Faculty Bibliography

Asian American populations are underrepresented within dietary programs and nutrition-specific funding. Existing understanding amongst Asian American communities focuses on those with pre-existing health conditions. There is a gap in published literature providing an overview of the food groups Asian American populations without noncommunicable diseases consume. This scoping review aims to provide a comprehensive mapping of the Asian American diet with a focus on food groups in the United States within existing literature. A scoping review was conducted from December 2023 to December 2024. Research databases (PubMed/Medline, CABI Digital Library, CINAHL, Scopus, Web of Science, EBSCO, and ProQuest Dissertations) were searched to identify articles published since 2000 that described food group consumption of Asian American populations. A total of 1486 articles were independently screened by 3 reviewers, leaving 165 articles for inclusion in this review. An additional 15 gray literature sources were separately reviewed for complementary information. Key findings (population and geographical focus, dataset, food group outcome, study limitations, and recommendations) were extracted and summarized in narrative form. Within the literature, Asian American adults and children generally consume more refined grains and less dairy than the standard United States population, though specific patterns vary: South Asians report higher saturated fat and dairy intake, while Chinese, Filipino, and Southeast Asian groups often fall short of recommended fruit and vegetable consumption. Dietary staples also differ by ethnicity, ranging from white rice and noodles in East/Southeast Asian diets to breads and buns among South Asian and Filipino communities. Recommendations for improving diets in Asian American communities emphasize culturally tailored nutrition education that incorporates traditional diets, promotes whole-grain substitutions, and adopts family-focused approaches. Future research efforts in Asian American diet and nutrition should better understand meal-sharing practices and cooking methods. Identifying broad insights in Asian American dietary consumption lays an essential framework for developing recommendations and interventions to address dietary behaviors contributing to diet-related disease burden among the Asian American population. This scoping review is registered on Open Science Framework (https://doi.org/10.17605/OSF.IO/K3X8S).

OBJECTIVE/UNASSIGNED:Diabetes Prevention Programs (DPP), year-long group-based lifestyle interventions, can reduce the incidence of type 2 diabetes (T2DM) by 58 % and improve cardiometabolic risk factors. However, the sustainability of these benefits and the effectiveness of booster interventions for DPP graduates remain unclear. This scoping review examined the availability, structure, and effectiveness of booster programs for DPP graduates. METHODS/UNASSIGNED:PubMed, CINAHL, and Cochrane Clinical Trials were searched for intervention studies published before January 23, 2025. Due to the small number of studies and reporting heterogeneity, findings were synthesized narratively. RESULTS/UNASSIGNED:Of 1613 articles screened, nine publications representing four unique studies were included. Booster interventions significantly reduced long-term T2DM incidence. Effect on blood glucose and hemoglobin A1c were inconsistent, but significant improvements were reported in key anthropometric measures, including body mass index, weight, weight change, and waist circumference. Longer intervention duration was commonly associated with greater effectiveness, though program structure and intensity likely contributed to inconsistencies in review findings. CONCLUSIONS/UNASSIGNED:Booster programs for DPP graduates may reduce long-term T2DM risk and improve cardiometabolic outcomes. This review highlights strategies to sustain DPP benefits and can inform the design of cost-effective, scalable interventions to address the growing global prediabetes burden.

BACKGROUND:This study aimed to explore whether patients' perception of procedural fairness in physicians' communication was associated with willingness to follow doctor's recommendations, self-efficacy beliefs, dietary behaviors, and body mass index. METHODS:(43.6% Black, 40.7% Hispanic/Latino, 55.8% female, mean age = 50 years), who enrolled in a weight management study in two New York City healthcare institutions. We conducted ordinary least squares path analyses with bootstrapping to explore direct and indirect associations among procedural fairness, willingness to follow recommendations, self-efficacy, dietary behaviors, and body mass index, while controlling for age and gender. RESULTS:Serial, multiple mediator models indicated that higher procedural fairness was associated with an increased willingness to follow recommendations which, in turn, was associated with healthier dietary behaviors and a lower BMI (indirect effect =  - .02, SE = .01; 95% CI [- .04 to - .01]). Additionally, higher procedural fairness was associated with elevated dietary self-efficacy, which was, in turn, was associated with healthier dietary behaviors and lower BMI (indirect effect =  - .01, SE = .003; 95% CI [- .02 to - .002]). CONCLUSIONS:These findings highlight the importance of incorporating procedural fairness in physician-patient communication concerning weight management in diverse primary care patients.

BACKGROUND:Type 2 diabetes (T2D) contributes to significant morbidity and mortality for Chinese immigrants in the United States, exacerbated by social determinants of health (SDOH) barriers such as language barriers, limited access to healthy foods, and low health literacy. OBJECTIVE:The goal of the Integrating Cultural Aspects into Diabetes Education (INCLUDE) study is to test a social media-based intervention adapting the Diabetes Prevention Program (DPP) for Chinese immigrants alongside a culturally adapted, community-supported agriculture program. Here, we report the protocol for the INCLUDE study. METHODS:INCLUDE is a 3-year randomized controlled trial (n=150). Participants with prediabetes or at risk for T2D are enrolled and randomized into either the control or intervention group (n=75 each). Participants from the intervention group receive 2-3 culturally tailored, in-language DPP videos weekly for 12 weeks, as well as biweekly phone calls from bilingual study staff to review video content, support goal setting, and assess and address SDOH-related barriers such as food insecurity. Intervention participants will also be given produce for 10 weeks as part of the community-supported agriculture program. Weight (primary outcome), self-efficacy, diet, physical activity, and food insecurity (secondary outcomes) are measured at baseline, 3-month, and 6-month intervals. Splined linear mixed models will be used to examine group differences in longitudinal weight and other secondary outcomes. The INCLUDE study was approved by the Institutional Review Board at the NYU Grossman School of Medicine. RESULTS:Recruitment started in May 2023, with the first cohort of 75 participants enrolled and randomized into 2 groups in July 2023. The 3-month and 6-month assessment of the first-year cohort has been completed. We have recruited 75 participants for the second cohort as of July 2024. CONCLUSIONS:The INCLUDE study will serve as an innovative model for culturally adapted, multilevel interventions for underserved communities previously unable to access evidence-based diabetes prevention initiatives. Aligning with several national calls for multilevel interventions, the INCLUDE intervention will provide critical data that will inform how researchers and public health professionals address SDOH barriers faced by underserved populations and prevent diabetes. TRIAL REGISTRATION/BACKGROUND:ClinicalTrials.gov NCT05492916; https://clinicaltrials.gov/study/NCT05492916. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)/UNASSIGNED:DERR1-10.2196/65455.

Tools to briefly assess diet among US Spanish-speaking adults are needed to identify individuals at risk for cardiometabolic disease (CMD) related to diet. Two registered dietitian nutritionists (RDNs) recruited bilingual medical students to translate the validated Diet Risk Score (DRS) into Spanish (DRS-S). Participants were recruited from a federally qualified health center. Students administered the DRS-S and one 24-h recall (Automated Self-Administered 24-Hour (ASA24^®) Dietary Assessment Tool) on one day; a second recall was administered within 1 week. Recalls were scored using the Healthy Eating Index (HEI)-2015, a measure of adherence to the Dietary Guidelines for Americans. Spearman correlations, weighted kappa, and ANOVA were conducted using SAS 9.4 to assess the relative validity of the DRS-S. Thirty-one Spanish-speaking adults (female: n = 17, 53%; mean age: 58 (42-69)) completed assessments. The mean DRS-S was 9 (SD = 4.2) (max: 27; higher score = higher risk) and the mean HEI-2015 score was 65.7 (SD = 9.7) (max: 100; higher score = lower risk), with significant agreement between measures (r: -0.45 (p = 0.01)), weighted kappa: -0.3 (p = 0.03). The DRS-S can be used in resource-constrained settings to assess diet for intervention and referral to RDNs. The DRS-S should be tested in clinical care to assess the impact of dietary changes to reduce CMD risk.

In the Diabetes Prevention Program (DPP) randomized, controlled clinical trial, participants who were  ≥ 60 years of age in the intensive lifestyle (diet and physical activity) intervention had a 71% reduction in incident diabetes over the 3-year trial. However, few of the 26.4 million American adults age ≥65 years with prediabetes are participating in the National DPP. The BRInging the Diabetes prevention program to GEriatric Populations (BRIDGE) randomized trial compares an in-person DPP program Tailored for Older AdulTs (DPP-TOAT) to a DPP-TOAT delivered via group virtual sessions (V-DPP-TOAT) in a randomized, controlled trial design (N = 230). Eligible patients are recruited through electronic health records (EHRs) and randomized to the DPP-TOAT or V-DPP-TOAT arm. The primary effectiveness outcome is 6-month weight loss and the primary implementation outcome is intervention session attendance with a non-inferiority design. Findings will inform best practices in the delivery of an evidence-based intervention.