Attention-deficit hyperactivity disorder (ADHD) is a developmental disorder categorized by symptoms of inattention, impulsivity, and/or hyperactivity. The onset of ADHD symptoms begin to appear in childhood, tend to be persistent into adulthood, and are associated with adverse physical and mental health outcomes (Caye et al., 2016; Yoshimasu et al., 2018). The current study examined the effects of health-promoting behavior (i.e., diet and physical activity) on ADHD symptoms in middle childhood. The sample consisted of 670 twins (30.1% monozygotic, 36.5% same-sex dizygotic, 32.3% opposite-sex dizygotic) from the ongoing longitudinal study, the Arizona Twin Project. The twin’s (51% female) diet, physical activity, and ADHD symptoms were assessed at age 8 (M = 8.45, SD = 0.69) and ADHD symptoms were assessed again at age 9 (M = 9.70, SD = 0.92). Mixed model regression analyses revealed that aspects of diet (i.e., protein, carbohydrates, and fiber) at age 8 negatively predicted ADHD symptoms at age 9. Similarly, sedentary behavior at age 8 negatively predicted ADHD symptoms at age 9, whereas moderate-to-vigorous activity at age 8 positively predicted ADHD symptoms at age 9. Univariate twin analyses revealed that certain aspects of diet (i.e., sugar, vegetable, and fruit consumption) were influenced by environmental factors whereas other aspects of diet (i.e., protein, carbohydrates, calories, fat, and fiber consumption) were influenced by both genetic and environmental factors. Both children’s sedentary behavior and moderate-to-vigorous activity were influenced primarily by genetic factors, with the remaining variance being attributed to non-shared environmental factors. Additive genetic influences explained the majority of the variance in ADHD symptoms. Future research should examine bidirectional effects of activity and diet on ADHD symptoms across childhood.

Purpose: The purpose of this project was to implement health promotion education for overweight and obese adults with endocrine disorders. The overarching goal was to change dietary intake and improve exercise to reduce the incidence, prevalence, and impact of comorbidities associated with obesity.

Background/Synthesis: Obesity is a significant epidemic facing the nation today with multiple impacts on the national healthcare system. There is often an association between obesity and endocrine disorders such as type 2 diabetes and prediabetes. Both obesity and diabetes cost the nation billions of dollars annually in healthcare costs. Evidence shows that lifestyle modifications related to nutrition and physical activity are effective in weight reduction and prevention of chronic disease, especially when given by a healthcare provider.

Methods: Fifteen adult patients at an endocrinology office in Arizona received individual counseling using the teach-back method focusing on health promotion behaviors through nutrition and exercise with a two-week follow-up phone call. Short-term outcomes measured in this project included changes in dietary intake and exercise behaviors through a pre- and post-test adapted from an obesity-screening tool developed by Greenwood et al. (2008).

Outcomes/Results: Participants were primarily Caucasian and Hispanic, married, female, average age of 50 years, average BMI of 34.5, and some college education. There was a statistically significant increase in health promoting behavior on posttest scores (M=66, SD=6.23, range=58-76) compared to pretest scores (M=61, SD=4.72, range=50-66), t(14)=-2.55, p=0.023.

Conclusions and Implications: Overall, patient health promotion behaviors increased with this educational intervention. Clinical implications include a potential decrease in patient comorbidities related to overweight and obesity. Implications for the greater healthcare system include decreased comorbidities, utilization of healthcare resources, and costs associated with overweight and obesity. Future recommendations would include determining weight and BMI changes over a longer period of time for even better outcome measures.

Keywords: obesity, obese, overweight, health promotion, health education, diet, exercise, nutrition

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.