Calcium is a nutrient of public health concern and commonly associated with dairy foods. In recent years, plant-based alternatives to dairy products have grown in popularity. This study examines public understanding of dietary calcium in dairy products and plant-based alternatives and explores whether knowledge is associated with product preference. In 2018, the U.S. Food and Drug Administration (FDA) solicited comments on the labeling of plant-based dairy alternatives (FDA-2018-N-3522), including input on consumer understanding of the nutritional content of dairy foods and plant-based products. All 11,906 submissions were obtained and 8,052 were retained after duplicate and near-duplicate comments were removed. Comments were coded for major nutrition themes and those that mentioned calcium and were analyzed for three calcium-specific themes: knowledge and beliefs about calcium content, calcium bioavailability, and health outcomes associated with intake. Submissions were examined in relation to each commenter's preference for dairy products or plant-based alternatives. 244 unique submissions (3.0%) mentioned calcium. Over half (51.2%) of commenters who mentioned calcium preferred plant-based alternatives. Comments mentioning calcium often reflected preference. Most commenters had an accurate understanding of calcium content in dairy and plant-based products. However, several commenters-especially those who preferred plant-based alternatives-misunderstood calcium metabolism and health outcomes related to calcium. Given declining consumption of fluid dairy milk-a key source of dietary calcium-and increasing consumption of plant-based alternatives, addressing gaps in nutrition knowledge and misunderstanding related to dairy and calcium intake is critical and has implications for nutrition education and policy.
Road user fatalities account for a leading cause of preventable death in Latin America with pedestrians and bicyclists at higher risk for more extensive injuries as compared to other road users. Despite these vulnerable road user (VRU) risks, encouraging individuals to walk and cycle is an important public health strategy for addressing the region's obesity epidemic through promoting physical activity via active transportation (AT). However, in order to promote AT as a viable source of physical activity, safety of the VRU must be considered. The purpose of this systematic review and metasummary is to describe the effectiveness of interventions that have been implemented in Latin America to improve pedestrian and bicyclist safety. A systematic search of public health, policy, and engineering databases was completed using terms generated through the PICO method. The PRISMA framework was used for article screening. Eight articles detailing nine interventions across four countries were included for final synthesis and organized according to the Three E's Model of Injury Prevention, including three education-based interventions, two engineering, three enforcements, and one utilizing all Three E's. VRU outcomes assessed ranged from attitudes and behaviors to fatal injuries, with only enforcement-based interventions reporting on the latter. No interventions reported on non-fatal injury outcomes. Interventions rooted in each arm of the Three E's demonstrated limited ability to improve VRU outcomes, with enforcement-based interventions providing the strongest body of evidence. Findings demonstrate the limited research on VRU safety in Latin America, and further efforts should be of urgent public health priority.
Commercial drivers are essential to the economic recovery, yet their work exposes them to many health and safety hazards. Research to improve driver health should be designed with an understanding of both the complex occupational environment and the risk management context. We present results from a small pilot study of driver health concerns and behaviors to illustrate concepts and frameworks from human health risk assessment and management that may assist in the design and translation of driver and other worker health research. The pilot study surveyed 18 long-haul truck drivers at a truck stop using an instrument adapted from the International Physical Activity Questionnaire and a transient community needs assessment developed for the US Antarctic Program Recreation and Wellness Survey. Respondents' characteristics and health concerns reflect existing literature: mostly male of older age with musculoskeletal and chronic health conditions. The two most common barriers to physical activity were lack of time and physical limitations. Applying cumulative risk assessment and risk-based decision-making frameworks, we suggest that preventive health management opportunities can be improved for these transient workers through actions of employers, truck stop owners and their communities. Considering lessons learned in implementing the pilot, cumulative risk assessment, and risk-based decision making in research design can facilitate holistic research considering co-exposures, risk factors and mitigators across multiple domains of health to inform worker protection.
The purpose of the current study is to understand how the early portion of COVID-19 pandemic impacted the health behaviors of rural families participating in a healthy lifestyles intervention. Caregivers of rural children participating in a healthy lifestyles intervention were invited to participate in a structured interview regarding how the COVID-19 pandemic affected their family and family health behaviors. Interviews were transcribed and the research team conducted a rigorous inductive thematic analysis. Structured qualitative interviews with caregivers (n=30) resulted in 5 saturated themes: (a) caregivers reported new or exacerbated mental health concerns and stress among family members, largely due to social isolation and external stressors, (b) caregivers reported feeling out of control of positive health behaviors for themselves and their children, (c) families reported variability in how they handled reductions in schedule demands, ranging from filling time with positive activities to negative behaviors such as snacking, (d) families continuously re-adjusted their approach to parenting, routines, and health behaviors due to internal and external factors, (e) families ate foods that were accessible and convenient, which impacted the health of the family diet. Despite being asked primarily about lifestyle behavior changes, families reported concerns around mental health. Implications are that professionals working with rural children and families, even those without mental health training, may be called upon to help address these concerns especially in these underserved, rural families.