Journal of the Academy of Nutrition and Dietetics最新文献

Background: Inclusion of malnutrition risk screening information in the 2022 National Survey of Older Americans Act Participants (NSOAAP) provided a first-time opportunity to estimate malnutrition risk in a representative sample of Older Americans Act (OAA) program participants.

Objective: Describe malnutrition risk prevalence and associated characteristics among 2022 NSOAAP participants, focusing particularly on those in home-delivered meal (HDM) and congregate meal (CM) programs.

Design: Cross-sectional study of a nationally representative sample of five OAA service programs.

Participants/setting: OAA nutrition (HDM, n=941; CM, n=738) and non-nutrition (homemaker, n=457; case management, n=490; transportation, n=905) program participants in the 2022 NSOAAP.

Main outcome measures: Malnutrition risk evaluated with the Malnutrition Screening Tool (MST). MST scores range 0-5, with >2=malnutrition risk.

Statistical analyses: Malnutrition risk prevalence was estimated within each OAA program and by demographic and health characteristics. Multivariable logistic regression models were constructed for HDM and CM participants to assess associations between malnutrition risk and duration of OAA nutrition program participation, food insecurity, and percent of daily food intake from OAA meals, after adjusting for covariates.

Results: Total malnutrition risk prevalence was 19.5%; by program type it was 19.4% HDM, 16.7% CM, 22.5% homemaker, 22.1% case management, and 21.4% transportation, with no statistically significant differences between programs. Participants receiving HDMs for 2-5 years were 72% less likely to be at malnutrition risk compared with those receiving HDMs for <6 months (adjusted OR: 0.28; 95% Cl: 0.19-0.44; p<0.05). No association between malnutrition risk and length receiving meals among CM participants was observed. Associations between risk and percent daily food intake from OAA meals or food insecurity were not observed for HDM or CM participants.

Conclusion: Approximately one-fifth of OAA program participants were at malnutrition risk in 2022 across all programs, and there was evidence that risk may decline with continued HDM OAA nutrition program participation.

Background: Researchers across the United States (US) often leverage community engagement (CE) as a strategy in interventions aiming to alter the retail food environment (RFE), especially in areas serving racially segregated neighborhoods with low incomes. However, little is known about the full breadth, intensity, and approaches used to engage communities in RFE intervention work.

Objective: The purpose of this scoping review is to identify what CE research approaches have been applied by researchers in the RFE intervention literature and how they vary by type of retail settings, phase of intervention, year of intervention, and key domains of equity.

Methods: Following the Joanna Briggs Institute and the PRISMA extension for Scoping Review guidelines, any study published in academic journals and English that discussed activities or strategies for CE in RFEs, irrespective of the type of study, was included. PubMed, CINAHL, and ProQuest were searched for reports published from inception until August 2023. CE research strategies were extracted and classified following the Centers for Disease Control and Prevention (CDC) continuum of community engagement framework, including outreach (lowest CE), consult/involve, collaboration, and shared leadership (highest CE). CE research strategies were then examined for their variation across RFE setting, intervention phase, intervention year, and key equity domains related to healthy food retail (e.g., affordability).

Results: A total of 98 RFE interventions reported in 104 reports were included in this review, and most were implemented in either supermarkets (21%), corner stores (20%), or multiple RFE settings (21%). All interventions employed CE research strategies of outreach (n=98), whereas about half employed strategies of shared leadership (n=52). Exploring CE research strategies by RFE settings and intervention phase, this review found stronger forms of CE in less traditional RFE settings, including mobile markets, and among interventions that used CE research strategies across all phases of the intervention study. RFE interventions that implemented the highest forms of CE research strategies (i.e., shared leadership) were also those that addressed all key equity domains.

Conclusion: The findings of this review reveal that the form of CE in RFE interventions varied widely, with more domains of equity addressed when higher forms of CE were used. Insights from this review suggest future research should prioritize assessing the effectiveness of shared leadership CE strategies on achieving and sustaining nutrition-related health equity outcomes for communities.

Background: The importance of addressing food insecurity in clinical settings has been highlighted in the American Academy of Pediatrics clinical guidelines for the treatment of childhood obesity. There is limited research on food security interventions for childhood obesity in the healthcare setting, particularly research that includes caregiver and pediatrician perspectives.

Objective: To explore caregiver and pediatrician perspectives related to a meal kit delivery program for families with children 6-11 years old with obesity and food insecurity.

Design: Qualitative analysis using semi-structured interviews with caregivers and pediatricians were conducted between July and November 2023.

Participants/setting: Of 29 caregivers and 12 pediatricians enrolled in a meal kit delivery program based at a clinic in Boston, Massachusetts, 13 caregivers and seven pediatricians were interviewed.

Analysis: Codebooks were generated using an inductive approach. NVivo12 was used to perform thematic coding analysis.

Results: Most caregivers reported the meal kits were easy and convenient to use. A few caregivers noted that use of the meal kits was limited by time and lack of preferred foods. Caregivers were split on the sufficiency of the meal kit food quantity. Most caregivers perceived the program improved food security and provided "hands-on" nutrition education. Several desired a longer program duration, more variety, and customization to align with preferred foods. Pediatricians perceived the meal kits met a social and clinical need, though barriers to referral included forgetting to refer and competing demands.

Conclusion: A meal kit delivery program was perceived to be beneficial for families with children with obesity and food insecurity. However, caregivers identified several barriers to using meal kits and both caregivers and pediatricians suggested areas of improvement, such as through customization and program financial sustainability, which warrant addressing prior to integration in the healthcare setting.

Background: Copper plays a vital role in human physiological functions. However, limited epidemiological evidence exists for an association between dietary copper intake and chronic obstructive pulmonary disease (COPD).

Objectives: This study aimed to assess the association between dietary copper intake and COPD in American adults.

Design: This cross-sectional study utilized data from the U.S. National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018.

Participants/setting: Following inclusion criteria, data from a total of 39,644 adults aged 20 and above were included in this study, out of which 3,159 individuals had been diagnosed with COPD by a healthcare provider.

Main outcome measures: Dietary data were obtained through 24-hour dietary recall, while COPD diagnosis information was derived from a standardized medical condition questionnaire.

Statistical analyses performed: Multivariable logistic regression analysis was conducted to explore the association between dietary copper intake and COPD. To assess the dose-response relationship, a three-piecewise restricted cubic spline analysis was employed. Potential thresholds were identified with a two-piecewise logistic regression model. Subgroup analysis was performed to assess heterogeneity and explore potential interactions.

Results: Compared to individuals in the lowest tertile of dietary copper intake (T1, < 0.89 mg/day), those in the highest tertile (T3, > 1.35 mg/day) had an adjusted odds ratio (OR) of 0.79 for COPD (95% CI: 0.68-0.92, p = 0.002). The relationship between dietary copper intake and COPD followed a non-linear L-shaped curve (p < 0.001). Threshold analysis found a statistically significant inverse association between dietary copper intake and the odds of COPD for intakes < 1.5 mg/day but no significant association for intakes ≥ 1.5 mg/day. Subgroup analysis indicated an interaction effect with age.

Conclusions: An L-shaped inverse association was observed between dietary copper intake and COPD in US adults, at a threshold of approximately 1.5 mg/day, with an observed age interaction.

Background: Resveratrol, a natural polyphenol compound, possesses anti-aging, anti-tumor, and vascular protective properties. These attributes are believed to stem from its influence on Sirt1, a member of the human Sirtuin family and a NAD+-dependent Histone Deacetylases (HDACs).

Objectives: This study aims to quantitatively investigate the impact of Resveratrol supplementation on Sirt1 levels in adults by conducting a systematic review and meta-analysis of Randomized Controlled Trials (RCTs) involving Resveratrol supplementation.

Methods: The GRADE-assessed systematic review involved a comprehensive search of PubMed, EMBASE, MEDLINE, Scopus, Web of Science, Cochrane CENTRAL, and Google Scholar databases using related keywords, conducted from March 14th, 2024, to April 15th, 2024, to identify all RCTs investigating Resveratrol's effects on Sirt1. Effect sizes were quantified as mean differences (MD) or standardized mean difference (SMD), with standard deviations (SD) of outcomes. An overall effect estimate was derived using a random-effects model when ≥ 2 studies reported similar outcomes. Statistical heterogeneity was assessed through the calculation of I² statistics. Additionally, a dose-response analysis was performed to assess potential dose-response relationships. Risk of bias was assessed using the Cochrane risk of bias tool for RCTs (RoB2.0). Publication bias was evaluated using Begg's test and a meta-regression using the year of publication as a moderator.

Results: Eleven RCTs examining the effects of Resveratrol on Sirt1 gene expression (4 RCTs), protein expression (5 RCs), and serum levels (3 RCTs) were included in the meta-analysis. The results showed no significant impact of Resveratrol on Sirt1 gene expression (SMD = 0.05; 95% CI: -0.24, 0.344, p = 0.73), protein expression (SMD = 0.3; 95% CI: -0.15, 0.77, p = 0.18), or serum levels (MD = -0.04; 95% CI: -0.235, 0.16, p = 0.7). However, subgroup analyses suggested a significant increase in Sirt1 gene expression in studies with an intervention duration of less than 12 weeks and evaluating blood tissue. Furthermore, the impact of Resveratrol on Sirt1 appeared to be influenced by the dosage regimen, with a significant effect for intervention duration.

Conclusions: This study indicates that Resveratrol supplementation does not significantly influence human Sirt1 based on the overall meta-analysis. However, the dose-response analysis suggests that the effect of Resveratrol on Sirt1 depends on the dosage regimen.