The role of ultra-processed foods (consistent with the Western diet) on gut microbiome and its role in metabolic disease represents a novel area of research that has implications for food policy and nutrition education in the US. This project aims to improve food literacy and dietary patterns using a novel, mobile-friendly intervention (N=300). Biochemical outcomes including gut health will be assessed and associations will be examined by dietary patterns and other risk indicators among a subsample of participants for this ancillary study (n=100).
Four of the top seven causes of death in the US are precipitated by nutritional causes and are almost completely preventable (e.g. coronary heart disease (CHD), diabetes, hypertension). The economic burden of these metabolic diseases, their associated comorbidities, plus the stress on the national healthcare infrastructure is massive. It is known that food insecurity or insufficiency is a risk factor for poor nutrition, and those that cannot afford proper food tend to have diets high in sugar, fat, and calories, leading to a disproportionate risk for nutrition-related chronic disease among lower socioeconomic groups. Indeed, risk for obesity, diabetes, and CHD are higher among individuals from lower socioeconomic groups.
Nearly 40% of college students experience hunger and food insecurity, which is strongly associated with not only poor physical and mental health, but also academic outcomes. The CalFresh Outreach project, taking place concurrently at 40 California college campuses including Cal Poly SLO (from 2019-2021), aims to enroll eligible students in the federal supplemental nutrition assistance program (SNAP, named CalFresh in California). Nationwide, more than 44 million people utilize SNAP, which has been shown to decrease food insecurity. However, participants do not receive any food or nutrition education, presenting major opportunities to examine strategies that address the myriad nutrition-related chronic diseases prevalent in the U.S., especially among vulnerable and low-income populations that tend to utilize SNAP.
The USDA MyPlate model portrays conventional food groups, and was created to help Americans choose healthier diets. It has shown limited promise, and data from young adult SNAP/CalFresh participants is lacking. The novel NOVA food classification system categorizes foods based on extent and purpose of industrial processing. NOVA is gaining significant traction internationally, but is completely untested, yet may be an effective nutrition education tool given the modern food environment that is rife with ultra-processed food products (i.e. Western diet). Indeed, 60% of the US diet by calories is comprised of ultra-processed food products. Biochemical risk indicators including blood pressure, blood glucose, inflammatory markers, triglycerides, cholesterol, body fat, and gut health are all directly related to diet, but data from young adults who may be food insecure is lacking.
We plan to capitalize on the infrastructure created by the CalFresh Outreach project to evaluate the impact of CalFresh/SNAP participation on food security status among participants, and to assess the effectiveness of a mobile-friendly nutrition education intervention on dietary habits and biochemical risk indicators for the most significant nutrition-related chronic diseases in the US using a randomized, controlled trial design. Our intervention will include a control group (no nutrition education) and two intervention groups (one utilizing the USDA MyPlate and the other utilizing MyPlate plus NOVA). If novel nutrition education approaches are causally associated with healthier dietary patterns and biochemical risk indicators, the health and economic burdens of nutrition related chronic diseases may be addressable through relatively low-cost and simple strategies, and may be effective solutions to the significant economic burden and glaring health disparities in the U.S
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