OBJECTIVE: This dissertation first evaluates food price variation within and between neighborhoods in order to improve our understanding of access to healthy foods and potential economic incentives and barriers to consuming a higher quality diet. The study then spatially links individuals to their nearby supermarkets to study the association between food price and dietary quality, insulin resistance (IR), and diabetes. METHODS: Prices of healthy foods (dairy, fruits, and vegetables) and unhealthy foods (soda, sweets, and salty snacks) were obtained from 1953 supermarkets across the US during 2009-2012 from the Information Resources Inc. (IRI) database. In Aim 1, prices of healthy and unhealthy foods, and the relative price of healthy foods compared with unhealthy foods (healthy-to-unhealthy price ratio) were linked to census block group socio-demographics in order to analyze associations between food prices with neighborhood SES and proportion Black/Hispanic. Linear hierarchical regression models were used to explore geospatial variation and adjust for confounders. The second and third aims of this study linked average price of healthy foods, unhealthy foods and their ratio to participants in The Multi-Ethnic Study of Atherosclerosis (MESA). For Aim 2, individuals who completed MESA exam 5 (2010-2012) and the food frequency questionnaire were included (N=2765). A Healthy Eating Index (HEI-2010) was calculated for each individual according to their FFQ. Logistic regression estimated adjusted odds ratios of a high quality diet (top quantile of HEI-2010) associated with each price exposure. Sensitivity analyses used an instrumental variable approach in which the price of brand name toilet paper served as an instrument for food prices. For Aim 3, individuals from MESA who completed exam 5 and exam 4 (administered five years prior, diabetes incidence analysis only) were included. Type 2 diabetes status was confirmed at each exam and IR was measured according to the homeostasis model assessment index of IR. Adjusted logistic, modified Poisson and linear regression models were used to model diabetes prevalence, incidence and IR, respectively. RESULTS: Overall, the price of healthy foods was nearly twice as high as the price of unhealthy foods ($0.590 vs. $0.298 per serving; healthy-to-unhealthy price ratio of 1.99). This trend was consistent across all neighborhood characteristics. After adjusting for covariates, no association was found between food prices (healthy, unhealthy, or the healthy-to-unhealthy ratio) and neighborhood SES, while small positive and negative associations were detected with the proportion Black/Hispanic, respectively. A larger healthy-to-unhealthy price ratio was associated with lower odds of having a high quality diet (Odds Ratio [OR]=0.76 per SD increase in the ratio, 95% CI=[0.64 to 0.91]). Instrumental variable analyses largely confirmed these findings although confidence intervals were wider and the result was no longer statistically significant (OR=0.82 [0.57 to 1.19]). A higher ratio of healthy-to-unhealthy food had a positive association with IR (4.8% increase in IR for each standard deviation increase in price ratio (estimate=0.048, 95% CI=[0.00 to 0.10]) after adjusting for confounders. No association with diabetes incidence (relative risk=1.11, 95% CI=[0.85 to 1.44]) or prevalence (OR=0.95, 95% CI=[0.81 to 1.11]) was observed. CONCLUSIONS: The price of healthy food was twice as expensive as unhealthy food per serving on average. A higher price of healthy food relative to unhealthy foods appears to be negatively associated with a high quality diet and with insulin resistance. There did not appear to be an association with diabetes prevalence or 5-year incidence. This study provides new insight into the relationship between food prices with diet quality, IR and diabetes. Policies to address the large price differences between healthy and unhealthy foods may help improve diet quality and downstream health effects in the U.S.

- NEW! Fully revised for a Canadian classroom includes Canadian statistics, references and resources, protocols, documentation standards, delegation rules, Canadian nursing best practice guidelines, metric measurements, and more! - NEW! All topics, skills, and sample documentation conform to Canadian provincial and territorial scopes of practice and Canadian standards in nursing practice. - NEW! Inclusion of Canadian concepts Person-Centred Care, Evidence-Informed Practice, Interprofessional Collaboration and Delegation and Care in the Community. - NEW! Greater emphasis on cultural assessment/considerations and caring for Indigenous and vulnerable populations. - NEW! Thoroughly revised chapters reflect Canadian practice and guidelines including Emergency Preparedness and Disaster Management, Palliative Care, Cardiac Care, Vascular Access and Infusion Therapy, Oral Nutrition, and Prevention of Skin Breakdown and Wound Care. - NEW! Enhanced and updated art program includes 70 new figures.

"On the occasion of World Health Day 2016, WHO issues a call for action on diabetes, drawing attention to the need to step up prevention and treatment of the disease. The first WHO Global report on diabetes demonstrates that the number of adults living with diabetes has almost quadrupled since 1980 to 422 million adults. This dramatic rise is largely due to the rise in type 2 diabetes and factors driving it include overweight and obesity. In 2012 alone diabetes caused 1.5 million deaths. Its complications can lead to heart attack, stroke, blindness, kidney failure and lower limb amputation. The new report calls upon governments to ensure that people are able to make healthy choices and that health systems are able to diagnose, treat and care for people with diabetes. It encourages us all as individuals to eat healthily, be physically active, and avoid excessive weight gain."--Publisher's description.

Learn more about how health nutrition experts can help you make the correct food choices for a healthy lifestyle The eighth edition of the Dietary Guidelines is designed for professionals to help all individuals, ages 2 years-old and above, and their families to consume a healthy, nutritionally adequate diet. The 2015-2020 edition provides five overarching Guidelines that encourage: healthy eating patterns recognize that individuals will need to make shifts in their food and beverage choices to achieve a healthy pattern acknowledge that all segments of our society have a role to play in supporting healthy choices provides a healthy framework in which individuals can enjoy foods that meet their personal, cultural and traditional preferences within their food budget This guidance can help you choose a healthy diet and focus on preventing the diet-related chronic diseases that continue to impact American populations. It is also intended to help you to improve and maintain overall health for disease prevention. **NOTE: This printed edition contains a minor typographical error within the Appendix. The Errata Sheet describing the errors can be found by clicking here. This same errata sheet can be used for the digital formats of this product available for free. Health professionals, including physicians, nutritionists, dietary counselors, nurses, hospitality meal planners, health policymakers, and beneficiaries of the USDA National School Lunch and School Breakfast program and their administrators may find these guidelines most useful. American consumers can also use this information to help make helathy food choices for themselves and their families.

During the past twenty years there has been a dramatic increase in obesity in the United States. An estimated thirty percent of adults in the US are obese; in 1980, only fifteen percent were. The issue is gaining greater attention with the CDC and with the public health world in general. This book will offer practical information about the methodology of epidemiologic studies of obesity, suitable for graduate students and researchers in epidemiology, and public health practitioners with an interest in the issue. The book will be structured in four main sections, with the majority of chapters authored by Dr. Hu, and some authored by specialists in specific areas. The first section will consider issues surrounding the definition of obesity, measurement techniques, and the designs of epidemiologic studies. The second section will address the consequences of obesity, looking at epidemiologic studies that focus on cardio-vascular disease, diabetes, and cancer The third section will look at determinants obesity, reviewing a wide range of risk factors for obesity including diet, physical activity and sedentary behaviors, sleep disorders, psychosocial factors, physical environment, biochemical and genetic predictors, and intrauterine exposures. In the final section, the author will discuss the analytical issues and challenges for epidemiologic studies of obesity.

“Personalised Nutrition” represents any initiative that attempts to provide tailor-made healthy eating advice based on the nutritional needs of each individual, as these are dictated by the individual’s behaviour, phenotype and/or genotype, and their interactions. This Special Issue of Nutrients is dedicated to the development, implementation and assessment of the effectiveness of evidence-based “Personalised Nutrition” strategies. In this regard, a selection of reviews and original research manuscripts will bring together the latest evidence on how lifestyle habits, physiology, nutraceuticals, gut microbiome and genetics can be integrated into nutritional solutions, specific to the needs of each individual, for maintaining health and preventing diseases.

Social factors, signals, and biases shape the health of our nation. Racism and poverty manifest in unequal social, environmental, and economic conditions, resulting in deep-rooted health disparities that carry over from generation to generation. In Perspectives on Health Equity and Social Determinants of Health, authors call for collective action across sectors to reverse the debilitating and often lethal consequences of health inequity. This edited volume of discussion papers provides recommendations to advance the agenda to promote health equity for all. Organized by research approaches and policy implications, systems that perpetuate or ameliorate health disparities, and specific examples of ways in which health disparities manifest in communities of color, this Special Publication provides a stark look at how health and well-being are nurtured, protected, and preserved where people live, learn, work, and play. All of our nation's institutions have important roles to play even if they do not think of their purpose as fundamentally linked to health and well-being. The rich discussions found throughout Perspectives on Health Equity and Social Determinants of Health make way for the translation of policies and actions to improve health and health equity for all citizens of our society. The major health problems of our time cannot be solved by health care alone. They cannot be solved by public health alone. Collective action is needed, and it is needed now.