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Purcino LS, Bedrikow R. Findings on dietary characteristics among Haitian immigrants and the threat of food insecurity: A scoping review. PUBLIC HEALTH IN PRACTICE 2024; 8:100520. [PMID: 39050009 PMCID: PMC11267026 DOI: 10.1016/j.puhip.2024.100520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 05/03/2024] [Accepted: 06/19/2024] [Indexed: 07/27/2024] Open
Abstract
Objectives This study aimed to map and describe the available evidence on dietary characteristics and diet-related health conditions among Haitian immigrants across the globe. Study design Scoping review. Methods This review was based on the international guide Preferred Reporting Items for Systematic review and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The searches were conducted in several electronic databases in July 2023. Reports focusing on diet, nutrition, and diet-related health conditions among international Haitian immigrants published in English, Portuguese, French, or Spanish with no year limit were included. The data extracted was tabulated and presented in a narrative summary. Results Database search retrieved 502 records, of which 30 met the inclusion criteria. The categories that emerged from the analysis were: food consumption patterns and trends, food and nutrition insecurity, cultural identity, and diet-related health conditions. Findings suggest: available evidence underrepresents Latin America and the Caribbean context; research gaps related to adolescents and the elderly and also to noncommunicable diseases except obesity; changes in food consumption after immigration towards less healthy eating; the Haitian immigrant's preference for healthy and traditional eating patterns; many experiences of food insecurity related to poverty, unemployment, and lack of social support, especially in host countries in Latin America and the Caribbean; and a high prevalence of obesity, especially among women. Conclusions Further research is required in countries in Latin America, mainly. Diet-related chronic diseases, adolescents, and the elderly should be targeted for further research. We recommend: longitudinal and qualitative research; field action reports describing local and global strategies to manage Haitian migration-related food and nutrition issues; culturally appropriate dietary interventions; and policies to protect and support the most vulnerable Haitian immigrants to have their fundamental right to adequate food guaranteed, reducing health inequalities.
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Affiliation(s)
- Luciana Sales Purcino
- Department of Collective Health, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), 80 Vital Brasil Street, Campinas, São Paulo, Brazil
| | - Rubens Bedrikow
- Department of Collective Health, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), 80 Vital Brasil Street, Campinas, São Paulo, Brazil
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Yuguang L, Chang Y, Li H, Li F, Zou Q, Liu X, Chen X, Cui J. Inflammation mediates the relationship between diet quality assessed by healthy eating index-2015 and metabolic syndrome. Front Endocrinol (Lausanne) 2024; 15:1293850. [PMID: 38379861 PMCID: PMC10877714 DOI: 10.3389/fendo.2024.1293850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 01/16/2024] [Indexed: 02/22/2024] Open
Abstract
Background Metabolic syndrome is a cluster of metabolic disorders, including obesity, hypertension, hyperglycemia, and abnormal lipid levels. However, researches on the association between overall dietary quality measured by the Healthy Eating Index-2015 (HEI-2015) and the risk of metabolic syndrome is still lacking. Methods This study utilized data from four cycles (2011-2018) of the National Health and Nutrition Examination Survey (NHANES) database, including 17,582 participants. Logistic regression analysis was employed to explore the correlation between HEI and the risk of metabolic syndrome. Additionally, mediation analysis was conducted to examine the effects of Systemic Immune-Inflammation Index (SII) and serum uric acid as potential mediators between HEI and metabolic syndrome risk. Weighted quantile sum (WQS) regression evaluated the composite exposure impact of the 13 components of the HEI on metabolic syndrome, as well as the proportion of their weights. Results Higher dietary quality measured by HEI-2015 (at the 75th percentile) was negatively correlated with the risk of metabolic syndrome (OR=0.80, 95%CI=0.72-0.89, P=0.003). Higher SII and serum uric acid levels were identified as risk factors for metabolic syndrome (P for trend<0.001). Approximately 37.5% of the effect of HEI on metabolic syndrome occurrence was mediated by SII (Indirect effect=-0.002, 95%CI (-0.003,-0.001), Direct effect=-0.022, 95%CI (-0.0273,-0.015)). Additionally, 25% of the effect of HEI on metabolic syndrome occurrence was mediated by serum uric acid levels (Indirect effect=-0.006, 95%CI (-0.010,-0.012), Direct effect=-0.024, 95%CI (-0.041,-0.009)). WQS regression analysis revealed the highest weighted proportions for seafood and plant proteins (25.20%) and sodium (17.79%), while the weight for whole fruit was the lowest (0.25%). Conclusion Better dietary quality measured by HEI-2015 was associated with a lower likelihood of metabolic syndrome. Higher SII and serum uric acid levels were identified as risk factors for metabolic syndrome and potential mediators.
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Affiliation(s)
- Li Yuguang
- Cancer Center, The First Hospital of Jilin University, Changchun, China
| | - Yu Chang
- Department of Anesthesiology, The First Hospital of Jilin University, Changchun, China
| | - Hongwei Li
- Cancer Center, The First Hospital of Jilin University, Changchun, China
| | - Fangqi Li
- Cancer Center, The First Hospital of Jilin University, Changchun, China
| | - Qing Zou
- Department of Anesthesiology, The First Hospital of Jilin University, Changchun, China
| | - Xiangliang Liu
- Cancer Center, The First Hospital of Jilin University, Changchun, China
| | - Xiao Chen
- Cancer Center, The First Hospital of Jilin University, Changchun, China
| | - Jiuwei Cui
- Cancer Center, The First Hospital of Jilin University, Changchun, China
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Faraji H, Jamshidi S, Ferrie S, Azar PS. The Relationship between Healthy Eating Index and Lipid Profile in Healthy Individuals: A Systematic Review. Int J Prev Med 2024; 15:6. [PMID: 38487701 PMCID: PMC10935573 DOI: 10.4103/ijpvm.ijpvm_404_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 05/17/2023] [Indexed: 03/17/2024] Open
Abstract
Background The Healthy Eating Index (HEI) and Alternate Healthy Eating Index (AHEI) are instruments developed by competing American research teams, aiming to assess the level of adherence to a dietary pattern, claimed to prevent chronic illness conditions such as dyslipidemia. This systematic review evaluated cross-sectional studies examining the association between HEI/AHEI score and the lipid profile in healthy participants. Methods The systematic review was Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) compliant, and a search process was conducted through Scopus, Web of Knowledge, Google Scholar, Cochrane, PubMed, and ScienceDirect up to November 2022. Studies assessing the relationship between HEI/AHEI and lipid profile (low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG)) were eligible for inclusion. The statistical differences in outcomes, anthropometric indices, and demographic data were extracted from the selected studies. Also, the quality assessment of studies was performed using the Newcastle-Ottawa scale. Results The systematic search presented 17 cross-sectional studies. Most of the studies revealed a significant correlation between HEI score and lipid profile (LDL-C, HDL-C, TG, and TC) (P < 0.05), while a few of them indicated a significant relationship between AHEI score and these factors. Overall, the elevation of HEI/AHEI score was associated with the improvement in lipid profile (P < 0.05), though this association was more obvious for HEI compared with AHEI. Conclusions Overall, the results of the study indicated that an improved lipid profile in healthy individuals is associated with a higher score in either HEI or AHEI. Further research in the future is required to confirm the claim.
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Affiliation(s)
- Hossein Faraji
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sanaz Jamshidi
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Suzie Ferrie
- Critical Care Dietitian, Royal Prince Alfred Hospital and Department of Nutrition and Dietetics, School of Life and Environmental Sciences, University of Sydney, Australia
| | - Pouria Sefidmooye Azar
- Department of Nutrition, School of Applied Sciences, The University of Mississippi, Oxford, MS, United States
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Magny-Normilus C, Whittemore R, Nunez-Smith M, Lee CS, Schnipper J, Wexler D, Sanders JA, Grey M. Self-Management and Glycemic Targets in Adult Haitian Immigrants With Type 2 Diabetes: Research Protocol. Nurs Res 2023; 72:211-217. [PMID: 36929756 PMCID: PMC10121794 DOI: 10.1097/nnr.0000000000000649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2022] [Indexed: 03/18/2023]
Abstract
BACKGROUND Type 2 diabetes (T2D) is a chronic condition affecting more than 34.2 million U.S. adults, and people of African descent have a disproportionate burden. Haitian immigrants' unique cultural and biological factors put them at elevated risk for T2D-related complications. Despite prior research highlighting the success of multimethod approaches to T2D self-management behaviors on glycemic targets, a dearth of studies have used these methods to improve diabetes self-management in this marginalized population. OBJECTIVES This article describes a repeated-measures design protocol of a going study about self-management behaviors among adult Haitian immigrants with T2D and characterizing their barriers to T2D self-management. METHODS We will enroll 100 Haitian immigrants aged 18-64 years who have lived with T2D for at least 1 year. Using multiple recruitment methods and Research Electronic Data Capture, subjective and objective data on T2D self-management practices, glucose variability via continuous glucose monitor, and a comprehensive view of physical activity via actigraphy are collected. RESULTS Data analysis will follow a two-part approach mirroring the two primary study objectives. DISCUSSION Findings from the study will guide the development and testing of a culturally tailored diabetes self-management education program that will contribute essential information about best practices for this population and break barriers that may impede research on unique individuals and subsequent effective self-management.
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KOÇAK Ö, YILDIRIM Y, ŞARER YÜREKLİ B. The relationship between intuitive eating and eating attitude and glycemic control in patients with type 2 diabetes mellitus. EGE TIP DERGISI 2022. [DOI: 10.19161/etd.1167421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Amaç: Bu çalışma, Tip 2 Diabetes Mellitus (T2DM) hastalarında sezgisel yemenin yeme tutumu ve glisemik kontrol ile ilişkisini belirlemek amacıyla yapılmıştır.
Gereç ve Yöntem: Araştırmanın örneklemini; 18 Kasım 2019 – 12 Mart 2020 tarihleri arasında Endokrinoloji ve Metabolizma Hastalıkları Bilim Dalı Polikliniği’ne gelen T2DM tanılı ve dahil edilme kriterlerini karşılayan 385 birey oluşturmuştur. Çalışma verileri; bireylerin demografik bilgilerine, sağlık bilgilerine ve biyokimyasal verilerine yönelik sorular ile Sezgisel Yeme Ölçeği (IES-2) ve Yeme Tutum Testinin (EAT-26) yer aldığı bir form kullanılarak yüz yüze görüşme yöntemi ile elde edilmiştir.
Bulgular: Çalışmaya katılan bireylerin yaş ortalaması 59,12±9,78 olup %62,6’sı kadındı. Sezgisel yeme ile bireylerin vücut ağırlığı, BKİ değeri, bel çevresi ve trigliserit değeri arasında istatistiksel olarak negatif yönde ve zayıf düzeyde anlamlı bir ilişki saptandı (p<0,05). EAT-26 puanı ile IES-2 alt ölçeklerinden olan “duygusal sebeplerden ziyade fiziksel sebeplerle yeme” alt ölçeği arasında istatistiksel olarak negatif yönde ve zayıf düzeyde anlamlı bir ilişki belirlendi (p<0,05). Ayrıca EAT-26 puanı ile “açlık ve tokluk işaretlerine güven” alt ölçeği arasında istatistiksel olarak pozitif yönde ve zayıf düzeyde anlamlı bir ilişki bulundu (p<0.05).
Sonuç: Çalışma sonucunda; sezgisel yeme ile T2DM’li bireylerin antropometrik ölçümleri, trigliserit değerleri ve yeme tutumları arasında zayıf düzeyde anlamlı ilişki olduğu belirlenmiştir. Sezgisel yemenin yeme tutumu ve glisemik kontrol ile arasındaki nedensellik ilişkisini daha iyi belirleyebilmek için ileri çalışmalara ihtiyaç vardır.
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Affiliation(s)
- Özlem KOÇAK
- Ege Üniversitesi, Sağlık Bilimleri Enstitüsü, Kronik Hastalıklar Anabilim Dalı, İzmir, Türkiye
| | - Yasemin YILDIRIM
- Ege Üniversitesi, Hemşirelik Fakültesi, İç Hastalıkları Hemşireliği Anabilim Dalı, İzmir, Türkiye
| | - Banu ŞARER YÜREKLİ
- Ege Üniversitesi, Tıp Fakültesi Endokrinoloji ve Metabolizma Hastalıkları Bilim Dalı, İzmir, Türkiye
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Lindsay KL, Milone GF, Grobman WA, Haas DM, Mercer BM, Simhan HN, Saade G, Silver RM, Chung JH. Periconceptional diet quality is associated with gestational diabetes risk and glucose concentrations among nulliparous gravidas. Front Endocrinol (Lausanne) 2022; 13:940870. [PMID: 36133312 PMCID: PMC9483841 DOI: 10.3389/fendo.2022.940870] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 08/18/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) and elevated glucose concentrations below the threshold for GDM diagnosis have been associated with adverse pregnancy and offspring outcomes. Dietary interventions initiated during pregnancy have demonstrated inconsistent beneficial effects. Limited data exist regarding the effects of periconceptional diet on gestational glycemia. OBJECTIVE To evaluate independent associations between periconceptional diet quality with GDM frequency and glucose concentrations from GDM screening and diagnostic tests among nulliparous gravidas. DESIGN This is a secondary analysis of N=7997 participants from the NuMoM2b multicenter, prospective, observational cohort study of first pregnancies. The Alternative Healthy Eating Index (AHEI)-2010 was computed from food frequency questionnaires completed in early pregnancy (6-13 weeks), reporting usual dietary intake over the preceding 3 months. GDM screening was performed either by non-fasting 1-hour 50g glucose load (N=6845), followed by 3-hour 100g glucose tolerance test (GTT) for those with raised glucose concentrations (N=1116; at risk for GDM), or by a single 2-hour 75g GTT (N=569; all GDM risk levels). Logistic and linear regression were used to estimate the associations between the AHEI-2010 score with odds of GDM, having raised blood glucose on the 1-hour screening test, and continuous glucose concentrations on screening and diagnostic tests. All models were adjusted for a priori covariates: maternal age, race/ethnicity, early-pregnancy body mass index, smoking habits, rate of gestational weight gain, energy intake, nausea and vomiting in early pregnancy, study site. RESULTS Poorer periconceptional diet quality was observed among participants who were younger, with higher BMI, lower income levels, and of non-Hispanic Black or Hispanic ethnicity. The GDM rate was 4%. Each 1-point increase in AHEI-2010 score was associated with a 1% decrease in the odds of being diagnosed with GDM (beta=-0.015, p=0.022, OR=0.986, 95% CI 0.973 to 0.998). Diet quality was inversely associated with each post glucose load concentration on the non-fasting screening test and the 2-hour and 3-hour GTT. CONCLUSION Poor periconceptional diet quality is independently associated with an increased risk of GDM and with minor elevations in serum glucose concentrations on GDM screening and diagnostic tests, in a diverse cohort of nulliparas. Periconception intervention studies targeting diet quality are warranted.
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Affiliation(s)
- Karen L. Lindsay
- Susan Samueli Integrative Health Institute, Susan & Henry Samueli College of Health Sciences, University of California, Irvine, CA, United States
- Division of Endocrinology, Department of Pediatrics, University of California, Irvine, School of Medicine, Orange, CA, United States
- *Correspondence: Karen L. Lindsay,
| | - Gina F. Milone
- Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, University of California, Irvine, School of Medicine, Orange, CA, United States
| | - William A. Grobman
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - David M. Haas
- Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Brian M. Mercer
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Cleveland, OH, United States
| | - Hyagriv N. Simhan
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - George R. Saade
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX, United States
| | - Robert M. Silver
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Utah Health Sciences Center, Salt Lake City, UT, United States
| | - Judith H. Chung
- Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, University of California, Irvine, School of Medicine, Orange, CA, United States
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Magny-Normilus C, Whittemore R, Wexler DJ, Schnipper JL, Nunez-Smith M, Fu MR. Barriers to Type 2 Diabetes Management Among Older Adult Haitian Immigrants. Sci Diabetes Self Manag Care 2021; 47:382-390. [PMID: 34610761 PMCID: PMC8939501 DOI: 10.1177/26350106211040435] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE The purpose of this study was to describe the experiences of older adult Haitian immigrants in managing type 2 diabetes mellitus (T2DM). METHODS A descriptive qualitative approach using semistructured interviews was conducted with 20 older adult Haitian immigrants with T2DM. Interviews were transcribed verbatim and categorized using NVivo. An iterative descriptive data analysis method was used to examine the data, compare codes, challenge interpretations, and develop themes inductively. RESULTS Older adult Haitian immigrants reported that T2DM affected every aspect of their lives. Financial hardship and social isolation were described as the major barriers to T2DM management, which forced them to choose between basic needs and health care, and at times, they had to forgo medications or avoid seeking medical care. They recognized that creating and maintaining good community support was the key to self-management of T2DM. CONCLUSIONS Financial hardship and social isolation have a tremendous impact on the ability of older Haitian immigrants to manage T2DM effectively. It is challenging to modify these barriers through individual efforts, and clinical, research, and public efforts may be necessary to address these concerns.
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Affiliation(s)
| | | | - Deborah J Wexler
- Massachusetts General Hospital Diabetes Unit, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Jefferey L Schnipper
- Harvard Medical School, Boston, Massachusetts
- Brigham and Women's Hospital, Boston, Massachusetts
| | | | - Mei R Fu
- Boston College William F. Connell School of Nursing, Chestnut Hill, Massachusetts
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Diet Quality Indices and Their Correlation with Glycemic Status and Lipid Profile in Patients with Type 2 Diabetes. Adv Prev Med 2021; 2021:2934082. [PMID: 33747570 PMCID: PMC7960043 DOI: 10.1155/2021/2934082] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 08/18/2020] [Accepted: 03/01/2021] [Indexed: 12/20/2022] Open
Abstract
Background The study aimed to determine the correlation between different diet quality indices and glycemic status and lipid profile in patients with diabetes. Methods This study was carried out on 235 patients with type 2 diabetes referred to Martyr Motahari Diabetes Clinic of Shiraz city so as to investigate the relationship between glycemic status and lipid profile and the diet quality using Healthy Eating Index (HEI-2010), phytochemical index (PI), and Diet Quality Index-International (DQI_I). Results A positive correlation was indicated between the serum levels of LDL-C and HEI-2010 scores (p=0.026). Furthermore, there was a positive correlation between the patients' age and scores of PI (p=0.006) and between PI and DQI_I (p < 0.001). There was no significant relationship between the scores for all three indicators and biochemical parameters. Conclusion The results of this study indicated that there was a significant correlation between the serum LDL-C levels and the HEI-2010 scores. Moreover, the age of the patients had a direct correlation with the PI scores.
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Hong X, Rosenberg AZ, Zhang B, Binns-Roemer E, David V, Lv Y, Hjorten RC, Reidy KJ, Chen TK, Wang G, Ji Y, Simpson CL, Davis RL, Kopp JB, Wang X, Winkler CA. Joint Associations of Maternal-Fetal APOL1 Genotypes and Maternal Country of Origin With Preeclampsia Risk. Am J Kidney Dis 2020; 77:879-888.e1. [PMID: 33359152 DOI: 10.1053/j.ajkd.2020.10.020] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 10/24/2020] [Indexed: 12/25/2022]
Abstract
RATIONALE & OBJECTIVES Preeclampsia, which disproportionately affects Black women, is a leading cause of preterm delivery and risk for future hypertension and chronic kidney disease (CKD). Apolipoprotein L1 (APOL1) kidney risk alleles, common among Black individuals, contribute substantially to CKD disparities. Given the strong link between preeclampsia and CKD, we investigated whether maternal and fetal APOL1 risk alleles can jointly influence preeclampsia risk, and explored potential modifiers of the association between APOL1 and preeclampsia. STUDY DESIGN Nested case-control study. SETTING & PARTICIPANTS 426 Black mother-infant pairs (275 African Americans and 151 Haitians) from the Boston Birth Cohort. EXPOSURE Maternal and fetal APOL1 risk alleles. OUTCOMES Preeclampsia. ANALYTICAL APPROACH Logistic regression models with adjustment for demographic characteristics were applied to analyze associations between fetal and maternal APOL1 risk alleles and risk of preeclampsia and to investigate the effects of modification by maternal country of origin. RESULTS Fetal APOL1 risk alleles tended to be associated with an increased risk of preeclampsia, which was not statistically significant in the total genotyped population. However, this association was modified by maternal country of origin (P<0.05 for interaction tests): fetal APOL1 risk alleles were significantly associated with an increased risk of preeclampsia among African Americans under recessive (odds ratio [OR], 3.6 [95% CI, 1.3-9.7]; P=0.01) and additive (OR, 1.7 [95% CI, 1.1-2.6]; P=0.01) genetic models but not in Haitian Americans. Also, maternal-fetal genotype discordance at the APOL1 locus was associated with a 2.6-fold higher risk of preeclampsia (P<0.001) in African Americans. LIMITATIONS Limited sample size in stratified analyses; self-reported maternal country of origin; pre-pregnancy estimated glomerular filtration rate (eGFR) and proteinuria data in mothers were not collected; unmeasured confounding social and/or environmental factors; no replication study. CONCLUSIONS This study supports the hypothesis that fetal APOL1 kidney risk alleles are associated with increased risk for preeclampsia in a recessive mode of inheritance in African Americans and suggests that maternal-fetal genotype discordance is also associated with this risk. These conclusions underscore the need to better understand maternal-fetal interaction and their genetic and environmental factors as contributors to ethnic disparities in preeclampsia.
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Affiliation(s)
- Xiumei Hong
- Department of Population, Family and Reproductive Health, Center for the Early Life Origins of Disease, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Avi Z Rosenberg
- Department of Pathology, Johns Hopkins University, Baltimore, MD
| | - Boyang Zhang
- Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Elizabeth Binns-Roemer
- Molecular Genetic Epidemiology Section, Frederick National Laboratory for Cancer Research in the Basic Research Laboratory, National Cancer Institute, Frederick, MD
| | - Victor David
- Basic Research Laboratory, Center for Cancer Research, National Cancer Institute, Frederick, MD
| | - Yiming Lv
- Department of Population, Family and Reproductive Health, Center for the Early Life Origins of Disease, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Rebecca C Hjorten
- Department of Medicine, Division of Nephrology, University of Washington, Seattle, WA
| | - Kimberly J Reidy
- Department of Pediatrics, Division of Pediatric Nephrology, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY
| | - Teresa K Chen
- Department of Medicine, Division of Nephrology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD
| | - Guoying Wang
- Department of Population, Family and Reproductive Health, Center for the Early Life Origins of Disease, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Yuelong Ji
- Department of Population, Family and Reproductive Health, Center for the Early Life Origins of Disease, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Claire L Simpson
- Department of Genetics, Genomics, and Informatics, University of Tennessee Health Science Center, Memphis, TN
| | - Robert L Davis
- Center for Biomedical Informatics, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN
| | - Jeffrey B Kopp
- Kidney Diseases Section, National Institute of Diabetes and Digestive and Kidney Disease, National Institutes of Health, Bethesda, MD
| | - Xiaobin Wang
- Department of Population, Family and Reproductive Health, Center for the Early Life Origins of Disease, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD; Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD.
| | - Cheryl A Winkler
- Molecular Genetic Epidemiology Section, Frederick National Laboratory for Cancer Research in the Basic Research Laboratory, National Cancer Institute, Frederick, MD.
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Ebrahimi S, McNaughton SA, Leech RM, Abdollahi M, Houshiarrad A, Livingstone KM. A comparison of diet quality indices in a nationally representative cross-sectional study of Iranian households. Nutr J 2020; 19:132. [PMID: 33278876 PMCID: PMC7719237 DOI: 10.1186/s12937-020-00646-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 11/18/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Iranian diet quality has been evaluated using indices that have not been created based on Iranian dietary guidelines. This study aimed to examine the applicability of two diet quality indices by examining their associations with nutrient adequacy, nutrient intakes and sociodemographics. METHODS Dietary data were collected using three 24-h dietary recalls from Iranian households. Nutrient adequacy was assessed using World Health Organization/Food and Agriculture Organization 2002 (WHO/FAO) cut points. Household diet quality was calculated using the Healthy Eating Index (HEI) and Diet Quality Index-International (DQI-I). Sociodemographics of the household members were assessed. Regression analyses were used to examine associations between diet quality and nutrient adequacy, and between sociodemographics and diet quality. RESULTS A total of 6935 households were included in the analysis. Higher household diet quality was associated with adequate intake of calcium (HEI: OR 1.11, 95% CI: 1.10, 1.13; DQI-I: OR 1.14, 95% CI: 1.13, 1.16), vitamin C (HEI: OR 1.19, 95% CI: 1.17, 1.20; DQI-I: OR 1.12, 95% CI: 1.11, 1.12) and protein (HEI: OR 1.01, 95% CI: 1.00, 1.02; DQI-I: OR 1.09, 95% CI: 1.08, 1.09). Higher household diet quality was associated with household heads who were older (> 56 years old) (HEI: β 2.06, 95% CI: 1.63, 2.50; DQI-I β 2.90, 95% CI: 2.34, 3.45), higher educated (college/university completed) (HEI: β 4.54, 95% CI: 4.02, 5.06; DQI-I: β 2.11, 95% CI: 1.45, 2.77) and living in urban areas (HEI: β 2.85, 95% CI: 2.54, 3.16; DQI-I: β 0.72, 95% CI: 0.32, 1.12). CONCLUSIONS Based on associations with nutrient adequacy and sociodemographics, the applicability of two diet quality indices for assessing the diet quality of Iranian households was demonstrated. Results also indicated DQI-I may be more applicable than HEI for evaluating Iranian nutrient adequacy. Findings have implications for the design and assessment of diet quality in Iranian populations. Future research should examine the link between these diet quality indices and health outcomes.
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Affiliation(s)
- Sara Ebrahimi
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220 Australia
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne Burwood Campus, 221 Burwood Highway, Burwood, Victoria 3125 Australia
| | - Sarah A. McNaughton
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220 Australia
| | - Rebecca M. Leech
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220 Australia
| | - Morteza Abdollahi
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Nutrition Research, National Nutrition and Food Technology Research Institute, School of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Anahita Houshiarrad
- Department of Nutrition Research, National Nutrition and Food Technology Research Institute, School of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Katherine M. Livingstone
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220 Australia
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11
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Messiah SE, Atem F, Lebron C, Ofori A, Mathew MS, Chang C, Natale RA. Comparison of Early Life Obesity-Related Risk and Protective Factors in Non-Hispanic Black Subgroups. Matern Child Health J 2020; 24:1130-1137. [PMID: 32632842 PMCID: PMC7423728 DOI: 10.1007/s10995-020-02979-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Previous obesity prevention studies in preschool-age children have included non-Hispanic Black (NHB) children, but few have investigated between-subgroup differences even though there may be cultural risk and protective practice differences, challenging the generalizability of findings. The purpose of this study was to examine differences in early childhood obesity-related factors in NHB subgroups (Haitian, other Caribbean Islander and African-American [AA]) children. METHODS Baseline data from two randomized controlled trials in 52 childcare centers of which 35 had data to test a preschool-based obesity prevention intervention was analyzed. The sub-sample included 370 caregiver-child dyads; 209 self-identified as AA, 120 as Haitian and 41 as Caribbean Islander/West Indian or mixed race. Multilevel regression models generated outcome estimates for group differences in body mass index (BMI) percentile, birthweight, breastfeeding initiation and duration, bottle feeding duration and age when solid foods were introduced. RESULTS Mean BMI percentile was similar for AA, Haitian and Caribbean Islander/West Indian/Multiracial (60.1th percentile, 60.8th percentile, 62.8th percentile, respectively) as was birthweight (6.3, 6.8, and 6.6 lb, respectively). Children of US-born caregivers had significantly lower BMI percentiles (9.13 percentile points) versus foreign-born caregivers. Haitian women were significantly more likely to initiate breastfeeding (64.9%) versus AA (47.6%) and Caribbean Islander/West Indian/Multiracial (62.2%) (p < .01). No significant group differences were found in breastfeeding or bottle feeding duration or age solid foods were introduced. CONCLUSIONS Findings here suggest that NHB race classification can identify important subgroup behavioral similarities which in turn may inform culturally sensitive strategies to promote early childhood healthy weight. Foreign-born caregivers may benefit from healthy weight promotion information, and as early as possible in their child's development.
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Affiliation(s)
- Sarah E Messiah
- University of Texas Health Science Center School of Public Health, Dallas, TX, USA.
- Center for Pediatric Population Health, Children's Health System of Texas and University of Texas Health Science Center School of Public Health, Dallas, USA.
| | - Folefac Atem
- University of Texas Health Science Center School of Public Health, Dallas, TX, USA
- Center for Pediatric Population Health, Children's Health System of Texas and University of Texas Health Science Center School of Public Health, Dallas, USA
| | - Cynthia Lebron
- Department of Public Health Sciences, University of Miami, Miami, FL, USA
| | - Ashley Ofori
- University of Texas Health Science Center School of Public Health, Dallas, TX, USA
- Center for Pediatric Population Health, Children's Health System of Texas and University of Texas Health Science Center School of Public Health, Dallas, USA
| | - M Sunil Mathew
- University of Texas Health Science Center School of Public Health, Dallas, TX, USA
- Center for Pediatric Population Health, Children's Health System of Texas and University of Texas Health Science Center School of Public Health, Dallas, USA
| | | | - Ruby A Natale
- Department of Pediatrics, University of Miami, Miami, FL, USA
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12
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Alcubierre N, Granado-Casas M, Real J, Perpiñán H, Rubinat E, Falguera M, Castelblanco E, Franch-Nadal J, Mauricio D. Spanish People with Type 2 Diabetes Show an Improved Adherence to the Mediterranean Diet. Nutrients 2020; 12:nu12020560. [PMID: 32093385 PMCID: PMC7071466 DOI: 10.3390/nu12020560] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 02/15/2020] [Accepted: 02/17/2020] [Indexed: 12/11/2022] Open
Abstract
The aim of this study was to assess the dietary pattern (i.e., Mediterranean Diet (MedDiet) and healthy eating) in people with type 2 diabetes (T2D) compared with those without diabetes. In addition, we explored clinical factors associated with the dietary pattern. This cross-sectional study was performed with a sample of 476 participants (238 with T2D and 238 participants without diabetes, matched for age and sex). The alternate Mediterranean Diet (aMED) score and the alternate Healthy Eating Index (aHEI) were calculated. Statistical analysis included comparison between groups and multivariable models. Participants with T2D showed higher aMED and aHEI scores (mean (SD): 4.3 (1.5) and 43.9 (6.5), respectively) in comparison with the control group (3.5 (1.8) and 39.4 (7.4), respectively; p < 0.001). In addition, a higher proportion of participants with T2D in higher tertiles of aMED (21.8%) and aHEI (39.9%) was observed compared with participants without diabetes (11.3% for the aMED, and 19.3% for the aHEI; p < 0.001). The adjusted multivariable analysis revealed that T2D (p < 0.001), increasing age (p = 0.006 and p = 0.030, respectively), and physical activity (p = 0.009) were positively associated with higher aMED and aHEI scores. Dyslipidemia and female gender were positively associated with aMED and aHEI (p = 0.031 and p < 0.001, respectively). The specific multivariable analysis for the group with T2D yielded a positive association of age (p < 0.001) and dyslipidemia (p = 0.021) with aMED. Regarding the aHEI, only female gender was positively related with this score in diabetes participants (p = 0.025). Participants with T2D showed a higher adherence to the MedDiet and a healthier eating pattern.
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Affiliation(s)
- Nuria Alcubierre
- Department of Nutrition and Dietetics, Avantmedic, 25008 Lleida, Spain;
| | - Minerva Granado-Casas
- Department of Endocrinology and Nutrition, Health Sciences Research Institute & University Hospital Germans Trias i Pujol, 08916 Badalona, Spain;
- Lleida Institute for Biomedical Research Dr. Pifarré Foundation IRB Lleida, University of Lleida, 25198 Lleida, Spain;
| | - Jordi Real
- DAP-Cat Group, Unitat de Suport a la Recerca de Barcelona, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), 08007 Barcelona, Spain;
- Center for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, 08907 Barcelona, Spain;
| | - Hèctor Perpiñán
- Conselleria de Sanitat Universal i Salut Pública, Generalitat Valenciana, 46010 Valencia, Spain;
| | - Esther Rubinat
- Lleida Institute for Biomedical Research Dr. Pifarré Foundation IRB Lleida, University of Lleida, 25198 Lleida, Spain;
- Center for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, 08907 Barcelona, Spain;
- Department of Nursing and Physiotherapy, Serra Hunter Lecture, University of Lleida, 25198 Lleida, Spain
| | - Mireia Falguera
- Primary Health Care Center Igualada Nord, 08700 Igualada, Spain;
| | - Esmeralda Castelblanco
- Center for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, 08907 Barcelona, Spain;
- Department of Endocrinology and Nutrition, Hospital de la Santa Creu i Sant Pau & Sant Pau Biomedical Research Institute (IIB Sant Pau), 08041 Barcelona, Spain
| | - Josep Franch-Nadal
- DAP-Cat Group, Unitat de Suport a la Recerca de Barcelona, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), 08007 Barcelona, Spain;
- Center for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, 08907 Barcelona, Spain;
- Correspondence: (J.F.-N.); (D.M.); Tel.: +34-933-293-912 (J.F.-N.); +34-935-565-602 (D.M.)
| | - Didac Mauricio
- Lleida Institute for Biomedical Research Dr. Pifarré Foundation IRB Lleida, University of Lleida, 25198 Lleida, Spain;
- Center for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, 08907 Barcelona, Spain;
- Department of Endocrinology and Nutrition, Hospital de la Santa Creu i Sant Pau & Sant Pau Biomedical Research Institute (IIB Sant Pau), 08041 Barcelona, Spain
- Department of Medicine, Barcelona Autonomous University (UAB), 08035 Barcelona, Spain
- Correspondence: (J.F.-N.); (D.M.); Tel.: +34-933-293-912 (J.F.-N.); +34-935-565-602 (D.M.)
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Doustmohammadian A, Keshavarz Mohammadi N, Omidvar N, Amini M, Abdollahi M, Eini-Zinab H, Amirhamidi Z, Esfandiari S, Nutbeam D. Food and nutrition literacy (FNLIT) and its predictors in primary schoolchildren in Iran. Health Promot Int 2019; 34:1002-1013. [PMID: 30101341 DOI: 10.1093/heapro/day050] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
This study used a locally designed and validated questionnaire to describe the distribution of food and nutrition literacy (FNLIT) in a cross-sectional sample of 803 students aged 10-12 years from elementary schools in Tehran city, Iran. Logistic regression was used to assess the extent to which various independent covariates were associated with low FNLIT. The data were used to identify significant differences using a range of social and cultural variables relevant to the context of school students in Iran. The results of the study showed that although the total FNLIT level was good, this headline finding masked important differences in the sub-domains. More than half of the children (69%) had high levels of FNLIT in the cognitive domain, but in the skills domain, very few (3%) scored highly. The study also identified some associations between the total FNLIT and its subscales and sociodemographic variables including gender, parent's education and age, birth order. These results highlighted groups within the school population who were at higher risk of having lower FNLIT levels. They also indicate that girls feel more able to exert choice and control over food and nutrition decisions than boys are but may be less able to do so in practice. Overall, these results are a general reminder to schools of the different learning needs of children from different family backgrounds. The article highlights the need for continuous improvement in the health education curriculum of schools in Iran, particularly highlighting the importance of giving greater attention to the development of practical food and nutrition skills alongside more traditional food and nutrition knowledge. Additional studies (with long-term follow-up) are needed to more fully assess and understand the predictors of FNLIT.
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Affiliation(s)
- Aazam Doustmohammadian
- Department of Nutrition Research, National Nutrition and Food Technology Research Institute; and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Nasrin Omidvar
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute; and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Amini
- Department of Nutrition Research, National Nutrition and Food Technology Research Institute; and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Morteza Abdollahi
- Department of Nutrition Research, National Nutrition and Food Technology Research Institute; and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hassan Eini-Zinab
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute; and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zeinab Amirhamidi
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute; and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeed Esfandiari
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute; and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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14
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Brown AGM, Houser RF, Mattei J, Rehm CD, Mozaffarian D, Lichtenstein AH, Folta SC. Diet quality among US-born and foreign-born non-Hispanic blacks: NHANES 2003-2012 data. Am J Clin Nutr 2019; 107:695-706. [PMID: 29722843 DOI: 10.1093/ajcn/nqy021] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 01/24/2018] [Indexed: 02/07/2023] Open
Abstract
Background Non-Hispanic blacks in the United States are less likely to not meet national dietary recommendations than non-Hispanic whites; however, most studies do not consider nativity of US blacks. Objective With the use of the Alternative Healthy Eating Index-2010 (AHEI-2010) and the Dietary Approach to Stop Hypertension (DASH) scores, this cross-sectional study compared diet quality between US-born (n = 3,911) and foreign-born (n = 408) non-Hispanic black adults aged 22-79 y, based on pooled nationally representative data (NHANES 2003-2012) as well as by length of US residency. Design The association between nativity and diet quality was determined by using multivariable-adjusted linear regression for the continuous total diet quality scores and their components or multinomial (polytomous) logistic regression for categorical tertiles (low, medium, or high) of the total scores and their components. Results Foreign-born blacks had significantly higher AHEI-2010 (β: 9.3; 95% CI: 7.5, 11.0) and DASH (β: 3.1; 95% CI: 2.5, 3.8) scores compared with US-born blacks and more favorable intakes for many of the score components. Among foreign-born blacks, diet quality did not significantly differ by length of residency. Foreign-born blacks were more likely to be in the high than in the low tertile for vegetables [excluding starchy vegetables; relative risk ratio (RRR): 1.68; 95% CI: 1.24, 2.29], fruit [excluding and including fruit juice-RRR: 2.42 (95% CI: 1.69, 3.47) and RRR: 2.95 (95% CI: 1.90, 4.59), respectively], percentage of whole grains (RRR: 2.39; 95% CI: 1.64, 3.49), and omega-3 (ω-3) fatty acids (RRR: 2.03; 95% CI: 1.38, 2.97). Conclusions Foreign-born blacks have better diet quality than their US-born counterparts. In nutrition research and public health efforts, considering the place of birth among US blacks may improve the accuracy of characterizing dietary intakes and facilitate the development of targeted nutrition interventions to reduce diet-related diseases in the diverse black population in the United States.
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Affiliation(s)
- Alison G M Brown
- Tufts University, Friedman School of Nutrition Science and Policy, Boston, MA
| | - Robert F Houser
- Tufts University, Friedman School of Nutrition Science and Policy, Boston, MA
| | | | - Colin D Rehm
- Albert Einstein College of Medicine, New York, NY
| | - Dariush Mozaffarian
- Tufts University, Friedman School of Nutrition Science and Policy, Boston, MA
| | | | - Sara C Folta
- Tufts University, Friedman School of Nutrition Science and Policy, Boston, MA
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15
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Roberts KM, Golian P, Nahikian-Nelms M, Hinton A, Madril P, Basch K, Conwell D, Hart PA. Does the Healthy Eating Index and Mediterranean Diet Score Identify the Nutritional Adequacy of Dietary Patterns in Chronic Pancreatitis? Dig Dis Sci 2019; 64:2318-2326. [PMID: 30798461 DOI: 10.1007/s10620-019-05536-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 02/14/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Chronic pancreatitis (CP) is a progressive, irreversible disease characterized by maldigestion and frequently accompanied by epigastric pain, exocrine insufficiency, and/or endocrine insufficiency. There is limited information about the dietary patterns in CP from which to guide medical nutrition therapy recommendations. METHODS Study design was a cross-sectional, case-control study comparing subjects with CP (n = 52) to healthy controls (n = 48). Vioscreen™ food frequency questionnaire was used to assess the dietary pattern and nutrient intake in both groups. Dietary quality scores (the Healthy Eating Index, Mediterranean Diet score), and daily energy, macronutrient, and micronutrient intake levels were compared between groups. ANALYSIS Two sample t tests and Wilcoxon rank sum tests were used to evaluate differences in continuous variables, and Chi-squared tests were used for categorical variables. RESULTS CP was associated with a lower body mass index (BMI) (24 vs. 31 mg/kg2; p < 0.001), lower HEI (57 vs. 65; p = 0.002), and aMED scores (29 vs. 32; p = 0.043) compared to healthy controls. Subjects with CP in the highest BMI quartile had the highest median aMED score compared to those in the lowest BMI quartile. There were no differences in kilocalories, macronutrients, or fat-soluble vitamin intake between groups, with the exception that vitamin K intake was lower in the CP group. CONCLUSIONS The overall quality of dietary intake is lower in subjects with CP compared to controls when assessed by two independent nutritional measurement tools. Further research is needed to examine contributing factors, such as food insecurity and coexisting endocrine or exocrine insufficiency, to dietary patterns in patients with CP from which to guide evidence-based recommendations for medical nutritional therapy.
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Affiliation(s)
- Kristen M Roberts
- Ohio State University, 453 West 10th Avenue, Columbus, OH, 43210, USA.
| | - Paige Golian
- Ohio State University, 453 West 10th Avenue, Columbus, OH, 43210, USA
| | | | - Alice Hinton
- Ohio State University, 1841 Neil Ave., Columbus, OH, 43210, USA
| | - Peter Madril
- Ohio State University, 453 West 10th Avenue, Columbus, OH, 43210, USA
| | - Kathleen Basch
- Ohio State University, 453 West 10th Avenue, Columbus, OH, 43210, USA
| | - Darwin Conwell
- Ohio State University, 410 West 10th Avenue, Columbus, OH, 43210, USA
| | - Phil A Hart
- Ohio State University, 410 West 10th Avenue, Columbus, OH, 43210, USA
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16
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Brown AGM, Houser RF, Mattei J, Lichtenstein AH, Folta SC. Qualitative exploration of cultural factors influencing diet among African-, Caribbean- and US-born Blacks living in the northeast USA. J Nutr Sci 2019; 8:e23. [PMID: 31328000 PMCID: PMC6635804 DOI: 10.1017/jns.2019.19] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 05/24/2019] [Accepted: 06/11/2019] [Indexed: 11/07/2022] Open
Abstract
Limited research considers the ethnic and cultural diversity among the US Black population, and how this diversity influences diet. The purpose of the present qualitative study is to (1) explore the influence of culture, nativity and ethnicity on the diet of US-born, African-born and Caribbean/Latin American-born Blacks and (2) explore a model of dietary acculturation among the African-born and Caribbean/Latin American-born Blacks. The purposive sample included twenty-two US-born, fifteen Caribbean/Latin American-born and ten African-born Blacks (n 47) living in Boston, who participated in either an in-depth interview (n 12) or a focus group (five groups, size 5-9). Satia-Abouta's model of dietary acculturation informed the interview and focus group questions, which explored the influence of psychosocial factors, taste preferences and environmental factors on dietary changes. NVivo 10 software was utilised for the coding and analysis. Topics based on a priori and posteriori analyses included differences in psychosocial factors and taste preferences and environmental factors by nativity. Caribbean/Latin American-born and African-born Blacks expressed the importance of cultural identity in their dietary preferences and found adaptive strategies to maintain cultural diet, while US-born Blacks demonstrated a variety of preferences for traditionally African American foods. Environmental factors varied by place of birth and residence, with US-born Blacks citing poorer quality and limited affordability of foods. These findings suggest the importance of psychosocial and environmental factors in shaping the diet of the ethnically diverse US Black population and underscore the dietary diversity within and across the different ethnic groups of Blacks.
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Affiliation(s)
- A. G. M. Brown
- National Heart, Lung, and Blood Institute, National Institutes of Health, 6701 Rockledge Drive, Bethesda, MA 20892, USA
| | - R. F. Houser
- National Heart, Lung, and Blood Institute, National Institutes of Health, 6701 Rockledge Drive, Bethesda, MA 20892, USA
| | - J. Mattei
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Building 2, Boston, MA 02115, USA
| | - A. H. Lichtenstein
- Tufts University Friedman School of Nutrition Science and Policy, 75 Kneeland Street, Boston, MA, USA
- Tufts University, Jean Mayer USDA Human Nutrition Research Center on Aging, 711 Washington Street, Boston, MA 02111, USA
| | - S. C. Folta
- Tufts University Friedman School of Nutrition Science and Policy, 75 Kneeland Street, Boston, MA, USA
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Abstract
Type 2 diabetes (T2D) is a complex, lifelong condition that is disproportionately prevalent among minority populations. Haitian immigrants (HIs) living in the US with T2D have unique factors that influence diagnosis, treatment, and self-management. The purpose of this integrative review was to provide a synthesis of the research on T2D in the HI population. In a systematic literature search, 14 studies met the inclusion criteria. Three themes were identified: risk factors for less self-management and/or worse metabolic control; protective factors for better self-management and/or metabolic control; and mixed results. HIs had higher HbA1c, yet better self-management, different genetic profiles, and lower levels of vitamin D and hemoglobin concentration compared to other ethnic groups. HIs also reported better dietary quality, less healthcare utilization, and higher perceived emotional/psychological stress compared to other ethnic groups. This study has implications for practice for integrating the unique cultural factors when assessing and intervening with HIs.
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Al-Ibrahim AA, Jackson RT. Healthy eating index versus alternate healthy index in relation to diabetes status and health markers in U.S. adults: NHANES 2007-2010. Nutr J 2019; 18:26. [PMID: 30995902 PMCID: PMC6471947 DOI: 10.1186/s12937-019-0450-6] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Accepted: 03/27/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND It remains to be determined whether the Alternate Healthy Eating Index 2010 (AHEI-2010) or the Healthy Eating Index 2010 (HEI-2010) is preferably recommended as means to assess dietary quality in people with type 2 diabetes (T2DM). METHODS The purpose of this study was to determine whether the AHEI-2010 provides a more accurate assessment of dietary quality than the HEI-2010 in relation to diabetes status, while controlling for health markers, sociodemographic and lifestyle factors. The 2007-2010 National Health and Nutrition Examination Survey (NHANES) was used as a representative sample of U.S. adults age 20+ years (n = 4097). HEI-2010 and the AHEI-2010 scores were used as measures of dietary quality and were calculated using data from the first 24-h dietary recall. Health markers evaluated include anthropometrics, blood pressure, lipid and inflammatory markers, and presence of co-morbid diseases. Least Squares Means were computed to determine differences across diabetes status (nondiabetes, prediabetes, T2DM) for total and sub-component HEI-2010 and AHEI-2010 scores, and to determine differences across total HEI-2010 and AHEI-2010 quartiles for health markers. Covariate-adjusted logistic regression was used to examine the association between total HEI-2010 and AHEI-2010 scores and diabetes status. RESULTS Adults with T2DM showed higher HEI-2010 and AHEI-2010 scores compared to adults with prediabetes and nondiabetes but did not have better health markers. For HEI-2010 component scores, adults with T2DM had highest consumption (highest score) of total protein foods and lowest consumption (highest score) for empty calories (p < 0.01). For AHEI-2010 component scores, adults with T2DM had the lowest consumption (highest score) for sugar-sweetened beverages and fruit juice, sodium, and alcohol (lowest score). In addition, adults with T2DM had the highest consumption (lowest score) for red and/or processed meats (p < 0.01). However, neither total HEI-2010 nor AHEI-2010 scores were significantly associated with diabetes status (p > 0.05). Results suggest that neither index was clearly superior to the other in terms of its predictive ability in relation to T2DM. CONCLUSION Neither total HEI-2010 nor AHEI-2010 scores performed better in terms of their relationship with diabetes status. However, the significant relationships between 1) diabetes status and health markers and 2) between HEI-2010 and AHEI-2010 scores and health markers suggest that diet has some influence on T2DM.
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Affiliation(s)
- Afnan A. Al-Ibrahim
- Department of Nutrition and Food Science, University of Maryland, 0112 Skinner Building, College Park, MD 20742 USA
| | - Robert T. Jackson
- Department of Nutrition and Food Science, University of Maryland, 0112 Skinner Building, College Park, MD 20742 USA
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Springfield S, Odoms-Young A, Tussing-Humphreys LM, Freels S, Stolley MR. A Step toward Understanding Diet Quality in Urban African-American Breast Cancer Survivors: A Cross-sectional Analysis of Baseline Data from the Moving Forward Study. Nutr Cancer 2019; 71:61-76. [PMID: 30775929 PMCID: PMC6527422 DOI: 10.1080/01635581.2018.1557217] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 10/27/2018] [Accepted: 11/06/2018] [Indexed: 01/09/2023]
Abstract
PURPOSE Little is known about the dietary behaviors of African-American breast cancer survivors (AABCS). We sought to describe dietary intake and quality in AABCS and examine associations with demographic, social, lifestyle, and body composition factors to potentially inform the development of effective dietary interventions. METHODS Baseline data from a prospective weight loss trial of 210 AABCS were assessed. A food frequency questionnaire was used to evaluate dietary intake and diet quality via the Healthy Eating Index 2010 (HEI-2010) and Alternative Healthy Eating Index 2010 (AHEI-2010). Linear regression analysis was conducted to determine the most influential variables on diet quality. RESULTS Mean HEI- and AHEI-2010 total scores were 65.11 and 56.83 indicating that diet quality needs improvement. Women were the least adherent to recommendations for intake of whole grains, dairy, sodium, empty calories, sugary beverages, red/processed meats, and trans-fat. Increased self-efficacy for healthy eating behaviors, more years of education (AHEI only), negative smoking status, smaller waist circumference, and increased physical activity (HEI only) were significantly associated with higher diet quality scores. CONCLUSION Our findings suggest the diet quality of AABCS needs improvement. Intervention programs may achieve higher diet quality in AABCS by focusing on increasing self-efficacy for healthy eating behaviors.
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Affiliation(s)
- Sparkle Springfield
- Stanford Prevention Research Center, School of Medicine, 3300 Hillview Ave (MC 5411), Palo Alto, CA 94304, US
| | - Angela Odoms-Young
- Department of Kinesiology and Nutrition, 646 Applied Health Sciences Building, 1919 West Taylor Street (MC 517), Chicago, IL 60612, US
- University of Illinois Cancer Center, 486 Westside Research Office Bldg., 1747 West Roosevelt Road (MC 275), Chicago, IL 60608, US
- School of Public Health, Division of Epidemiology and Biostatistics, 953 SPHP1, 1603 W Taylor St (MC 923), Chicago, IL 60612, US
| | - Lisa M. Tussing-Humphreys
- University of Illinois Cancer Center, 486 Westside Research Office Bldg., 1747 West Roosevelt Road (MC 275), Chicago, IL 60608, US
- School of Public Health, Division of Epidemiology and Biostatistics, 953 SPHP1, 1603 W Taylor St (MC 923), Chicago, IL 60612, US
| | - Sally Freels
- School of Public Health, Division of Epidemiology and Biostatistics, 953 SPHP1, 1603 W Taylor St (MC 923), Chicago, IL 60612, US
| | - Melinda R. Stolley
- Medical College of Wisconsin, Department of Medicine, 8701 Watertown Plank Road, Milwaukee, WI 53226, US
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Antwi J, Huffman F, Sullivan S. Relationship of serum Vitamin D concentrations with Adipokines and Cardiometabolic risk among non-Hispanic black type 2 diabetic and non-diabetic subjects: a cross-sectional study. BMC Nutr 2018; 4:50. [PMID: 32153911 PMCID: PMC7050721 DOI: 10.1186/s40795-018-0259-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 12/05/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To report the association of serum 25-hydroxyvitamin D [25(OH)D] and its association with adipokines and cardiometabolic risk factors in Haitian Americans (HA) and African Americans (AA) by ethnicity and type 2 diabetes (T2D) status. METHODS A cross-sectional study in 197 HA (92 with T2D and 102 without T2D) and 200 AA (97 with T2D and 103 without T2D) recruited in South Florida. Serum 25(OH)D concentrations and adipokines were analyzed by ELISA and cardiometabolic risk factors were indexed by obesity, glycemic control, insulin sensitivity, lipid profile, and blood pressure. RESULTS Controlling for age, BMI, energy intake, smoking status and HOMA2-IR in multivariate linear regression analyses, serum 25(OH)D concentrations were significantly associated with WC (R2 = 0.760, B = - 0.092, P = 0.027), HbA1C (R2 = 0.142, B = - 0.012, P = 0.010), and TG (R2 = 0.159, B = - 1.192, P = 0.003) in only HA without T2D. While serum 25(OH)D concentrations were significantly associated with TC (R2 = 0.168, B = - 0.329, P = 0.040), log leptin (R2 = 0.544, B = - 0.007, P = 0.021), and adiponectin (R2 = 0.144, B = 0.111, P = 0.033), but slightly associated with LDL-c (R2 = 0.133, B = - 0.278, P = 0.064) in only AA without T2D. Among individuals with T2D, serum 25(OH)D concentrations were marginally associated with IL-6 (R2 = 0.109, B = 0.076, P = 0.085) in HA with T2D, and there was a trend toward significance with log leptin (R2 = 0.393, B = - 0.006, P = 0.075) in AA with T2D in regression analysis. CONCLUSIONS The findings that the associations of serum 25(OH)D concentrations with adipokines and cardiometabolic factors differ between HA and AA has clinical and public implications to guide design of T2D preventive strategies that are culturally specific even within the same ethnicity.
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Affiliation(s)
- Janet Antwi
- 0000 0001 2160 918Xgrid.264272.7Dietetics and Nutrition, Human Ecology Department, State University of New York at Oneonta, New York, USA
| | - Fatma Huffman
- 0000 0001 2110 1845grid.65456.34Department of Dietetics and Nutrition, Robert Stempel College of Public Health, Florida International University, Miami, USA
| | - Stacey Sullivan
- 0000 0001 2160 918Xgrid.264272.7Dietetics and Nutrition, Human Ecology Department, State University of New York at Oneonta, New York, USA
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Okoro FO, Veri S, Davis V. Culturally Appropriate Peer-Led Behavior Support Program for African Americans With Type 2 Diabetes. Front Public Health 2018; 6:340. [PMID: 30533408 PMCID: PMC6265436 DOI: 10.3389/fpubh.2018.00340] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 11/02/2018] [Indexed: 11/15/2022] Open
Abstract
Current literature poorly defines the specific ways trained peer supporter influences health care behaviors. This study attempts to identify the key defining features of a culturally appropriate peer support program for African Americans with type 2 diabetes by exploring participants experiences related to assistance with daily disease management, emotional support, linkage to clinic care and community resources, and ongoing support. We used a qualitative interpretive descriptive approach to collect data through semi-structured interviews from 20 African Americans with type 2 diabetes participating in a peer support program. Interviews captured participants' background and experiences with the peer supporter and evaluated the cultural appropriateness of the peer support intervention. Data was coded deductively using predetermined codes found in the peer support literature and inductively to identify emergent themes. Three specific themes were identified namely [1] healthy behaviors [2] frequent telephonic contact and [3] emotional support as a by-product of other support activities. These findings mirror the broader literature on what constitutes culturally appropriate peer support programs for ethnic minorities. We recommend the inclusion of culturally appropriate peer support program to complement diabetes management as targeted plan for improvement in clinical care and ultimately, diabetes outcome.
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Affiliation(s)
- Florence O Okoro
- School of Nursing, University of North Carolina at Charlotte, Charlotte, NC, United States
| | - Shelby Veri
- Department of Public Health, University of North Carolina at Charlotte, Charlotte, NC, United States
| | - Valencia Davis
- Community Care Partners of Greater Mecklenburg, Charlotte, NC, United States
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Moise RK, Conserve DF, Elewonibi B, Francis LA, BeLue R. Diabetes Knowledge, Management, and Prevention Among Haitian Immigrants in Philadelphia. DIABETES EDUCATOR 2017. [PMID: 28627321 DOI: 10.1177/0145721717715418] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose Guided by the PEN-3 Cultural Model, the purpose of this study is to generate culturally framed insight into diabetes knowledge, management, and prevention among Haitians. Despite the disproportionate distribution of type II diabetes mellitus among US minorities, limited research explores outcomes within racial ethnic groups. It is particularly important to disaggregate the large racial-ethnic groups of black given the population growth among foreign-born blacks, such as Haitians, whose population has more than quadrupled in recent decades. Methods Focus group interviews were employed to understand diabetes knowledge, management, and prevention in the Haitian immigrant population in Philadelphia. Interviews were conducted in 2 groups: (1) people living with diabetes and (2) an at-risk sample for diabetes (defined as 30 and older with self-reported family history of diabetes). Interviews were recorded and transcribed verbatim in preparation for content analysis. Results Of the 10 participants, who were recruited through a Philadelphia church-based population, ages ranged from 41 to 91, with an average of 65. Content analysis revealed 3 emergent themes across: (1) cultural identity, including person, extended family, and neighborhood; (2) relationships and expectations, including perceptions, enablers, and nurturers; and (3) cultural empowerment, including positive, existential, and negative. Conclusions Results may inform culturally appropriate diabetes interventions for Haitians. Future research should explore compliance with food recommendations as well as the cultural competency of health care professional's information delivery.
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Affiliation(s)
- Rhoda K Moise
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida (Ms Moise)
| | - Donaldson F Conserve
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Arnold School of Public Health, Columbia, South Carolina (Dr Conserve)
| | - Bilikisu Elewonibi
- Department of Health Policy and Administration, The Pennsylvania State University, University Park, Pennsylvania (Miss Elewonibi, Dr BeLue)
| | - Lori A Francis
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, Pennsylvania (Dr Francis)
| | - Rhonda BeLue
- Department of Health Policy and Administration, The Pennsylvania State University, University Park, Pennsylvania (Miss Elewonibi, Dr BeLue)
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Willig AL, Richardson BS, Agne A, Cherrington A. Intuitive eating practices among African-American women living with type 2 diabetes: a qualitative study. J Acad Nutr Diet 2014; 114:889-896. [PMID: 24699138 DOI: 10.1016/j.jand.2014.02.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2012] [Accepted: 01/30/2014] [Indexed: 11/20/2022]
Abstract
Intuitive eating programs that improve self-efficacy and dietary habits could enhance glycemic control in African-American women with type 2 diabetes. The goal of our study was to investigate how current eating practices and beliefs of African-American women living with diabetes aligned with intuitive eating concepts. African-American women with type 2 diabetes referred for diabetes education class during 2009-2012 were recruited for a qualitative study using focus groups for data collection. Verbatim group transcriptions were analyzed by two independent reviewers for themes using a combined inductive-deductive approach. Participants (n=35) had an average age 52±9 years, mean body mass index 39±7, and mean time with a type 2 diabetes diagnosis of 10±10 years. Participants' self-reported dietary practices were poorly aligned with intuitive eating concepts. The women reported a lack of self-control with food and regularly eating in the absence of hunger, yet stated that the determinant factor for when to stop eating was to recognize a feeling of fullness. Participants reported knowing they were full when they felt physically uncomfortable or actually became sick. Women frequently cited the belief that individuals with diabetes have to follow a different diet than that recommended for the general public. Many women also discussed diabetes-related stigma from family/friends, and often did not tell others about their diabetes diagnosis. These findings demonstrate that intuitive eating techniques are not currently applied by the women in this sample. Future studies should assess the influence of intuitive eating interventions on dietary habits among low-income African-American women with type 2 diabetes.
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Frankenfeld CL, Poudrier J, Waters N, Gillevet PM. Past residence outside of the United States is associated with diet quality in adults currently residing in the United States. Am J Hum Biol 2014; 26:64-72. [DOI: 10.1002/ajhb.22477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Cara L. Frankenfeld
- Department of Global and Community HealthGeorge Mason UniversityFairfax Virginia22030
| | - Jill Poudrier
- Department of Global and Community HealthGeorge Mason UniversityFairfax Virginia22030
| | - Nigel Waters
- Department of Geography and Geinformation ScienceGeorge Mason UniversityFairfax Virginia22030
| | - Patrick M. Gillevet
- Department of Environmental Science and PolicyGeorge Mason UniversityFairfax Virginia22030
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Wilcox S, Sharpe PA, Turner-McGrievy G, Granner M, Baruth M. Frequency of consumption at fast-food restaurants is associated with dietary intake in overweight and obese women recruited from financially disadvantaged neighborhoods. Nutr Res 2013; 33:636-46. [PMID: 23890353 PMCID: PMC3758906 DOI: 10.1016/j.nutres.2013.05.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Revised: 05/07/2013] [Accepted: 05/11/2013] [Indexed: 11/29/2022]
Abstract
Fast-food restaurants are more prevalent in lower-income and predominately African American neighborhoods, where consumption of fast food is also higher. In general populations, fast-food consumption is related to less healthy dietary intake. This cross-sectional study examined the hypotheses that greater fast-food consumption is associated with less healthy dietary intake and poorer diet quality in overweight and obese women (n = 196, 25-51 years, 87% African American) recruited from financially disadvantaged Census tracts. Dietary intake and diet quality (Alternate Healthy Eating Index) were assessed via three 24-hour dietary recalls. Linear regression models tested the association between fast-food consumption and each outcome (model 1). Model 2 added sociodemographics and physical activity. Model 3 added total caloric intake. Fast-food consumption was significantly associated with total caloric intake; total intake of meat, grains, sweetened beverages, dairy, fiber, cholesterol, sodium, and added sugar; and percent of calories from total fat, saturated fat, and trans-fatty acids. Statistically significant associations remained in model 2, but most were not significant in model 3. Fast-food consumption was not associated with diet quality (Alternate Healthy Eating Index) in any model. In this at-risk sample, fast-food consumption was associated with more negative dietary practices. Significant associations generally disappeared when controlling for total caloric intake, suggesting that women who eat more fast food have higher total caloric intakes as a result of increased consumption of unhealthy rather than healthy foods.
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Affiliation(s)
- Sara Wilcox
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
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Guenther PM, Casavale KO, Kirkpatrick SI, Reedy J, Hiza HA, Kuczynski KJ, Kahle LL, Krebs-Smith SM. Update of the Healthy Eating Index: HEI-2010. J Acad Nutr Diet 2013; 113:569-80. [PMID: 23415502 PMCID: PMC3810369 DOI: 10.1016/j.jand.2012.12.016] [Citation(s) in RCA: 988] [Impact Index Per Article: 89.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2012] [Accepted: 12/21/2012] [Indexed: 12/25/2022]
Abstract
The Healthy Eating Index (HEI) is a measure of diet quality in terms of conformance with federal dietary guidance. Publication of the 2010 Dietary Guidelines for Americans prompted an interagency working group to update the HEI. The HEI-2010 retains several features of the 2005 version: (a) it has 12 components, many unchanged, including nine adequacy and three moderation components; (b) it uses a density approach to set standards, eg, per 1,000 calories or as a percentage of calories; and (c) it employs least-restrictive standards; ie, those that are easiest to achieve among recommendations that vary by energy level, sex, and/or age. Changes to the index include: (a) the Greens and Beans component replaces Dark Green and Orange Vegetables and Legumes; (b) Seafood and Plant Proteins has been added to capture specific choices from the protein group; (c) Fatty Acids, a ratio of polyunsaturated and monounsaturated to saturated fatty acids, replaces Oils and Saturated Fat to acknowledge the recommendation to replace saturated fat with monounsaturated and polyunsaturated fatty acids; and (d) a moderation component, Refined Grains, replaces the adequacy component, Total Grains, to assess overconsumption. The HEI-2010 captures the key recommendations of the 2010 Dietary Guidelines and, like earlier versions, will be used to assess the diet quality of the US population and subpopulations, evaluate interventions, research dietary patterns, and evaluate various aspects of the food environment.
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Affiliation(s)
- Patricia M. Guenther
- Center for Nutrition Policy and Promotion U.S. Department of Agriculture 3101 Park Center Dr., Ste. 1034 Alexandria, VA 22302 Telephone: 703-605-0253 Fax:703-305-3300
| | - Kellie O. Casavale
- Office of Disease Prevention and Health Promotion U.S. Department of Health and Human Services 1101 Wootton Pkwy., Ste. LL100 Rockville, MD 20852 Telephone: 240-453-8252 Fax: 240-453-8281
| | - Sharon I. Kirkpatrick
- Risk Factor Monitoring and Methods Branch Applied Research Program Division of Cancer Control and Population Sciences National Cancer Institute 6130 Executive Blvd. MSC 7344 Bethesda, MD 20892-7344 Telephone: 301-435-1638 Fax: 301-465-3710
| | - Jill Reedy
- Risk Factor Monitoring and Methods Branch Applied Research Program Division of Cancer Control and Population Sciences National Cancer Institute 6130 Executive Blvd. MSC 7344 Bethesda, MD 20892-7344 Telephone: 301-496-8500 Fax: 301-465-3710
| | - Hazel A.B. Hiza
- Center for Nutrition Policy and Promotion U.S. Department of Agriculture 3101 Park Center Dr., Ste. 1034 Alexandria, VA 22302 Telephone: 703-305-2979 Fax: 703-305-3300
| | - Kevin J. Kuczynski
- Center for Nutrition Policy and Promotion U.S. Department of Agriculture 3101 Park Center Dr., Ste. 1034 Alexandria, VA 22302 Telephone: 703-305-2153 Fax: 703-305-3300
| | - Lisa L. Kahle
- Information Management Services, Inc. 3901 Calverton Blvd, Suite 200 Calverton MD 20705 Telephone: 301-680-9770 Fax: 301-680-8304
| | - Susan M. Krebs-Smith
- Applied Research Program Division of Cancer Control and Population Sciences National Cancer Institute 6130 Executive Blvd. MSC 7344 Bethesda, MD 20892-7344 Telephone: 301-496-8500 Fax: 301-465-3710
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