Extension programming that incorporates both physical activity and dietary behaviors is necessary for the prevention of certain chronic diseases, including obesity. The purpose of the study presented here was to systematically identify the presence of physical activity objectives in the strategic plan for each Extension system in the United States. Few Extension systems (13) included physical activity in their strategic plans, yet lack of inclusion of physical activity in a strategic plan may limit the degree to which a system supports physical activity objectives and outcomes. As strategic plans lead to strategic thinking, the integration of physical activity objectives may improve the public health impact of Extension programming.

Diabetes mellitus (DM) is a major clinical and public health concern because of its high population burden. Clinical trials report promising antidiabetic effects of dietary polyphenols using supplementation. This systematic review investigated habitual-level polyphenol intake associations in observational studies for pre-, type 1, type 2, and gestational DM prevention and management. This review aimed to evaluate whether these associations may have implications for public health nutrition guidance. Database searches were last conducted in January 2025. Only articles available in English were considered. We identified 32,662 articles, of which 53 studies met the eligibility criteria and were included in the review. We used The Risk of Bias In Non-Randomized Studies-of Exposure (ROBINS-E) tool to assess risk of bias. Measures of association for each type of DM (primarily pre-DM and T2DM) were evaluated and synthesized. Strengths of associations between each polyphenol class and DM outcomes varied; however, flavonoids and lignans had repeated small to moderate DM risk reduction. Our findings suggest that higher habitual intake of polyphenol-rich foods may be associated with DM prevention, but the strength of evidence is not sufficient to justify dietary recommendations. T1DM and GDM were underrepresented in our review, warranting future investigations (PROSPERO registration #CRD420251003017).