J Am Diet Assoc
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Randomized Controlled Trial
A low-fat vegan diet elicits greater macronutrient changes, but is comparable in adherence and acceptability, compared with a more conventional diabetes diet among individuals with type 2 diabetes.
Although therapeutic diets are critical to diabetes management, their acceptability to patients is largely unstudied. ⋯ Despite its greater influence on macronutrient intake, a low-fat, vegan diet has an acceptability similar to that of a more conventional diabetes diet. Acceptability appears to be no barrier to its use in medical nutrition therapy.
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Rates of overweight and obesity have increased dramatically during the past 2 decades. Children obtain a large fraction of their food energy while at school. ⋯ There was no evidence that either the school breakfast or lunch program is contributing to rising rates of childhood obesity. In fact, School Breakfast Program participation may be a protective factor, by encouraging students to consume breakfast more regularly.
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Good nutrition is essential to healthy childhood. Because the school meal programs--the National School Lunch Program and the School Breakfast Program--are so widely available, they are in a unique position to influence the nutritional quality of children's diets. ⋯ School meal programs play an important role in the nutritional adequacy of children's diets. However, the association between program participation and excessive sodium intakes, along with the high prevalence of excessive saturated fat intakes among all students, suggest areas for improvement in the meals these programs provide.
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Changes to school food environments and practices that lead to improved dietary behavior are a powerful strategy to reverse the childhood obesity epidemic. ⋯ To improve children's diet and reduce obesity continued changes to school food environments and practices are essential. Removing sugar-sweetened beverages from school food stores and snack bars, improving à la carte choices, and reducing the frequency of offering french fries merit testing as strategies to reduce energy from low-nutrient, energy-dense foods at school.
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Concerns about the diets of school-aged children and new nutrition recommendations for the US population have increased interest in the nutritional quality of meals available through the National School Lunch Program and School Breakfast Program. ⋯ For school meals to meet nutrient standards and promote eating behaviors consistent with the Dietary Guidelines, future policy, practice, and research should focus on reducing levels of fat and sodium and increasing fiber.