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Redmond LC, Wensel CR, Estradé M, Fleischhacker SE, Poirer L, Jock BW, Gittelsohn J. Dietary outcomes of a multilevel, multicomponent, cluster randomized obesity intervention in six Native American communities in the upper Midwest and Southwest United States. Curr Dev Nutr 2023. [DOI: 10.1016/j.cdnut.2023.100043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
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Kim N, Leshner G, Miller C. Native Americans' Responses to Obesity Attributions and Message Sources in an Obesity Prevention Campaign. JOURNAL OF HEALTH COMMUNICATION 2022; 27:777-789. [PMID: 36576156 DOI: 10.1080/10810730.2022.2153289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
This study investigated the effectiveness of Native American (NA) targeted obesity prevention messages. The researchers manipulated obesity attributions (internal vs. external) and message sources (NAs vs. non-NAs) in a 2 × 2 mixed experimental design to examine the way these message attributes influence NAs' emotional, attitudinal, cognitive, and behavioral responses. One-hundred and eighteen Cheyenne and Arapaho (C&A) tribal citizens read two paper-based obesity prevention PSAs and then answered questions that assessed their message responses. The key findings demonstrated that the match between participants' ethnicity and the message source's ethnicity had a significant effect, as it reduced anger and promoted positive message attitudes and favorable source evaluations. Implications, limitations, and suggestions for future research and NA targeted health campaigns are discussed.
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Affiliation(s)
- Narae Kim
- College of Communication and Media Sciences, Zayed University, Abu Dhabi, United Arab Emirates
| | - Glenn Leshner
- Gaylord College of Journalism & Mass Communication, University of Oklahoma, Norman, Oklahoma, USA
| | - Claude Miller
- Department of Communication, University of Oklahoma, Norman, Oklahoma, USA
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Wang X, Ammerman A, Orr CJ. Family‐based interventions for preventing overweight or obesity among preschoolers from racial/ethnic minority groups: A scoping review. Obes Sci Pract 2022; 8:371-386. [PMID: 35664252 PMCID: PMC9159561 DOI: 10.1002/osp4.578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 11/10/2021] [Accepted: 11/21/2021] [Indexed: 11/11/2022] Open
Abstract
Objective This scoping review aimed to synthesize the published literature on family‐based childhood obesity prevention interventions from 2015 to 2021 that focused on children 2–5 years of age from racial and/or ethnic minority households. Methods A PICOS (population, intervention, comparison, outcome, and setting) framework was used to guide the development of the research question, search strategy, and inclusion/exclusion criteria. To be included, the study must have been a randomized controlled trial or quasi‐experimental trial that enrolled participants 2–5 years of age and their caregivers who identified as being from a racial and/or ethnic minority group in the United States. The study must have also examined a family‐based intervention that incorporated components to prevent childhood obesity (i.e., fruits and vegetable intake, parental responsive feeding, physical activity), be conducted in a remote (i.e., online, text, mail), home, community, primary care setting, or early childhood education institution setting, and report on body mass index (BMI, kg/m2), BMI z‐score, anthropometric measures (weight, waist circumference, fat mass, etc.), changes in health behaviors, or increase in nutritional knowledge. Results Fourteen individual studies were identified. Most interventions used multiple components for promoting nutritional knowledge and behavioral changes among families. Eight interventions included culturally tailored components targeting four aspects: (1) language barriers, (2) food choices, (3) relationships between family members, and (4) rapport building. Conclusions There is limited research in this field focusing on children from racial and/or ethnic minority groups. Future efforts should invest in developing culturally appropriate interventions for these groups.
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Affiliation(s)
- Xiran Wang
- Department of Nutrition University of North Carolina at Chapel Hill Gillings School of Public Health Chapel Hill North Carolina USA
| | - Alice Ammerman
- Health Promotion and Disease Prevention University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
| | - Colin J. Orr
- Department of Pediatrics University of North Carolina at Chapel Hill School of Medicine Chapel Hill North Carolina USA
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Estradé M, Yan S, Trude AC, Fleischhacker S, Hinman S, Maudrie T, Jock BW, Redmond L, Pardilla M, Gittelsohn J. Individual- and household-level factors associated with fruit, vegetable, and dietary fiber adequacy among Native American adults in 6 reservation communities. Prev Med Rep 2021; 24:101414. [PMID: 34976600 PMCID: PMC8683900 DOI: 10.1016/j.pmedr.2021.101414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 05/15/2021] [Accepted: 05/25/2021] [Indexed: 11/12/2022] Open
Abstract
This study utilized baseline data collected in 2017 from the OPREVENT2 trial, which included 540 Native Americans in six Midwest and Southwest reservation communities. The objective was to identify correlates of fruit, vegetable, and dietary fiber adequacy among participants 18–75 years old who self-identified as the main food purchaser or preparer in their household. Mean daily servings of fruits and vegetables and grams of dietary fiber were quantified based on a 30-day semi-quantitative food frequency questionnaire. Participants consumed an average of 0.5 (±0.4) cup-equivalent servings of fruit, 2.5 (±1.8) cup-equivalent servings of vegetables, and 15.5 (±8.9) grams of fiber per day. <2% of the study population met the 2015–2020 Dietary Guidelines for Americans recommendations for fruit consumption, while 12 and 42% met recommendations for dietary fiber and vegetable consumption, respectively. Females had a prevalence ratio 1.4 times greater than males for adequate intakes of vegetables (p = 0.008) and over 6 times greater for dietary fiber (p < 0.001). Participants over the age of 30 were about twice as likely to meet dietary fiber recommendations (p = 0.031) compared to those 30 years and younger. Participants receiving food assistance from the USDA’s Food Distribution Program on Indian Reservations (FDPIR) were nearly twice as likely as non-FDPIR recipients to meet recommendations for dietary fiber (p = 0.008). These findings can help guide the development of targeted interventions to improve diet quality; however, further work is needed to understand and address underlying reasons for low fruit consumption in these rural reservation communities.
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Haozous EA, Jaramillo ET, Willging CE. Getting to Know: American Indian Elder Health Seeking in an Under-funded Healthcare System. SSM. QUALITATIVE RESEARCH IN HEALTH 2021; 1:100009. [PMID: 34988544 PMCID: PMC8725791 DOI: 10.1016/j.ssmqr.2021.100009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
American Indian (AI) Elders are the heart of the community. Existing research explores links between specific health behaviors and social determinants of health, but there is little theory explaining patient behaviors in the context of the Indian Health Service (IHS) system of care. We drew from a multiyear mixed-methods participatory study of Elder healthcare experiences to identify the systemic, interpersonal, and historic factors in the IHS that impact their health-seeking behaviors. We conducted an interpretive grounded theory analysis guided by Indigenous methodologies to analyze interviews with 96 AI Elders from two Southwestern states. Our resulting theory, Getting to Know, explains how Elders knew, owned, accessed, and were denied information and resources in their efforts to receive care. Findings highlight how Elders' health-seeking behaviors reflect longstanding inequities, the many ways Elder knowledge was incongruent with Western knowledge embedded in the IHS system, and how this conflict contributed to Elder discomfort in clinical settings. Future work will test the applicability of Getting to Know in other AI communities and design culturally safe care to meet Elder needs. By applying an Indigenous-centered analysis to the voices of Elders, we identified key influences on health outcomes not previously observed in the literature. By illuminating these influences, we show how culturally safe care can be better formulated to meet the needs of Elders, ultimately improving health for AI communities.
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Affiliation(s)
- Emily A Haozous
- Pacific Institute for Research and Evaluation, 851 University Blvd SE, Suite 101, Albuquerque NM 87106-4341, USA
| | - Elise Trott Jaramillo
- Pacific Institute for Research and Evaluation, 851 University Blvd SE, Suite 101, Albuquerque NM 87106-4341, USA
| | - Cathleen E Willging
- Pacific Institute for Research and Evaluation, 851 University Blvd SE, Suite 101, Albuquerque NM 87106-4341, USA
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Estradé M, van Dongen EJI, Trude ACB, Poirier L, Fleischhacker S, Wensel CR, Redmond LC, Pardilla M, Swartz J, Treuth MS, Gittelsohn J. Exposure to a Multilevel, Multicomponent Obesity Prevention Intervention (OPREVENT2) in Rural Native American Communities: Variability and Association with Change in Diet Quality. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212128. [PMID: 34831884 PMCID: PMC8621011 DOI: 10.3390/ijerph182212128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 02/22/2021] [Accepted: 03/01/2021] [Indexed: 11/16/2022]
Abstract
The OPREVENT2 obesity prevention trial was a multilevel multicomponent (MLMC) intervention implemented in rural Native American communities in the Midwest and Southwest U.S. Intervention components were delivered through local food stores, worksites, schools, community action coalitions, and by social and community media. Due to the complex nature of MLMC intervention trials, it is useful to assess participants’ exposure to each component of the intervention in order to assess impact. In this paper, we present a detailed methodology for evaluating participant exposure to MLMC intervention, and we explore how exposure to the OPREVENT2 trial impacted participant diet quality. There were no significant differences in total exposure score by age group, sex, or geographic region, but exposure to sub-components of the intervention differed significantly by age group, sex, and geographical region. Participants with the highest overall exposure scores showed significantly more improvement in diet quality from baseline to follow up compared to those who were least exposed to the intervention. Improved diet quality was also significantly positively associated with several exposure sub-components. While evaluating exposure to an entire MLMC intervention is complex and imperfect, it can provide useful insight into an intervention’s impact on key outcome measures, and it can help identify which components of the intervention were most effective.
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Affiliation(s)
- Michelle Estradé
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA; (L.P.); (C.R.W.); (M.P.); (J.S.); (J.G.)
- Correspondence: (M.E.); (E.J.I.v.D.)
| | - Ellen J. I. van Dongen
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA; (L.P.); (C.R.W.); (M.P.); (J.S.); (J.G.)
- Correspondence: (M.E.); (E.J.I.v.D.)
| | - Angela C. B. Trude
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD 21201, USA;
| | - Lisa Poirier
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA; (L.P.); (C.R.W.); (M.P.); (J.S.); (J.G.)
| | | | - Caroline R. Wensel
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA; (L.P.); (C.R.W.); (M.P.); (J.S.); (J.G.)
| | - Leslie C. Redmond
- School of Allied Health, University of Alaska Anchorage, Anchorage, AK 99508, USA;
| | - Marla Pardilla
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA; (L.P.); (C.R.W.); (M.P.); (J.S.); (J.G.)
| | - Jacqueline Swartz
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA; (L.P.); (C.R.W.); (M.P.); (J.S.); (J.G.)
| | - Margarita S. Treuth
- Department of Kinesiology, School of Pharmacy and Health Professions, University of Maryland Eastern Shore, Princess Anne, MD 21853, USA;
| | - Joel Gittelsohn
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA; (L.P.); (C.R.W.); (M.P.); (J.S.); (J.G.)
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Piperidi A, Foscolou A, Kouki K, Moussikoudi-Hatterer I, Papalazarou A, Tyrovolas S, Polychronopoulos E, Sidossis LS, Panagiotakos D. The Association of Dietary Habits and Lifestyle Characteristics with Successful Aging among Older Greek Origin Individuals Living in France, Canada, and Greece: The Epidemiological Mediterranean Islands Study (MEDIS). Ecol Food Nutr 2021; 61:201-214. [PMID: 34595961 DOI: 10.1080/03670244.2021.1982708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The aim of the present work was to investigate the association of dietary habits and lifestyle characteristics with successful aging among native Greeks and Greeks of Diaspora (Canada and France). During 2005-2019, 2,434 Greek men and women, living in Greece, in France, and in Canada, over 65 years of age were enrolled voluntarily in the study. Anthropometric, clinical and socio-demographic characteristics, dietary habits, and lifestyle parameters were derived through standard procedures, while successful aging was evaluated using the validated Successful Aging Index (SAI, range 0-10). The SAI of the overall sample was 2.8 ± 1.4. Greeks of Diaspora had higher SAI levels compared to their counterparts in Greece (p's < .001). However, there was no difference between Greeks of Canada and these of France (p > .05). Actually, Greeks of Diaspora had almost 1.9 units higher SAI compared to native Greeks (p < .001). Work and financial status, dietary and lifestyle behaviors (i.e., physical activity, smoking habits), and several clinical characteristics (i.e., history of hypertension and hypercholesterolemia) were statistically different between the three groups (all p's < .05). Greeks of Diaspora had higher SAI levels, probably because of their healthier lifestyle practices, which mainly depend on their traditions and cultural background of their homelands and living conditions in the host countries.
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Affiliation(s)
- Alexandriani Piperidi
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Alexandra Foscolou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Konstantina Kouki
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Ioanna Moussikoudi-Hatterer
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Anastasios Papalazarou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Stefanos Tyrovolas
- Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain
| | - Evangelos Polychronopoulos
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Labros S Sidossis
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece.,Department of Kinesiology and Health, School of Arts and Sciences, Rutgers University, New Brunswick, New Jersey, USA
| | - Demosthenes Panagiotakos
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
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8
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Maudrie TL, Colón-Ramos U, Harper KM, Jock BW, Gittelsohn J. A Scoping Review of the Use of Indigenous Food Sovereignty Principles for Intervention and Future Directions. Curr Dev Nutr 2021; 5:nzab093. [PMID: 34345758 PMCID: PMC8321882 DOI: 10.1093/cdn/nzab093] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 05/11/2021] [Accepted: 06/28/2021] [Indexed: 12/19/2022] Open
Abstract
Indigenous food sovereignty (IFS) represents a community-led movement with potential to reduce health inequities, but no scoping review of the impact of taking an IFS approach on intervention research has been conducted. This review sought to: 1) describe intervention studies that employ IFS principles, and 2) describe the impact of studies using IFS principles on food access, eating patterns, diet quality, physical activity, and health. Through a literature review, 4 IFS principles were identified: 1) community ownership, 2) inclusion of traditional food knowledge, 3) inclusion and promotion of cultural foods, and 4) environmental/intervention sustainability. Twenty intervention studies published between January 1, 2000 and February 5, 2020 were included. Most of the studies that scored high in IFS principles saw a positive impact on diet. This review found evidence supporting the value of IFS principles in the development, implementation, and evaluation of health interventions for Indigenous communities.
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Affiliation(s)
- Tara L Maudrie
- Department of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Uriyoán Colón-Ramos
- Department of Global Health, Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health at The George Washington University, Washington, DC, USA
| | - Kaitlyn M Harper
- Department of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Brittany W Jock
- School of Human Nutrition, Centre for Indigenous Peoples’ Nutrition and Environment (CINE), McGill University, Montreal, Quebec, Canada
| | - Joel Gittelsohn
- Department of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Byker Shanks C, Ahmed S, Dupuis V, Tryon M, Running Crane M, Houghtaling B, Garvin T. Dietary Quality Varies Among Adults on the Flathead Nation of the Confederated Salish and Kootenai Tribes in Montana. J Community Health 2021; 45:388-399. [PMID: 31602533 DOI: 10.1007/s10900-019-00753-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Diet-related chronic disease is among the most pressing public health issues and represents a health disparity among Native American communities. A community-based participatory approach was taken to evaluate dietary quality of adult residents of the Flathead Reservation of the Confederated Salish & Kootenai Tribes in Montana (the Flathead Nation). A survey was administered to collect basic demographic information and food security status (N = 80). Dietary quality was assessed using the 24-h dietary recall method with subsequent calculation of Healthy Eating Index 2010 (HEI-2010) scores, modified HEI without a dairy category, and the Dietary Diversity Scores (DDS). Participants included 80 adults from different households across eight communities (n = 10 per community) at the Flathead Nation. Approximately 50% of participants reported low or very low food security status while the remainder scored high or marginal food security. The mean total HEI-2010 score of study participants was 45.5 out of 100 points with a range between 20.0 and 78.1. The mean DDS of study participants was 4.6 (± 1.365) out of a total of 9 points. Participants with higher DDS had significantly higher intake of dietary fiber (p < 0.0003), potassium (0.0024), and cholesterol (p < 0.0048) compared to the lower DDS group. No significant correlations were found between HEI-2010 scores with DDS, demographic information, or food security status while significant differences were found between food security status and income (p < 0.01) and enrollment in nutrition assistance programs (p < 0.03). This study highlights the need to evaluate multiple parameters of dietary quality coupled with a community-based participatory approach in order for findings to be culturally relevant and support food and nutrition interventions.
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Affiliation(s)
- Carmen Byker Shanks
- Food and Health Lab, Food and Nutrition and Sustainable Food Systems Programs, Department of Health and Human Development, Montana State University, Bozeman, MT, 59717, USA
| | - Selena Ahmed
- Food and Health Lab, Food and Nutrition and Sustainable Food Systems Programs, Department of Health and Human Development, Montana State University, Bozeman, MT, 59717, USA.
| | | | - Mike Tryon
- Salish Kootenai College, Pablo, MT, 59855, USA
| | | | - Bailey Houghtaling
- Food and Health Lab, Food and Nutrition and Sustainable Food Systems Programs, Department of Health and Human Development, Montana State University, Bozeman, MT, 59717, USA
| | - Teresa Garvin
- Gretchen Swanson Center for Nutrition, Omaha, NE, 68114, USA
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Zamora-Kapoor A, Sinclair K, Nelson L, Lee H, Buchwald D. Obesity risk factors in American Indians and Alaska Natives: a systematic review. Public Health 2019; 174:85-96. [PMID: 31326761 DOI: 10.1016/j.puhe.2019.05.021] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 05/08/2019] [Accepted: 05/16/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVES We systematically reviewed the literature on risk factors for obesity in American Indians (AIs) and Alaska Natives (ANs) of all ages. STUDY DESIGN We searched titles and abstracts in PubMed with combinations of the following terms: obesity, body mass index (BMI), American Indian, Alaska Native, and Native American. METHODS We limited our review to articles that provided an empirically testable claim about a variable associated with obesity, measured obesity as a dependent variable, and provided data specific to AI/ANs. RESULTS Our final sample included 31 articles; 20 examined AI/AN youth (<18 years), and 11 examined AI/AN adults (≥18 years). Risk factors for obesity varied by age. In infants, low birth weight, early termination of breastfeeding, and high maternal BMI, and maternal diabetes increased the risk of childhood obesity. In children and adolescents, parental obesity, sedentary behaviors, and limited access to fruits and vegetables were associated with obesity. In adulthood, sedentary behaviors, diets high in fats and carbohydrates, stress, verbal abuse in childhood, and the belief that health cannot be controlled were associated with obesity. CONCLUSIONS Extant studies have three limitations: they do not apply a life course perspective, they lack nationally representative data and have limited knowledge of the resilience, resistance and resourcefulness of AI/ANs. Future studies that avoid these shortcomings are needed to inform interventions to reduce the prevalence of obesity in AI/ANs across the life course.
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Affiliation(s)
- A Zamora-Kapoor
- Initiative for Research and Education to Advance Community Health, Washington State University, Seattle, WA 98101, USA; Department of Pediatrics, University of Washington, Seattle, WA 98195, USA.
| | - K Sinclair
- Initiative for Research and Education to Advance Community Health, Washington State University, Seattle, WA 98101, USA; College of Nursing, Washington State University, Spokane, WA 99202, USA
| | - L Nelson
- Initiative for Research and Education to Advance Community Health, Washington State University, Seattle, WA 98101, USA; College of Nursing, Washington State University, Spokane, WA 99202, USA
| | - H Lee
- Department of Sociology, Washington University in St. Louis, St. Louis, MO 63130, USA
| | - D Buchwald
- Initiative for Research and Education to Advance Community Health, Washington State University, Seattle, WA 98101, USA; College of Medicine, Washington State University, Spokane, WA 99202, USA
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Setiono FJ, Jock B, Trude A, Wensel CR, Poirier L, Pardilla M, Gittelsohn J. Associations between Food Consumption Patterns and Chronic Diseases and Self-Reported Morbidities in 6 American Indian Communities. Curr Dev Nutr 2019. [DOI: 10.1093/cdn/nzz067] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
ABSTRACT
Background
American Indian (AI) have the highest rates of diet-related chronic diseases in the country. Yet, the relation between dietary patterns and chronic diseases in this population has not been well explored.
Objective
We aimed to characterize common dietary patterns among adults from 6 AI communities (N = 580) and assess their relation with BMI, percentage body fat, waist-to-hip ratio, hypertension, and self-reported type 2 diabetes and cardiovascular disease.
Methods
We conducted a baseline assessment of an obesity prevention study (N = 580). Dietary intake data were collected using a modified Block FFQ. Exploratory factor analysis was used to characterize dietary patterns. We used multivariate linear and logistic regression analyses to assess associations between dietary patterns and health outcomes, controlling for age, sex, employment status, smoking status, geographic region, and energy intake.
Results
Five dietary patterns, explaining 81.8% of variance in reported food consumption, were identified: “meat and fried foods,” “processed foods,” “fruits and vegetables,” “sugary snacks,” and “meat alternatives and high-protein foods.” “Those with higher consumption of “meat and fried foods” were associated with higher mean waist-to-hip ratio (0.03; 95% CI: 0.01, 0.04), higher mean BMI (2.45 kg/m2; 95% CI: 0.83, 4.07), and increased odds of being overweight or obese (OR: 2.63; 95% CI: 1.10, 6.31) compared to those with lower consumption of “meat and fried foods.” Higher consumption of “processed foods” was associated with increased odds of self-reported type 2 diabetes (OR: 3.41; 95% CI: 1.31, 8.90). No protective effect of consumption of “fruits and vegetables” was observed, although average consumption was below national recommendation levels.
Conclusions
AI dietary patterns corroborate nutritional concerns previously reported among AI populations. Future interventions should discourage overconsumption of meat, fried foods, and processed foods, and promote consumption of fruits and vegetables to reduce chronic disease burden in this population.
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Affiliation(s)
- Felicia J Setiono
- Johns Hopkins Bloomberg School of Public Health, Department of International Health, Global Obesity Prevention Center, and Center for Human Nutrition, Baltimore, MD, USA
| | - Brittany Jock
- Johns Hopkins Bloomberg School of Public Health, Department of International Health, Global Obesity Prevention Center, and Center for Human Nutrition, Baltimore, MD, USA
| | - Angela Trude
- Johns Hopkins Bloomberg School of Public Health, Department of International Health, Global Obesity Prevention Center, and Center for Human Nutrition, Baltimore, MD, USA
| | - Caroline R Wensel
- Johns Hopkins Bloomberg School of Public Health, Department of International Health, Global Obesity Prevention Center, and Center for Human Nutrition, Baltimore, MD, USA
| | - Lisa Poirier
- Johns Hopkins Bloomberg School of Public Health, Department of International Health, Global Obesity Prevention Center, and Center for Human Nutrition, Baltimore, MD, USA
| | - Marla Pardilla
- Johns Hopkins Bloomberg School of Public Health, Department of International Health, Global Obesity Prevention Center, and Center for Human Nutrition, Baltimore, MD, USA
| | - Joel Gittelsohn
- Johns Hopkins Bloomberg School of Public Health, Department of International Health, Global Obesity Prevention Center, and Center for Human Nutrition, Baltimore, MD, USA
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12
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Tomayko EJ, Prince RJ, Cronin KA, Kim K, Parker T, Adams AK. The Healthy Children, Strong Families 2 (HCSF2) Randomized Controlled Trial Improved Healthy Behaviors in American Indian Families with Young Children. Curr Dev Nutr 2019; 3:53-62. [PMID: 31453428 PMCID: PMC6700460 DOI: 10.1093/cdn/nzy087] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 09/13/2018] [Accepted: 11/09/2018] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND American Indian (AI) families experience a disproportionate risk of obesity due to a number of complex reasons, including poverty, historic trauma, rural isolation or urban loss of community connections, lack of access to healthy foods and physical activity opportunities, and high stress. Home-based obesity prevention interventions are lacking for these families. OBJECTIVE Healthy Children, Strong Families 2 (HCSF2) was a randomized controlled trial of a healthy lifestyle promotion/obesity prevention intervention for AI families. METHODS Four hundred and fifty dyads consisting of an adult primary caregiver and a child ages 2 to 5 y from 5 AI communities were randomly assigned to a monthly mailed healthy lifestyle intervention toolkit (Wellness Journey) with social support or to a child safety control toolkit (Safety Journey) for 1 y. The Wellness Journey toolkit targeted increased fruit/vegetable (F/V) intake and physical activity, improved sleep, decreased added sugar intake and screen time, and improved stress management (adults only). Anthropometrics were collected, and health behaviors were assessed via survey at baseline and at the end of Year 1. Adults completed surveys for themselves and the participating child. Repeated measures analysis of variance was used to assess change over the intervention period. RESULTS Significant improvements to adult and child healthy diet patterns, adult F/V intake, adult moderate-to-vigorous physical activity, home nutrition environment, and adult self-efficacy for health behavior change were observed in Wellness Journey compared with Safety Journey families. No changes were observed in adult body mass index (BMI), child BMI z-score, adult stress measures, adult/child sleep and screen time, or child physical activity. Qualitative feedback suggests the intervention was extremely well-received by both the families and our community partners across the 5 participating sites. CONCLUSIONS This multi-site community-engaged intervention addressed key gaps regarding family home-based approaches for early obesity prevention in AI communities and showed several significant improvements in health behaviors. Multiple communities are working to sustain intervention efforts. This trial was registered at clinicaltrials.gov as NCT01776255.
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Affiliation(s)
- Emily J Tomayko
- Nutrition, School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR
| | - Ronald J Prince
- Departments of Population Health, University of Wisconsin, Madison, WI
| | - Kate A Cronin
- Departments of Surgery, University of Wisconsin, Madison, WI
| | - KyungMann Kim
- Departments of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin, Madison, WI
| | - Tassy Parker
- Department of Family and Community Medicine, School of Medicine, University of New Mexico, Albuquerque, NM
| | - Alexandra K Adams
- Center for American Indian and Rural Health Equity, Montana State University, Bozeman, MT
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Ahmed J, Alnasir F, Jaradat A, Al Marabheh AJ, Hamadeh RR. Association of Overweight and Obesity with High Fast Food Consumption by Gulf Cooperation Council Medical Students. Ecol Food Nutr 2019; 58:495-510. [PMID: 31062621 DOI: 10.1080/03670244.2019.1613986] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Fast food and sugar-sweetened soft drink consumption, adiposity, and physical activity behavior were determined through a cross-sectional study with 251 medical students from the Gulf Cooperation Council countries. Approximately 38% of the students were overweight or obese, and 56.2% consumed fast food in the past 24 h. Main reasons for consuming fast foods were lack of time to cook healthy food (51%), pleasant taste (26%) and the influence of family and friends (15%). Overweight status or obesity was more prevalent among males (50%), those having greater knowledge about calories in fast-food meals (51.6%), who checked fast food calories before eating (47.7%) or overestimated the amount of sugar in a soft drink (17.82 ± 26.59 spoons). Overweight or obese participants also performed more moderate physical activity (1.73 ± 2.08 days per week) compared to those with normal weight or underweight (p = <0.05). Fast food consumption can be curtailed by improving the availability of and access to healthier foods and implementing behavior change and regulatory interventions.
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Affiliation(s)
- Jamil Ahmed
- Department of Family and Community Medicine, College of Medicine and Medical Sciences, Arabian Gulf University , Manama , Bahrain
| | - Faisal Alnasir
- Department of Primary Care and Social Medicine, Imperial College London , London , UK
| | - Ahmed Jaradat
- Department of Family and Community Medicine, College of Medicine and Medical Sciences, Arabian Gulf University , Manama , Bahrain
| | - Amer Jebril Al Marabheh
- Department of Family and Community Medicine, College of Medicine and Medical Sciences, Arabian Gulf University , Manama , Bahrain
| | - Randah Ribhi Hamadeh
- Department of Family and Community Medicine, College of Medicine and Medical Sciences, Arabian Gulf University , Manama , Bahrain
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14
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Lucke-Wold B, Misra R, Patel TG. Risk factors for low high-density lipoprotein among Asian Indians in the United States. World J Diabetes 2017; 8:297-303. [PMID: 28694930 PMCID: PMC5483428 DOI: 10.4239/wjd.v8.i6.297] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 03/26/2017] [Accepted: 05/24/2017] [Indexed: 02/05/2023] Open
Abstract
AIM To examine the differences in metabolic risk factors (RFs) by gender in the Asian Indian (AI) population in the United States.
METHODS Using cross-sectional data from 1038 randomly selected Asian Indians, we investigated the relationship between metabolic syndrome (MetS) RFs, cardiovascular disease, and diabetes.
RESULTS A greater percent of women in this group had increased waist circumference and low high density lipoprotein (HDL) levels than men, but AI males had increased blood glucose, increased blood pressure, and increased triglycerides compared to females. Those individuals who met the MetS criteria had increased cardiovascular disease. One of the biggest single RFs for cardiovascular disease and diabetes reported in the literature for AIs is low HDL.
CONCLUSION Our results show that lack of knowledge about diabetes, low physical activity, increased body mass index, and age were the factors most significantly correlated with low HDL in this population. Future studies and prospective trials are needed to further elucidate causes of the MetS and diabetes in AIs.
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15
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Zheng J, Zhou Y, Li S, Zhang P, Zhou T, Xu DP, Li HB. Effects and Mechanisms of Fruit and Vegetable Juices on Cardiovascular Diseases. Int J Mol Sci 2017; 18:E555. [PMID: 28273863 PMCID: PMC5372571 DOI: 10.3390/ijms18030555] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 02/23/2017] [Accepted: 02/28/2017] [Indexed: 02/07/2023] Open
Abstract
Many studies have indicated that consumption of vegetables and fruits are positively related to lower incidence of several chronic noncommunicable diseases. Although composition of fruit and vegetable juices is different from that of the edible portion of fruits and vegetables, they contain polyphenols and vitamins from fruits and vegetables. Drinking vegetable and fruit juices is very popular in many countries, and also an efficient way to improve consumption of fruits and vegetables. The studies showed that fruit and vegetable juices affect cardiovascular risk factors, such as lowering blood pressure and improving blood lipid profiles. The main mechanisms of action included antioxidant effects, improvement of the aspects of the cardiovascular system, inhibition of platelet aggregation, anti-inflammatory effects, and prevention of hyperhomocysteinemia. Drinking juices might be a potential way to improve cardiovascular health, especially mixtures of juices because they contain a variety of polyphenols, vitamins, and minerals from different fruits and vegetables. This review summarizes recent studies on the effects of fruit and vegetable juices on indicators of cardiovascular disease, and special attention is paid to the mechanisms of action.
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Affiliation(s)
- Jie Zheng
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Yue Zhou
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Sha Li
- School of Chinese Medicine, The University of Hong Kong, Hong Kong, China.
| | - Pei Zhang
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Tong Zhou
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Dong-Ping Xu
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| | - Hua-Bin Li
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
- South China Sea Bioresource Exploitation and Utilization Collaborative Innovation Center, Sun Yat-sen University, Guangzhou 510006, China.
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16
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Mohammed SA, Udell W. American Indians/Alaska Natives and Cardiovascular Disease: Outcomes, Interventions, and Areas of Opportunity. CURRENT CARDIOVASCULAR RISK REPORTS 2017. [DOI: 10.1007/s12170-017-0526-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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17
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Kozak AT, Buscemi J, Hawkins MAW, Wang ML, Breland JY, Ross KM, Kommu A. Technology-based interventions for weight management: current randomized controlled trial evidence and future directions. J Behav Med 2016; 40:99-111. [PMID: 27783259 DOI: 10.1007/s10865-016-9805-z] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2016] [Accepted: 10/12/2016] [Indexed: 01/19/2023]
Abstract
Obesity is a prevalent health care issue associated with disability, premature morality, and high costs. Behavioral weight management interventions lead to clinically significant weight losses in overweight and obese individuals; however, many individuals are not able to participate in these face-to-face treatments due to limited access, cost, and/or time constraints. Technological advances such as widespread access to the Internet, increased use of smartphones, and newer behavioral self-monitoring tools have resulted in the development of a variety of eHealth weight management programs. In the present paper, a summary of the most current literature is provided along with potential solutions to methodological challenges (e.g., high attrition, minimal participant racial/ethnic diversity, heterogeneity of technology delivery modes). Dissemination and policy implications will be highlighted as future directions for the field of eHealth weight management.
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Affiliation(s)
- Andrea T Kozak
- Department of Psychology, Oakland University, Rochester, MI, 48309, USA.
| | - Joanna Buscemi
- Department of Psychology, DePaul University, Chicago, IL, USA
| | - Misty A W Hawkins
- Department of Psychology, Oklahoma State University, Stillwater, OK, USA
| | - Monica L Wang
- Department of Community Health Sciences, Boston University, Boston, MA, USA
| | - Jessica Y Breland
- Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA, USA.,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Kathryn M Ross
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
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18
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Péter S, Saris WHM, Mathers JC, Feskens E, Schols A, Navis G, Kuipers F, Weber P, Eggersdorfer M. Nutrient Status Assessment in Individuals and Populations for Healthy Aging-Statement from an Expert Workshop. Nutrients 2015; 7:10491-500. [PMID: 26694458 PMCID: PMC4690099 DOI: 10.3390/nu7125547] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2015] [Accepted: 12/10/2015] [Indexed: 11/17/2022] Open
Abstract
A workshop organized by the University Medical Center Groningen addressed various current issues regarding nutrient status of individuals and populations, tools and strategies for its assessment, and opportunities to intervene. The importance of nutrient deficiencies and information on nutrient status for health has been illustrated, in particular for elderly and specific patient groups. The nutrient profile of individuals can be connected to phenotypes, like hypertension or obesity, as well as to socio-economic data. This approach provides information on the relationship between nutrition (nutrient intake and status) and health outcomes and, for instance, allows us to use the findings to communicate and advocate a healthy lifestyle. Nutrition is complex: a broader profile of nutrients should be considered rather than focusing solely on a single nutrient. Evaluating food patterns instead of intake of individual nutrients provides better insight into relationships between nutrition and health and disease. This approach would allow us to provide feedback to individuals about their status and ways to improve their nutritional habits. In addition, it would provide tools for scientists and health authorities to update and develop public health recommendations.
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Affiliation(s)
- Szabolcs Péter
- Nutrition Science & Advocacy, DSM Nutritional Products Ltd., Wurmisweg 576, Kaiseraugst 4303, Switzerland.
| | - Wim H M Saris
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Universiteitssingel 40, Maastricht 6229 ER, The Netherlands.
| | - John C Mathers
- Human Nutrition Research Centre, Institute of Cellular Medicine, Campus for Aging and Vitality, Newcastle University, Newcastle upon Tyne NE4 5PL, UK.
| | - Edith Feskens
- Division of Human Nutrition, Wageningen University, Bomenweg 4, Wageningen 6703 HD, The Netherlands.
| | - Annemie Schols
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Universiteitssingel 40, Maastricht 6229 ER, The Netherlands.
| | - Gerjan Navis
- University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen 9700 RB, The Netherlands.
| | - Folkert Kuipers
- University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen 9700 RB, The Netherlands.
| | - Peter Weber
- Nutrition Science & Advocacy, DSM Nutritional Products Ltd., Wurmisweg 576, Kaiseraugst 4303, Switzerland.
- University Hohenheim, Schloß Hohenheim 1, Stuttgart 70599, Germany.
| | - Manfred Eggersdorfer
- Nutrition Science & Advocacy, DSM Nutritional Products Ltd., Wurmisweg 576, Kaiseraugst 4303, Switzerland.
- University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen 9700 RB, The Netherlands.
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