Childhood obesity is a worsening epidemic in the U.S. with substantial racial/ethnic and socioeconomic disparities. Community-based approaches are necessary to target populations that are disproportionately affected by childhood obesity. The current randomized controlled trial assessed the effects of Athletes for Life (AFL), a 12-week community-based nutrition education and physical activity program that aims to improve cardiovascular fitness and promote healthy eating among families in the South Phoenix region, relative to a control condition. One of the goals of the intervention was to increase participating children's intake of fruits/vegetables and reduce their sugar intake, measured by a parent-reported food-frequency questionnaire. Data were collected on 110 child participants aged 6-11 years old. Relative to baseline values, participants in the intervention reportedly increased their fruit intake frequency by 0.12 + 2.0 times per day, whereas the control group decreased their intake by 0.32 + 1.28 times per day (p=0.026). Participants in the intervention group also increased their vegetable intake by 0.21 + 0.65 times per day, whereas control participants decreased their intake by 0.05 + 0.72 times per day (p=0.019). Participants in the intervention group decreased their intake of sugar-sweetened beverage (SSB) intake by 0.22 + 0.62 times per day, whereas control participants decreased their intake of SSBs by 0.04 + 0.40 times per day, however, the change observed in SSB intake was not significant between groups. Lastly, frequency of sugar-laden food intake decreased by 0.86 + 1.10 times per day among the intervention group, whereas control participants increased their intake by 0.02 + 1.10 times per day (p=0.033). The AFL study may serve as a framework for future community-based interventions to promote health in underserved areas.

Hispanic children have the highest prevalence of obesity versus other ethnic groups. This leaves this population susceptible to many adverse health risks, including hypertension, cardiovascular disease, and high blood pressure. Unfortunately, little research has been done investigating the contributing cause to this issue, specifically common sedentary behaviors in children that limit physical activity and it’s purpose in expending energy. Amongst these behaviors, amount of time spent on electronic devices has proven to have increased drastically in recent years. The relationship between screen time and electronic device use, specifically with television, video games, and computer usage, and physical activity levels, and how those affect cardiometabolic disease risk factors, were explored in this study. Participants of this study were elementary school-aged children from Maricopa County, AZ. Electronic device usage, physical activity amounts, and presence of the specific devices in the child’s were collected from the participants’ parents through self-reported survey questions. Anthropometric and biochemical markers of cardiometabolic disease risk were directly measured. The average time spent engaged in physical activity per day by these participants was 20.02 ± 21.1 minutes and the average total screen time per day was 655 ± 605 minutes. Findings showed strong significance between total screen time and computer and video game use (r=0.482; p=0.01 and r=0.784; p=0.01, respectively). Video game time in the group of children with a video game in their room (350.66 ± 445.96 min/day) was significantly higher than the sample of kids without one in their room (107.19 ± 210.0 min/day ; p=0.000). Total screen time was also significantly greater with children who had a video game system in their room (927.56 ± 928.7 min/day) versus children who did not (543.14 ± 355.11 min/day; p=0.006). Additionally, significance was found showing children with a computer in the bedroom spent more time using the computer per day (450.95 ± 377.95 min/day), compared to those children who did not have a computer in their room (333.5 ± 395.6 min/day; p=0.048). No significant association was found between metabolic markers and screen time. However, HDL-cholesterol, triglycerides, and insulin proved to be dependent on BMI percentile (r=-0.582; p=0.01, r=0.476; p=0.01, r=0.704; p=0.01 respectively). Our data suggest further research needs to be done investigating other potential sources that limit physical activity so that strategies can focus on reducing obesity incidence and the associated health risks. Future studies should use larger sample sizes to be more representative of this population, and develop more direct observations instead of self-reported values to limit bias.

Background. Effects of lifestyle interventions on early biomarkers of oxidative stress and CVD risk in youth with prediabetes are unknown. Objective. To evaluate the effects of a lifestyle intervention to prevent type 2 diabetes among obese prediabetic Latino adolescents on oxidized lipoproteins. Design: In a quasi-experimental design, 35 adolescents (51.4% male, age 15.5(1.0) y, body mass index (BMI) percentile 98.5(1.2), and glucose 2 hours after an oral glucose tolerance test-OGTT 141.2(12.2) mg/dL) participated in a 12-week intervention that included weekly exercise (three 60 min-sessions) and nutrition education (one 60 min-session). Outcomes measured at baseline and post-intervention were: fasting oxidized LDL and oxidized HDL (oxLDL and oxHDL) as oxidative stress variables; dietary intake of fresh fruit and vegetable (F&V) and fitness (VO2max) as behavioral variables; weight, BMI, body fat, and waist circumference as anthropometric variables; fasting glucose and insulin, 2hour glucose and insulin after an OGTT, insulin resistance (HOMA-IR), and lipid panel (triglycerides, total cholesterol, VLDL-c, LDL-c, HDL-c, and Non-HDL) as cardiometabolic variables. Results. Comparing baseline to post-intervention, significant decreases in oxLDL concentration were shown (51.0(14.0) and 48.7(12.8) U/L, p=0.022); however, the intervention did not decrease oxHDL (395.2(94.6) and 416.1(98.4) ng/mL, p=0.944). F&V dietary intake (116.4(97.0) and 165.8(91.0) g/d, p=0.025) and VO2max (29.7(5.0) and 31.6(4.7) ml*kg-1*min-1, p<0.001) significantly increased. Within-subjects correlations between changes in F&V intake and oxidized lipoproteins, adjusted for VO2max changes, were non-significant (R=-0.15, p=0.52 for oxLDL; R=0.22, p=0.25 for oxHDL). Anthropometric variables were significantly reduced (weight -1.3% p=0.042; BMI -2.2% and BMI percentile -0.4%, p=0.001; body fat -6.6% and waist circumference -1.8%, p=0.025). Cardiometabolic variables significantly improved, including reductions in glucose 2hour (-19.3% p<0.001), fasting insulin (-12.9% p=0.008), insulin 2hour (-53.5% p<0.001), and HOMA-IR (-12.5% p=0.015), with 23 participants (66%) that reverted toward a normal glucose tolerance status. Most lipid panel significantly changed (triglycerides -10.2% p=0.032; total cholesterol -5.4% p=0.002; VLDL-c -10.4% p=0.029; HDL-c -3.2% p=0.022; and Non-HDL -5.5% p=0.0007). Conclusion. The intervention resulted in differential effects on oxidized lipoproteins and significant improvements in behavioral, anthropometric and cardiometabolic variables, reducing the high metabolic risk of obese prediabetic kids.

Although many studies have looked into the relationship between home food availability and dietary intake, few have assessed actual change in the home food environment as a result of an intervention program. This secondary data analysis of the Athletes for Life 3 (AFL3) program investigated the efficacy of a randomized controlled 12-week community-based, family-focused exercise and dietary behavior intervention program in improving the home food environment of families with children between the ages of 6 and 11 years old. A total of twenty-six adults from Phoenix, Arizona allowed research staff into their homes to assess variety of food availability, using a modified version of the Home Food Inventory and were randomized to either the AFL3 program or wait-list control group. The main outcomes of interest were change in availability of vegetables, fruits, sugar-sweetened beverages and desserts and WIC-approved breakfast cereal. There was a significant increase in the number of vegetable items (3.88 ± 0.85; p=0.006) and WIC-approved cereal items (1.16 ± 0.31; p=0.003) in the homes of the intervention participants, relative to the wait-list control group. Additionally, there was a significant decrease in the number of sugar-sweetened beverage items (1.18 ± 0.31; p=0.014) available in wait-list control participant homes. There were no other significant findings related to home food availability. Furthermore, dietary intake among adult participants did not significantly change as a result of change in home availability. In conclusion, the AFL3 intervention program was successful in eliciting small but significant changes at a household level related to vegetable and WIC-approved breakfast cereal availability.

Low income, pregnant adolescents have an increased risk of adverse pregnancy outcomes, such as preterm birth, delivery of low birth weight babies and excessive gestational weight gain that increases the risk of postpartum overweight and obesity. Inadequate dietary intake is a modifiable risk factor that may differentially impact maternal health and fetal outcomes for pregnant adults and adolescents. To evaluate the effectiveness of a social media intervention on improving prenatal health knowledge and dietary intake, 22 racially diverse pregnant women (59% Black and 36% White) were recruited and adolescent (n=10) outcomes compared to those of adults (n=12) across the intervention. Pre- and post-intervention nutrition knowledge questionnaires and diet recalls were completed to assess nutrition knowledge and dietary intake. When assessing dietary change across the intervention, significant decreases in fat (pre vs. post, 97.9 ± 0.2 g vs. 90.2 ± 0.2 g, P=0.047) and folate intake (pre vs. post, 537.6 ± 0.3 μg vs. 531.2 ± 0.2 μg, P=0.041) were observed while significant increases in carbohydrate (pre vs. post, 318.9 ± 0.2 g vs. 335.9 ± 0.2 g, P<0.001), calcium (pre vs. post, 851.3 ± 0.3 mg vs. 893.5 ± 0.2 mg, P<0.001) and magnesium intakes (pre vs. post, 212.9 ± 0.2 mg vs. 227.8 ± 0.2 mg, P<0.001) occurred. These time effects occurred independent of group (adolescents vs. adults) as time*group interactions were not significant (p>0.05) with the exception of sugar intake. Increases in sugar intake across the intervention were greater among the adolescent group (adolescent vs. adult, 7.9 ± 0.2 g vs. 6.0 ± 0.2 g, P=0.023). Overall nutrition knowledge was limited and confusion regarding MyPlate recommendations persisted. The inadequate dietary behaviors observed suggest that future interventions should focus education on specific dietary nutrients such as added sugars and fiber to improve dietary intakes. The best way to actively engage pregnant adolescents is unknown: however, social media has the potential to reach teens and low-income women with education that may be key in allowing interventions to change dietary habits and behaviors.

College weight gain and obesity are significant problems impacting our society, leading to a considerable number of comorbidities during and after college. Gut microbiota are increasingly recognized for their role in obesity and weight gain. Currently, research exploring the gut microbiome and its associations with dietary intake and body mass index (BMI) is limited among this population. Therefore, the purpose of this study was to assess associations between the gut microbiome, BMI, and dietary intake in a population of healthy college students living in two dorms at Arizona State University (n=90). Cross-sectional analyses were undertaken including 24-hour dietary recalls and anthropometrics (height, weight and BMI). High throughput Bacterial 16S rRNA gene sequencing of fecal samples was performed to quantify the gut microbiome and analyses were performed at phyla and family levels. Within this population, the mean BMI was 24.4 ± 5.3 kg/m2 and mean caloric intake was 1684 ± 947 kcals/day. Bacterial community analysis revealed that there were four predominant phyla and 12 predominant families accounting for 99.3% and 97.1% of overall microbial communities, respectively. Results of this study suggested that a significant association occurred between one principal component (impacted most by 22 microbial genera primarily within Firmicutes) and BMI (R2=0.053, p=0.0301). No significant correlations or group differences were observed when assessing the Firmicutes/Bacteroidetes ratio in relation to BMI or habitual dietary intake. These results provide a basis for gut microbiome research in college populations. Although, findings suggest that groups of microbial genera may be most influential in obesity, further longitudinal research is necessary to more accurately describe these associations over me. Findings from future research may be used to develop interventions to shift the gut microbiome to help moderate or prevent excess weight gain during this important life stage.

Background: Although childhood engagement in physical activity has received growing attention, most children still do not meet the recommended daily 60 minutes of moderate to vigorous physical activity [MVPA]. Children of ethnic minorities are less likely to meet the guidelines. Interventions have been implemented in various settings to increase child physical activity levels, yet these efforts have not yielded consistent results. The purpose of this study was to assess the preliminary effects of a community-based intervention on light physical activity and MVPA among 6-11 year old children. Methods: The present study was part of a larger study called Athletes for Life [AFL], a family-based, nutrition-education and physical activity intervention. The present study focused on physical activity data from the first completed cohort of participants (n=29). This study was a randomized control trial in which participating children were randomized into a control (n=14) or intervention (n=15) group. Participants wore accelerometers at two time points. Intervention strategies were incorporated to increase child habitual physical activity. Analyses of covariance were performed to test for post 12-week differences between both groups on the average minutes of light physical activity and MVPA minutes per day.

Results: The accelerometer data demonstrated no significant difference in light physical activity or MVPA mean minutes per day between the groups. Few children reported engaging in activities sufficient for meeting the physical activity guidelines outside the AFL program. Of the 119 total distributed child physical activity tracker sheets (7 per family), 55 were returned. Of the 55 returned physical activity tracker sheets, parents reported engaging in physical activity with their children only 7 times outside of the program over seven weeks.

Conclusion: The combined intervention strategies implemented throughout the 12-week study did not appear to be effective at increasing habitual mean minutes per day spent engaging in light and MVPA among children beyond the directed program. Methodological limitations and low adherence to intervention strategies may partially explain these findings. Further research is needed to test successful strategies within community programs to increase habitual light physical activity and MVPA among 6-11 year old children.

Background: Latinos have disproportionately high rates of obesity and type 2 diabetes. Family-based interventions may reduce chronic disease risk among Latinos across generations.

Purpose: To assess the efficacy of Athletes for Life (AFL), a 12-week community-and-family-based behavioral intervention, for improving diet, physical activity (PA), anthropometrics, fitness, and biochemical outcomes among mostly Latino parents.

Methods: Parents with at least one child 6-11 years of age were randomized to active AFL participation (n=14) or a wait-list control (n=14) group. AFL consisted of twice weekly 90 minute sessions (45 minutes of nutrition-focused lessons and 45 minutes of PA participation) designed to promote fruit and vegetable consumption, reduction of sugar intake, and increasing habitual PA. Data were collected prior to and immediately after the 12 week intervention.

Results: Participants (37.9±7.2y) were mostly Latino (93%), Spanish speaking (68%), and women (93%). Relative to participants in the control group, AFL participants had a significant reduction in body fat (-1.1±1.2% vs. 0.2±1.2%; p=0.014), resting (-7.6±10.2 bpm vs. +2.1±6.8 bpm; p<0.01), exercise (-8.4±8.7 bpm vs. +0.4±7.3 bpm; p<0.01), and recovery heart rate (-11.9±12.8 bpm vs. -0.3±11.4 bpm; p=0.01), and one mile run time (-1.5±1.0 min vs. -0.1±0.9 min; p<0.01), and a significant increase in estimated VO2 peak (+1.9±1.9 ml/kg/min vs. 0.0±1.8 ml/kg/min; p=0.01). AFL participants also reported an increase in the number of days/week accumulating 30 minutes of MVPA (+0.8±3.2 vs. -1.5±2.3; p=0.004) and daily servings of fruits (+1.3±1.4 vs. +0.3±1.4; p<0.05) and vegetables (+1.8±1.7 vs. +0.1±1.2; p<0.05), relative to control participants. There were no significant differences between groups in changes in diet assessed by 3-day food record, accelerometer-measured PA, weight, blood pressure, visceral fat, biomarkers for cardiovascular disease or nutritional biomarkers.

Conclusions: Despite the lack of effects on diet and PA behaviors, AFL shows promising preliminary efficacy for reducing body fat and improving fitness among adult participants. Future research aimed at improving fitness among Latino parents with family-based intervention is warranted.

Despite recent strides for awareness, treatment, and control of hypertension, prevalence remains high with estimates suggesting one third of Americans have hypertension. The hypotensive effects of potassium and magnesium have been known and administered in a clinical setting for nearly a century. The purpose of this study was to examine the effectiveness of taking a potassium/magnesium supplement to help reduce blood pressure in individuals with mildly-moderately elevated blood pressure. In this randomized, controlled crossover trial, potassium and magnesium supplementation was explored among healthy adults with mildly elevated blood pressure in Phoenix, Arizona. Subjects (n = 12) were randomly assigned to ingest either the treatment chewy bar (217 mg potassium/day; 70.8 mg magnesium/day) or a placebo chewy bar for four weeks. For the subsequent four weeks, subjects ingested the other corresponding chewy bar. Systolic (SBP), diastolic (DBP), and average blood pressure values were not significantly different between the two groups (p = 0.645, p = 0.464 and p = 0.939, respectively). Baseline mean blood pressure was 121.0/75.7 mm Hg. The 12 subjects (8 females, 4 males) had a mean age of 29.3 years old and a mean BMI of 26.2. After four weeks, the treatment group had a slightly higher SBP (118.3 ± 13.3 mm Hg) than the control group (116.5 ± 17.8 mm Hg); however, DBP was lower in the treatment group (71.7 ± 12.4 mm Hg) than the control group (73.0 ± 10.0 mm Hg). In conclusion, daily supplementation of potassium and magnesium (217.2 mg/day and 70.8 mg/day, respectively) did not significantly lower blood pressure in adults with mildly-moderately elevated blood pressure.

Background: Despite the reported improvements in glucose regulation associated with flaxseeds (Linum usitatissimum) few clinical trials have been conducted in diabetic participants. Objective: To evaluate the efficacy of ground flaxseed consumption at attenuating hyperglycemia, dyslipidemia, inflammation, and oxidative stress as compared to a control in adults with non-insulin dependent type 2 diabetes (T2D). Design: In a randomized parallel arm controlled efficacy trial, participants were asked to consume either 28 g/d ground flaxseed or the fiber-matched control (9 g/d ground psyllium husk) for 8 weeks. The study included 17 adults (9 male, 8 females; 46±14 y; BMI: 31.4±5.7 kg/m2) with a diagnosis of T2D ≥ 6 months. Main outcomes measured included: glycemic control (HbA1c, fasting plasma glucose, fasting serum insulin, and HOMA-IR), lipid profile (total cholesterol, LDL-C, HDL-C, total triglycerides, and calculated VLDL-C), markers of inflammation and oxidative stress (TNF-alpha, TBARS, and NOx), and dietary intake (energy, total fat, total fiber, sodium). Absolute net change for measured variables (week 8 values minus baseline values) were compared using Mann-Whitney U non-parametric tests, significance was determined at p ≤ 0.05. Results: There were no significant changes between groups from baseline to week 8 in any outcome measure of nutrient intake, body composition, glucose control, or lipid concentrations. There was a modest decrease in TNF-alpha in the flaxseed group as compared to the control (p = 0.06) as well as a mild decrease in TBARS in the flaxseed as compared to the control group (p = 0.083), though neither were significant. Conclusions: The current study did not detect a measurable association between 28 g/d flaxseed consumption for 8 weeks in T2D participants and improvements in glycemic control or lipid profiles. There was a modest, albeit insignificant, decrease in markers of inflammation and oxidative stress in the flaxseed group as compared to the control, which warrants further study.