Journal of the Academy of Nutrition and Dietetics最新文献

Background: Late sleep timing and sleep irregularity are associated with an increased risk of diabetes, and high diet quality is associated with a lower risk of diabetes. However, the associations of sleep timing and regularity with diabetes, as well as the potential interactions of diet quality with these associations, are unclear.

Objective: The aims of the study were to examine the associations of sleep timing and sleep regularity with diabetes and to examine whether sleep timing and sleep regularity interact with diet quality in relation to diabetes.

Design: This was a cross-sectional analysis of data from the National Health and Nutrition Examination Survey 2017-March 2020.

Participants: US adults 20 years or older who responded to questions regarding sleep health and completed at least 1 valid 24-hour diet recall were included in the analysis (n = 7270).

Main outcome measures: Diabetes was defined as having received a diagnosis of diabetes from a physician or health care professional; glycated hemoglobin ≥6.5%; fasting blood glucose ≥126 mg/dL (to convert to mmol/L, multiply by 0.0555); and taking insulin or oral medication for diabetes.

Statistical analyses: Survey-multivariable logistic regression models were used to estimate the associations of sleep timing, sleep regularity, and their interactions with diet quality and diabetes.

Results: A total of 1494 participants (15.3%) were identified as having diabetes. Late chronotype (odds ratio [OR] 1.45; 95% CI, 1.12 to 1.87; Bonferroni corrected P = .02) and social jet lag of >0.5 hours (OR 1.44; 95% CI, 1.10 to 1.87; Bonferroni corrected P = .03) were associated with higher ORs of diabetes. Interactions were observed for diet quality with social jet lag (P for interaction = .02) on diabetes. Among participants with social jet lag of >0.5 hour, medium (OR 0.62; 95% CI, 0.41 to 0.92) and high diet quality (OR 0.63; 95% CI, 0.43 to 0.94) were associated with lower ORs of diabetes compared with low diet quality.

Conclusions: Later chronotype and more severe social jet lag were associated with higher ORs of diabetes. Higher diet quality may attenuate the adverse association of social jet lag with diabetes.

Background: Household food insecurity is a major public health concern that disproportionately burdens mothers. Infants may be especially vulnerable to its negative impacts, given the central role mothers play in their feeding. Mothers' insights on infant complementary feeding while experiencing household food insecurity are needed to expand on previous research focused on breastfeeding.

Objective: The aim of the study was to explore the experiences of New Zealand mothers introducing complementary foods to their infants in the context of household food insecurity.

Design: This qualitative study involved in-person, semi-structured interviews (conducted in 2022) with participants from the First Foods New Zealand study (conducted in 2020-2022), focusing on mothers' infant feeding experiences and particularly complementary feeding.

Participants/setting: Participants were mothers (n = 15) living in Dunedin (New Zealand) who had been identified as experiencing moderate or severe household food insecurity when their infant was aged 7 to 10 months.

Analysis: Thematic analysis of transcripts was performed using a reflexive thematic analysis approach.

Results: Three main themes and 1 subtheme were generated: (1) Food purchasing strategies were used to stretch money; (2) the infant's nutrition was prioritized (subtheme: breast milk was perceived to support the infant's nutrition); and (3) support was appreciated, but seeking money or food often brought a sense of shame and disempowerment.

Conclusions: Mothers prioritized feeding their infants by stretching limited resources, compromising their own diets, and seeking support despite considerable challenges. Their determination and skill in feeding their infants nutritiously highlight the extensive labor involved in infant feeding and food provision in the context of household food insecurity. However, these efforts also contributed to ongoing cognitive and emotional strain for the mothers themselves.

Background: Appropriate preoperative nutrition is a critical element of positive surgical outcomes and enhanced recovery. Immediately preoperatively, gastric clearance of nutritional intake must be considered for safely providing anesthesia. Despite updates in preoperative fasting guidelines regarding clear liquids, practical implementation of multinutrient preoperative supplements has been hampered by aspiration concerns.

Objective: The study aim was to provide an objective measurement of gastric clearance times using a multinutrient supplement to confirm an appropriate immediate preoperative window for nutrient provision beyond simple carbohydrates and noncaloric fluids.

Design: This is a prospective, single-group intervention, gastric ultrasound study.

Participants/setting: Fifty-six individuals participated, with 52 adults from the community in the clinic procedure room and 4 patients undergoing spine surgery in the surgical center preoperative area.

Intervention: Following an overnight fast, participants consumed a 250 mL exemplar amino acid, micronutrient, and carbohydrate-containing supplement and were followed for gastric emptying time.

Main outcome measure: Ultrasound measurements were taken before and after consuming the multinutrient supplement to determine gastric emptying time both qualitatively and quantitatively.

Statistical analysis: Analysis included descriptive statistics, a 1-sample t test for gastric emptying, and ordinal and linear regression analysis for participant characteristic relationships.

Key results: Ultrasound cross-sectional area determined 57% of subjects were safe for surgery with residuals <1.5 mL/kg by 30 minutes postconsumption, 93% by 60 minutes, and 96% by 75 minutes, including participants taking glucagon-like peptide-1 receptor agonists or having surgery that day (P < .0001 for mean time <120 minutes).

Conclusions: All participants consuming a 250 mL preoperative exemplar supplement containing 12 g amino acids, select micronutrients, and 45 g carbohydrates had gastric clearance within 2 hours, with a majority safe for surgery within 1 hour, demonstrating effective emptying of amino acids in addition to the standard carbohydrates typically utilized preoperatively and an opportunity to provide more effective preoperative nutrition.

It is the position of the Academy of Nutrition and Dietetics that all individuals with nutrition-related health conditions or risk factors should have access to medical nutrition therapy (MNT) provided by a registered dietitian nutritionist (RDN). MNT provided by RDNs is effective in improving health outcomes for many chronic conditions that are leading drivers of morbidity, mortality, and health care costs in the United States. Widespread access to MNT using an individualized, client-centered, and evidence-based approach has the potential to improve population health, reduce health disparities, and reduce health care costs associated with nutrition-related health conditions. This Academy of Nutrition and Dietetics position paper summarizes recent evidence from systematic reviews on the effectiveness of MNT provided by an RDN for the prevention and treatment of nutrition-related health conditions. A total of 25 systematic reviews published between 2017 and 2024 were summarized and assessed for certainty of evidence. Systematic reviews with high or moderate certainty of evidence demonstrate that MNT is likely effective in improving a range of health outcomes in adults with pre-diabetes, type 1 diabetes, type 2 diabetes, obesity, pre-hypertension, hypertension, dyslipidemia, chronic kidney disease, head and neck cancer, and chronic obstructive pulmonary disease compared with no MNT or standard care. Barriers exist to accessing MNT, including inadequate staffing of RDNs in some areas, a lack of provider referrals to an RDN for MNT, and a lack of payer coverage and reimbursement. This position was approved in September 2025 and will remain in effect until December 31, 2032.

Background: At least 8 states currently have universal free school meal programs that offer school meals at no charge to all students regardless of their household income. Marketing campaigns offer a scalable strategy for motivating parents to encourage their children to participate in these programs, but little is known about what topics campaigns should address.

Objective: To explore perceptions of the content and design of messages encouraging school meal participation among parents of elementary school-aged children.

Design: Qualitative online semistructured interviews conducted during February and March 2024. Interviews explored parents' reactions to messages encouraging school meal participation with a variety of topics (eg, saving time, improving nutrition) and design elements (eg, cartoons, photographs).

Participants: Parents of children in grades 1 through 5 not frequently consuming school meals and living in states with universal free school meal programs (N = 18; 14 women; 6 Spanish-speaking).

Analysis: Discussions were transcribed verbatim. Investigators developed codes in vivo and analyzed transcripts using a thematic approach.

Results: Parents perceived messages that focused on how school meals are convenient and save money to be most likely to motivate them to encourage their children to eat school meals. Parents also believed that school meals can foster social and developmental benefits. Parents perceived messages describing the nutritional quality of school meals as likely to be motivating, but only if they perceived school meals to be nutritious. Some parents reported they did not know school meals were free, despite living in states with universal free school meals. In terms of design, parents preferred succinct messages with bold colors, modern layouts, and references or statistics.

Conclusions: Campaigns seeking to motivate parents to encourage their children to participate in universal free school meal programs may wish to discuss convenience, saving money, and social and developmental benefits, and to communicate that school meals are free for all students. Future studies will be needed to evaluate whether campaigns discussing these topics successfully promote school meal participation.