Evaluating the potential of Special Olympics fitness models as a health intervention for adults with intellectual disabilities.

BACKGROUND: People with intellectual disabilities (ID) have high prevalence of cardiovascular disease (CVD) risk factors; yet, few behavioral health interventions are designed and implemented for people with ID. OBJECTIVE: This study examined Special Olympics Inc. (SOI) fitness models as a potential intervention to reduce CVD risk in people with ID. METHODS: Data from SOI fitness models implemented in 2016-2018 were assessed. Special Olympics Programs received funding, resources, and technical assistance from SOI to conduct fitness models centered on inclusive physical activity and goal setting. Weight, body mass index, systolic blood pressure (SBP), and diastolic blood pressure (DBP) were measured at baseline and 4-12 weeks into the model. Multi-level multivariable quintile linear regression assessed change. RESULTS: 383 participants with ID (athletes) and 281 partners without ID met inclusion criteria. Mean weight loss among athletes was 0.67 kg and 132 (31.9%) lost ≥ 1 kg. Blood pressure decreased in SBP quintile 4 (-7.52 mm Hg, 95% confidence interval [CI]: 11.8, -4.0), SBP quintile 5 (-9.52 mm Hg, 95% CI: 13.5, -5.6), and DBP quintile 5 (-7.49 mm Hg, 95% CI: 13.1, -1.9). Partners had similar results. Strongest effects were in a 'high-risk' group that was in the quintile 4 or 5 in all baseline measures. CONCLUSION: In fitness models developed to improve fitness for people with ID, there was a reduction in weight and blood pressure. SOI fitness models show promise and potential as a health intervention. This work enables further examination of indicators for successful implementation and evaluation of health.

A Review of Field Experiments on the Effect of Forest Bathing on Anxiety and Heart Rate Variability.

Many studies have explored the physiological and psychological benefits of the Japanese nature therapy practice of "shinrin-yoku," known in the West as forest bathing. This review article has narrowed its focus to include the most recent literature about the beneficial effects of forest bathing on heart rate variability, expressed as an increase in InHF, indicating activation of the parasympathetic nervous system and also its effect on reducing anxiety.

Assessing the Availability of Healthier Children's Meals at Leading Quick-Service and Full-Service Restaurants.

OBJECTIVE: To compare the calorie, fat, saturated fat, and sodium content of available children's meal combinations in leading restaurants with national recommendations. DESIGN: Cross-sectional. SETTING: Children's menu offerings and corresponding nutrition information were collected (May, 2014) from Web sites of the top 10 quick-service (QSR) and top 10 full-service (FSR) restaurant chains that offered a children's menu and provided nutrition information. VARIABLES MEASURED: Total calories (kcal), percent calories from fat and saturated fat, and total sodium (mg) were calculated for children's meal combinations (QSR N = 1,363; FSR N = 6,654). Combinations with ≤ 600 kcal, ≤ 35% kcal from fat, ≤ 10% kcal from saturated fat, ≤ 770 mg sodium, and those that met all 4 of these criteria were identified. ANALYSIS: Frequencies by restaurant segment. RESULTS: The majority of QSR (72%) and FSR (63%) meal combinations had ≤ 600 kcal. Only 31.9% of combinations at QSRs and 21.7% at FSRs met all 4 criteria. In both segments the calorie target was most frequently met, and the sodium target the least. CONCLUSIONS AND IMPLICATIONS: Children's meal combinations with ≤ 600 kcal are available at leading restaurant chains, but many meals fail to meet current national recommendations for fat, saturated fat, and sodium. Menu labeling legislation may address caloric content but implications for other nutrients remain unclear.

Changes in children's meal orders following healthy menu modifications at a regional U.S. restaurant chain.

OBJECTIVE: To examine changes in children's meal orders, price, and revenue following the implementation of a healthier children's menu in a full-service restaurant chain. METHODS: In April 2012, the healthier menu was implemented, featuring more meals meeting nutrition standards, healthy side dishes by default, and removal of French fries and soda (which could be substituted). Orders (n = 352,192) were analyzed before (September 2011 to March 2012; PRE) and after (September 2012 to March 2013; POST) implementation. RESULTS: Children's meal prices increased by $0.79 for breakfasts and $0.19 for non-breakfast meals from PRE to POST. Revenue continued to increase post-implementation. Orders of healthy meals, strawberry and vegetable sides, milk, and juice increased, and orders of French fries and soda decreased (P < 0.0001). Orders at POST were more likely to include healthy sides (P < 0.0001) and substitutions (P < 0.0001) and less likely to include a la carte sides (P < 0.0001) and desserts (P < 0.01), versus PRE. Total calories ordered by children accepting all defaults decreased (684.2 vs. 621.2; P < 0.0001) and did not change for those not accepting defaults (935.0 vs. 942.9; P = 0.57). CONCLUSIONS: Healthy children's menu modifications were accompanied by healthier ordering patterns, without removing choice or reducing revenue, suggesting that they can improve child nutrition while restaurants remain competitive.

Healthier side dishes at restaurants: an analysis of children's perspectives, menu content, and energy impacts.

BACKGROUND: Children consume restaurant-prepared foods at high rates, suggesting that interventions and policies targeting consumption of these foods have the potential to improve diet quality and attenuate excess energy intake. One approach to encouraging healthier dietary intake in restaurants is to offer fruits and vegetables (FV) as side dishes, as opposed to traditional, energy-dense accompaniments like French fries. The aims of the current study were to examine: children's views about healthier side dishes at restaurants; current side dish offerings on children's menus at leading restaurants; and potential energy reductions when substituting FV side dishes in place of French fries. METHODS: To investigate children's attitudes, a survey was administered to a nationally representative sample of U.S. 8- to 18-year-olds (n = 1178). To examine current side dish offerings, children's menus from leading quick service (QSR; n = 10) and full service restaurant chains (FSR; n = 10) were analyzed. Energy reductions that could result from substituting commonly-offered FV side dishes for French fries were estimated using nutrition information corresponding to the children's menu items. RESULTS: Two-thirds of children reported that they would not feel negatively about receiving FV sides instead of French fries with kids' meals. Liking/taste was the most common reason that children gave to explain their attitudes about FV side dishes. Nearly all restaurants offered at least 1 FV side dish option, but at most restaurants (60% of QSR; 70% of FSR), FV sides were never served by default. Substituting FV side dishes for French fries yielded an average estimated energy reduction of at least 170 calories. CONCLUSIONS: Results highlight some healthy trends in the restaurant context, including the majority of children reporting non-negative attitudes about FV side dishes and the consistent availability of FV side dish options at leading QSR and FSR. Yet the minority of restaurants offer these FV sides by default. Promoting creative, appealing FV side dishes can result in healthier, less energy-dense meals for children. Substituting or displacing energy-dense default side dishes with such FV dishes show promise as part of continued, comprehensive efforts to increase the healthfulness of meals consumed by children in restaurant settings.