Will a Programmatic Framework Integrating Food Is Medicine Achieve Value on Investment?

Diet-related chronic diseases account for seven out of the ten leading causes of death in the USA. Food is Medicine (FIM) interventions can be effective adjuncts to standard medical care to address this cost burden. While the Food is Medicine Pyramid recommends some culinary skill development when integrating FIM into healthcare, the emphasis is on medically tailored meals and food provision.

Proposed Nutrition Competencies for Medical Students and Physician Trainees: A Consensus Statement.

Importance: In 2022, the US House of Representatives passed a bipartisan resolution (House of Representatives Resolution 1118 at the 117th Congress [2021-2022]) calling for meaningful nutrition education for medical trainees. This was prompted by increasing health care spending attributed to the growing prevalence of nutrition-related diseases and the substantial federal funding via Medicare that supports graduate medical education. In March 2023, medical education professional organizations agreed to identify nutrition competencies for medical education.

Characteristics of Current Teaching Kitchens: Findings from Recent Surveys of the Teaching Kitchen Collaborative.

Teaching kitchens are physical and virtual forums that foster practical life skills through participation in experiential education. Given the well-supported connection between healthy eating patterns and the prevention and management of chronic diseases, both private and public organizations are building teaching kitchens (TKs) to enhance the health and wellness of patients, staff, youth, and the general community. Although implementation of TKs is becoming more common, best practices for starting and operating programs are limited.

Perspective: Teaching Kitchens: Conceptual Origins, Applications and Potential for Impact within Food Is Medicine Research.

There is a need to identify innovative strategies whereby individuals, families, and communities can learn to access and prepare affordable and nutritious foods, in combination with evidence-based guidance about diet and lifestyle. These approaches also need to address issues of equity and sustainability. Teaching Kitchens (TKs) are being created as educational classrooms and translational research laboratories to advance such strategies.

Gender differences in global estimates of cooking frequency prior to COVID-19.

The frequency of cooking at home has not been assessed globally. Data from the Gallup World Poll in 2018/2019 wave (N = 145,417) were collected in 142 countries using telephone and face to face interviews. We describe differences in frequency of 'scratch' cooking lunch and dinner across the globe by gender.

Randomized Crossover Comparison of Automated Insulin Delivery Versus Conventional Therapy Using an Unlocked Smartphone with Scheduled Pasta and Rice Meal Challenges in the Outpatient Setting.

Automated Insulin Delivery (AID) hybrid closed-loop systems have not been well studied in the context of prescribed meals. We evaluated performance of our interoperable artificial pancreas system (iAPS) in the at-home setting, running on an unlocked smartphone, with scheduled meal challenges in a randomized crossover trial. Ten adults with type 1 diabetes completed 2 weeks of AID-based control and 2 weeks of conventional therapy in random order where they consumed regular pasta or extra-long grain white rice as part of a complete dinner meal on six different occasions in both arms (each meal thrice in random order).

Maternal healthful dietary patterns during peripregnancy and long-term overweight risk in their offspring.

Adherence to healthful dietary patterns is associated with lower body mass index (BMI) in adults; however, whether maternal diet quality during peripregnancy is related to a lower overweight risk in the offspring remains to be elucidated. We investigated the associations between the Alternate Healthy Eating Index (AHEI), Alternate Mediterranean Diet (aMED) and Dietary Approach to Stop Hypertension (DASH) during peripregnancy and offspring weight outcomes in a study including 2729 mother-child pairs from the Nurses' Health Study II and offspring cohort Growing Up Today Study II. Children, 12-14 years at baseline were 21-23 years at the last follow-up.

Rotating night shift work and risk of multiple sclerosis in the Nurses' Health Studies.

Objectives: Night shift work has been suggested as a possible risk factor for multiple sclerosis (MS). The objective of the present analysis was to prospectively evaluate the association of rotating night shift work history and MS risk in two female cohorts, the Nurses' Health Study (NHS) and NHSII.

Methods: A total of 83 992 (NHS) and 114 427 (NHSII) women were included in this analysis.

The Effect of Two Types of Pasta Versus White Rice on Postprandial Blood Glucose Levels in Adults with Type 1 Diabetes: A Randomized Crossover Trial.

Food choices are essential to successful glycemic control for people with diabetes. We compared the impact of three carbohydrate-rich meals on the postprandial glycemic response in adults with type 1 diabetes (T1D). We performed a randomized crossover study in 12 adults with T1D (age 58.

Rotating night shift work and colorectal cancer risk in the nurses' health studies.

Animal and human data have suggested that shift work involving circadian disruption may be carcinogenic for humans, but epidemiological evidence for colorectal cancer remains limited. We investigated the association of rotating night shift work and colorectal cancer risk in two prospective female cohorts, the Nurses' Health Study (NHS) and NHS2, with 24 years of follow-up. In total, 190,810 women (NHS = 77,439; NHS2 = 113,371) were included in this analysis, and 1,965 incident colorectal cancer cases (NHS = 1,527; NHS2 = 438) were reported during followup (NHS: 1988-2012, NHS2: 1989-2013).

Feasibility Pilot Study of a Teaching Kitchen and Self-Care Curriculum in a Workplace Setting.

. To examine the feasibility of a prototype Teaching Kitchen (TK) self-care intervention that offers the combination of culinary, nutrition, exercise, and mindfulness instruction with health coaching; and to describe research methods whereby the impact of TK models can be scientifically assessed. .

Rotating night shift work, sleep, and colorectal adenoma in women.

Purpose: This study aims to investigate the associations of rotating night shift work history and sleep duration with risk of colorectal adenoma.

Methods: We evaluated 56,275 cancer-free participants of the Nurses' Health Study II, who had their first colonoscopy or sigmoidoscopy between 1991 and 2011; rotating night shift work and sleep duration were reported by mailed questionnaire. Multivariable-adjusted logistic regression was used to estimate relative risks (RR) of colorectal adenoma, with 95% confidence intervals (CI), across categories of rotating night shift work history (none, 1-4, 5-9, and ≥10 years) and sleep duration (≤5, 6, 7, 8, and ≥9 h/day).

Physical activity and the incidence of multiple sclerosis.

Objective: To study whether physical activity during adulthood or early life is associated with multiple sclerosis (MS) incidence in 2 prospective cohorts of women.

Methods: Women in the Nurses' Health Study (NHS) (n = 81,723; 1986-2004) and NHS II (n = 111,804; 1989-2009) reported recent physical activity at baseline and in selected follow-up questionnaires. Using this information, we calculated total metabolic equivalent hours of physical activity per week, a measure of energy expenditure.

Association Between Rotating Night Shift Work and Risk of Coronary Heart Disease Among Women.

Importance: Prospective studies linking shift work to coronary heart disease (CHD) have been inconsistent and limited by short follow-up.

Objective: To determine whether rotating night shift work is associated with CHD risk.

Design, Setting, And Participants: Prospective cohort study of 189,158 initially healthy women followed up over 24 years in the Nurses' Health Studies (NHS [1988-2012]: N = 73,623 and NHS2 [1989-2013]: N = 115,535).

The organizational structure of an intensive care unit influences treatment of hypotension among critically ill patients: A retrospective cohort study.

Purpose: Prior studies report that weekend admission to an intensive care unit is associated with increased mortality, potentially attributed to the organizational structure of the unit. This study aims to determine whether treatment of hypotension, a risk factor for mortality, differs according to level of staffing.

Methods: Using the Multiparameter Intelligent Monitoring in Intensive Care database, we conducted a retrospective study of patients admitted to an intensive care unit at Beth Israel Deaconess Medical Center who experienced one or more episodes of hypotension.

The association of body size in early to mid-life with adult urinary 6-sulfatoxymelatonin levels among night shift health care workers.

Background: Adult body mass index (BMI) has been associated with urinary melatonin levels in humans; however, whether earlier-life body size is associated with melatonin, particularly among night shift workers, remains unknown.

Methods: We evaluated associations of birth weight, body shape (or somatotype) at ages 5 and 10, BMI at age 18 and adulthood, weight change since age 18, waist circumference, waist to hip ratio, and height with creatinine-adjusted morning urinary melatonin (6-sulfatoxymelatonin, aMT6s) levels among 1,343 healthy women (aged 32-53 at urine collection, 1996-1999) in the Nurses' Health Study (NHS) II cohort. Using multivariable linear regression, we computed least-square mean aMT6s levels across categories of body size, and evaluated whether these associations were modified by night shift work.

Vitamin D and actigraphic sleep outcomes in older community-dwelling men: the MrOS sleep study.

Study Objectives: Maintaining adequate serum levels of vitamin D may be important for sleep duration and quality; however, these associations are not well understood. We examined whether levels of serum 25(OH)D are associated with objective measures of sleep in older men.

Setting And Participants: Cross-sectional study within a large cohort of community-dwelling older men, the MrOS study.

Total calcium intake and colorectal adenoma in young women.

Background: Total calcium intake appears to reduce occurrence of colorectal adenoma; however, the dose necessary for prevention in young women is unclear. We examined fine categories of calcium intake in relation to occurrence of first colorectal adenoma in a cohort of mostly premenopausal (88 %) women aged 26-60 at time of endoscopy.

Design: We conducted an analysis among 41,403 participants in the Nurses' Health Study II and assessed intakes of calcium prior to endoscopy through participants' responses to biannual questionnaires.

Preclinical serum 25-hydroxyvitamin D levels and risk of type 1 diabetes in a cohort of US military personnel.

To determine whether serum levels of 25-hydroxyvitamin D (25(OH)D) in young adults are associated with risk of type 1 diabetes mellitus (T1D), we conducted a prospective, nested case-control study among US active-duty military personnel with serum in the US Department of Defense Serum Repository, identifying 310 T1D cases diagnosed between 1997 and 2009 with at least 2 serum samples collected before disease onset and 613 controls matched to cases on age, sex, race/ethnicity, branch of military service, and dates of serum collection. Conditional logistic regression was used to estimate rate ratios and 95% confidence intervals. Among non-Hispanic whites, those with average 25(OH)D levels of ≥ 100 nmol/L had a 44% lower risk of developing T1D than those with average 25(OH)D levels < 75 nmol/L (rate ratio = 0.

Serum uric acid and risk of multiple sclerosis.

Because of evidence implicating oxidative stress in multiple sclerosis pathogenesis, it has been postulated that high levels of urate, a potent antioxidant, could reduce risk or favorably influence disease progression. We conducted a prospective study to determine whether serum urate levels contribute to prediction of multiple sclerosis risk. Analyses included 31 cases with blood collected a median of 1.

The world trade center clean up and recovery worker cohort study: respiratory health amongst cleanup workers approximately 20 months after initial exposure at the disaster site.

Objective: Respiratory health among cleanup workers at the World Trade Center (WTC) disaster site was evaluated approximately 20 months after the initial exposure to assess the risk of lower respiratory symptoms.

Methods: In 2003 a self-administered questionnaire requesting information about site experience, current respiratory and historical health, and smoking was sent to 4,546 workers employed at the site (response 25%), and 2103 workers who were never at the WTC (response 12%).

Results: As compared with those never at the site, WTC workers were more than three times as likely to report any lower respiratory symptoms (rate ratio = 3.

Posttraumatic stress disorder and other psychological sequelae among world trade center clean up and recovery workers.

We assessed the health of workers exposed to the World Trade Center (WTC) site and of a comparison group of unexposed workers, by means of a mail survey. Exposed workers reported higher frequency of symptoms consistent with posttraumatic stress disorder (PTSD), depression, anxiety, and other psychological problems, approximately 20 months after the disaster. PTSD was positively associated with traumatic on-site experiences and with respiratory problems.

Rethinking first response: effects of the clean up and recovery effort on workers at the world trade center disaster site.

Objective: We sought to describe the physical and mental health effects of the cleanup and recovery effort on workers at the World Trade Center disaster site.

Methods: A mailed survey was sent to truck drivers, heavy equipment operators, laborers, and carpenters. It assessed work-related exposures and somatic and mental health symptoms.