Objective: To assess the impact of a yoga curriculum in an elementary school on student quality of life, and to assess teacher and staff perception of potential barriers to, and benefits of, introducing yoga and mindfulness into the classroom. Methods: A randomized controlled trial was utilized to assess the impact of a brief intervention on third-grade students who screened positive for symptoms of anxiety. Students were randomized to an intervention group of 20 students receiving small-group yoga/mindfulness activities for 8 weeks between October 2016 and February 2017, and a control group of 32 students receiving care as usual. The Brief Multidimensional Students’ Life Satisfaction Scale-Peabody Treatment Progress Battery and the Pediatric Quality of Life Inventory (PedsQL) served as outcomes. Teachers were invited to participate in two professional development sessions about introducing yoga and mindfulness into the classroom, and completed a survey following each of the sessions. Results: In generalized estimating equation models adjusted for time, the yoga-based intervention was associated with a 14.17 unit increase in student emotional PedsQL (p-value 0.001) and a 7.43 unit increase in psychosocial PedsQL (p-value 0.01). Results were not attenuated by adjustment. Teachers and staff reported using yoga more frequently in the classroom following the second of two professional development sessions (p-value <0.05). Perceived barriers to introducing yoga to the classroom were similar at two data collection time points, while perceived benefits remained high. Conclusion: The intervention was associated with a significant improvement in emotional and psychosocial quality of life in the intervention group when compared to the control group, suggesting that yoga/mindfulness interventions may improve symptoms of anxiety among students. Yoga/mindfulness activities may facilitate stress management among elementary school students and may be added as a complement to social and emotional learning activities.

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides supplemental healthy foods and nutrition education to children under age 5 y in low-income households. We aimed to identify characteristics associated with duration of WIC participation and assess how participation duration relates to household food insecurity (HFI), child diet quality, and child weight status at age 60 mo. This analysis of the WIC Infant and Toddler Feeding Practices Study-2, a prospective cohort of WIC-participating children enrolled in 2013, included children with complete baseline–60 mo data (n = 836). Outcomes assessed with WIC participation duration in multivariable regression were HFI (USDA 6-item Household Food Security Screener), child diet quality on a given day [Healthy Eating Index (HEI)-2015], and obesity (CDC BMI-for-age ≥95th percentile). Factors associated with longer WIC participation included male sex; lower household income; reported diet changes in response to WIC nutrition education; household Supplemental Nutrition Assistance Program participation; English-speaking Hispanic, Spanish-speaking Hispanic, and non-Hispanic other maternal race-ethnicity and language preference; an ever-married mother; lower maternal education; higher maternal age; earlier enrollment during pregnancy; and reporting a subsequent pregnancy. Longer WIC participation was associated with lower HFI odds (OR: 0.69; 95% CI: 0.51, 0.95), higher total HEI-2015 (β: 0.73; 95% CI: 0.20, 1.25), and higher obesity odds (OR: 1.20; 95% CI: 1.05, 1.37) in multivariable-adjusted regression models. Longer WIC participation was associated with reduced HFI and higher diet quality, and unexpectedly with higher obesity odds, at 60 mo. Further research is needed to confirm and understand mechanisms underlying the unexpected associations identified with longer WIC participation (e.g., male sex, obesity). Groups with shorter participation durations may benefit from targeted WIC retention efforts to maximize nutrition security.

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), a federal nutrition assistance program supporting low-income families, serves half of United States–born infants, most of whom are issued infant formula by age 2 mo. Obesity prevalence is high among children of low-income households, particularly formula-fed children. This study was conducted to determine whether glucose-based lactose-reduced infant formula made with corn syrup solids (CSSF) is associated with increased obesity risk compared with non-CSSFs that are lactose based. WIC administrative data on infant formula issuance and child weights and lengths were collected prospectively in Southern California between 2012 and 2020. Included children stopped breastfeeding by 3 mo, were issued cow's milk–based formula through 12 mo, and were enrolled through the final year of WIC eligibility at age 4 y ( n = 15,246). CSSF issuance was assessed continuously (range 0–13 mo) and dichotomously (any, none). Poisson and linear risk regression with robust SE estimates generated risk ratios (RRs), risk differences, and CIs for child obesity [BMI for age (in kg/m ²) ≥95th percentile]. Any CSSF was issued to 23% of children, and 25% were obese at age 4 y. Children with any CSSF issuance had 10% higher obesity risk (RR: 1.10; 95% CI: 1.02, 1.20) than children with no CSSF issuance at age 2 y. Associations remained significant through age 4 y (RR: 1.07; 95% CI: 1.01,1.14), independent of maternal weight status, total formula issued and breastfeeding duration, and were not modified by child race or sex. Obesity risk increased with additional mo of CSSF exposure, reaching 16% higher risk (RR: 1.16; 95% CI: 1.05, 1.28) at age 2 y for children with 12 mo of CSSF. CSSF issuance is associated with increased obesity risk in the first 5 y life in a dose dependent manner, independently of maternal weight status, breastfeeding duration, and total formula issuance.

There are limited data on the associations of circulating angiogenic factors with chronic kidney disease (CKD). We investigate the associations of circulating vascular endothelial growth factor (VEGF)-A, angiopoietin-1, angiopoietin-1/VEGF-A ratio, VEGF receptor 1 (VEGFR-1), VEGFR-2, and pentraxin-3 with CKD. We recruited 201 patients with CKD and 201 community controls without CKD from the greater New Orleans area. CKD was defined as estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 or presence of albuminuria. Multivariable quantile and logistic regression models were used to examine the relationship between angiogenesis-related factors and CKD adjusting for confounding factors. After adjusting for covariables including traditional cardiovascular disease (CVD) risk factors, C-reactive protein, and history of CVD, the medians (interquartile range) were 133.08 (90.39, 204.15) in patients with CKD vs. 114.17 (72.45, 170.32) pg/mL in controls without CKD (p = 0.002 for group difference) for VEGF-A; 3951.2 (2471.9, 6656.6) vs. 4270.5 (2763.7, 6537.2) pg/mL (p = 0.70) for angiopoietin-1; 25.87 (18.09, 47.90) vs. 36.55 (25.71, 61.10) (p = 0.0001) for angiopoietin-1/VEGF-A ratio; 147.81 (122.94, 168.79) vs. 144.16 (123.74, 168.05) ng/mL (p = 0.25) for VEGFR-1; 26.20 (22.67, 29.92) vs. 26.28 (23.10, 29.69) ng/mL (p = 0.31) for VEGFR-2; and 1.01 (0.79, 1.49)vs. 0.89 (0.58, 1.18) ng/mL (p = 0.01) for pentraxin-3, respectively. In addition, an elevated VEGF-A level and decreased angiopoietin-1/VEGF-A ratio were associated with increased odds of CKD. These data indicate that plasma VEGF-A and pentraxin-3 levels were increased and the angiopoietin-1/VEGF-A ratio was decreased in patients with CKD. Future prospective studies are warranted to examine whether angiogenic factors play a role in progression of CKD.

In 2009, for the first time since the program's inception in 1974, the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) changed their food packages, providing food options better aligned with the 2005 Dietary Guidelines for Americans. The aim of this study was to evaluate whether the 2009 WIC food package change was associated with changes in growth trajectories from age 0 to 4 y or obesity at age 4 among children who participated in WIC in Los Angeles County between 2003 and 2016. Children were grouped into 1 of 4 exposure groups: full-dose, new food package group (participating in WIC from birth to age 4, post 2009, N = 70,120), full-dose, old food package group (participating from birth to age 4, pre 2009, N = 85,871), late-dose, new food package group (participating from age 2 to 4 y, post 2009, N = 8386), and late-dose, old food package group (participating from age 2 to 4 y, pre 2009, N = 18,241). Children were matched across groups on gender, race/ethnicity, maternal education and language, family income, and initial weight status, and matched analyses were performed. Longitudinal growth trajectories were modeled using piecewise linear spline mixed models, and differences in obesity at age 4 were compared using Poisson regression models. Children receiving a full dose of the new food package had healthier growth trajectories and a lower obesity risk at age 4 than children receiving a full dose of the old food package (RR [95% CI]: 0.88 [0.86, 0.91] for boys, 0.90 [0.87, 0.93] for girls). Boys, but not girls, in the late-dose, new food package group had a lower obesity risk at age 4 compared with boys in the late-dose, old food package group (RR = 0.89, 95% CI = 0.81, 0.98). The WIC food package change appears to be associated with improved childhood obesity outcomes. These findings are important in informing policymakers considering further improvements to the WIC food packages.

Background Research has found breastfeeding to be protective of obesity; however, this link remains contentious. We examined longitudinal associations between exclusive breastfeeding duration, growth trajectories and obesity at 4 years among children participating in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), and whether these associations differed in the context of the 2009 WIC food package change, implemented to improve alignment with dietary guidelines and promote breastfeeding. Methods Longitudinal data from 260 935 WIC-participating children in Los Angeles County, California, 2003–2016, were used to assess the relationship between duration of receipt of the fully breastfeeding package (an exclusive breastfeeding proxy) with childhood growth and obesity using mixed effects and Poisson regression models. Results Children exclusively breastfed for longer duration had healthier growth trajectories and lower obesity risk at age 4. Compared with infants with no fully breastfeeding package receipt, any receipt (a breastfeeding initiation proxy) was associated with reduced obesity risk. Obesity risk was lowest for boys and girls exclusively breastfed for 7 (risk ratio (RR)=0.73, 95% CI=0.64 to 0.82) and 13 months (RR=0.63, 95% CI=0.58 to 0.69), respectively. Exclusive breastfeeding duration increased, but associations between exclusive breastfeeding duration and growth and obesity were not modified, following the 2009 WIC food package change. Conclusion Increased duration of exclusive breastfeeding was associated with reduced obesity risk. The greatest incremental benefit was observed going from none to any exclusive breastfeeding, and the maximum cumulative benefit was among children receiving the fully breastfeeding package for more than 6 months. Breastfeeding promotion in WIC remains important for obesity prevention.