings for low-income adults. Process and outcome evaluations were conducted with respective samples using administrative program data (recruitment, retention, and prescription redemption) and self-administered pre- and postintervention surveys with validated measures on dietary intake, nutrition knowledge and behavior, and food purchasing practices. Descriptive statistical analyses were conducted. The FVRx program retained 77.3% of participants who spent nearly 90% of their prescription dollars. After the intervention, the FVRx group reported significantly increased total intake of fruits and vegetables, knowledge of fresh fruit and vegetable preparation, purchase of fresh fruits and vegetables from a farmers market, and significantly altered food purchasing practices compared with the control group. Community-based nutrition education organizations enhance the feasibility and effectiveness of community and clinic-based FVRx programs for improving low-income adults' ability to enhance food and nutrition-related behaviors.

Produce Prescriptions and Nutrition Education Improve Experiences and Perceptions of Farm Direct Settings in Adults With Low Income.

OBJECTIVE: To examine Fruit and Vegetable Prescription (FVRx) Program participants' and nonparticipants' experiences and perceptions of farm direct (FD) settings. DESIGN: Multiple-case study of adults with low income from 3 study groups: (1) FVRx intervention (produce prescription, nutrition education [NE], financial literacy education, health screening), (2) NE only, and (3) control (standard health care). Participant interviews with each group at baseline and 6 months. SETTING: Supplemental Nutrition Assistance Program-Education (SNAP-Ed) eligible adults from 3 Georgia counties. PARTICIPANTS: A total of 46 adults with ≥ 1 diet-related condition. PHENOMENA OF INTEREST: Fruit and Vegetable Prescription Program participant and nonparticipant experiences and perceptions of FD settings. ANALYSIS: Constant comparative methods and thematic analysis of qualitative interview data across groups. FINDINGS: Two main themes emerged: (1) baseline FD setting experiences and perceptions and (2) divergent experiences and perceptions with FD settings postintervention. Participants across each group employed price-conscious food purchasing practices because of limited food budgets, limiting local food access. Combining produce prescription, NE, and farmers' market access enhanced FVRx participant associations with FD settings to reinforce motivation for accessing and purchasing fruits and vegetables beyond program participation. CONCLUSIONS AND IMPLICATIONS: Fruit and Vegetable Prescription Programs reduce multiple barriers to participating in FD settings compared with NE or standard health care alone.

Effects of a Fruit and Vegetable Prescription Program With Expanded Education for Low-Income Adults.

Fruit and Vegetable Prescription (FVRx) Programs combine produce prescriptions and nutrition education to reduce fruit and vegetable consumption barriers and promote health among low-income patient populations. This study examined whether a multi-level FVRx intervention model with intensive education improves dietary behaviors, food security, and health outcomes over single-level interventions alone. A 6-month nonrandomized, parallel, controlled trial was conducted with one intervention, FVRx (n = 31) and two comparison groups, Ad hoc Nutrition Education (n = 13) and Control (n = 16). The FVRx group received produce prescriptions (US$1/day/household member) redeemable at a farmer's market, two SNAP-Ed programs, one financial literacy program, and monthly health screenings. The Nutrition Education (NE) group participated in one SNAP-Ed program, and the Control group received safety-net clinic care only. Surveys assessed dietary intake, food security, food purchasing practices, and financial and food resource management. Pre-post clinical biomarkers (blood lipid and hemoglobin A1c) and monthly biometrics (anthropometrics and blood pressure) were measured. Descriptive analysis and one-way analysis of variance (ANOVA) were conducted. Compared with comparison groups, FVRx participants significantly increased the frequency of consuming dark green vegetables, FVRx (0.36 ± 0.72); NE (0.14 ± 0.33); Control (-0.09 ± 0.19) cups/day (p < .05). FVRx participants significantly improved multiple healthful food purchasing practices, and the ability to afford more utilities (FVRx (33%); NE (0%); Control (10%); p < .05). Limited changes were observed in food security and clinical biomarker outcomes between groups. Combining expanded nutrition and financial literacy education with produce prescriptions improves low-income adults' financial and food resources, preference, knowledge, purchase, and consumption of locally grown vegetables over single-level interventions.

Food Security and Clinical Outcomes of the 2017 Georgia Fruit and Vegetable Prescription Program.

OBJECTIVE: Evaluate improvements in food security and health outcomes associated with participation in a produce prescription program. DESIGN: Program evaluation with repeated measures over 6 months. SETTING: Six sites across Georgia. PARTICIPANTS: Of the 159 enrolled through primary care sites, 122 participants were considered graduates (attended at least 3 of the 6 monthly visits). The majority of program graduates were Black (78.7%), earned <$25,000 annually (76.6%), and were food insecure (74.2%). INTERVENTION: Six-month program offering group-based nutrition and cooking education along with subsidies for fresh produce worth $1 per family member per day, redeemable weekly. MAIN OUTCOME MEASURES: Food security, blood pressure, body mass index, waist circumference, and glycated hemoglobin. ANALYSIS: Linear mixed models estimating association of change in outcomes with program visits 1-6. Fixed effects included participant sex and age, whereas random effects included random intercepts and slopes for the site of program participation and participants. RESULTS: Participation in a produce prescription program combining subsidies for produce and nutrition education decreased food insecurity (P < 0.001) and diastolic blood pressure significantly (P = 0.019). CONCLUSIONS AND IMPLICATIONS: These findings highlight the promise of this program and similar programs for improving patient food security and health outcomes among the most vulnerable, underserved communities while aiding in setting realistic expectations and suggestions for program implementation.