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      Incorporating an Increase in Plant-Based Food Choices into a Model of Culturally Responsive Care for Hispanic/Latino Children and Adults Who Are Overweight/Obese

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          Abstract

          Introduction: The national rate of obesity in US Hispanic/Latinos exceeds all other major ethnic subgroups and represents an important health disparity. Plant-based diet interventions that emphasize whole plant foods with minimal processing and less refined grains and sugar have shown have shown great promise in control of obesity, but there is a paucity of data translating this treatment effect to disparate populations. The objective of our study was to evaluate the efficacy of the Healthy Eating Lifestyle Program (HELP) for accomplishing weight management in a hospital-based, family centered, culturally tailored, plant-based diet intervention for Hispanic/Latino children who were overweight or obese. Methods: Our mixed methods evaluation included: (1) A one arm study to measure changes in body mass index (BMI) from pre- to post-intervention, and (2) A stakeholder analysis of the program staff. Results: For children ages 5–12 years who were overweight/obese, we found no evidence of excess weight gain evidenced by BMI Z scores (Z post-pre = −0.02, p = 0.11). Among the parent/guardians who were overweight or obese, we found a decrease in BMI that was stronger in men (BMI post-pre = −0.75 kg/m 2, p = 0.01) than in women (BMI post-pre = −0.12 kg/m 2, p = 0.30). A program strength was the cultural tailoring of the plant-based diet choices. Conclusions: The evaluation raises the possibility that incorporating intervention components of HELP (plant-based food choices, family-based, cultural tailoring) into pediatric weight management can improve the standard of care.

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          The National Institute on Minority Health and Health Disparities Research Framework

          We introduce the National Institute on Minority Health and Health Disparities (NIMHD) research framework, a product that emerged from the NIMHD science visioning process. The NIMHD research framework is a multilevel, multidomain model that depicts a wide array of health determinants relevant to understanding and addressing minority health and health disparities and promoting health equity. We describe the conceptual underpinnings of the framework and define its components. We also describe how the framework can be used to assess minority health and health disparities research as well as priorities for the future. Finally, we describe how fiscal year 2015 research project grants funded by NIMHD map onto the framework, and we identify gaps and opportunities for future minority health and health disparities research.
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            Vegetarian diets: what do we know of their effects on common chronic diseases?

            A number of studies have evaluated the health of vegetarians. Others have studied the health effects of foods that are preferred or avoided by vegetarians. The purpose of this review is to look critically at the evidence on the health effects of vegetarian diets and to seek possible explanations where results appear to conflict. There is convincing evidence that vegetarians have lower rates of coronary heart disease, largely explained by low LDL cholesterol, probable lower rates of hypertension and diabetes mellitus, and lower prevalence of obesity. Overall, their cancer rates appear to be moderately lower than others living in the same communities, and life expectancy appears to be greater. However, results for specific cancers are much less convincing and require more study. There is evidence that risk of colorectal cancer is lower in vegetarians and in those who eat less meat; however, results from British vegetarians presently disagree, and this needs explanation. It is probable that using the label "vegetarian" as a dietary category is too broad and that our understanding will be served well by dividing vegetarians into more descriptive subtypes. Although vegetarian diets are healthful and are associated with lower risk of several chronic diseases, different types of vegetarians may not experience the same effects on health.
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              Meats, Processed Meats, Obesity, Weight Gain and Occurrence of Diabetes among Adults: Findings from Adventist Health Studies

              Aim: To examine the relation between meat intake and diabetes occurrence in adults. Methods: In a prospective cohort study we examined the relation between diet and incident diabetes recorded among 8,401 cohort members (ages 45–88 years) of the Adventist Mortality Study and Adventist Health Study (California, USA) who were non-diabetic at baseline. During the 17-year follow-up, we identified 543 incident diabetes cases. Results: (1) Subjects who were weekly consumers of all meats were 29% (OR = 1.29; 95% CI 1.08, 1.55) more likely (relative to zero meat intake) to develop diabetes. (2) Subjects who consumed any processed meats (salted fish and frankfurters) were 38% (OR = 1.38; 95% CI 1.05–1.82) more likely to develop diabetes. (3) Long-term adherence (over a 17-year interval) to a diet that included at least weekly meat intake was associated with a 74% increase (OR = 1.74; 95% CI 1.36–2.22) in odds of diabetes relative to long-term adherence to a vegetarian diet (zero meat intake). Further analyses indicated that some of this risk may be attributable to obesity and/or weight gain – both of which were strong risk factors in this cohort. It is noteworthy that even after control for weight and weight change, weekly meat intake remained an important risk factor (OR = 1.38; 95% CI 1.06–1.08) for diabetes. Conclusions: Our findings raise the possibility that meat intake, particularly processed meats, is a dietary risk factor for diabetes.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                06 July 2020
                July 2020
                : 17
                : 13
                : 4849
                Affiliations
                [1 ]Center for Health Research, Loma Linda University, Loma Linda, CA 92350, USA; jsteinbach@ 123456llu.edu
                [2 ]School of Public Health, Loma Linda University, Loma Linda, CA 92350, USA; anelson@ 123456llu.edu (A.N.); wshih@ 123456llu.edu (W.S.)
                [3 ]Diabetes Education Center, Adventist Health White Memorial Medical Center, Los Angeles, CA 90033, USA; DAvilaME@ 123456ah.org (M.D.); CastilS3@ 123456ah.org (S.C.)
                [4 ]Research and Center for Hispanic Health, Adventist Health White Memorial Medical Center, Los Angeles, CA 90033, USA; JordanMB@ 123456ah.org
                [5 ]Department of Health Policy and Management, School of Public Health, UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA 90095, USA; wmccarth@ 123456ucla.edu
                [6 ]Center for Study of Latino Health and Culture, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA 90095, USA; dhayesb@ 123456ucla.edu
                [7 ]Department of Family Medicine, Adventist Health White Memorial Medical Center, Los Angeles, CA 90033, USA; FloresH1@ 123456ah.org
                Author notes
                [* ]Correspondence: psingh@ 123456llu.edu ; Tel.: +1-(909)-651-5732; Fax: +1-(909)-558-0306
                Author information
                https://orcid.org/0000-0002-9820-2887
                https://orcid.org/0000-0002-2177-0405
                https://orcid.org/0000-0001-8296-7765
                Article
                ijerph-17-04849
                10.3390/ijerph17134849
                7370208
                32640565
                90a50b6c-e970-4612-9dcf-117197b91157
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 21 April 2020
                : 01 July 2020
                Categories
                Article

                Public health
                diabetes,vegetarian diet,nutrition,metabolic syndrome,obesity,disparity
                Public health
                diabetes, vegetarian diet, nutrition, metabolic syndrome, obesity, disparity

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