Objective We aimed to assess the relative validity and reproducibility of a semi-quantitative FFQ in Puerto Rican adults. Design Participants completed an FFQ, followed by a 6 d food record and a second administration of the FFQ, 30 d later. All nutrients were log transformed and adjusted for energy intake. Statistical analyses included correlations, paired t tests, cross-classification and Bland–Altman plots. Setting Medical Sciences Campus, University of Puerto Rico. Subjects Convenience sample of students, employees and faculty members (n 100, ≥21 years). Data were collected in 2010. Results A total of ninety-two participants completed the study. Most were young overweight females. All nutrients were significantly correlated between the two FFQ, with an average correlation of 0·61 (range 0·43–0·73) and an average difference of 4·8 % between them. Most energy-adjusted nutrients showed significant correlations between the FFQ and food record, which improved with de-attenuation and averaged 0·38 (range 0·11–0·63). The lowest non-significant correlations (≤0·20) were for trans-fat, n 3 fatty acids, thiamin and vitamin E. Intakes assessed by the FFQ were higher than those from the food record by a mean of 19 % (range 4–44 %). Bland–Altman plots showed that there was a systematic trend towards higher estimates with the FFQ, particularly for energy, carbohydrate and Ca. Most participants were correctly classified into the same or adjacent quintile (average 66 %) by both methods with only 3 % gross misclassification. Conclusions This semi-quantitative FFQ is a tool that offers relatively valid and reproducible estimates of energy and certain nutrients in this group of mostly female Puerto Ricans.

Objectives To describe the development, implementation and lessons learned of lifestyle intervention to promote appropriate gestational weight gain among Hispanic pregnant women. Design The intervention was informed by an empowerment oriented theoretical framework, and targeted women in the Pregnancy and Early Life Improvement Study. Methods The nutrition component consisted of recommendations for total calories, food quantity and improving carbohydrate and fat quality. We provided brown rice, omega-3 rich vegetable oil and spread, and water monthly. The physical activity focused on limiting sedentary behavior and promoting regular movement. The intervention was delivered through individual and group sessions and phone calls. Participants set their own goals, which were closely monitored. The intervention was evaluated extracting data from participant's record (attendance, goals, and challenges) and using a questionnaire. Results Participants were from underserved communities with economic, time, cultural and social barriers for engaging in lifestyle interventions. Modifications were done to facilitate participation, such as coordinating sessions with prenatal appointments and reducing group size and duration of sessions. Weekly text messages were added to reinforce the intervention. The main goal chosen by participants was reduction of sweetened beverages. The greatest challenges were replacing white rice with brown rice and improving physical activity. Participants suggested conducting sessions near their community and using social media as a motivation tool. Main outcomes results will be published elsewhere. Conclusion We identified barriers to delivering the lifestyle intervention, mainly related to group session's participation. Sessions should be conducted in the community, using text messages and social media as reinforcement.

Dietary recommendations for healthy adults include adequate hydration (males: 125 ounces/day, females: 91 ounces/day) from drinking water, other beverages, and water contained in food. Bottled water sales in U.S. exceeded 11.7 billion gallons in 2015 (36.5 gallons per capita). Low water intake, as well as some chemicals in water sources, are associated with hyperglycemia. However, the association between drinking water sources and hyperglycemia/diabetes has not been studied. In a cohort of overweight/obese Puerto Ricans, we evaluated the association between water sources (bottled and filtered compared to tap water) and prediabetes/diabetes. In 2014-2016, 1023 participants reported their primary source of water as bottled (52%), filtered (25%) and tap (23%); diabetes status was assessed using ADA criteria for fasting and 2-hour post load glucose, and HbA1c. Logistic regression models controlled for age, gender, waist circumference, smoking, alcohol intake, physical activity, and hypertension. Bottled water consumers (compared to tap water) had higher prediabetes (OR=1.43; 95% CI: 1.02, 2.01), and diabetes (OR=1.93; 95% CI: 1.08, 3.46). Further controlling for amount of water, sugar sweetened beverages, or canned food and drinks did not change the associations, but controlling for education or income strengthened the association with diabetes. Results were stronger when restricted to San Juan city residents (43%): prediabetes (OR=1.68; 95% CI: 1.01, 2.79), and diabetes (OR=4.05; 95% CI: 1.48, 11.1). Filtered water users had somewhat higher prediabetes/diabetes (OR=1.38; 95% CI: 0.93, 2.04) compared to tap water users. Results suggest that drinking bottled water may be associated with higher prevalence of diabetes compared to tap water, potentially mediated by endocrine disruptors in plastic bottles. We cannot determine time sequence or causality, given the cross-sectional analyses. The impact of water sources on diabetes risk needs to be further evaluated longitudinally. Disclosure K.J. Joshipura: None. M.A. Trak: None. F.J. Muñoz-Torres: None.

Adequate nutrition early in life optimizes growth and reduces the risk of obesity and chronic diseases in infancy and later in life. However, there is lack of data and instruments specifically designed to assess consumption early in life. This pilot study assessed an infant food frequency questionnaire (FFQ) for clarity of questions and to identify additional questions/examples for inclusion. This FFQ was based on the 19‐item FFQ developed by the CDC, which was expanded to 55 items with additional questions on preparation/source of foods and supplements. A convenience sample of mothers 蠅21 years with infants <12 months (m) of age attending the pediatric hospital clinics in San Juan, Puerto Rico were recruited. Sixty mothers (28 with infants 1‐4m; 14 with infants 5‐8m and 18 with infants 9‐12m) completed the FFQ. Most considered it to be clear (90%). Ten percent was not clear when to report frequency by day or week. The word baby food was more accepted than commercial baby pure. In the open‐ended options, the most common fruits and vegetables reported were bananas, carrots, green beans, squash and pears. In terms of frequencies, only 18% of infants at 1‐4m, 7% at 5‐8m and 6% at 9‐12m were exclusively breastfed. In combination with formula, 11% at 1‐4m, 7% at 5‐8m and 0% at 9‐12m were breastfed. Cow’s milk was introduced <12m in 11%. Water was introduced early (39% of infants at 1‐4 m). Fruit juice (any type) was consumed by 14% at 1‐4m, 57% at 5‐8m and 89% at 9‐12m old. “Baby juice” (juice marketed for babies) was consumed by 11% at 1‐4m, 50% at 5‐8m and 61% at 9‐12m. Sodas were not consumed. Solids foods (cereals, fruits & vegetables) were started <6m in 11%. Sweets were consumed by 12% starting at 7m. Most common supplements given were iron (67%) and multi‐vitamin (38%). Further work to assess validity of the FFQ is needed. A valid infant FFQ is important for understanding dietary consumption patterns in infants, which can help develop specific recommendations for fostering healthy eating habits in this stage of life. Grant Funding Source: This project was supported in part by NIMHHD 8G12‐MD007600