Journal of the Academy of Nutrition and Dietetics最新文献

Background: Hispanic adults are disproportionately diagnosed with type 2 diabetes (T2DM) and are more likely to use functional foods for T2DM management as compared with non-Hispanic White adults. Functional foods contain biologically active ingredients associated with physiological health benefits for preventing and managing chronic disease. Understanding which functional foods are used for T2DM management among Hispanic adults is essential for planning interventions.

Objectives: To identify the self-reported types, frequency of use, and reasons for functional food use among Hispanic and Latino adults with T2DM; and to examine the demographic characteristics and T2DM-related health behaviors associated with using functional foods.

Design: This cross-sectional study used an online Qualtrics survey to assess the types of foods used to manage T2DM, demographic characteristics, and T2DM-related health behaviors.

Participants: Adults (n=488) were ≥18 years old, used social media, identified as Hispanic or Latino, lived in the United States, and self-reported T2DM. The study was conducted in April 2021.

Statistical analyses performed: Multivariable negative binomial regression models were used to assess the association between weekly functional food use, demographic characteristics, and T2DM-related health behaviors.

Results: Participants were, on average, 39.9 ± 10.3 years (mean±SD), had lived with T2DM for 4.0 ± 3.5 years, and consumed functional foods 2.6 ± 1.9 times/week. Participants with significantly higher weekly intakes of functional foods were more likely to have a college degree (Prevalence rate ratio (PrR) = 1.45, 95% CI 1.20; 1.74), lower perceived health ratings (PrR = 1.47, 95% CI 1.22; 1.78), more frequent blood glucose monitoring (PrR = 1.78, 95% CI 1.46; 2.17), and higher glycosylated hemoglobin (HgbA1c) (PrR = 1.49, 95% CI 1.24; 1.81).

Conclusions: These findings suggest that gathering information specific to functional food use and incorporating these foods into diabetes care plans, when applicable, may be beneficial for nutrition professionals working with Hispanic and Latino adults.

Background: Federal child nutrition programs are a key part of the nutrition safety net, but cost serves as a key participation barrier for students. This can also lead to meal debt for schools when students are unable to pay for the meals they take. The Community Eligibility Provision (CEP) seeks to address these challenges by providing free meals to all students within lower-income schools or school districts. While pandemic-related waivers provided universal school meals (USM) nationwide, once the waivers expired, states were again confronted with meal participation barriers.

Objective: To examine the prevalence of state laws addressing CEP and USM.

Design: Content analysis. State laws effective as of December 31, 2023 were obtained from commercial legal databases and coded using an ordinal coding scheme as part of the National Cancer Institute's Classification of Laws Associated with School Students system.

Participants/setting: Statutes and regulations were collected in all 50 states and the District of Columbia.

Main outcome measures: Measures included: 1) degree to which laws provided access to free breakfast and/or lunch, 2) reporting requirements for school/district CEP compliance/implementation, 3) waivers from expanded meal access requirements based on feasibility, 4) additional reimbursement to provide free meals, and 5) temporary funding or programs with funding contingencies.

Statistical analyses performed: Percent agreement and kappa statistics assessed the interrater reliability of the coding scheme. Descriptive statistics were computed to examine the prevalence of specific items in state laws.

Results: Mean percent agreement was 97% and mean kappa was 0.856 across the items coded. Thirty states' laws aimed to reduce the cost burden of school breakfast and/or lunch through the use of CEP and/or other universal meal initiatives. Specific to lunch policy, twelve states' laws mandated that when students qualify for reduced-priced lunch, they must be served a lunch at no cost. Other laws varied based on identified student percentage (ISP)-the percent of students directly certified as eligible for free meals through participation in other means-tested programs, such as the Supplemental Nutrition Assistance Program (SNAP); one state's law mandated CEP participation at ISP above 40%, two states' laws at ISP of 40%, and ten states' laws required universal free lunch.

Conclusions: Federal programs such as CEP can be used by states to leverage all available funding to help feed children. State laws can act as a springboard toward broader healthy school meals for all initiatives.