Dietetics and Clinical Nutrition Commons^™

Thyroid Storm At Sea: A Case Report Of Algae-Induced Thyrotoxicosis, Alynna Knaub, Amanda Cecchini, John Janousek, Laura Strojny, Jairo Noreña, Zachary Pawlikowski

Department of Medicine Faculty Publications

Iodine-induced thyrotoxicosis (IIT), also known as the Jod-Basedow phenomenon, is a rare yet recognized cause of hyperthyroidism. While iodinated contrast is the most frequent trigger, iodine-rich supplements such as seaweed products or supplements can also precipitate thyrotoxicosis, particularly in individuals with prior chronic iodine deficiency or preexisting thyroid nodular disease. We present a case of thyroid storm following short-term ingestion of Irish sea moss as part of a “crash diet.” A 37-year-old woman with type 1 diabetes mellitus, well controlled on subcutaneous insulin therapy, presented with nausea and vomiting after 6 days of following a restrictive diet consisting solely of …

Ultra-Processed Foods And The Cardiovascular-Kidney-Metabolic Continuum: Integrating Epidemiological, Multi-Omics, And Translational Evidence, Saiful Singar, Amirhossein Ataei Kachouei, Leandro Lantigua-Somoano, David Manley, Anthony Cardinale, Muhammad Zulfiqah Sadikan, Saurabh Kadyan, Donya Shahamati, Lorena Dias, Amber Wood, Cinthia Chavarria, Sara K. Rosenkranz, Neda S. Akhavan

Department of Medicine Faculty Publications

Cardiovascular-kidney-metabolic (CKM) syndrome integrates excess adiposity, metabolic dysfunction, kidney impairment, subclinical cardiovascular diseases, and clinical events along a staged continuum that invites unified prevention and treatment. Ultra-processed foods (UPFs) are a complex, high-prevalence exposure that may influence risk across CKM stages through nutrient profiles, additives, processing-induced compounds, and packaging-related contaminants. This review synthesizes epidemiologic, mechanistic, and translational evidence with attention to exposure definition and analytic rigor. We summarize NOVA-based UPF operationalization across dietary assessment tools, highlighting misclassification of mixed dishes, brand heterogeneity, and energy under-reporting, and we propose further examination of energy-adjusted models, calibration, and harmonized metrics. Observational studies consistently …

Gastrointestinal Symptoms Associated With Sodium Bicarbonate Supplementation Protocols: A Systematic Review, Ian P. Winter, Paul Sarac, Patrick B. Wilson

Exercise Science Faculty Publications

Sodium bicarbonate positively impacts performance, but its associated gastrointestinal symptoms (GIS) may limit use. This systematic review synthesized literature that has evaluated GIS with sodium bicarbonate supplementation. Literature searches were performed from February 2024-March 2026. Eligible studies provided ≥ 5 g of sodium bicarbonate within a 24-h period or, if a multi-day protocol, at least one day involving ≥ 5 g. Included studies had a placebo group/condition or a comparison group/condition that created a contrast related to delivery method, form, or dose. In total, 101 investigations were summarized in six categories: acute single dosing (n = 35); acute spread dosing …

Chronobiology Of Meal Timing In Early-Stage Hypertension: A Controlled Feeding Pilot Study Investigating The Effects On Renal And Vascular Function, Natalie J. Bohmke, Brittany Barton, Patrice Wiecek, Paula Rodriguez-Miguelez, Dave L. Dixon, Youngdeok Kim, Salvatore Carbone, Danielle L. Kirkman

EVMS School of Health Professions Faculty Publications

Lifestyle intervention is critical for young adults with early-stage hypertension. A Western diet has negative effects on kidney function and blood pressure; however, time-of-day effects are understudied. We hypothesized that consumption of a Western-style meal that is misaligned with the endogenous circadian rhythm would have adverse effects on blood pressure, kidney function, and vascular function. Ten young adults with elevated blood pressure or stage 1 hypertension (means ± SD: 26 ± 8 yr, 50% female) underwent a randomized crossover, isocaloric controlled feeding intervention. Participants were allocated to receive a Western-style meal high in sodium, sugar, and saturated fat in the …

Translating Cardiovascular Clinical Practice Guidelines On Nutrition Therapy: Validation Of The Portfolio Diet Toolkit For Healthcare Providers, Gabrielle Viscardi, Sahba Eskandari, Alyssa Chen, Nicholas Chiang, Meaghan E. Kavanagh, Songhee Back, Micheal Vallis, Mary J. Scourboutakos, Vasanti S. Malik, Cyril W.C. Kendall, David J.A. Jenkins, John L. Sievenpiper, Laura Chiavaroli

Department of Family and Community Medicine Faculty Publications

Background

Cardiovascular disease (CVD) remains a leading cause of death in Canada. Although the Portfolio Diet, a dietary pattern of cholesterol-lowering foods, is supported by CVD clinical practice guidelines, its uptake in clinical practice remains limited. This study assessed the content and face validity of a healthcare provider (HCP)-facing toolkit (infographic and video), designed to support implementation of the Portfolio Diet.

Methods

HCPs were recruited for a 2-round evaluation. They assessed the toolkit using a questionnaire. Content validity of the infographic was assessed using a 4-point Likert scale (1 = irrelevant to 4 = extremely relevant) and face validity of …

Novel Insights Into Beta Cell Er Stress Chop And It's Role In Hfpef Development, Balaji Srinivas, Paula Fortuno, Hongmei Peng, Jiang Xu, Hamid Suhail, Hani N. Sabbah, Nour-Eddine Rhaleb, Khalid Matrougui

Department of Physiological Sciences Faculty Publications

Introduction: Heart failure with preserved ejection fraction (HFpEF) is a multifactorial cardiovascular disorder characterized by diastolic dysfunction and often associated with hypertension and metabolic disturbances. We aimed to determine the inter-relationship between C/EBP homologous protein (CHOP) in b-cells and HFpEF development.

Methods: Eight-week-old male mice b-cell^flox/flox and b-cell^CHOP-/- were randomly divided into four groups: control b-cell^flox/flox and b-cell^CHOP-/- mice subjected to standard diet and water. b -cell^flox/flox and b-cell^CHOP-/- mice fed a high-fat diet (HFD) and L-NAME (0.5 g/L) for five weeks. A comprehensive cardiovascular, metabolic, and histological evaluation was conducted.

Results: Following …

Exploring The Role Of 5-Hydroxymethyl-2-Furfural And Sumiki's Acid In Beta-Cell Metabolism, Daiwik Munjwani, Demitrius Hill, David Regan, David Lee, Mike Muehlbauer, Hans-Ewald Hohmeier, Mette Jensen, Neolle E. Younge, James Bain

Department of Medicine Faculty Publications

Type 1 diabetes (T1D), a leading cause of mortality in the United States, is associated with heart disease, nephropathy, neuropathy, retinopathy, and stroke. While management of T1D with medications and healthy lifestyle choices is critical, recent research highlights the contributory role of environmental diabetogens in the pathogenesis of T1D. Here, we propose that the furan compound, 5-hydroxymethyl-2-furfural (HMF), which forms when hexoses such as glucose or fructose lose three water molecules during thermal food processing, might be an unrecognized dietary diabetogen. HMF is a suspected mutagen and carcinogen. In a previous experiment in the rat 832/13 beta-cell line, when cultures …

Family Structure, Family Transitions, And Child Overweight And Obesity: Comparing Australia, The United Kingdom, And The United States, Sadie A. Slighting, Kirsten Rasmussen, Mikaela J. Dufur, Jonathan A. Jarvis, Shana Pribesh, Alyssa J. Alexander, Carolina Otero

STEMPS Faculty Publications

Growing rates of childhood obesity globally create concern for individuals' health outcomes and demands on health systems. While many policy approaches focus on macro-level interventions, we examine how the type of stability of a family structure might provide opportunities for policy interventions at the micro level. We examine the association between family structure trajectories and childhood overweight and obesity across three Anglophone countries using an expanded set of eight family structure categories that capture biological relationships and instability, along with potential explanatory variables that might vary across family trajectories and provide opportunities for intervention, including access to resources, family stressors, …

Trends In Stunting, Underweight And Overweight Among Children Aged < 5 Years In Kuwait: Findings From Kuwait Nutritional Surveillance System (2007-2019), Nawal Alqaoud, Abdullah Al-Taiar

Community & Environmental Health Faculty Publications

Background: There is a paucity of data on the secular trends of stunting and overweight among children aged < 5 years in oil-rich countries in the Middle East.

Aims: To examine the secular trends of stunting, underweight and overweight in children aged < 5 years in Kuwait between 2007 and 2019.

Methods: We used large individual data records (n=48 108) from the Kuwait Nutritional Surveillance System (KNSS) to calculate height/length-for-age z score (HAZ), weight-for-age z score and body mass index (BMI)-for-age z score using World Health Organization growth references. Stunting and underweight were defined as less than -2 standard deviation (SD) and overweight (including obesity) as ≥ 2 SD. Trends of stunting, underweight and overweight were …

Vitamin D Level In Relation To Depression Symptoms During Adolescence, Reem Al-Sabah, Abdullah Al-Taiar, Lemia Shaban, Ahmed N. Albatineh, Reem Sharaf Alddin, Praveen K. Durgampudi

Community & Environmental Health Faculty Publications

BACKGROUND: This study aimed to investigate the association between 25-hydroxyvitamin D (25(OH)D) and depression symptoms among adolescents in Kuwait, a country with a high prevalence of vitamin D deficiency.

METHODS: A school based cross-sectional study was conducted on randomly selected 704 adolescents in middle schools. Data on depression symptoms were collected using the Children's Depression Inventory (CDI). Data on covariates were collected from the parents by self-administered questionnaire and from adolescents by face-to-face interview. Blood samples were analyzed in an accredited laboratory; and 25(OH)D was measured using liquid chromatography-tandem mass spectrometry.

RESULTS: Of 704 adolescents, 94 (13.35%; 95%CI:10.35-17.06%) had depression …

The Online Ordering Behaviors Among Participants In The Oklahoma Women, Infants, And Children Program: A Cross-Sectional Analysis, Qi Zhang, Kayoung Park, Junzhou Zhang, Chuanyi Tang

Community & Environmental Health Faculty Publications

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a nutrition assistance program in the United States (U.S.). Participants in the program redeem their prescribed food benefits in WIC-authorized grocery stores. Online ordering is an innovative method being pilot-tested in some stores to facilitate WIC participants' food benefit redemption, which has become especially important in the COVID-19 pandemic. The present research aimed to examine the online ordering (OO) behaviors among 726 WIC households who adopted WIC OO in a grocery chain, XYZ (anonymous) store, in Oklahoma (OK). These households represented approximately 5% of WIC households who redeemed …

A Meta-Analysis Of Associations Between Weight Bias Internalization And Conceptually-Related Correlates: A Step Towards Improving Construct Validity, Kelly A. Romano, Kristin E. Heron, Cassidy M. Sandoval, Lindsay M. Howard, Rachel I. Macintyre

Psychology Faculty Publications

Weight bias internalization (WBI), a process of weight-based self-devaluation, has been associated with adverse mental and physical health. However, there are limitations with the existing conceptualization and operationalization of WBI that raise questions about the implications of this evidence-base. To address these limitations, the present study investigated the construct validity of WBI by conducting a meta-analysis of associations between WBI (as currently operationalized) and conceptually-related correlates. Studies identified through October 2021 that provided zero-order correlations for associations between WBI and conceptually-related constructs were examined. Meta-regression determined whether these associations differed across WBI measures and demographic (age, sex/gender, race, BMI) and …

There's An App For That: Promoting Health App Use In Rural Ireland, Noor Yahya, Marcus Simon

Undergraduate Research Symposium

Problem Statement: Smartphones and mobile applications (commonly referred to as apps) were first introduced in the late 20th century and early 21st century. Due to the public’s time constraints, lack of transportation, lack of medical insurance, and a growing desire for healthier lifestyles, the total global mHealth market forecast to reach 100 billion dollars in 2021 – a fivefold increase from 21 billion in 2016. mHealth apps have been successfully used for health promotion activities but barriers such as lack of knowledge and comfort in using health apps exist.

Purpose: Evaluate readiness of a rural community and the …

Physical Activity, Dietary Patterns, And Glycemic Management Of Active Individuals With Type 1 Diabetes: An Online Survey, Sheri Colberg, Jihan Kannane, Norou Diawara

Human Movement Studies & Special Education Faculty Publications

Individuals with type 1 diabetes (T1D) are able to balance their blood glucose levels while engaging in a wide variety of physical activities and sports. However, insulin use forces them to contend with many daily training and performance challenges involved with fine-tuning medication dosing, physical activity levels, and dietary patterns to optimize their participation and performance. The aim of this study was to ascertain which variables related to the diabetes management of physically active individuals with T1D have the greatest impact on overall blood glucose levels (reported as A1C) in a real-world setting. A total of 220 individuals with T1D …

Dietary Phytoestrogens Ameliorate Hydrochloric Acid-Induced Chronic Lung Injury And Pulmonary Fibrosis In Mice, Pavel Solopov, Ruben Manuel Luciano Colunga Biancatelli, Christiana Dimitropoulou, John D. Catravas

Bioelectrics Publications

We previously reported that female mice exhibit protection against chemically induced pulmonary fibrosis and suggested a potential role of estrogen. Phytoestrogens act, at least in part, via stimulation of estrogen receptors; furthermore, compared to residents of Western countries, residents of East Asian countries consume higher amounts of phytoestrogens and exhibit lower rates of pulmonary fibrosis. Therefore, we tested the hypothesis that dietary phytoestrogens ameliorate the severity of experimentally induced pulmonary fibrosis. Male mice placed on either regular soybean diet or phytoestrogen-free diet were instilled with 0.1 N HCl to provoke pulmonary fibrosis. Thirty days later, lung mechanics were measured as …

Assessment Of Cooking Matters Facebook Platform To Promote Healthy Eating Behaviors Among Low-Income Caregivers Of Young Children In The United States: A Pilot Study, Qi Zhang, Jill Panichelli, Leigh Ann Hall

Community & Environmental Health Faculty Publications

How best to deliver healthy-eating education through social media among a low-income population remains understudied. To assess the impact of the Cooking Matters (CM) Facebook page on healthy eating behaviors among low-income caregivers, we conducted a pre–post survey of new CM Facebook followers in early 2020. A convenience sample was recruited at baseline from WICShopper app users and the CM Facebook page. The recruited sample included 397 low-income caregivers of a child younger than 6 who never followed CM Facebook. Among the baseline caregivers, 184 completed the follow-up survey. Paired t-test and McNemar–Bowker tests were conducted to compare the outcomes …

Disordered Eating, Food Insecurity, And Weight Status Among Transgender And Gender Nonbinary Youth And Young Adults: A Cross-Sectional Study Using A Nutrition Screening Protocol, Whitney R. Linsenmeyer, Ian M. Katz, Jaime L. Reed, Andrea M. Giedinghagen, Christopher B. Lewis, Sarah K. Garwood

Psychology Faculty Publications

Purpose: The purpose of this study was to describe the prevalence of and relationships among disordered eating, food insecurity, and weight status among transgender and gender nonbinary youth and young adults.

Methods: This cross-sectional study involved a screening protocol to assess disordered eating and food insecurity risk from September to December of 2019 at a gender clinic using five validated measures: (1) previous eating disorder diagnosis (yes/no); (2) Sick, Control, One Stone, Fat, Food Questionnaire (SCOFF); (3) Adolescent Binge Eating Disorder Questionnaire (ADO-BED); (4) Nine-Item Avoidant/Restrictive Food Intake Disorder Screen (NIAS); and (5) Hunger Vital Sign. Age, assigned sex at …

Examining The Ecological Validity Of The Power Of Food Scale, Lindsay M. Howard, Kristin E. Heron, Kathryn E. Smith, Ross D. Crosby, Scott G. Engel, Stephen A. Wonderlich, Tyler B. Mason

Psychology Faculty Publications

Purpose

Appetite for palatable foods may impact eating-related behaviors in everyday life. The present study evaluated the real-world predictive validity of the Power of Food Scale (PFS) using ecological momentary assessment (EMA).

Methods

30 women who reported binge eating completed the PFS and related measures. Subsequently, during a 14-day assessment period, participants completed five daily EMA surveys of appetite and binge eating via text message and web.

Results

Results of generalized estimating equations showed that higher PFS scores were associated with higher momentary levels of hunger, eagerness to eat, and urge to eat but were unrelated to fullness, preoccupation with …

Somatic Symptoms And Binge Eating In Women's Daily Lives, Kelly A. Romano, Kristin E. Heron, Kathryn E. Smith, Ross D. Crosby, Scott G. Engel, Stephen A. Wonderlich, Raina D. Pang, Tyler B. Mason

Psychology Faculty Publications

Objective

The present study aimed to determine whether the momentary severity of women's somatic symptoms was concurrently and prospectively associated with their engagement in binge eating in naturalistic settings.

Method

Thirty women (M_age = 34.13, SD = 13.92) who had engaged in binge eating at least once over the month prior to study entry completed a 14-day ecological momentary assessment (EMA) protocol. During each of the 14 days, participants received five semi-random surveys via text message that assessed momentary somatic symptom severity (i.e., headaches, stomachaches/pain, chest/heart pain, faintness/dizziness, shortness of breath, fatigue) and disordered eating behaviors. Generalized estimating equations …

Independent And Interactive Associations Of Negative Affect, Restraint, And Impulsivity In Relation To Binge Eating Among Women, Tyler B. Mason, Kathryn E. Smith, Jason M. Lavender, Robin J. Lewis

Psychology Faculty Publications

There is growing recognition that impulsivity may serve as an underlying risk factor for binge eating. In addition, the association of impulsivity with binge eating may be moderated by other affective and cognitive risk factors. This study examined independent and interactive associations of negative affect, dietary restraint, and facets of impulsivity with binge eating. A diverse sample of 566 undergraduate women completed online questionnaires of study variables. Results revealed a three-way interaction of negative affect, dietary restraint, and attentional impulsivity in relation to binge eating. Women who were high on each of these three variables reported the greatest levels of …

Preconceptional Health Behavior Change In Women With Overweight And Obesity: Prototype For Smart Strong Healthy Women Intervention, Frank T. Materia, Joshua M. Smyth, Kristin E. Heron, Marianne Hillemeier, Mark E. Feinberg, Patricia Fonzi, Danielle Symons

Psychology Faculty Publications

Background: The prevalence of maternal perinatal obesity is rising, and in turn, increases health risks and morbidity for both mother and child. Past evidence suggests the preconceptional Strong Healthy Women (SHW) intervention can reduce multiple biobehavioral risk factors for adverse perinatal health. The SHW intervention, however, was time- and resource-intensive to deliver. Mobile health (mHealth) technologies provide an opportunity to expand intervention reach while reducing implementation cost and burden. Previous research suggests that preconceptional women are broadly supportive of using smartphones for behavior change, yet few studies have elicited their specific preferences for a targeted mHealth intervention. The objective of …

Exploring Community-Based Nutrition Education Programs On Children’S Knowledge Of Effective Budgeting And Nutritional Analysis, Danielle Beard, Katie Harris, Charlotte Harrison, Amanda Hawley, Kerri Healy, Ashley Tuttle

OUR Journal: ODU Undergraduate Research Journal

Children from low-income areas, ages 5-18, are at high risk for obesity and other related nutritional issues, partially due to lack of knowledge about effective budgeting and nutritional content analysis. Little information is known about the education provided by current community programs in Hampton Roads for teaching children to 1) shop smart, 2) read nutrition labels, and 3) the importance of eating healthier. We propose a longitudinal (12-week) observational study to determine what community-based education is provided to children on how and why to shop smart and read nutritional content; and to determine whether or not the education is effective. …

Nutritional Status Of Food Insecure Older Adults, Chelsie Walker, Lindsey Asbury, Javier Way, Brent Johnson, Alex Biddle, Courtney Wagner

OUR Journal: ODU Undergraduate Research Journal

Approximately 9.8 million seniors across America were at risk of going hungry in 2015. The percentage of seniors who faced the threat of hunger was equivalent to the percentage of seniors compared with the whole population of the United States. The prevalence rate of hypertension, which contributes to heart attacks and strokes, is over 50%, and the prevalence rate of diabetes is over 25% in seniors. Both heart disease and diabetes are among the top 10 leading causes of death in America with heart disease being number one. Appropriate dieting is recommended as a way to prevent and treat both …

Using Sensewear Armband And Diet Journal To Promote Adolescents' Energy Balance Knowledge And Motivation, Senlin Chen, Xihe Zhu, Gregory J. Welk, Youngwon Kim, Jungmin Lee, Nathan F. Meier

Human Movement Studies & Special Education Faculty Publications

Purpose: Educating adolescents about energy balance (EB) is essential for effective weight control. This study utilized the Sensewear (SWA) armband and a diet journal to promote adolescents' EB knowledge and motivation.

Methods: Ninety sixth graders were randomly assigned into the experimental group (n = 46) who utilized SWA and diet journal for 7 consecutive days or the control group (n = 44) who did not. Both groups were pre-and post-measured on EB knowledge, situational interest, and weight. The experimental group was tracked on motivation effort, energy expenditure (EE), and energy intake (EI).

Results: EB knowledge significantly increased and situational interest …

Melatonin Supplementation Improves Glycemic Control While Lowering Oxidative Stress In Type 2 Diabetes, Carmine R. Grieco, Sheri R. Colberg, C. Thomas Somma, Andrew G. Thompson, Aaron I. Vinik

Human Movement Studies & Special Education Faculty Publications

The purpose of this investigation was to evaluate the effect of melatonin on glycemic control and oxidative stress (OS) in adults with type 2 diabetes (T2D). Fourteen subjects with T2D (10 female, 4 male; 52.5 ± 5.0 years) were randomly assigned to melatonin (MEL) or placebo groups (PLA) for 42 days, in a crossover design. Subjects ingested 10 mg of MEL or an identical placebo (PLA) 30 minutes prior to sleep. Fasting blood draws occurred at baseline, 42 days, and 84 days. Plasma malondialdehyde, a marker of OS, significantly decreased on MEL (-6.25±2.10 nmol/ml) compared to PLA (0.72±3.30, p=0.028). The …

Review Of The Multi-Level Factors Contributing To Fruit And Vegetable Consumption In The U.S., Qi Zhang, Liuliu Fu

Community & Environmental Health Faculty Publications

The consumption of fruits and vegetables (F&V) has a significant protective effect in reducing various cardiometabolic diseases. In recent years, the U.S. government has made a lot of effort to promote F&V consumption through different projects and programs, including the MyPyramid food guidance system supported by the USDA’s Center for Nutrition Policy and Promotion, and the Fruits & Veggies More Matters program (previously called the 5-A-Day for Better Health program), supported by the Centers for Disease Control and Prevention (CDC) and other public and private agencies. However, modest success has been achieved in promoting healthy diets among the American public. …

Demographic, Cultural, And Environmental Factors Associated With Frequency And Severity Of Malnutrition Among Zambian Children Less Than Five Years Of Age, Selestine H. Nzalal, Seter Siyizal, Olusegun Babaniyi, Peter Songolo, Adamson S. Muula, Emmanuel Radatsikira

Community & Environmental Health Faculty Publications

Under-nutrition prevents growth and development in children and is the leading factor to illness and death among children less than five years of age in developing countries. The objective of the study was to determine associations of demographic, cultural and environmental factors with frequency and severity of malnutrition among children less than five years of age in Zambia. We used data from the Zambia multiple indicator cluster survey (MICS) from years of 1999 to 2000. Altogether 6,142 children participated in the survey. The prevalence rates for being "underweight", "stunted" and "wasted" were 17.6, 37.5 and 4.1%, respectively. Compared to children …

Maternal Employment And Childhood Obesity Among Immigrant Families, Qi Zhang

Community & Environmental Health Faculty Publications

There are continued interests to examine the relationship between maternal employment and childhood obesity. However, little research has been focused on childhood obesity among immigrant families with working mothers. This study used the Panel Survey of Income Dynamics (PSID) and Child Development Supplement (CDS) in 2002 and compared the impact of maternal employment on childhood obesity between immigrant families and US-born families. The positive effect of maternal employment on children’s body weight status was much stronger in immigrant families than in US-born families. The full-time employment status of mothers had strong and significant effect on immigrant children’s BMI (beta = …

Childhood Obesity In Minority Populations In The United States, Qi Zhang, Youfa Wang

Community & Environmental Health Faculty Publications

Obesity became a public health crisis in the United States, which affects both adults and children.^1,2,24,25 Approximately 31% of U.S. children and adolescents aged 2-19 years were overweight or obese, and almost 17% were obese in 1999-2004.^3-5,24 Studies suggest that increased consumption of more energy-dense, nutrient-poor foods with high levels of sugar and saturated fats, combined with reduced physical activity, have contributed to the rising obesity epidemic among children.^6,21,28 Childhood obesity increased the risk of many diet-related chronic diseases, including type 2 diabetes, cardiovascular disease, hypertension, stroke, and certain forms of cancers.⁷ It is important to …