Sex- and Race/Ethnicity-Specific Associations Between Food Insecurity and Metabolic Dysfunction-Associated Steatotic Liver Disease in American Adults

an innovative in preventing obesity.We assessed the effectiveness of peer-led intervention on physical activity, sedentary behaviors and dietary patterns among adolescents in HCM city, Vietnam.Methods: Eight secondary schools were randomized to the intervention group (4 schools) and the control group (4 schools).We matched the intervention and control schools by location and school size.The peer-education intervention was delivered at the start of the school year over 4 weeks for all grade-6 students in the allocated schools, followed by peer-support and home engagement activities over the next 6 months.The supporting system was launched to maintain 6th graders' compliance.Students in control schools received usual educational curriculum.We conducted assessments at baseline in October 2021 and at the end of the intervention in April 2022.Mixed effect models were applied to evaluate the effects of the intervention, which were adjusted for age, gender, BMI at baseline, and cluster effect in schools.Results: A comparison of pre-and post-intervention assessments showed significant decreases in total energy, protein, fat, carbohydrate, and sweet foods intake in the intervention group (p < 0.05), but not in the control one.The intake of cereals decreased by 62 AE 19.0 gram/day and the fruit consumption increased by 36 AE 15.0 gram/day in intervention schools (p < 0.05) compared to the control.Students in the intervention group reduced the frequency of soft drinks intake by 0.79 times compared to the control (p < 0.05).After a 6-month follow-up, there were an increase in the time spent on physical activities by 8 AE 3.5 minutes/day, and a decrease in the time spent on sedentary behaviors on weekdays by 35 AE 9.9 minutes/day in the intervention arm (p < 0.05) compared to the control group, which were adjusted for age, gender, BMI at baseline, and cluster effect in schools.Conclusions: Our project proved the effectiveness of the peer-led intervention on physical activity and dietary behaviors among adolescents.