Introduction: Few studies have evaluated the associations between total, subgroup, and individual vegetable intake and coronary heart disease (CHD) risk using objective biomarkers of specific vegetables. Hypothesis: Urinary biomarkers reflecting specific vegetable intake can be identified in an observational study setting and may predict CHD risk. Methods: Using untargeted proton nuclear magnetic resonance ( 1 H-NMR) metabolomics and 7-day diet record data from 1,209 participants in the Lifestyle Validation Study, we used the Least Absolute Shrinkage and Selection Operator (LASSO) to construct urinary multi-feature indices for total and subgroup vegetable intake. Index replication was performed in an ancillary study of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Two-part models were used to identify features specifically associated with individual vegetable intake. Associations of urinary features with CHD risk were examined using conditional logistic regression in nested case-control studies within the Nurses’ Health Study (NHS), NHSII, and HCHS/SOL (652 matched pairs). Results: Among the 589 NMR features, LASSO selected 9 to 55 features to construct urinary indices reflecting the intake of total vegetables, legumes, starchy vegetables [SVs], non-starchy vegetables, dark-green vegetables, and red/orange vegetables, respectively. These indices showed moderate correlations with their respective intakes (Pearson r = 0.31-0.49; Figure ), except for SV ( r = 0.20). Indices for total and most subgroups, except for red/orange and SVs, were externally replicated, with de-attenuated r ranging from 0.27 to 0.49. Multivariable-adjusted ORs (95% CIs) for CHD risk per 1-SD increase in urinary indices were 0.88 (0.77-0.99) for total vegetables including potatoes, 0.92 (0.81-1.04) excluding potatoes, 0.88 (0.77-1.00) for legumes, 0.83 (0.75-0.93) for non-starchy vegetables, and 0.81 (0.73-0.91) for dark-green vegetables. For NMR features reflecting specific vegetable intake, the strongest correlations were found for S-methyl cysteine sulfoxide and levulinate with Brussels sprout intake, with r of 0.48 and 0.41 among consumers. Both features were associated with a lower CHD risk. Conclusions: Urinary biomarkers for the intake of total, subgroup, and individual vegetables were identified and replicated across free-living populations. Higher biomarker-assessed intake of total vegetables, legumes, and non-starchy vegetables was associated with a lower CHD risk.

BACKGROUND:The increase in food insecurity (FI) during the COVID-19 pandemic resulted in greater demand for food- and nutrition-related services. Yet, little is known about the experiences of local food- and nutrition-related agencies and how they responded to address the increased need. PURPOSE:We aimed to elucidate the perspectives and experiences of key informants from diverse food- and nutrition-related stakeholder agencies in addressing FI in San Diego County, CA during the COVID-19 pandemic. METHODS:The Socioecological Model and a capacity-oriented approach informed this qualitative study. Trained researchers conducted semi-structured interviews virtually on Zoom with 20 key informants from 14 food- and nutrition-related stakeholder agencies and analyzed data using thematic content analysis. RESULTS:Three linked themes emerged relating to how agencies addressed FI during the COVID-19 pandemic: (i) the pandemic uniquely influenced the agencies and the services they provided by presenting both challenges (e.g. limited in-person contact created distinct barriers) and opportunities (e.g. charitable contributions and federal funding increased); (ii) agencies leveraged new and existing within-agency capacities (e.g. adaptability, volunteers) and across-agency partnerships to address the increased demand; and (iii) agencies became forward-thinking as a result of the pandemic (e.g. focused on intentional and innovative strategic goals). CONCLUSIONS:The COVID-19 pandemic influenced how food- and nutrition-related stakeholder agencies provided services, leading agencies to create new and leverage existing within-agency capacities and across-agency partnerships and to prioritize forward-thinking goals. Future research should consider the long-term implications of the pandemic on the effectiveness of agency services.

Introduction: Socioeconomic position (SEP) is one of the main determinants of cardiovascular health (CVH). Among Hispanic/Latino populations living in the US, economic hardship is a leading stressor and a risk factor for suboptimal CVH. However, little is known about how changes in SEP can influence CVH across generations. Hypothesis: We hypothesized worse CVH for offspring and caregivers with persistent low SEP versus higher intergenerational SEP. Methods: The Hispanic Community Children’s Health Study/Study of Latino Youth (SOL Youth; 2012-2014) is a cross-sectional study of 1466 Hispanic/Latino youth (aged 8-16 years). Social mobility was assessed using the grandparents' and caregivers' SEP. Grandparents' SEP was defined using the highest level of education attained by grandmother or grandfather: lower ( Results: Among caregivers, lower total LE-8 scores were observed for stable low [β= -3.91(-7.33; -0.49)] and downward [β= -4.85 (-9.61; -0.09)] groups compared to those in the stable high group. Lower BMI scores were observed in the stable low [β= -7.87 (-15.31; -0.43)] compared to those in the stable high group. Lower diet [β= -8.57(-16.75; -0.38)] and nicotine exposure [β= -22.23 (-34.48; -9.98)] scores were observed in the downward group compared to the stable high group. Among offspring, lower total LE-8 [β= -3.00 (-5.24; -0.75)] and glucose [β= -4.96 (-7.89; -2.04) scores were observed in the stable low compared to the stable high group. Conclusions: Among Hispanic/Latinos, the intergenerational persistence of low SEP was associated with worse CVH in caregivers and their offspring compared to remaining in high SEP. Our findings highlight that disadvantages transferred across generations may help explain how CVH disparities emerge early in life. Future policies focused on structural interventions are needed to address these disparities in CVH.

U.S. Hispanic/Latino households disproportionally experience food insecurity, which may intersect with their food environments and food shopping behaviors to shape diet and health, but more representative findings are needed. We identified latent classes related to household food security (HFS), food environments, and food shopping behaviors among U.S. Hispanic/Latino households, and investigated their relationships with sociodemographic characteristics. We used cross-sectional data from 983 adult caregivers residing with youth (8-16 y) and participating in the multisite Study of Latino Youth. Caregivers completed the USDA HFS Survey Module (high, marginal, low, very low FS), a 5-item perceived neighborhood food environment (healthy food availability, quality, cost) questionnaire, and a 5-item food outlet shopping frequency questionnaire. We identified the best-fitting solution of latent classes by examining standard fit criteria and determined the relationship of latent classes to distal sociodemographic characteristics. We identified a 5-class solution. The “average quality, somewhat costly food environment” class (19.7 %) had low and high HFS and shopped at a variety of food stores; this class had the highest proportion of participants who were foreign-born (96 %) and reporting Spanish as their preferred language (90 %). The “high quality, high-cost food environment, food-insecure household” class (22.6 %) shopped at supermarkets and had the highest proportion of participants with a household income of ≤$20,000 (68 %). The “poor quality, high-cost food environment” class (16.8 %) had low and high HFS and shopped at supermarkets and convenience stores; this class had the highest proportion of participants who were single (33 %), without a vehicle (53 %), and reporting English as their preferred language (39 %). The “high quality, somewhat costly food environment, food-secure household” class (15.0 %) shopped at a variety of food stores and had the highest proportion (65 %) of participants with a household income of >$20,000. The “high quality, affordable food environment, food-secure household” class (25.9 %) shopped at supermarkets and had the highest proportion of participants who were US-born (25 %). U.S. Hispanic/Latino adults living with youth reported distinct combinations of HFS status, perceived neighborhood food environments, and food shopping behaviors, which underscores the complexity of factors defining adequate food access.

Little is known about neighborhood retail food environments and cardiometabolic health among Hispanic/Latino adults, who experience significant health inequities. This study aimed to examine associations of the neighborhood retail food environment with cardiometabolic health of Hispanic/Latino adults over a 6-year period. Participants from the Hispanic Community Health Study/Study of Latinos San Diego Field Center (n = 3851) underwent assessments of cardiometabolic risk factors at baseline (2008–2011) and approximately 6 years later (2014–2017). Weight (body mass index [BMI] and overweight/obesity), hypertension (normotensive, prehypertensive, or hypertensive), and diabetes (normoglycemia, prediabetes, or diabetes) status were considered cardiometabolic risk factors. Participants’ home addresses at baseline and 6 years later were geocoded. The neighborhood retail environment was quantified using the Modified Retail Food Environment Index (mRFEI) within 800-m circular buffers around these two addresses. Complex survey regression analyses quantified associations between both baseline and changes in neighborhood retail food environment and cardiometabolic health of Hispanic/Latino adults over 6 years. A one standard deviation higher baseline standardized mRFEI score was associated with approximately 14.3

Socioeconomic position (SEP) in childhood and beyond may influence the gut microbiome, with implications for disease risk. Studies evaluating the relationship between life-course SEP and the gut microbiome are sparse, particularly among Hispanic/Latino individuals, who have a high prevalence of low SEP. We use the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a population-based cohort study conducted in four field centers in the United States (U.S.), to evaluate the association between life-course SEP and gut microbiome composition. Life-course SEP indicators included parental education (proxy of childhood SEP), current SEP (n = 2174), and childhood (n = 988) and current economic hardship (n = 994). Shotgun sequencing was performed on stool samples. Analysis of Compositions of Microbiomes was used to identify associations of life-course SEP indicators with gut microbiome species and functions. Parental education and current SEP were associated with the overall gut microbiome composition; however, parental education and current education explained more the gut microbiome variance than the current SEP. A lower parental education and current SEP were associated with a lower abundance of species from genus Bacteroides. In stratified analysis by nativity, we found similar findings mainly among foreign-born participants. Early-life SEP may have long-term effects on gut microbiome composition underscoring another biological mechanism linking early childhood factors to adult disease.

Background:The United States (US) has the largest immigrant population globally. Immigrants endure social and structural factors that adversely influence cardiovascular health (CVH), a construct focused on health preservation, not merely the absence of disease, and defined by eight modifiable health factors and behaviors that support healthy longevity. We compared overall and individual CVH metrics between immigrants and non-immigrants and characterized CVH and its determinants among immigrant sub-populations. Methods:The analytic sample included 13,471 adults (19% immigrants, i.e., foreign-born, 51% female), ages 20-79 y (mean ± SD for immigrants and non-immigrants: 44.8 ± 4.8 y and 45.7 ± 11.2 y, respectively) from the 2013 to 2018 National Health and Nutrition Examination Survey. CVH was characterized consistent with the American Heart Association's (AHA) Life's Essential 8 (LE8) guidelines (metrics: body mass index (BMI), blood glucose, blood lipids, blood pressure, nicotine use, sleep health, diet quality, and physical activity; score range: 0-100, low CVH: LE8 score <50). CVH scores were compared among immigrants and non-immigrants and by sex, ethnicity, years in the US, and citizenship among immigrants. Survey-weighted regression models evaluated psychosocial and demographic factors in relation to CVH. Findings:Immigrants had higher overall CVH scores (69.1 vs. 66.4) (p < 0.0001) and significantly higher subscores for diet (52.5 vs. 38.8), nicotine exposure (80.3 vs. 68.0), BMI (61.6 vs. 57.1), and blood pressure (74.1 vs. 71.8), but lower physical activity (47.0 vs. 52.6), glucose (82.2 vs. 86.1), and cholesterol (63.0 vs. 68.5) scores compared to non-immigrants. Among immigrants, those who were male vs. female (67.5 vs. 70.7) (p = 0.003), Hispanic vs. non-Hispanic (66.6 vs. 71.5) (p < 0.0001), and living in the US ≥15 y vs. <15 y (67.7 vs. 71.8) (p < 0.0001) had lower CVH. In regression models, being male, 45+ y, or Hispanic, having food insecurity, lower education and income, depression, no health insurance, and ≥15 y living in the US were associated with lower CVH. Interpretation:While US immigrants have more favorable overall CVH compared to US-born persons, CVH status is complex and heterogenous across immigrant sub-populations. Glycemic control, physical inactivity, and blood lipids may be important targets for CVH promotion interventions in this population; Hispanic immigrants and those who lived in the US for ≥15 y may represent key subpopulations to engage in these efforts. Funding:National Institutes of Health and American Heart Association.

BACKGROUND:Adequate dietary intake is critical for healthy pregnancies. Recent changes in social services in Mexico, coupled with high levels of food insecurity, call into question whether expecting women of the lowest socioeconomic status are able to meet their dietary and nutritional needs in this changing context. The aim of this study was to explore the nutritional practices, education and received and employed among women during their pregnancy. METHODS:Guided by Ecological Systems Theory and an Intersectionality Framework, this qualitative study was carried out in Oaxaca City and Puerto Escondido, in Oaxaca, a Mexican state with high levels of food insecurity. Women who had at least one child in the past five years and had lived in Oaxaca for the past five years were eligible to participate. Twenty-five women participated in semi-structured in-depth interviews conducted between June and December of 2023. A grounded theory approach was used for coding. NVivo was used for coding and analyses. RESULTS:Five key themes emerged linked to individual-level characteristics and the multiple social identities related to the social support for nutritional knowledge and practices among low-income Oaxacan women during pregnancy: (1) Life experiences, sociodemographic, and health characteristics that influence nutritional practices and knowledge during pregnancy; (2) Female family members as a primary source of nutritional knowledge and food support; (3) Support from other members of women's social networks; (4) Medical guidance for nutrition during pregnancy; and (5) Quality and gaps in the broader health care system and social services. These themes highlight how women's own experiences and social identities and the different interpersonal and community-level environments, particularly those of mothers and grandmothers and health care providers, interact and shape women's nutritional knowledge and practices, such as foods and nutritional supplements consumed, during pregnancy. CONCLUSION:Nutritional knowledge and practices during pregnancy are impacted by multiple social identities women have and different factors at the individual, group, and structural level. Future multi-level approaches in research and programming that take into consideration the individual, family members, and other social influences are needed to address the gaps in nutrition that women in Oaxaca go through during the prenatal period.

Background: U.S. Mexican-born Hispanic/Latino households are at a high risk of experiencing food insecurity and its poor dietary and health consequences but may have attributes that can be leveraged to promote food security and healthy dietary quality. To gain more in-depth understanding and capacity-oriented data to inform programming, we sought to elucidate potential food provisioning-related factors protecting low-income U.S. Mexican-born households with young children from food insecurity. Methods: We conducted a community-based qualitative study, guided by Life Course Perspective and Ecological Systems Theory, in two New York State counties. Low-income Mexican-born mothers (n = 27) of young children (≤5 years) with ≤10 years in the U.S. completed two semi-structured interviews, including a participant-driven photo elicitation interview, and responded to the 18-item Household Food Security Survey Module. We conducted thematic content analyses to identify emergent themes. Results: We identified four themes related to important attributes and behaviors of participants, which appeared to protect their households from food insecurity: resourcefulness and creativity with food provisioning, valuing new knowledge and skill-building opportunities, reflectiveness on poverty and food insecurity experiences, and the ability to establish beneficial food-provisioning routines, with the latter appearing to differentiate food-secure and food-insecure households. These attributes and behaviors facilitated management of economic resources while also meeting cultural ideals and family preferences. Conclusions: Low-income Mexican-born households appear to have human and cultural capital (i.e., assets) that may serve to be protective. Improved policies and programming are necessary to leverage these capacities to promote food security and healthier dietary intake.

BACKGROUND:In the past decade, hashtag feminism has emerged in Mexico as a prevalent strategy to build social movements against gender-based violence (GBV). For example, during the global "16 Days of Activism Against GBV" campaign held between November 25 and December 10 each year, Mexico-based nongovernmental organizations (NGOs) turn to X (formerly known as Twitter) to share messages. Despite this prevalence, there is limited research on the type of information shared by these NGO activists on social media and the public's engagement with these messages. OBJECTIVE:This study aims to explore the themes covered by Mexican NGOs on X and examine what types of messages related to GBV potentially resonated more with the public. METHODS:We collated and reviewed posts (commonly known as tweets) published in Spanish on the platform X by Mexico-based NGOs between November 25 and December 10 of 2020, 2021, and 2022, a period when digital interactions increased during the COVID-19 pandemic. We then extracted posts using the following 4 hashtags: #16días, #16DiasdeActivismo, or #16DíasdeActivismo; #25N or #25Noviembre; #DiaNaranja or #DíaNaranja; and #PintaElMundoDeNaranja. We subsequently assessed the number of likes each post had and retained the top 200 posts from each year with the highest number of likes. We used the iterative content analysis process and the inductive 6-step qualitative thematic analysis method in NVivo software to code and analyze the final 600 posts. RESULTS:Five themes emerged from the 16 Days of Activism Against GBV campaigns, covering both knowledge-sharing and activism-generating messages as follows: (1) activism and how to be an activist, (2) types of GBV most commonly highlighted in posts, (3) changing public discourse surrounding GBV, (4) GBV as a violation of human rights, and (5) the COVID-19 pandemic's impact on GBV. Most of the messages on these posts exclusively mentioned women and younger girls, while a few included adolescents. Gaps in the representation of vulnerable populations were also found. CONCLUSIONS:The posts from this campaign that were highly liked by the public reflect some of the most significant societal issues currently present in the country. Our results could help guide further GBV campaigns. Still, further research related to hashtag feminism by Mexico-based NGOs on GBV is needed to understand the population that NGOs reach and how the messages shared on these campaigns translate into activism on online and offline social media platforms.

No population-based studies examined gut microbiota and related metabolites associated with sugar-sweetened beverage (SSB) intake among US adults. In this cohort of US Hispanic/Latino adults, higher SSB intake was associated with nine gut bacterial species, including lower abundances of several short-chain-fatty-acid producers, previously shown to be altered by fructose and glucose in animal studies, and higher abundances of fructose- and glucose-utilizing Clostridium bolteae and Anaerostipes caccae. Fifty-six serum metabolites were correlated with SSB intake and a gut microbiota score based on these SSB-related species in consistent directions. These metabolites were clustered into several modules, including a glycerophospholipid module, two modules comprising branched-chain amino acid (BCAA) and aromatic amino acid (AAA) derivatives from microbial metabolism, etc. Higher glycerophospholipid and BCAA derivative levels and lower AAA derivative levels were associated with higher incident diabetes risk during follow-up. These findings suggest a potential role of gut microbiota in the association between SSB intake and diabetes.

Background Time-restricted eating may help control weight through caloric restriction, circadian rhythm, or influence on the gut microbiome (GMB). Physical activity (PA) also plays a role, as people with a longer eating window (EW, time between first and last daily intake) may be more active. The associations between meal timing, adiposity, PA, sedentary behavior (SB), and GMB characteristics are of interest in Hispanic/Latino persons, who experience a high burden of cardiometabolic diseases. Objectives We explored the relationship of EW with energy intake and accelerometer-measured activity and assessed whether a longer EW and later midpoint of intake (MOI, midpoint time of intake) are associated with adiposity and GMB differences in Hispanic/Latino adults. Methods Using data from the prospective Hispanic Community Health Study/Study of Latinos (n = 11,778 participants with valid 24-h dietary recall and accelerometer data, no unplanned weight loss, and BMI ≥ 18.5 kg/m2; n = 1925 with GMB data), we explored the relationship between EW, SB, and energy intake. We used multivariable linear regression models to study the relationship between EW or MOI and adiposity measures and GMB characteristics, adjusted for clinical, behavioral, and demographic characteristics. Results Those with longer EW tended to have less SB and greater energy intake, suggesting that some individuals may balance greater intake with greater expenditure. After adjustments including energy balance, each hour of EW was associated with 0.29% higher BMI (95% confidence interval [CI]: 0.07, 0.51; P = 0.011). Longer EW and caloric EW (EWC, EW, caloric meals only) were associated with several obesity-associated GMB taxa, such as Streptococcus (enriched, β: 0.04; 95% CI: 0.01, 0.07, for EW). MOI was not significantly associated with adiposity or GMB characteristics. Conclusions Shorter EW may promote healthy weight, but some individuals with longer compared with shorter EWs tend to have greater activity that could balance their greater energy intake. EW and EWC may influence GMB characteristics.

Prior research shows that diets high in government subsidized foods may be associated with cardiometabolic disease risk factors. Our aim was to evaluate the relationship between diets high in subsidized foods and the development of chronic kidney disease (CKD) and other cardiometabolic risk factors in United States (US) Hispanics/Latinos. Using data from 16,172 Hispanics/Latino’s living in the United States, we used the Cochran-Armitage test to assess the relationship between subsidized foods in the diets of participants and baseline characteristics. We used survey-weighted Poisson regression models to examine whether intake of subsidized foods was associated with incident CKD or cardiometabolic risk factors. Several baseline characteristics were associated with higher subsidized food scores. Higher subsidized food scores were not associated with incident CKD or cardiometabolic risk factors. These findings may be useful for future researchers, clinicians, and nutritional policy advocates who are interested in the way Hispanic and Latinos consume foods subsidized by the US government and the structural factors that may shape observed dietary and disease patterns.

Background:Ethnicity, cultural background, and geographic location differ significantly within the United States Hispanic/Latino population. These variations can greatly define diet and its relationship with cardiometabolic disease, thus influencing generalizability of results. Objectives:We aimed to examine nutrient-based food patterns (NBFPs) of Hispanic/Latino adults and their association with cardiometabolic risk factors (dyslipidemia, hypertension, obesity, diabetes) across 2 United States population-based studies with differing sampling strategies. Methods:Data were collected from Mexican or other Hispanic adult participants from 2007-2012 National Health and Nutrition Examination Survey (NHANES) (n = 3605) and 2007-2011 Hispanic Community Health Survey/Study of Latinos (HCHS/SOL, n = 14,416). NBFPs were derived using factor analysis on nutrient intake data estimated from 24-h dietary recalls and interpreted using common foods in which these nutrients are prominent. Cross-sectional associations between NBFPs (quintiles) and cardiometabolic risk factors, defined by clinical measures and self-report, were estimated using survey-weighted multivariable-adjusted logistic models, accounting for multiple testing. Results:Five NBFPs were identified in both studies: 1) meats, 2) grains/legumes, 3) fruits/vegetables, 4) dairy, and 5) fats/oils. Associations with cardiometabolic risk factors differed by NBFP and study. In HCHS/SOL, the odds of diabetes were lower for persons in the highest quintile of meats NBFP (odds ratio [OR]: 0.73; 95% confidence interval [CI]: 0.58, 0.92) and odds were higher for those in the lowest quintile of fruits/vegetables (OR: 0.71; 95% CI: 0.55, 0.93) compared to those in the third (moderate intake) quintile. Those in the fourth quintile of dairy NBFP had higher odds of hypertension than those in the third quintile (OR: 1.31; 95% CI: 1.01, 1.70). In NHANES, the odds of hypertension were higher for those in the fourth quintile of dairy (OR: 1.88; 95% CI: 1.10, 3.24) than those in the third quintile. Conclusions:Diet-disease relationships among Hispanic/Latino adults vary according to 2 population-based studies. These differences have research and practical implications when generalizing inferences on heterogeneous underrepresented populations.

OBJECTIVE:To evaluate the association between meal timing and type 2 diabetes risk in U.S. Hispanic/Latino adults. RESEARCH DESIGN AND METHODS:The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) is a multicenter, community-based, prospective cohort study. This study included 8,868 HCHS/SOL adults without diabetes at baseline (2008-2011) and attending the visit 2 examination (2014-2017). Energy intake and glycemic load (GL) in each meal timing were assessed at baseline using two 24-h dietary recalls. Incident diabetes was identified through annual follow-up calls or at visit 2. Hazard ratios (HRs) for incident diabetes were estimated using Cox models, accounting for the complex survey design. RESULTS:The study population (50.9% female) had a baseline mean age of 39.0 (95% CI, 38.4-39.5) years. Over a median (range) follow-up of 5.8 (0.8-9.6) years, 1,262 incident diabetes cases were documented. Greater energy intake and GL in late morning (9:00-11:59 a.m.) were associated with a lower diabetes risk, whereas greater energy intake and GL in other meal timings were not. After accounting for diet quantity and quality, sociodemographic characteristics, lifestyle factors, and chronic conditions, the HRs were 0.94 (95% CI, 0.91-0.97) per 100-kcal energy intake increment and 0.93 (0.89-0.97) per 10-unit GL increment in late morning. Replacing energy intake or GL from early morning (6:00-8:59 a.m.), afternoon (12:00-5:59 p.m.), or evening (6:00-11:59 p.m.) with late-morning equivalents was associated with a comparably lower diabetes risk. CONCLUSIONS:This study identified late morning as a favorable meal timing in Hispanic/Latino adults, providing a novel perspective on type 2 diabetes prevention that warrants confirmation.

Introduction Non-consented care, a form of obstetric violence involving the lack of informed consent for procedures, is a common but little-understood phenomenon in the global public health arena. The aim of this secondary analysis was to measure the prevalence and assess change over time of non-consented care during childbirth in Mexico in 2016 and 2021, as well as to examine the association of sociodemographic, pregnancy-, and childbirth-factors with this type of violence.Methods We measured the prevalence of non-consented care and three of its variations, forced sterilization or contraception, forced cesarean section, and forced consent on paperwork, during childbirth in Mexico for 2016 (N = 24,036) and 2021 (N = 19,322) using data from Mexico's cross-sectional National Survey on the Dynamics of Household Relationships (ENDIREH). Weighted data were stratified by geographical regions. We performed adjusted logistic regression analyses to explore associations.Results The national prevalence of non-consented care and one of its variations, pressure to get a contraceptive method, increased from 2016 to 2021. A decrease in the prevalence was observed for forced contraception or sterilization without knowledge, forcing women to sign paperwork, and non-consented cesarean sections nationally and in most regions. Women between the ages of 26 and 35 years, married, cohabiting with partner, living in urban settings, who do not identify as Indigenous, and who received prenatal services or gave birth at the Mexican Institute of Social Security (IMSS) facilities experienced a higher prevalence of non-consented care. Being 26 years of age and older, living in a rural setting, experiencing stillbirths in the last five years, having a vaginal delivery, receiving prenatal services at IMSS, or delivering at a private facility were significantly associated with higher odds of reporting non-consented care.Conclusion While a decrease in most of the variations of non-consented care was found, the overall prevalence of non-consented care and, in one of its variations, pressure to get contraceptives, increased at a national and regional level. Our findings suggest the need to enforce current laws and strengthen health systems, paying special attention to the geographical regions and populations that have experienced higher reported cases of this structural problem.

Introduction: Time-restricted feeding has been associated with healthier weight, and as a weight-control intervention, can reduce caloric intake without calorie counting. Previous research showed that individuals with overweight who shortened their eating duration (time between first and last food intake of the day) experienced beneficial weight reduction. We explored this association in understudied US Hispanic/Latino individuals, as they experience a high prevalence of overweight and obesity. Hypothesis: We assessed the hypothesis that shorter eating duration is associated with healthier body mass index (BMI), percent body fat, or waist to hip ratio. Methods: We analyzed cross-sectional data from n=12079 Hispanic/Latino participants from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) who were not pregnant, not underweight, had reliable 24-hour dietary recall data, and had at least 3 accelerometer wear days. For each participant, we calculated eating duration, defined as the time between the first and last food intake of the day averaged over two 24-hour dietary recalls. We modeled eating duration in hours as the primary exposure in linear regression models with baseline measured BMI, percent body fat, or waist to hip ratio as outcomes of interest. We adjusted for age, sex, Hispanic background, field center, socioeconomic factors, sleep duration, glycemic status, diet quality, measured physical activity, and energy balance (ratio of energy intake to estimated energy needs). BMI was log transformed to help meet assumptions. Analyses accounted for complex survey design, missing accelerometer data, and accelerometer wear time. Results: Mean (SE) eating duration was 11.9 (0.04) hours. Those with longer eating duration tended to have higher energy intake (though less apparent for those with BMI at least 30), spend more time in moderate or vigorous physical activity, and were more likely to be employed full-time and perform shift work. After adjusting for energy balance and socioeconomic, medical and lifestyle factors, we found a significant positive association between eating duration and log-transformed BMI (regression coefficient 0.003 for eating duration in hours, SE 0.001, p=0.02). This significant association emerged only after adjusting for energy balance, demonstrating the importance of controlling for confounding between eating duration and intake. In sensitivity analysis, we excluded those with prevalent heart disease or diabetes, and obtained similar results. No statistically significant associations were noted between eating duration and the other obesity measures. Conclusions: Longer eating duration was associated with higher BMI in Hispanic/Latino persons after adjusting for covariates and energy balance from self-reported intake.

BACKGROUND: Dietary acculturation, or adoption of dominant culture diet by migrant groups, influences human health. We aimed to examine dietary acculturation and its relationships with cardiovascular disease (CVD), gut microbiota, and blood metabolites among US Hispanic and Latino adults. METHODS: In the HCHS/SOL (Hispanic Community Health Study/Study of Latinos), US exposure was defined by years in the United States (50 states and Washington, DC) and US nativity. A dietary acculturation pattern was derived from 14 172 participants with two 24-hour dietary recalls at baseline (2008–2011) using least absolute shrinkage and selection operator regression, with food groups as predictors of US exposure. We evaluated associations of dietary acculturation with incident CVD across ≈7 years of follow-up (n=211/14 172 cases/total) and gut microbiota (n=2349; visit 2, 2014 to 2017). Serum metabolites associated with both dietary acculturation–related gut microbiota (n=694) and incident CVD (n=108/5256 cases/total) were used as proxy measures to assess the association of diet-related gut microbiome with incident CVD. RESULTS: We identified an empirical US-oriented dietary acculturation score that increased with US exposure. Higher dietary acculturation score was associated with higher risk of incident CVD (hazard ratio per SD, 1.33 [95% CI, 1.13–1.57]), adjusted for sociodemographic, lifestyle, and clinical factors. Sixty-nine microbial species (17 enriched from diverse species, 52 depleted mainly from fiber-utilizing Clostridia and Prevotella species) were associated with dietary acculturation, driven by lower intakes of whole grains, beans, and fruits and higher intakes of refined grains. Twenty-five metabolites, involved predominantly in fatty acid and glycerophospholipid metabolism (eg, branched-chain 14:0 dicarboxylic acid** and glycerophosphoethanolamine), were associated with both diet acculturation-related gut microbiota and incident CVD. Proxy association analysis based on these metabolites suggested a positive relationship between diet acculturation-related microbiome and risk of CVD ( r =0.70, P <0.001). CONCLUSIONS: Among US Hispanic and Latino adults, greater dietary acculturation was associated with elevated CVD risk, possibly through alterations in gut microbiota and related metabolites. Diet and microbiota-targeted interventions may offer opportunities to mitigate CVD burdens of dietary acculturation.

Introduction: Dietary acculturation, defined as diet adaptation after migration, is related to human health. However, the influence of dietary acculturation on cardiovascular disease (CVD) is largely unknown, nor is the potential mechanism clear. Hypothesis: Dietary acculturation (diet reflecting U.S. exposure - years in the U.S. and nativity [U.S. 50 states/DC vs. foreign-born]) is associated with altered gut microbiota and related metabolites, which may contribute to CVD risk. Methods: A dietary acculturation score was derived from 14172 participants with two 24-hr dietary recalls at baseline (2008-11) using LASSO regression (29 food groups as predictors of U.S. exposure). We evaluated associations of dietary score with incident CVD over 7 years follow-up (including coronary heart disease, stroke and heart failure, n=14172/211 total/cases) and gut microbiota (shotgun sequencing, n=2349, 2014-17). Further, we identified serum metabolites associated with diet-related microbiome (n=694, 2014-17) and examined associations of baseline metabolites with incident CVD (n=5256/108 total/cases). Results: We identified a dietary acculturation pattern (Fig1A) which increased with years in the U.S. and was highest in U.S.-born adults (Fig1B). Higher dietary acculturation was associated with risk of incident CVD (HR per SD, 1.33 [95%CI: 1.13-1.57]), adjusting for sociodemographic, lifestyle, and clinical factors. We identified 69 diet-related species (17 enriched and 52 depleted, mainly from Clostridium , Prevotella and Eubacterium , Fig1C), and 25 metabolites associated with both diet-related microbiome score and incident CVD (Fig1D). Proxy association analysis based on these metabolites suggested a positive relationship between diet-related microbiome and incident CVD (r=0.70, p<0.001) (Fig1E). Conclusions: Among U.S. Hispanics/Latinos, greater dietary acculturation was associated with increased risk of CVD, possibly via diet-related alterations in gut microbiota and related serum metabolites.