Theresa A. Nicklas

Bio: Theresa A. Nicklas is an academic researcher from North Dakota State University. The author has contributed to research in topics: Saturated fat & School meal. The author has an hindex of 11, co-authored 21 publications receiving 839 citations. Previous affiliations of Theresa A. Nicklas include Tulane Medical Center.

Impact of breakfast consumption on nutritional adequacy of the diets of young adults in Bogalusa, Louisiana: ethnic and gender contrasts.

Abstract: Objective To evaluate the impact of breakfast consumption patterns on the nutritional adequacy of diets of young adults and determine possible ethnic and gender differences. Design and setting Cross-sectional survey of young adults in Bogalusa, La. Subjects Twenty-four-hour dietary recalls were collected from October 1988 through October 1991 on 504 young adults (mean age=23 years, 58% women, 70% white). Statistics Analysis of variance and logistic regression techniques were used to investigate the relationship of breakfast consumption, ethnicity, and gender on dietary adequacy. The P values are from an analysis of variance model that adjusted for gender and ethnicity. Results Thirty-seven percent of young adults skipped breakfast. Of those who ate breakfast, 75% ate at home, 10% ate a fast-food breakfast, and 15% reported other sources. Mean energy intake from breakfast was 485kcal; men consumed more energy than women ( P P P P P Applications Encouraging consumption of breakfast, along with selection of more healthful breakfast food choices or snacks that are culturally appropriate, may be important strategies for improving the nutritional quality of young adults' diets. J Am Diet Assoc. 1998;98:1432–1438 .

Outcomes of a High School Program to Increase Fruit and Vegetable Consumption: Gimme 5 — A Fresh Nutrition Concept for Students

Abstract: This paper describes an intervention to increase high school students' fruit and vegetable consumption. Twelve schools were randomized to intervention or control conditions. The cohort (2,213 students; 56% females, 84% Caucasian) were followed from 9th to 12th grades. Interventions comprised a media campaign, classroom workshops, school meal modification, and parental support. Usual daily servings of fruit/vegetables increased 14% in the intervention compared to the control group (p > 0.001) the first three years. At follow-up, consumption within the control group also increased, resulting in no significant difference between groups. Intervention group knowledge scores and awareness indicators were significantly higher than those of the control group (p < 0.0001). Gimme 5 provided a first model to show that dietary habits of high school students can be influenced by positive media messages relative to that age group, increased exposure to a variety of tasty products, and minimal classroom activity.

Stages of Change for Increasing Fruit and Vegetable Consumption among Adults and Young Adults Participating in the National 5-a-Day for Better Health Community Studies

Abstract: Higher fruit and vegetable consumption is associated with a reduced risk of certain cancers and chronic diseases. The 5-a-Day for Better Health community studies are evaluating population-based strategies to achieving dietary behavior change using the stages-of-change model and associated theories. The authors present baseline comparisons of stages of change for fruit and vegetable consumption among adults and young adults in eight study sites representing diverse regions of the United States and diverse populations and settings. Three dominant stages, precontemplation, preparation, and maintenance, were found across sites. Women and those with college degrees were more likely to be in action/maintenance. Fruit and vegetable consumption, self-efficacy, and knowledge of the 5-a-Day recommendation were positively associated with more advanced stages of change in all study sites. The authors discuss the findings in relation to possible limitations of this and other dietary stages-of-change measures and suggest directions for future research.

Nutrient intake of Head Start children: home vs. school.

Abstract: Objective: To determine mean intake of energy and protein, total fat, saturated fat, percent energy from total and saturated fat, cholesterol, carbohydrate, calcium, iron, zinc, folate, vitamins A, C, E, B-6 and B-12, thiamin, niacin, riboflavin, magnesium, sodium and fiber of preschool Head Start children at school and away from school.Design: Twenty-four-hour food intakes for 358 Head Start children were obtained by observing food intake at school and acquiring intake recalls from parents or guardians specifying food their children consumed for the balance of the day. After determining group estimates of energy and nutrient intake, mean intake was compared to standard nutrient recommendations for the entire 24-hour day, i.e., for the time the children were in school and for the remaining hours away from school (“home” intake).Subjects: The 358 Head Start children attended school either half-day (2- to 3-hour AM and PM sessions) or all-day (5 to 6 hours).Statistical analyses: Differences in nutrient inta...

Studies of consistency of dietary intake during the first four years of life in a prospective analysis: Bogalusa Heart Study.

Abstract: The consistency of intake levels for several dietary components over a 5-year period (age 6 months to 4 years) in a biracial infant-early childhood cohort has been demonstrated. Young children with high intakes of selected dietary components associated with risk of cardiovascular disease (e.g., total fat, saturated fat, dietary cholesterol) continue to have higher intakes as they mature than do their peers. Spearman rank correlation coefficients at a significant level are noted between ages 2 and 4 for the following nutrients: total protein (r = 0.65), animal protein (r = 0.46), total sugar (r = 0.39), sucrose (r = 0.37), starch (r = 0.33), total fat (r = 0.53), saturated fatty acid (SFA, r = 0.48), polyunsaturated fatty acid (PUFA, r = 0.43), and cholesterol (r = 0.49). At 2 years of age, some 47-65% of those in the upper tertile for total fat, SFA, and cholesterol intake remain in the upper tertile at age 4. Persistence of eating behaviors appears to begin as early as age 2, in part because of parental control over food patterns. These observations have implications for reduction of early cardiovascular risk factors in children and adoption of a more prudent dietary intake through consumer education.

Expert Committee Recommendations Regarding the Prevention, Assessment, and Treatment of Child and Adolescent Overweight and Obesity: Summary Report

Abstract: To revise 1998 recommendations on childhood obesity, an Expert Committee, comprised of representatives from 15 professional organizations, appointed experienced scientists and clinicians to 3 writing groups to review the literature and recommend approaches to prevention, assessment, and treatment. Because effective strategies remain poorly defined, the writing groups used both available evidence and expert opinion to develop the recommendations. Primary care providers should universally assess children for obesity risk to improve early identification of elevated BMI, medical risks, and unhealthy eating and physical activity habits. Providers can provide obesity prevention messages for most children and suggest weight control interventions for those with excess weight. The writing groups also recommend changing office systems so that they support efforts to address the problem. BMI should be calculated and plotted at least annually, and the classification should be integrated with other information such as growth pattern, familial obesity, and medical risks to assess the child’s obesity risk. For prevention, the recommendations include both specific eating and physical activity behaviors, which are likely to promote maintenance of healthy weight, but also the use of patient-centered counseling techniques such as motivational interviewing, which helps families identify their own motivation for making change. For assessment, the recommendations include methods to screen for current medical conditions and for future risks, and methods to assess diet and physical activity behaviors. For treatment, the recommendations propose 4 stages of obesity care; the first is brief counseling that can be delivered in a health care office, and subsequent stages require more time and resources. The appropriateness of higher stages is influenced by a patient’s age and degree of excess weight. These recommendations recognize the importance of social and environmental change to reduce the obesity epidemic but also identify ways healthcare providers and health care systems can be part of broader efforts.

Interventions for preventing obesity in children

Abstract: The current evidence suggests that many diet and exercise interventions to prevent obesity in children are not effective in preventing weight gain, but can be effective in promoting a healthy diet and increased physical activity levels.Being very overweight (obese) can cause health, psychological and social problems for children. Children who are obese are more likely to have weight and health problems as adults. Programmes designed to prevent obesity focus on modifying one or more of the factors considered to promote obesity.This review included 22 studies that tested a variety of intervention programmes, which involved increased physical activity and dietary changes, singly or in combination. Participants were under 18 and living in Asia, South America, Europe or North America. There is not enough evidence from trials to prove that any one particular programme can prevent obesity in children, although comprehensive strategies to address dietary and physical activity change, together with psycho-social support and environmental change may help. There was a trend for newer interventions to involve their respective communities and to include evaluations.Future research might usefully assess changes made on behalf of entire populations, such as improvements in the types of foods available at schools and in the availability of safe places to run and play, and should assess health effects and costs over several years.The programmes in this review used different strategies to prevent obesity so direct comparisons were difficult. Also, the duration of the studies ranged from 12 weeks to three years, but most lasted less than a year.

Health benefits of dietary fiber

Abstract: Dietary fiber intake provides many health benefits. However, average fiber intakes for US children and adults are less than half of the recommended levels. Individuals with high intakes of dietary fiber appear to be at significantly lower risk for developing coronary heart disease, stroke, hypertension, diabetes, obesity, and certain gastrointestinal diseases. Increasing fiber intake lowers blood pressure and serum cholesterol levels. Increased intake of soluble fiber improves glycemia and insulin sensitivity in non-diabetic and diabetic individuals. Fiber supplementation in obese individuals significantly enhances weight loss. Increased fiber intake benefits a number of gastrointestinal disorders including the following: gastroesophageal reflux disease, duodenal ulcer, diverticulitis, constipation, and hemorrhoids. Prebiotic fibers appear to enhance immune function. Dietary fiber intake provides similar benefits for children as for adults. The recommended dietary fiber intakes for children and adults are 14 g/1000 kcal. More effective communication and consumer education is required to enhance fiber consumption from foods or supplements.

Individual and environmental influences on adolescent eating behaviors.

Abstract: Food choices of adolescents are not consistent with the Dietary Guidelines for Americans. Food intakes tend to be low in fruits, vegetables, and calcium-rich foods and high in fat. Skipping meals is also a concern among adolescents, especially girls. Factors influencing eating behaviors of adolescents need to be better understood to develop effective nutrition interventions to change eating behaviors. This article presents a conceptual model based on social cognitive theory and an ecological perspective for understanding factors that influence adolescent eating behaviors and food choices. In this model, adolescent eating behavior is conceptualized as a function of individual and environmental influences. Four levels of influence are described: individual or intrapersonal influences (eg, psychosocial, biological); social environmental or interpersonal (eg, family and peers); physical environmental or community settings (eg, schools, fast food outlets, convenience stores); and macrosystem or societal (eg, mass media, marketing and advertising, social and cultural norms).

Breakfast Habits, Nutritional Status, Body Weight, and Academic Performance in Children and Adolescents

Abstract: Breakfast has been labeled the most important meal of the day, but are there data to support this claim? We summarized the results of 47 studies examining the association of breakfast consumption with nutritional adequacy (nine studies), body weight (16 studies), and academic performance (22 studies) in children and adolescents. Breakfast skipping is highly prevalent in the United States and Europe (10% to 30%), depending on age group, population, and definition. Although the quality of breakfast was variable within and between studies, children who reported eating breakfast on a consistent basis tended to have superior nutritional profiles than their breakfast-skipping peers. Breakfast eaters generally consumed more daily calories yet were less likely to be overweight, although not all studies associated breakfast skipping with overweight. Evidence suggests that breakfast consumption may improve cognitive function related to memory, test grades, and school attendance. Breakfast as part of a healthful diet and lifestyle can positively impact children's health and well-being. Parents should be encouraged to provide breakfast for their children or explore the availability of a school breakfast program. We advocate consumption of a healthful breakfast on a daily basis consisting of a variety of foods, especially high-fiber and nutrient-rich whole grains, fruits, and dairy products.