The Role of Race and Gender in Nutrition Habits and Self-Efficacy: Results from the Young Adult Weight Loss Study

Diet, polycyclic aromatic hydrocarbons, and oxidative stress biomarkers in pregnancy: A Los Angeles pregnancy cohort

Polycyclic aromatic hydrocarbon (PAH) exposure during pregnancy has been associated with increased oxidative stress. Few studies have evaluated the relationship between diet, urinary PAHs, and oxidative stress biomarkers among pregnant women. We enrolled a prospective cohort of pregnant women who gave birth at UCLA between 2016 and 2019. Dietary intake over the past month was evaluated by a food frequency questionnaire during mid-pregnancy, and three diet index scores were calculated: Healthy Eating Index (HEI) 2015, Alternate Mediterranean Diet (aMED), and Alternate Healthy Eating Index for Pregnancy (AHEI-P). Urine samples were collected up to three times during pregnancy and analyzed for PAH biomarkers, including 2-hydroxyfluorene + 3-hydroxyfluorene (FLUO2FLUO3), 1-hydroxyphenanthrene (PHEN1), 2-hydroxyphenanthrene (PHEN2), 3-hydroxyphenanthrene (PHEN3), 4-hydroxyphenanthrene (PHEN4), 2-hydroxynaphthalene (NAP2), and 1-hydroxypyrene (PYR1), and two oxidative stress biomarkers, malondialdehyde (MDA) and 8-hydroxyguanosine (8-OHdG). We employed multiple linear regression models to estimate effects of diet on measures of urinary PAHs and oxidative stress biomarkers. A better diet quality, as indicated by three diet indices, was associated with lower urinary PAH metabolites and lower concentrations of oxidative stress biomarkers. This pattern appeared to be consistent across all three sampling periods (9-17 weeks, 18-29 weeks, and 30 weeks-delivery). Healthier diets may lower PAH exposure and oxidative stress in pregnancy.

Impact of self-rationing on academic performance of college students

OBJECTIVE

Self-rationing or one's ability to regulate allocation of resources for consumption can be an inefficient process. Despite the negative impact of self-rationing inefficiencies (eg unhealthy food choices), there is scarce research to understand this phenomenon. This study investigated college students' self-rationing efficiency of eating behavior and spending choices, and their relationship to academic performance.

PARTICIPANTS AND METHODS

This study used a combination of a real-time experiment, self-reported surveys (n = 101), and interviews with college students (n = 12). Data was collected using two 24-hour recall periods, online surveys, and semi-structured interviews.

RESULTS

College students demonstrated self-rationing inefficiency of eating behavior, but not of expenditure on food. Furthermore, there was a significant relationship between self-rationing inefficiencies in eating behavior and students' academic performance.

CONCLUSIONS

This study directly investigated self-rationing efficiency amongst college students' food choices and food expenditure, and enhances our understanding of its impact on college students' academic performance.

Interest and Perseverance Are Not Enough to Be Physically Active: The Importance of Self-Efficacy toward Healthy Eating and Healthy Weight to Move More in Adolescents

(1) Background: Insufficient physical activity in adolescents remains an important issue for health promotion. Given the current relevance of understanding the adoption and maintenance of moderate and vigorous physical activity (MVPA), the aim of this study was to analyze, in a sample of adolescents, the role of grit personality as an antecedent of healthy eating and healthy weight (HEW) self-efficacy and its implications for the practice of MVPA. (2) Methods: Participants were 987 adolescents (597 girls, 390 boys) aged between 15 and 19 years from Mexico and Spain. The Spanish versions of the grit personality scale, the healthy eating and weight self-efficacy scale and the global physical activity questionnaire were used to measure the variables of interest. (3) Results: Mediated regression analysis showed that grit personality was not directly related to MVPA practice. However, the results indicate the significant relationship between grit personality and HEW self-efficacy, as well as the positive and significant relationship of this self-efficacy on MVPA practice. HEW self-efficacy totally mediated the relationship between grit personality and MVPA in both boys and girls. (4) Conclusions: These results suggest that having a grit personality (i.e., having interest and perseverance) is not enough for adolescents to be physically active, but that perceiving oneself as effective in having a healthy diet and healthy weight may be the key for adolescents to move more. At the intervention level, we suggest targeting an enhancement of young people's competence to eat healthily and regulate their weight as a strategy to enhance the performance of more MVPA, with a possible transfer between healthy behaviors (spill over).

Relationship between dietary pattern and depressive symptoms: an international multicohort study

BACKGROUND

Several previous studies have shown that dietary patterns are associated with the incidence of depressive symptoms. However, the results have been inconsistent. This study aimed to prospectively investigate the association between dietary patterns and the risk of depressive symptoms in two large cohort studies.

METHODS

The Tianjin Chronic Low-grade Systemic Inflammation and Health (TCLSIH) cohort study included a total of 7,094 participants living in Tianjin, China from 2013 to 2019, and the UK Biobank cohort study includes 96,810 participants who were recruited from 22 assessment centers across the UK taken between 2006 and 2010. All participants were free of a history of cardiovascular disease (CVD), cancer, and depressive symptoms at baseline. Dietary patterns at baseline were identified with factor analysis based on responses to a validated food frequency questionnaire in TCLSIH or Oxford WebQ in UK Biobank. Depressive symptoms were evaluated using the Chinese version of the Zung Self-Rating Depression Scale (SDS) in TCLSIH or hospital inpatient records in UK Biobank. Cox proportional hazards regression models were used to estimate the association between dietary patterns and depressive symptoms.

RESULTS

A total of 989, and 1,303 participants developed depressive symptoms during 17,410 and 709,931 person-years of follow-up. After adjusting for several potential confounders, the multivariable HRs (95% CIs) of the depressive symptoms were 0.71 (0.57, 0.88) for traditional Chinese dietary pattern, 1.29 (1.07, 1.55) for processed animal offal included animal food dietary pattern, and 1.22 (1.02, 1.46) for sugar rich dietary pattern in TCLSIH (all Q4 vs Q1). In the UK Biobank, the HRs (95% CIs) of depressive symptoms were 1.39 (1.16, 1.68) for processed food dietary pattern (Q4 vs Q1), 0.90 (0.77, 1.00) for healthy dietary pattern (Q3 vs Q1), and 0.89 (0.75, 1.05) for meat dietary pattern (Q4 vs Q1) in the final adjusted model.

CONCLUSION

Dietary patterns rich in processed foods were associated with a higher risk of depressive symptoms, and following a traditional Chinese dietary pattern or healthy dietary pattern was associated with a lower risk of depressive symptoms, whereas meat dietary pattern was not associated.

Consumption of ultraprocessed food and development of chronic kidney disease: the Tianjin Chronic Low-Grade Systemic Inflammation and Health and UK Biobank Cohort Studies

BACKGROUND

Many ultraprocessed food (UPF)-derived by-products may play a role in the development of chronic kidney disease (CKD). Although several studies have assessed the association of UPFs with kidney function decline or CKD in various countries, no evidence has been shown in China and the United Kingdom.

OBJECTIVES

This study aims to evaluate the association between UPF consumption and risk of CKD in 2 large cohort studies from China and the United Kingdom.

METHODS

In total, 23,775 and 102,332 participants without baseline CKD were enrolled in the Tianjin Chronic Low-Grade Systemic Inflammation and Health (TCLSIH) and UK Biobank cohort studies, respectively. Information on UPF consumption was obtained from a validated food frequency questionnaire in the TCLSIH and 24-h dietary recalls in the UK Biobank cohort. CKD was defined as an estimated glomerular filtration rate of <60 mL/min/1.73 m², albumin-to-creatinine ratio ≥30 mg/g, or as having a clinical diagnosis of CKD in both cohorts. Multivariable Cox proportional hazard models were used to examine the association between UPF consumption and the risk of CKD.

RESULTS

After a median follow-up of 4.0 and 10.1 y, the incidence rates of CKD were around 1.1% and 1.7% in the TCLSIH and UK Biobank cohorts, respectively. The multivariable hazard ratio [95% confidence interval] of CKD across increasing quartiles (quartiles 1-4) of UPF consumption were 1 (reference), 1.24 (0.89, 1.72), 1.30 (0.91, 1.87), and 1.58 (1.07, 2.34) (P for trend = 0.02) in the TCLSIH cohort and 1 (reference), 1.14 (1.00, 1.31), 1.16 (1.01, 1.33), and 1.25 (1.09, 1.43) (P for trend < 0.01) in the UK Biobank cohort, respectively.

CONCLUSIONS

Our finding indicated that higher UPF consumption is associated with a higher risk of CKD. Moreover, restricting UPF consumption may potentially benefit the prevention of CKD. Further clinical trials are required to clarify the causality. This trial was registered at UMIN Clinical Trials Registry as UMIN000027174 (https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000031137).

Psychometric Testing: Self-Efficacy for Calorie Control and Exercise

Enhancing self-efficacy for calorie control and exercise is a crucial strategy for successful weight management. This study developed and psychometrically tested a 13-item quick checklist for assessing self-efficacy for calorie control and exercise (QCSE-CCE). A convenience sample of 425 adults between 18 and 69 years old completed the QCSE-CCE online. The principle axis factor analysis and a parallel analysis demonstrated a three-factor structure that accounts for 72.8% of the total variance. The confirmatory factor analysis indicated a good model fit (χ²/df = 2.168, GFI = .913, AGFI = .873, RMR = .049, RMSEA = .073, CFI = .959). The predictive validity was adequate (.38 < r < .39, p < .000), with Cronbach's alphas ranging from .87 to .91. The test-retest demonstrated good stability (r = .69; p < .001). The QCSE-CCE is a valid and reliable instrument for assessing self-efficacy for calorie control and exercise for weight management purposes.

Effects of the UNI-PAHNP on physical activity and nutrition behaviors in overweight/obese university students in Turkey

PURPOSE

This study aimed to determine the effectiveness of a Pender's health promotion model-based Physical Activity and Healthy Nutrition Program for University Students (UNI-PAHNP) as a means for improving university students' nutrition and physical activity behaviors.

METHOD

A total of 110 overweight and obese students were randomized into study and control groups.

FINDINGS

Students in the intervention group showed significant decreases in body mass index and waist circumference and significant increases in step count, physical activity, nutrition and exercise scores, vegetable and water intake frequency, and self-efficacy to regulate nutrition and exercise from pre-intervention to six months post-intervention (p < 0.05).

PRACTICE IMPLICATIONS

This study shows the value of utilizing nurses to implement a health promotion program for overweight/obese university students.

Sex Differences in Healthy Eating: Investigating the Moderating Effect of Self-Efficacy

OBJECTIVES

This study aimed to evaluate sex differences in dietary habits and the moderating effect of self-efficacy on the adoption of a healthy diet.

DESIGN

Cross-sectional study.

SETTING

The healthy population of Tehran, Iran.

PARTICIPANTS

A total of 262 participants from the general population with normal health status.

MAIN OUTCOME MEASURE

The adoption of a healthy diet was based on the Healthy Eating Index-2015 (HEI-2015) scores and the moderating effect of self-efficacy on eating behaviors.

ANALYSIS

Logistic regression analysis and multiple linear regression (moderation) analysis were conducted using PROCESS macro (version 3.5).

RESULTS

The sex-based analysis revealed that females were more likely to adopt a healthy diet vs males (adjusted odds ratio, 1.85; 95% confidence interval, 1.02-3.35). The moderation analysis showed that eating behavior self-efficacy significantly moderated the relationship between sex differences and HEI-2015 scores (ΔR2 = 0.01; P = 0.033). Males with low self-efficacy scores had the highest difference in HEI-2015 with females with low self-efficacy scores, whereas the difference in HEI-2015 was very small in males and females with high self-efficacy scores.

CONCLUSIONS AND IMPLICATIONS

Eating behavior self-efficacy had a significantly decreasing moderating effect on sex differences in the adoption of a healthy diet. Future research needs to clarify the impact of eating`` behavior self-efficacy in the adoption of a healthy diet, particularly in males, and to confirm the study's findings.

Eating self-efficacy changes in individuals with type 2 diabetes following a structured lifestyle intervention based on the transcultural Diabetes Nutrition Algorithm (tDNA): A secondary analysis of a randomized controlled trial

OBJECTIVE

Eating self-efficacy behavior is an important predictor of successful lifestyle intervention. This secondary analysis evaluated the changes in eating self-efficacy behavior in patients with type 2 diabetes (T2D) and overweight/obesity following structured lifestyle intervention based on the Malaysian customized transcultural Diabetes Nutrition Algorithm (tDNA).

METHODS

Patients with T2D and overweight/obesity (n = 230) were randomized either into the tDNA group which included a structured low-calorie meal plan using normal foods, incorporation of diabetes-specific meal replacements, and an exercise prescription or usual T2D care (UC) for 6 months. Patients in the tDNA group also received either counseling with motivational interviewing (tDNA-MI) or conventional counseling (tDNA-CC). The UC group received standard dietary and exercise advice using conventional counseling. Eating self-efficacy was assessed using a locally validated Weight Efficacy Lifestyle (WEL) questionnaire. All patients were followed up for additional 6 months' post-intervention.

RESULTS

There was a significant change in WEL scores with intervention over one-year [Group X Time effect: F = 51.4, df = (3.4, 318.7), p<0.001]. Compared to baseline, WEL scores improved in both the tDNA groups with significantly higher improvement in the tDNA-MI group compared to the tDNA-CC and UC groups at 6 months (tDNA-MI: 25.4±2.1 vs. tDNA-CC: 12.9±2.8 vs. UC: -6.9±1.9, p<0.001). At 12 months' follow-up, both the tDNA groups maintained improvement in the WEL scores, with significantly higher scores in the tDNA-MI group than tDNA-CC group, and the UC group had decreased WEL scores (tDNA-MI: 28.9±3.1 vs. tDNA-CC: 11.6±3.6 vs. UC: -13.2±2.1, p<0.001). Patients in the tDNA-MI group with greater weight loss and hemoglobin A1C reduction also had a higher eating self-efficacy, with a similar trend observed in comparative groups.

CONCLUSION

Eating self-efficacy improved in patients with T2D and overweight/obesity who maintained their weight loss and glycemic control following a structured lifestyle intervention based on the Malaysian customized tDNA and the improvement was further enhanced with motivational interviewing.

CLINICAL TRIAL

This randomized clinical trial was registered under National Medical Research Registry, Ministry of Health Malaysia with registration number: NMRR-14-1042-19455 and also under ClinicalTrials.gov with registration number: NCT03881540.

Objective Church Environment Audits and Attendee Perceptions of Healthy Eating and Physical Activity Supports within the Church Setting

Interventions in faith-based settings are increasingly popular, due to their effectiveness for improving attendee health outcomes and behaviors. Little past research has examined the important role of the church environment in individual-level outcomes using objective environmental audits. This study examined associations between the objectively measured physical church environment and attendees' perceptions of physical activity (PA) and healthy eating (HE) supports within the church environment, self-efficacy for PA and HE, and self-reported PA and HE behaviors. Data were collected via church audits and church attendee surveys in 54 churches in a rural, medically underserved county in South Carolina. Multi-level regression was used to analyze associations between the church environment and outcomes. Physical elements of churches were positively related to attendees' perceptions of church environment supports for PA (B = 0.03, 95% CI = 0.01, 0.05) and HE (B = 0.05, 95% CI = 0.01, 0.09) and there was a significant interaction between perceptions of HE supports and HE church environment. Self-efficacy and behaviors for PA and HE did not show an association with the church environment. Future research should establish a temporal relationship between the church environment and these important constructs for improving health. Future faith-based interventions should apply infrastructure changes to the church environment to influence important mediating constructs to health behavior.

Adaptation and Initial Psychometric Evaluation of an Informed Prostate Cancer Screening Decision Self-Efficacy Scale for African-American Men

OBJECTIVE

To evaluate whether computer-based prostate cancer screening decision aids enhance decision self-efficacy for African-American men, culturally relevant and reliable measures are needed. However, limited psychometric evidence exists on the health-related decision self-efficacy of African-American men. This study describes the development and psychometric evaluation of the 11-item Informed Prostate Cancer Screening Decision Self-Efficacy Scale among 354 African-American men.

METHODS

Exploratory factor analysis was conducted with maximum-likelihood estimation and polychoric correlations followed by Promax and Varimax rotations.

RESULTS

Exploratory factor analysis yielded a one-factor, 11-item model of the modified scale with excellent internal consistency reliability at 0.95 and factor loadings ranging from 0.70 to 0.90. Both parallel analysis and a scree plot confirmed the retention of one factor, and the standardized root mean square residual (0.06) indicated that the factor structure explained most of the correlations.

CONCLUSIONS

Findings suggest the one-factor, 11-item Informed Prostate Cancer Screening Decision Self-Efficacy Scale has excellent psychometric properties and utility in reliably measuring health-related decision self-efficacy in African-American men. Future research is needed to confirm this factor structure among socio-demographically diverse African Americans.

Effectiveness of lifestyle interventions for preventing harmful weight gain among young adults from lower socioeconomic status and ethnically diverse backgrounds: a systematic review

The incidence of overweight and obesity are increasing with each successive generation of young adults. Associated co-morbidities will emerge at an earlier age unless weight gain is prevented. Evidence has demonstrated young adults (aged 18-35 years) from low socioeconomic and ethnically diverse backgrounds are at greater risk of overweight or obesity, yet it is unclear how to effectively intervene in this population. This systematic review aimed to assess the effectiveness of lifestyle interventions conducted in this population. Thirty studies reporting on lifestyle interventions for prevention of weight gain were identified from eight electronic databases searched. Six interventions included subgroup analyses to determine if ethnicity moderated weight change, and two included subgroup analyses to determine if socioeconomic status had an effect on change in weight. Five of these six studies were effective in preventing weight gain, and subgroup analyses showed no differences in effect by ethnicity. Of these five studies, two included a subgroup analysis that showed socioeconomic status to have no effect on weight outcome. Despite the promising results from these five lifestyle interventions utilizing online and mobile components to effectively reach and prevent weight gain in this priority population, the evidence base of high quality trials is limited.