Many College Students Underestimate Diabetes Risk.

BACKGROUND: College students form long-lasting diet and health behaviors that are associated with an increased lifetime risk of type 2 diabetes. Thus, colleges and universities can be critical settings to increase awareness of diabetes risk and for nutrition education and health interventions. However, it is not clear if high-risk students recognize the likelihood of diabetes in their future. OBJECTIVE: To assess personal risk perceptions of a sample of multiracial college students with three or more known risk factors for diabetes, and to identity characteristics of students with an unrealistic perception of their future risk. DESIGN: Self-reported data on health and behavior were collected from 1,579 students from three urban colleges. The students at high risk (n=541) for diabetes were categorized as having either a realistic or unrealistic perception of their future risk of diabetes. Characteristics of the two groups were examined using multivariate logistic regression. RESULTS: Approximately 61% of the high-risk students recognized they were more likely to develop diabetes than others, while the remaining 39% did not perceive their personal risk to be high. The under-estimators were significantly more likely to be male (p=0.010), have no family history of diabetes (p=0.029), and be born outside the United States (p<0.001). CONCLUSIONS: The under-estimators, an unrealistically optimistic high-risk group, warrant attention, as an unrealistic perception may reduce their likelihood of taking preventive actions to diminish the threat. There is a pressing need to heighten knowledge and awareness of diabetes risk and to develop models of health education and behavior change that are both relevant and effective for young adults.

Diet quality of urban older adults age 60 to 99 years: the Cardiovascular Health of Seniors and Built Environment Study.

There are few studies that evaluate dietary intakes and predictors of diet quality in older adults. The objectives of this study were to describe nutrient intakes and examine associations between demographic, economic, behavioral, social environment, and health status factors and diet quality. Cross-sectional data were from black, white, and Hispanic adults, age 60 to 99 years, living independently in New York City and participating in the Cardiovascular Health of Seniors and the Built Environment Study, 2009-2011 (n=1,306). Multivariable log-linear regression estimated associations between selected factors and good diet quality, defined as a Healthy Eating Index score more than 80 (based on the 2005 Dietary Guidelines for Americans [HEI-2005]). Dietary intakes were similar for men and women; intakes of energy, fiber, and the majority of micronutrients were less than recommendations, whereas intakes of fats, added sugar, and sodium were within the upper range or exceeded recommendations. Hispanic ethnicity (relative risk [RR]=1.37; 95% CI 1.07 to 1.75), energy intake <∼ 1,500 kcal/day (RR=1.93; 95% CI, 1.37 to 2.71), adherence to a special diet (RR=1.23; 95% CI: 1.02 to 1.50), purchasing food at supermarkets at least once/week (RR=1.34; 95% CI, 1.04 to 1.74), and being married/living with a partner (RR=1.37; 95% CI, 1.10 to 1.71) were positively associated with HEI-2005 score more than 80. Consuming at least one restaurant meal/day was negatively associated with HEI-2005 score more than 80 (RR=0.69; 95%CI, 0.50-0.94). These findings identify specific groups of older adults, such as blacks or those who live alone, who may benefit from dietary interventions, as well as specific modifiable behaviors among older adults, such as eating restaurant meals or shopping at supermarkets, which may be targeted through interventions.

Navigating the urban food environment: challenges and resilience of community-dwelling older adults.

OBJECTIVE: Identify factors involved in food shopping among older urban adults. DESIGN: A qualitative study of 30 in-depth interviews and 15 "tagalong" shopping trip observations were conducted. SETTING: Brooklyn, New York. PARTICIPANTS: Black, white, and Latino men and women aged 60-88 years. MAIN OUTCOME MEASURE: Transcripts were coded inductively to identify emergent themes. RESULTS: Older adults shopped at multiple stores to obtain the quality of foods preferred at prices that fit their food budgets. Participants often traveled outside their neighborhoods to accomplish this, and expressed dissatisfaction with the foods locally available. Adaptive food shopping behaviors included walking or the use of public transit to purchase food in small batches, as well as reliance on community resources and social network members. CONCLUSIONS AND IMPLICATIONS: Participants identified a number of multilayered factors and challenges involved in procuring food. These factors conform to elements of ecological behavioral models described as intrapersonal, social, and environmental level influences and have resulted in adaptive behaviors for this population. These findings provide evidence that can be used to develop more effective programs, as well as promote testable interventions aimed at keeping older adults independent and capable of acquiring food that meets their age-specific needs.

"Healthy-start": outcome of an intervention to promote a heart healthy diet in preschool children.

OBJECTIVE: We evaluated the effects of a preschool nutrition education and food service intervention "Healthy Start," on two-to-five-year-old children in nine Head Start Centers in upstate NY. The primary objective was to reduce the saturated fat (sat-fat) content of preschool meals to <10% daily energy (E) and to reduce consumption of sat-fat by preschoolers to <10% E. METHODS: Six centers were assigned to the food service intervention and three to control condition. Food service intervention included training workshops for cooks and monthly site visits to review progress towards goals. Child dietary intake at preschool was assessed by direct observation and plate waste measurement. Dietary intake at home was assessed by parental food record and telephone interviews. Dietary data were collected each Fall/Spring over two years, including five days of menus and recipes from each center. Dietary data were analyzed with the Minnesota NDS software. RESULTS: Consumption of saturated fat from school meals decreased significantly from 1.0%E to 10.4%E after one year of intervention and to 8.0%E after the second year, compared with an increase of 10.2% to 13.0% to 11.4%E, respectively, for control schools (p < 0.001). Total caloric intake was adequately maintained for both groups. Analysis of preschool menus and recipes over the two-year period of intervention showed a significant decrease in sat-fat content in intervention preschools (from 12.5 at baseline to 8.0%E compared with a change of 12.1%E to >11.6%E in control preschools (p < 0.001)). Total fat content of menus also decreased significantly in intervention schools (31.0% to >25.0%E) compared with controls (29.9% to >28.4%E). CONCLUSIONS: The Healthy Start food service intervention was effective in reducing the fat and saturated fat content of preschool meals and reducing children's consumption of saturated fat at preschool without compromising energy intake or intake of essential nutrients. These goals are consistent with current U.S Dietary Guidelines for children older than two years of age.