Health care providers (HCPs) are an important source of physical activity (PA) information. Two studies were conducted to qualitatively and quantitatively examine nurse practitioners'(NPs) and physician assistants' current PA counseling practices, knowledge and confidence to provide PA counseling and providers' perceptions about their current PA counseling practices. The specific aims for these two studies included quantitatively and qualitatively identifying the prevalence of PA counseling, perceived counseling knowledge and confidence, and educational training related to counseling. In study 1, survey respondents were currently practicing NPs and physician assistants. Participants completed a modified version of the Promotion of Physical Activity by Nurse Practitioners Questionnaire either online or in person during a population specific conference. The majority of both NP and physician assistant respondents reported routinely counseling patients about PA. There were no differences in perceived knowledge or confidence to provide PA counseling between the two populations. Approximately half of all respondents reported receiving training to provide PA counseling as part of their educational preparation for becoming a health practitioner. Nearly three-quarters of respondents reported interest in receiving additional PA counseling training. In study 2, five focus groups (FGs), stratified by practice type, were conducted with NPs and physician assistants. Both NPs and physician assistants reported discussing PA with their patients, particularly those with chronic illness. Participants reported that discussing lifestyle modifications with patients was the most common type of PA counseling provided. Increased confidence to counsel was associated with having PA knowledge and providing simple counseling, such as lifestyle modifications. Barriers to counseling included having more important things to discuss, lack of time during appointments, the current healthcare system, lack of reimbursement and perceived patient financial barriers. PA recommendation knowledge was highly variable, with few participants reporting specific guidelines. FG participants, while not familiar with the American College of Sports Medicines' "Exercise is Medicine" initiative indicated interest in its use and learning more about it. The findings of these two studies indicate that while NPs and physician assistants are knowledgeable, confident and currently providing some amount of PA counseling to patients, additional training in PA counseling is needed and desired.

A brief history of the Mediterranean diet and its geographical origins as a meeting point for cultures will guide understanding of the construction of this specific dietary pattern. The nutrients and foods typical of the Mediterranean diet will be outlined as well as their health benefits, allowing for a deeper analysis of the ways in which the Mediterranean diet is associated with reducing the risk of certain chronic diseases. The lifestyle choices and physical activity practiced adjacently to the diet will establish the positive synergistic effects of conviviality and moderate exercise on general human health. Contemporary movements in the Mediterranean region, like Slow Foods, aim to preserve traditional dietary and lifestyle choices. In comparison, the U.S. food system seems to be most shaped by the influences of globalization and industrialization. Economic and health-cost perspectives as well as the role of modern-day media in diet trends, body image, and food marketing will establish and deepen the complexities of food choices and health disparities in Western societies. The diagnosis of the Mediterranean Diet in the U.S. as a solution to poor general population health will be challenged and holistic perspectives on eating will provide an exploratory lens for understanding health and food choice as a modern-day consumer.