BACKGROUND AND OBJECTIVES: Addressing food insecurity while promoting healthy body weights among children is a major public health challenge. Our objective is to examine longitudinal associations between food insecurity and obesity in US children aged 1 to 19 years. METHODS: Sources for this research include PubMed, CINAHL, and Scopus databases (January 2000 to February 2022). We included English language studies that examined food insecurity as a predictor of obesity or increased weight gain. We excluded studies outside the United States and those that only considered the unadjusted relationship between food security and obesity. Characteristics extracted included study design, demographics, methods of food security assessment, and anthropometric outcomes. RESULTS: Literature searches identified 2272 articles; 13 met our inclusion criteria. Five studies investigated the relationship between food insecurity and obesity directly, whereas 12 examined its relationship with body mass index or body mass index z-score. Three studies assessed multiple outcomes. Overall, evidence of associations between food insecurity and obesity was mixed. There is evidence for possible associations between food insecurity and obesity or greater weight gain in early childhood, for girls, and for children experiencing food insecurity at multiple time points. Heterogeneity in study methods limited comparison across studies. CONCLUSIONS: Evidence is stronger for associations between food insecurity and obesity among specific subgroups than for children overall. Deeper understanding of the nuances of this relationship is critically needed to effectively intervene against childhood obesity.

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Americans spend the majority of their food dollars at restaurants and other prepared food sources, including quick-service and fast-food restaurants (PFS); independent small restaurants make up 66% of all PFS in the US. In this feasibility study, 5 independent and Latino-owned PFS in the Washington DC metro area worked with academic partners to start offering healthy combo meals with bottled water and promote these using on-site, community, and social media advertising. The number of healthy combos sold was collected weekly, showing that the new combos sold, and customers in all 5 sites were surveyed as they exited the PFS (n=50): >85% had noticed the combo meals; 100% thought it was a good idea to offer it, 68% had ordered the combo (of these, >94% of customers responded that they liked it).  Results suggest that it is feasible to work with independent Latino-owned restaurants to promote healthy combos and collect data.

School disruptions during the COVID-19 pandemic were a likely threat to food security and exacerbated risk factors associated with poor nutrition and health outcomes among low-income youth. As part of an ongoing school-based study aimed at improving physical activity and dietary behaviors (the COACHES study), associations between youth-reported food insecurity and dietary intake across the pandemic-affected academic year of 2020–2021 were examined. Middle school students (6th and 7th grade, 94% Black/African-American, 92% free-/reduced-price lunch eligible) answered validated surveys on food insecurity and diet and were measured for height and weight for calculation of weight status during Fall 2020 (n = 88) and Spring 2021 (n = 56). During this time, schools underwent a combination of in-person, hybrid, and remote learning. Nearly half of participants were overweight or obese (47%), and self-reported food insecurity was near 30% at both time points. Less than one-third of youth met fruit and vegetable intake guidelines, and more than half drank two or more sugar-sweetened beverages daily. While controlling for sex, maternal education, and weight status, food insecurity was not significantly associated with fruit and vegetable or sugar-sweetened beverage intake. Independent of weight status, youth were aware of being food insecure, yet it did not have an apparent impact on these food groups of concern. These findings highlight the need for greater understanding of youth perceptions of food insecurity in order to adequately address dietary quality and quantity concerns among children.

Objectives Disruption to nutrition education and school meal programs and widespread reports of increased food insecurity due to COVID-19 have raised concerns about the potential effect on the dietary quality of youth. Accordingly, this study sought to examine the impact of the pandemic on the dietary intake of youth participating in the Creating Opportunities for Adolescents through Coaching, Healthy Eating, and Sports (COACHES) program, an intervention using coaches trained in trauma-informed coaching strategies to improve health of youth from at-risk communities. Methods The COACHES program recruited 6th and 7th grade students from five schools in New Orleans, LA. Students (n = 67) completed an adapted version of the CoRonavIrus Health Impact Survey (CRISIS) for Youth (V0.3) to assess dietary intake and perception of health during the pandemic. Descriptive statistics were used to examine self-reported impact of the pandemic on eating behaviors. Results Among the students who completed the CRISIS questionnaire (n = 67, 11.7+/−0.73 yrs, 55.2% female, 41.8% overweight/obese), 49.3% reported an overall physical health decrease during the pandemic, 65.6% were not meeting recommendations for daily fruit and vegetable intake, and 72.7% consumed sugary beverages two or more times daily. However, more than one-third actually reported increasing fruit and vegetable consumption during the pandemic, and more than one-quarter reduced their sugary beverage intake. Boys were more likely than girls to report increased fruit and vegetable intake, and youth who were overweight or obese were more likely to report maintaining or improving their overall diet, though results were only significant at the 90% level (P = 0.065). Conclusions Despite challenges due to COVID-19, urban youth report improved dietary intake during the pandemic. These results highlight the importance of school-based intervention programs in meeting the nutrition needs of at-risk youth. Funding Sources Department of Health and Human Services, Office of Minority Health.

Context-appropriate nutrition education interventions targeting middle school students have the potential to promote healthy dietary patters that may help prevent unnecessary weight gain at a point in childhood development when youth experience increasing agency over their food choices. The aim of this review was to identify and synthesize themes in train-the-trainer approaches, intervention content and delivery, and youth receptivity across teacher, mentor, and peer-led nutrition education interventions that targeted middle school-age youth in urban, primarily low-income settings. A systematic, electronic literature search was conducted in seven electronic databases, PubMed/Medline, CINAHL, ERIC, PsycINFO, Scopus, SPORTDiscus, and Cochrane CENTRAL, using fixed inclusion and exclusion criteria. A total of 53 papers representing 39 unique interventions were selected for data extraction and quality assessment. A framework synthesis approach was used to organize the interventions into six categories and identify themes according to whether the intervention was classroom-based or out-of-school-based and whether adults, cross-age peers or same-age peers delivered the intervention. Ten of the interventions contained multiple components such that they were included in two of the categories. The review findings indicated that trainings should be interactive, include opportunities to role-play intervention scenarios and provide follow-up support throughout intervention delivery. Interventions targeting middle school youth should include positive messaging and empower youth to make healthy choices within their specific food environment context.

The human immune system is poised to recognize and respond to foreign particulate substances, like crystals, pollen, bacteria or fungal spores. While some particles can induce significant inflammation others are relatively non-inflammatory. The physical and chemical characteristics that determine the response to different particles are unclear. In this study, we sought to systematically examine the roles that particle size, shape, and surface texturing play in uptake efficiency and subsequent immune cell activation. Using a novel micro-capillary flow focusing technique, we generated microparticles of similar composition but varying in shape from spherical to budding. We discovered that particles with high surface curvature (budding particles) were associated with and phagocytosed by macrophages at higher frequency than particles with low surface curvature, i.e., smooth particles. Remarkably, budding particles also induced stronger IL-1β secretion than smooth particles, through activation of the Nalp3 inflammasome-signaling complex. In vivo, budding particles induced more rapid neutrophil recruitment to the injection site, a hallmark of acute inflammation, than spherical particles. Although currently underappreciated, these findings demonstrate a remarkable and pronounced role for particle shape and surface curvature, independent of chemical composition and surface ligand recognition, in immune cell activation.