Objectives. To determine how health-related conversations between parents and their adolescent children are associated with mealtime media device use by adolescents. Methods. A sample of Hispanic parents (n=344; 40.4 ± 6.6 years; 89.2% female) of 6th, 7th, or 8th-grade adolescents enrolled in a parenting intervention promoting healthy nutrition and substance use prevention. Parents completed baseline surveys to self-report the frequency with which they had health- or weight-related conversations with their adolescent child, and the frequency with which the adolescent used media devices during mealtimes (television/movie watching, cellphone use/texting, hand-held gaming devices, listening to music with headphones). Associations between health-related conversations and mealtime media devices were assessed with Spearman’s rank correlations. Chi-square tests and crosstabs were used to identify differences in parents setting limits on media use during mealtime depending on adolescent gender. Independent sample t-tests were used to compare the frequency of health- and weight-related conversations and media device use during mealtime based on adolescent gender. Results. Reported conversations about healthy eating, being physically active, and general weight of the adolescent were not associated with reported use of media devices by adolescents during mealtimes. Having conversations related to the adolescent weighing too much was positively and significantly correlated with television/movie watching (r=0.213; p<0.001), talking on a cellphone (r=0.119; p=0.034), using hand-held gaming devices (r=0.131; p=0.022), and listening to music with headphones (r=0.129; p=0.022). Having conversations about exercising to lose weight was also significantly correlated with television/movie watching during mealtimes (r=0.134; p=0.017). Parents reported having more frequent conversations about weighing too much with males when compared to adolescent females (2.45 ± 1.43 vs. 1.93 ± 1.28; t-stat= 3.58; p=0.005). Parents also reported more frequent weight-related conversations overall (weight-related scale) with males when compared to female adolescents (2.73 ± 1.39 vs 2.52 ± 1.26; t-stat=1.51; p=0.024). Conclusion. Findings suggest that higher frequency of weight-related conversation is associated with higher usage of media devices during mealtimes. Whether parenting practices, parental concerns about their children’s weight, and the home mealtime environment play a role on adolescent weight status in Hispanic households warrants further investigation.

Background: Children in the United States have low diet quality scores and consume less than the recommended amounts of fruits, vegetables, whole grains, and dairy. The National School Lunch Program serves nearly 30 million children daily, and has the potential to improve the diet quality of children. However, there are high levels of food waste, particularly of fruits and vegetables. Purpose: The purpose of this study is to determine which menu items students are throwing away untouched most frequently. A secondary purpose of this study is to determine which menu items students are fully consuming most frequently. Methods: Student participants (n=2,881) in Arizona elementary, middle, and high schools who participated in school lunch were randomly selected to participate in the study. Student lunch trays were photographed before and after the student ate. Visual estimation was used to determine if menu items were untouched or fully consumed. Menu item names were standardized and categorized into menu categories. The frequency menu items were untouched or fully consumed were summarized in percentages by menu category, and stratified by school level. Results: Findings show that menu items within each menu category are untouched and fully consumed with different frequencies. Cold vegetable items were untouched with the greatest frequency, with 39% of all servings untouched. Some menu items were both untouched and fully consumed with high frequency. Conclusion: Food service managers can use these results to plan menus with food items that are more popular among their students to help increase consumption and decrease waste. Future research should explore the relationship between packaging and preparation with student consumption and waste. Researchers should also examine aspects of the high school food environment that may lead to increased student consumption.

Background: Rapid infant weight gain (RWG) by six months of age has been identified as one of the earliest indicators of childhood obesity. Previous research suggests that exclusive breastfeeding over formula feeding may serve a protective effect from RWG. In addition, the makeup of the infant gut microbiome may influence RWG as differences in feeding practices have been shown to alter the bacterial makeup of the gut, potentially impacting energy metabolism. However, little research has been conducted investigating the potential relationships between RWG, infant feeding practices, and the infant gut microbiome.Methods: This study was a pilot study, which included 31 mother-infant dyads who were primarily recruited from Women, Infant, and Children’s Supplemental Nutrition Program (WIC) clinics and by word of mouth in the Southwestern United States. Participants were followed over six months, with study staff conducting home study visits four times (pregnancy, two days postpartum, three weeks and six months). Mothers who participated in this study were majority White (n=40.6%), non-Hispanic or Latino (67.7%), and obtained a graduate degree (n=22.6%). Participants were included in this analysis (n=22) if they provided at least two infant fecal samples, and the study staff were able to collect infant anthropometric data at the three-week and six-month study visits. Microbial DNA from fecal samples was sequenced using the Illumina MiSeq instrument after polymerase chain reaction (PCR) amplification was performed on the V4 region of the 16S rRNA gene sequence. Statistical analysis was performed using the QIIME2 longitudinal plug-in. Results: Results of this study suggested a significant difference in weighted UniFrac between infants who were exclusively breastfed and formula-fed from birth to three weeks of age. Additionally, an exploratory statistical method identified family Prevotellaceae as a potentially volatile microbe; however, this model failed to reach significance for either RWG or mode of feeding. Overall, no additional alpha or beta diversity metrics or differential abundance of microbes by either RWG or feeding practice group was found in this study. Conclusion: Future research is warranted to further explore potential connections between RWG, infant feeding practices, and the infant gut microbiome in a longitudinal study with a larger sample size.

Background: Studies show that rural schools may be less supportive of student fruit/vegetable (FV) consumption, but few studies have investigated the relationship between school locale and FVs. The aim of this research is to analyze the relationship between school locale (rural vs. urban) and students’ FV selection, consumption, and waste in elementary, middle, and high schools. Methods: A cross-sectional analysis of 37 Arizona schools evaluated differences in the selection, consumption, and waste of fresh FVs from students (n=2525; 45.7% female; 41% non-white; mean age=11.6±3.3; 23.5% rural) using objective plate waste measures. Zero-inflated negative binomial regressions examined differences in FV grams selected, consumed, and wasted by urban vs. rural locale, adjusted for sociodemographics and school. Results: The percent of students who selected, consumed, and wasted zero grams of FVs were 14%, 21%, 20%, respectively. Among students with some (non-zero amounts), the average selected, consumed, and wasted FVs were 115.0±81.4g, 51.7.5±65.1g, 65.2±66.7g, respectively. Rural students (versus urban) had lower odds of selecting (OR=0.75), consuming (OR=0.78), and wasting (OR=0.71) any FVs, after adjusting for covariates. However, among students with some FVs on their plates, rural students selected (IRR=1.40), consumed (IRR=1.18) and wasted (IRR=1.62) more grams of FVs. Conclusions: Rural students had reduced odds of selecting and consuming any FVs, but with lower odds of waste, perhaps due to reduced selection. Once some FVs were on the tray, likelihood of consumption and waste by rural students were greater. Results support interventions targeting rural students’ FV intake to reduce waste.

Objective: To conduct a content analysis of nutrition marketing in school cafeterias in Arizona to understand how nutrition concepts are currently marketed to students. This is the first study to investigate the content of nutrition marketing in school cafeterias, and also the first to compare content across elementary, middle, and high schools. Methods: Photographs of marketing materials on display in school cafeterias were obtained from a convenient sample of 13 elementary schools, 12 middle schools, and 12 high schools. In total, n=284 examples of nutrition marketing were collected. The photographs were sorted by grade level and then coded quantitatively and qualitatively based on their purpose, visual aspects, marketing strategies used, and language and literacy aspects. Given the multiple comparisons, statistical significance was assessed with a Bonferroni adjustment of p<0.0006. Results: The average number of nutrition marketing materials within the school cafeterias was 7.7 ± 7.2. The purpose of the marketing materials ranged from promoting selection and consumption of fruits and vegetables, promoting nutrition and physical activity together, food safety, and educating about healthy eating. The sample of nutrition marketing materials emphasized selecting F/Vs over consumption of F/Vs. However, the opposite was found in marketing that exclusively promoted fruits and vegetables. The most common type of marketing in school cafeterias were flyers and most of the materials were small in size. The sample demonstrated a lack of implementation of marketing appeals in half of the sample, but the half that did utilized techniques that are known to be appealing to child and adolescent demographics, such as use of cartoons, humor, and social media/websites. 98.9% of the nutrition marketing with text were written in English and only 1.1% of the materials (n=3) were written in Spanish. Conclusion: The nutrition marketing sample demonstrated some use of social marketing principles but does not compete with the scale and scope of the child-directed food and beverage marketing that students encounter in their environment. More research is needed to better understand how to best target nutrition marketing to child and adolescent student populations.

Background: The Child and Adult Care Food Program (CACFP), as a federal nutrition assistance program, provides guidance and financial support to early childcare education centers (ECECs) who provide nutritious foods to children in care. Understanding factors that predict participating in CACFP is necessary to expanding CACFP reach. The purpose of this study was to assess center-level predictors of ECECs participating in CACFP in Arizona to guide state-wide recruitment efforts. Methods: This study analyzed data from ECECs in Arizona in 2020 (n=2228), sourcing data from the Arizona Department of Economic Services (Quality First rating (an Arizona-based score for quality of the ECE centers), accreditation Status, highest educational attainment, enrichment center status, and total licensed capacity), Arizona Department of Education (CACFP), Arizona Department of Health and Sanitation (SNAP-Ed participation), and the US Census. Logistic regression was used to examine the association between the predictors and participating in CACFP, adjusting for SNAP-Ed eligibility by census tract. Results: Centers had a significantly greater odds of participating in CACFP if they were an enrichment site (OR=5.9; 95% CI: 4.6, 7.5), had a Quality First rating (OR=2.5; 95% CI: 2.0, 3.0), and when the highest educational attainment by staff was a bachelor’s degree or higher (OR=1.4; 95% CI: 1.1, 1.7). Discussion: The findings support indicate that certain modifiable center-level factors were related to participation in CACFP. Findings may assist possible linkages with other state-level programs to improve the recruitment and retention of ECE centers to CACFP.

Historically, researchers in the gut microbiome have deemed the composition of the microbiome as being adult by the age of two. However, recent studies have contradicted this, demonstrating statistically significant differences in the microbiome even through childhood and adolescence. This difference is important in the field of microbiome research, particularly in studies examining this relationship with weight, because even though there have been significant associations between the gut microbiome and weight, they have been largely studied in adults. The freshman year of college is an interesting time to study this relationship in younger populations, due to the lifestyle changes that make them vulnerable to weight gain. This study included N=139 participants, a majority female (N=97, 69.8%), white (N=59, 42.4%), and non-Hispanic (N=89, 64%). Participants were only included in this analysis if they gave 2 or more fecal samples over the 4 timepoint study. Samples were sequenced using the Illumina MiSeq instrument after polymerase chain reaction (PCR) amplification was performed on the V4 region of the 16S rRNA gene sequence. Statistical analysis was performed using the longitudinal plugin of QIIME2. Results demonstrate that low abundance features seemed to drive a majority of the differences in variability between those who maintained their weight over the course of the study and those who gained weight. This was demonstrated through many significant Unweighted UniFrac results with corresponding nonsignificant Weighted UniFrac data. This study demonstrated that changes in lower abundance features may have driven the significant differences in weight status in this study. This study emphasized the importance of low abundance features and how this relates to changes in weight status during a period of major lifestyle changes. Further work is needed to confirm these findings and explore how gut microbes change in free-living individuals gaining weight over time.

Food insecurity and childhood obesity are both major public health concerns in the United States of America. Research has not found a definite relationship between childhood obesity and food insecurity to date, with conflicting results being found due to differences in sample sizes and protocol for measuring key variables. Preschoolers (children aged 2-5 years) are a population of particular interest as there tends to be improved health behaviors and greater adaptability to change at this period of growth and development. This study aims to evaluate if there is a relationship between food insecurity and childhood obesity with diet quality as a mediator among preschoolers in the Phoenix area. A secondary data analysis from participants (n=154) from the SAGE (Sustainability via Active Garden Education) research project was used to evaluate food insecurity status, diet quality components (kcal, saturated fat, added sugars, and servings of juice, fruits, and vegetables), and anthropometrics (waist circumference and BMI percentile). No significant associations between food insecurity status, diet quality components, and anthropometric data were found. There was an increased rate of food insecurity and childhood overweight/obesity in this sample compared to state and national averages. Further research of high quality is necessary to determine whether a relationship exists between childhood obesity and food insecurity exists and in what context. Additionally, practice and policy will need to be implemented to decrease rates of food insecurity and childhood obesity among Phoenix preschoolers.

Purpose: To develop a valid and feasible short-form corner store audit tool (SCAT) that could be used in-store or over the phone to capture the healthfulness of corner stores.

Design: Nonexperimental.

Setting: Four New Jersey cities.

Subjects: Random selection of 229 and 96 corner stores in rounds 1 and 2, respectively.

Measures: An adapted version of the Nutrition Environment Measures Survey for Corner Stores (NEMS-CS) was used to conduct in-store audits. The 7-item SCAT was developed and used for round 2 phone audits.

Analysis: Exploratory factor analysis and item response theory were used to develop the SCAT.

Results: The SCAT was highly correlated with the adapted NEMS-CS ( r = .79). Short-form corner store audit tool scores placed stores in the same healthfulness categories as did the adapted NEMS-CS in 88% of the cases. Phone response matches indicated that store owners did not distinguish between 2% and low-fat milk and tended to round up the fruit and vegetable count to 5 if they had fewer varieties.

Conclusion: The SCAT discriminates between higher versus lower healthfulness scores of corner stores and is feasible for use as a phone audit tool.

In response to lack of access to healthy foods, many low-income communities are instituting local healthy corner store programs. Some stores also participate in the United States Department of Agriculture's Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and the Supplemental Nutrition Assistance Program (SNAP). This study used two assessment tools to compare the healthfulness of offerings at stores participating in local healthy store programs (upgraded stores), WIC, and/or SNAP to that of similar non-participating stores.

Based on store audits conducted in 315 New Jersey corner stores in 2014, we calculated healthy food availability scores using subsections of the Nutrition Environment Measures Survey for Corner Stores (NEMS-CS-Availability) and a short-form corner store audit tool (SCAT). We used multivariable regression to examine associations between program participation and scores on both instruments.

Adjusting for store and block group characteristics, stores participating in a local healthy store program had significantly higher SCAT scores than did non-participating stores (upgraded: M = 3.18, 95% CI 2.65–3.71; non-upgraded: M = 2.52, 95% CI 2.32–2.73); scores on the NEMS-CS-Availability did not differ (upgraded: M = 12.8, 95% CI 11.6–14.1; non-upgraded: M = 12.5, 95% CI 12.0–13.0). WIC-participating stores had significantly higher scores compared to non-participating stores on both tools. Stores participating in SNAP only (and not in WIC) scored significantly lower on both instruments compared to non-SNAP stores.

WIC-participating and non-SNAP corner stores had higher healthfulness scores on both assessment tools. Upgraded stores had higher healthfulness scores compared to non-upgraded stores on the SCAT.