Objective: The purpose of the present study was to characterise the food landscape of an inner city African American neighbourhood and its mixed-race suburban neighbour. Detailed analysis focuses on the relationship between community store mix and price, availability and produce quality. Design: A market basket study was completed by members of the Chicago Food Systems Collaborative. The US Department of Agriculture's standard market basket survey and methodology were used. Additional items and analyses were added in consultation with community members. Setting: Austin is a lower-middle-class African American community of 117 500 on the western edge of Chicago. Oak Park, which borders Austin, is an upper-middleincome suburb of 52 500 with a mixed racial profile. Subjects: A market basket survey of every retail food store in Austin and Oak Park was completed. A total of 134 were included. Results: Results indicate that Austin has many grocery stores and few supermarkets. Many Austin groceries stores carry produce that is usually competitively priced, but often of unacceptable quality. Supermarkets had the best selection. Prices were lowest at discount supermarkets. Prices of packaged items were higher at independent stores than at chain supermarkets, but fresh items were cheaper. Conclusions: Food access is related more to store type than number. In this study, item availability and produce quality varied greatly between store types. Price differences were complicated and varied by store type and food category. This has consequences in terms of food purchasing decisions and dietary quality that public health professionals should acknowledge.

Depression in its own right is a disabling condition impairing all aspects of human function. In persons with a chronic medical disease, depression often makes the management of chronic illness more difficult. Recently, vitamin D has been reported in the scientific and lay press as an important factor that may have significant health benefits in the prevention and the treatment of many chronic illnesses. Most individuals in this country have insufficient levels of vitamin D. This is also true for persons with depression as well as other mental disorders. Whether this is due to insufficient dietary intake, lifestyle (e.g., little outdoor exposure to sunshine), or other factors is addressed in this paper. In addition, groups at risk and suggested treatment for inadequate vitamin D levels are addressed. Effective detection and treatment of inadequate vitamin D levels in persons with depression and other mental disorders may be an easy and cost-effective therapy which could improve patients’ long-term health outcomes as well as their quality of life.

Interdisciplinary partnerships foster innovation to address pressing social problems. This paper describes an interdisciplinary partnership called the Chicago Food System Collaborative (CFSC) composed of a team of partners from four academic institutions and three community-based organizations representing a total of eight disciplines that included: community development and community organizing, community psychology, geography, nursing, nutrition, public health, sociology, and urban planning and policy. Partners came together to address the issue of access to healthy foods and nutrition in a working class African American neighborhood. We analyze and discuss the core principles that guided the partnership and its impact across three dimensions: understanding through interdisciplinary action research, building capacity, and facilitating innovations in practices and policies. Despite the challenges of interdisciplinary partnerships, the potential benefits and impact of such efforts reflect their value as a comprehensive approach to addressing complex social problems.

Objective The aim of this study was to determine the effect of vitamin D supplementation on improving mood (depression and anxiety) and health status (mental and physical) in women with type 2 diabetes mellitus (T2DM). Methods Fifty women with T2DM and significant depressive symptomology were enrolled into the “Sunshine Study,” where weekly vitamin D supplementation (ergocalciferol, 50,000 IU) was given to all participants for six months. The main outcomes included (1) depression (Center for Epidemiologic Studies Depression, CES-D, and Patient Health Questionnaire, PHQ-9), (2) anxiety (State-Trait Anxiety), and (3) health status (Short Form, SF-12). Results Forty-six women (92%) completed all visits. There was a significant decrease in depression (CES-D and PHQ-9, p < 0.001) and anxiety (state and trait, p < 0.001). An improvement in mental health status (SF-12, p < 0.001) was also found. After controlling for covariates (race, season of enrollment, baseline vitamin D, baseline depression (PHQ-9), and body mass index), the decline in depression remained significant (CES-D, p < 0.001). There was a trend for a better response to supplementation for women who were not taking medications for mood (antidepressants or anxiolytics) (p = 0.07). Conclusions Randomized trials to confirm that vitamin D supplementation can improve mood and health status in T2DM women are needed.

A major public health crisis facing America's society is the increase in child and youth obesity, which has seen a fourfold increase in the last four decades. Major concerns include what children eat for school lunch and what other foods are available in schools. This paper illustrates efforts towards systems change in the luncheon program and food vending machines in the Chicago Public Schools. We discuss the different factors that lead to such changes using the framework of the social ecological model and the soft systems methodology, and we analyze how the resulting innovation was implemented and evaluated. First, we present a theoretical perspective to explain factors that influence children's eating patterns from a systems approach. Second, we discuss the antecedent factors that lead to systems change. Finally, we examine challenges to systems change, such as resistance to change, different stakeholder priorities, lack of resources, institutional bureaucracy, and unrealistic funder expectations.

Knowledge of CAC score does impact risk perception for some at-risk groups. This knowledge does enhance motivation for behavior change. Knowledge of CAC score does not impact quality of life. It is hoped that through improved understanding of the effect of CAC scoring on behavior change, nurses can better assist patients to modify behaviors during teachable moments.

Diabetes is a leading cause of cardiovascular disease. Persons with diabetes are at greater risk for early cardiac mortality, and for repeat events if they survive their first cardiac event. Recently, low serum concentrations of vitamin D have been associated with increased risk for cardiac events. Evidence indicates that persons with diabetes have lower serum concentrations of vitamin D. In addition, persons at risk for diabetes or metabolic syndrome have inadequate serum concentrations of vitamin D. This review will assess the evidence relative to the impact of vitamin D in the development of diabetes, metabolic syndrome, and diabetes complications. Studies that address vitamin D and its impact on metabolic outcomes as well as possible mechanisms of action are provided. Finally, the assessment and suggested treatment for vitamin D deficiency is addressed. Effective detection and treatment of inadequate vitamin D concentrations in persons with diabetes or those at risk for diabetes may be an easy and cost-effective therapy which could improve their long-term health outcomes as well as their quality of life.Proper nutrition is one of the most challenging issues for persons with diabetes. To be successful in the treatment of their disease and in the prevention of long-term complications, a diet that meets the daily requirements and is also satisfying to the individual is optimal. However, sometimes diet alone may not be sufficient for adequate intake of certain nutrients. Recently, vitamin D has sparked widespread interest because of its potential health benefits. Previously, research on vitamin D as it related to health outcomes was limited to persons with cancer and osteoporosis. Recently, however, its impact on other chronic illness has been examined. 1,2 Some information on vitamin D deficiency and the development of metabolic syndrome and diabetes has been reported. [3][4][5] However, specific information relative to its impact on metabolic control and complications in persons with diabetes has not been well addressed. This is an important area of study because many individuals with diabetes have decreased levels of vitamin D. 5 And, evidence suggests that lack of vitamin D may be associated with hyperglycemia, increased hemoglobin A1c, insulin resistance, progression of diabetes, as well as hypertension, and cardiovascular disease. Treatment of low vitamin D by diet and oral supplements may be an easy and cost-effective method to improve metabolic control and prevent the serious complications associated with diabetes. Vitamin D and DiabetesThe relationship between lack of vitamin D and diabetes (type 1 and 2) has been reported in the literature. Hyppönen et al 6 examined a birth cohort of pregnant women (n = 12 055) in Finland who were scheduled to give birth in 1966. One year later, there were 10 821 for follow-up, and 81 were diagnosed with type 1 diabetes. Vitamin D supplementation (regular [1988][1989][1990][1991][1992][1993][1994] for serum levels of 25 (OH) D, fasting and/or 2-hour plasma glu...

Asthma is the most prevalent chronic illness in childhood affecting 7 million youth. Many youth with asthma face another risk factor in obesity. Obesity, in turn, increases disorders such as asthma. Studies have recommended that asthma programs also address weight management in youth. Taking this into consideration, the I Can Control Asthma and Nutrition Now (ICAN) program is an innovative school-based program composed of (1) nutrition and weight management education, (2) asthma education, and (3) monthly reenforcement visits. This pilot study tested the initial effectiveness of the ICAN pilot program on a variety of asthma and nutrition outcomes in 25 urban minority students with asthma. Over the course of the pilot program, significant increases in asthma knowledge, asthma self-efficacy, asthma quality of life, asthma self-care, nutrition knowledge, nutrition self-efficacy, and asthma control were observed. The ICAN program has demonstrated promising preliminary results in improving nutrition and asthma health outcomes with urban minority high school students.