Food Prescriptions to Promote Affordable Diets that Meet RDAs Among Multi-Generational Latino Households

在多代拉丁裔家庭中推广符合 RDA 的负担得起的饮食的食品处方

• 批准号: 10494271
• 负责人: Deborah A Cohen
• 金额: $ 74.95万
• 依托单位: CHILDREN'S HOSPITAL OF LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-24 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10494271
• 关键词: 10 year old; Address; Adult; Affect; Age; Blood Pressure; Blood specimen; Body Weight decreased; Body mass index; Budgets; California; Child; Child Health; Chronic; Chronic Disease; Code; Crossover Design; Cues; Data; Development; Diet; Dietary intake; Dyslipidemias; Eating; Economics; Enrollment; Environmental Risk Factor; Enzymes; Family; Family member; Focus Groups; Food; Generations; Glycosylated hemoglobin A; Goals; Guidelines; Health; Home; Home environment; Household; Impulsivity; Incentives; Individual; Intervention; Latino; Latino Population; Link; Lipids; Liver; Logistics; Los Angeles; Low income; Marketing; Measurement; Mental Fatigue; Menu Planning; Modeling; Neighborhoods; New York City; Non-Insulin-Dependent Diabetes Mellitus; Nutrient; Nutritional; Obesity; Overweight; Participant; Personal Satisfaction; Persons; Pilot Projects; Population; Prediabetes syndrome; Process; Randomized Clinical Trials; Randomized Controlled Trials; Recommended Dietary Allowance; Research Personnel; Restaurants; Risk; Risk Reduction; Sex Behavior; Supermarket; Testing; Unhealthy Diet; United States Department of Agriculture; Waiting Lists; Weight; Weight maintenance regimen; aged; base; blood lipid; blood pressure reduction; cognitive function; community engagement; cost; dietary; disorder risk; efficacy testing; health disparity; improved; intervention delivery; liver function; member; negative affect; non-alcoholic fatty liver disease; nutrition; obesity in children; primary outcome; programs; randomized trial; response; secondary outcome; service delivery; social; social factors; sugar; trend; weight maintenance

Latino families are disproportionately affected by obesity, type 2 diabetes, non-alcoholic fatty liver disease, and dyslipidemia. Diet is a major contributing factor and poor diet is heavily driven by environmental cues, including large restaurant portions and aggressive marketing of low-nutrient, highly processed and high sugar foods. This is especially true in low-income neighborhoods where marketing and availability of unhealthy foods is more salient. Furthermore, the marketing, discounts and promotional strategies in supermarkets often nudge shoppers to buy low-nutrient discretionary foods or buy in excessive quantities. One promising approach to address these nutritional, social, and economic contributors to disparities in chronic disease risk is the concept of food prescriptions, which includes menu planning and home-delivery of affordable and nutritious food. This approach is premised on modifying contextual cues in the home environment rather than relying on self- regulatory control. Project 3 will test the effects of a culturally sensitive meal planning and affordable grocery delivery service in a randomized controlled trial to improve diet quality, weight control and chronic disease risk among multi-generational Latino households. Food prescriptions will meet the EAT-Lancet sustainability guidelines and achieve at least 90% of the recommended dietary allowances for 23 critical nutrients for all family members, at a cost not exceeding $680/month, the current CalFresh (California’s SNAP) budget for a family of four. We will include tailored directions on portion size based on age, sex, activity level and weight goals. We will develop and validate our menus and test logistics with focus groups of Latino adults with overweight or obesity. Thereafter, we will enroll 180 Latino households of 3-5 people (n=720) from Kaiser Permanente members with at least two individuals with overweight or obesity, and at least 1 child aged 5-10 years of age, to participate in a 6-month randomized trial with a wait-list cross-over design. Based on the weekly menu plan, a grocery list will be generated, and items delivered to the home. Anthropometric measurements, blood pressure, dietary intake and blood samples for HbA1c, liver enzymes and lipids will be collected at baseline, 6, and 12 months. Each family will be expected to contribute $100/week, with the amount above this subsidized as an incentive for participation. Specific aims are: 1) Develop an affordable and culturally sensitive meal-planning and grocery delivery intervention for Latino households. 2) Determine the impact of food prescriptions and grocery delivery on parental obesity, diet quality and chronic disease risk. 3) Determine the impact of food prescriptions and grocery delivery on child obesity, diet quality and chronic disease risk. In a cross-center aim, data from this Project will be combined with Projects 1 and 2 to examine: 1) The multi-level determinants of chronic disease risk in Latino children; and 2) The effects of different types of family-based interventions and how social and environmental factors affect the response to intervention. If this approach proves effective, food prescriptions could provide a scalable and sustainable model to improve diet, health, and well-being in Latino families.

拉丁裔家庭受肥胖，2型糖尿病，非酒精性脂肪肝的影响不成比例 疾病和血脂异常。饮食是主要的促成因素，饮食不良受环境的驱动 提示，包括大型餐厅部分以及低营养，高度加工和高较高的积极营销 糖食品。在市场营销和不健康可用性的低收入社区中尤其如此 食物更重要。此外，经常在超市的营销，折扣和促销策略 轻推购物者购买低营养的酌处食品或购买过多的食品。一种承诺的方法 解决这些营养，社会和经济促进慢性疾病风险差异的贡献者是这个概念 食品处方，包括菜单计划和负担得起和营养食品的家庭交付。这 方法以修改家庭环境中的上下文提示为前提，而不是依靠自我 监管控制。项目3将测试对文化敏感的餐食计划和负担得起的杂货的影响 在一项随机对照试验中提供服务，以提高饮食质量，体重控制和慢性病风险 在多代拉丁裔家庭中。食品处方将满足Eat-Lancet的可持续性 指南并至少为所有家庭提供23个关键营养素的建议饮食津贴的至少90％ 成员的费用不超过每月680美元，目前的Calfresh（加利福尼亚的快照）预算 四个。我们将根据年龄，性别，活动水平和体重目标提供有关部分大小的量身定制指示。我们 将开发和验证我们的菜单和测试物流，与有超重或超重的拉丁裔成年人的焦点小组 肥胖。此后，我们将从Kaiser Permanente招收180名3-5人（n = 720）的拉丁裔家庭 至少有两个患有超重或肥胖的人，至少1名5-10岁的孩子 参加6个月的随机试验，并进行等待列表的交叉设计。根据每周菜单计划 将生成杂货清单，并将物品交付给房屋。人体测量值，血压， HbA1c，肝酶和脂质的饮食摄入量和血液样本将在基线，6和12中收集 月份。每个家庭都会有望每周捐款100美元，而该金额以上的金额作为一个补贴 参与的动机。具体目的是：1）开发负担得起的文化敏感餐食和 拉丁裔家庭的杂货交付干预措施。 2）确定食物处方和杂货的影响 关于父母肥胖，饮食质量和慢性疾病风险的交付。 3）确定食物处方的影响 以及有关儿童物体，饮食质量和慢性疾病风险的杂货店。在跨中心的目标中，来自此的数据 项目将与项目1和2结合使用：1）慢性病的多层次决定者 拉丁裔儿童的风险； 2）不同类型的基于家庭的干预措施以及社会和如何社会和 环境因素会影响对干预的反应。如果这种方法被证明有效，则食物处方 可以提供可扩展和可持续的模型，以改善拉丁裔家庭的饮食，健康和福祉。