American journal of preventive medicine
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Comparative Study
Restaurant menus: calories, caloric density, and serving size.
The increasing trend toward eating out, rather than at home, along with concerns about the adverse nutritional profile of restaurant foods has prompted the introduction of calorie labeling. However, the calorie content in food from sit-down and fast-food restaurants has not been analyzed. ⋯ Variation in calories per serving was seen when comparing various types of food, types of establishments, and the specific establishments that provided the foods. Compared to caloric density, serving size was shown to be a more important driver of calories per serving in restaurant foods.
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There is growing recognition that policymakers can promote access to healthy, affordable foods within neighborhoods, schools, childcare centers, and workplaces. Despite the disproportionate risk of obesity and type 2 diabetes among American Indian children and adults, comparatively little attention has been focused on the opportunities tribal policymakers have to implement policies or resolutions to promote access to healthy, affordable foods. This paper presents an approach for integrating formative research into an action-oriented strategy of developing and disseminating tribally led environmental and policy strategies to promote access to and consumption of healthy, affordable foods. ⋯ Using community-based participatory research and informed by the Social Cognitive Theory and ecologic frameworks, the American Indian Healthy Eating Project was started in fall 2008 and has evolved through five phases: (1) starting the conversation; (2) conducting multidisciplinary formative research; (3) strengthening partnerships and tailoring policy options; (4) disseminating community-generated ideas; and (5) accelerating action while fostering sustainability. Collectively, these phases helped develop and disseminate Tools for Healthy Tribes-a toolkit used to raise awareness among participating tribal policymakers of their opportunities to improve access to healthy, affordable foods. Formal and informal strategies can engage tribal leaders in the development of culturally appropriate and tribe-specific sustainable strategies to improve such access, as well as empower tribal leaders to leverage their authority toward raising a healthier generation of American Indian children.
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Comparative Study
School wellness policies: effects of using standard templates.
Public school policies related to physical activity and nutrition recently have become the focal point for policymakers to evaluate the effect of regulations on the childhood obesity epidemic. State school board associations have begun to provide school districts templates for wellness policies, and little research exists that evaluates the effect of a template on the strength and comprehensiveness of these policies. ⋯ In this sample, locally developed policies were stronger than template-based policies. If replicated in large studies, these findings suggest that further research is needed about how best to support schools that wish to develop school wellness policies.
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Little is known about the prevalence of physicians offering nonrecommended breast or colorectal cancer screening for young women. ⋯ A high percentage of physicians report offering nonrecommended breast or colorectal cancer screening tests for young women. Physicians' higher cancer-risk estimation accounted for some overscreening, but even physicians who estimated the patient to be at the same risk as the general population reported offering nonrecommended screening tests.