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Hoffman RK, Donze LF, Agurs-Collins T, Belay B, Berrigan D, Blanck HM, Brandau A, Chue A, Czajkowski S, Dillon G, Kompaniyets L, Kowtha B, Li R, Mujuru P, Mudd L, Nebeling L, Tomoyasu N, Young-Hyman D, Zheng X(T, Pratt C. Adult obesity treatment and prevention: A trans-agency commentary on the research landscape, gaps, and future opportunities. Obes Rev 2024; 25:e13769. [PMID: 38830619 PMCID: PMC11309895 DOI: 10.1111/obr.13769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 03/30/2024] [Accepted: 04/06/2024] [Indexed: 06/05/2024]
Abstract
Given the high and growing prevalence of obesity among adults in the United States, obesity treatment and prevention are important topics in biomedical and public health research. Although researchers recognize the significance of this problem, much remains unknown about safe and effective prevention and treatment of obesity in adults. In response to the worsening obesity epidemic and the many unknowns regarding the disease, a group of key scientific and program staff members of the National Institutes of Health (NIH) and other federal and non-government agencies gathered virtually in September 2021 to discuss the current state of obesity research, research gaps, and opportunities for future research in adult obesity prevention and treatment. The current article synthesizes presentations given by attendees and shares their organizations' current initiatives and identified gaps and opportunities. By integrating the information discussed in the meeting and current initiatives, we identify potential targets and overlapping priorities for future research, including health equity and disparities in obesity, the heterogeneity of obesity, and the use of technological and innovative approaches in interventions.
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Affiliation(s)
- Rebecca K. Hoffman
- Pacific Institute for Research and Evaluation, Beltsville, Maryland, USA
| | - Laurie Friedman Donze
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Tanya Agurs-Collins
- National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Brook Belay
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - David Berrigan
- National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Heidi M. Blanck
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- United States Public Health Service, Rockville, Maryland, USA
| | - Andrea Brandau
- Patient-Centered Outcomes Research Institute, Washington, DC, USA
| | - Amanda Chue
- Patient-Centered Outcomes Research Institute, Washington, DC, USA
| | - Susan Czajkowski
- National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | | | - Lyudmyla Kompaniyets
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Bramaramba Kowtha
- Office of Disease Prevention, National Institutes of Health, Bethesda, Maryland, USA
| | - Rui Li
- Maternal and Health Child Bureau, Health Resources and Services Administration, Rockville, Maryland, USA
| | - Priscah Mujuru
- National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland, USA
| | - Lanay Mudd
- National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Linda Nebeling
- National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Naomi Tomoyasu
- Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, Rockville, Maryland, USA
| | - Deborah Young-Hyman
- Office of Behavioral and Social Sciences Research, National Institutes of Health, Bethesda, Maryland, USA
| | - Xincheng (Ted) Zheng
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Charlotte Pratt
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
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Lytvynenko O, König LM. Investigation of Ukrainian refugees' eating behavior, food intake, and psychological distress: Study protocol and baseline data. Appl Psychol Health Well Being 2024; 16:923-943. [PMID: 37548127 DOI: 10.1111/aphw.12477] [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] [Received: 02/17/2023] [Accepted: 07/12/2023] [Indexed: 08/08/2023]
Abstract
Since the start of the war in Ukraine, almost 8 million people left the country; more than 1 million of them relocated to Germany. It is to be expected that the war puts considerable strain on refugees, which will impact the public health system in host countries. This paper presents baseline data and protocol of longitudinal online experimental study of 619 Ukrainian refugees in Germany started in autumn 2022, focusing on participants' self-reports of appetite, food intake, and levels of stress, anxiety, and depressive symptoms to examine their associations. Results indicate that levels of stress, anxiety, and depressive symptoms in refugees significantly exceed the indicators of relevant parameters as reported by independent large-scale surveys conducted in Ukraine before the war as well as strong correlations between these deviations (.59 ≤ r ≤ .69, p = .005). Changes in appetite were related to more severe psycho-emotional deviations (.15 ≤ r ≤ .19, p = .003) and somewhat unhealthier food intake (r = -.08, p < .001). The study underlines the need of psychological care for refugees to improve their mental health and counteract potential negative consequences for physical health via changes in food intake, for which suitable interventions need to be developed.
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Affiliation(s)
- Olena Lytvynenko
- University of Bayreuth, Bayreuth, Germany
- Borys Grinchenko Kyiv University, Kyiv, Ukraine
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Sterling SR, Bowen SA. Effect of a Plant-based Intervention Among Black Individuals in the Deep South: A Pilot Study. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:68-76. [PMID: 36333197 DOI: 10.1016/j.jneb.2022.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 08/15/2022] [Accepted: 08/21/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To explore the feasibility, acceptability, and clinical/behavioral outcomes of a remotely-delivered, culturally-tailored plant-based nutrition and lifestyle intervention designed to improve cardiovascular risk among Black adults in a rural, Black Belt community. METHODS We implemented a 12-week intervention with weekly educational sessions, cooking lessons, social support, exercise, and food items. OUTCOME(S) Body mass index, waist circumference, total cholesterol, low-density lipoprotein, high-density lipoprotein, high-sensitivity C-reactive protein, trimethylamine N-oxide, diet/physical activity. Paired t tests analyzed preintervention and postintervention differences (n = 24). RESULTS Body mass index and waist circumference were reduced (P < 0.001), and total and low-density lipoprotein cholesterol decreased by 10.8% and 13.9%, respectively (P < 0.05). There was a 25.8% reduction in high-sensitivity C-reactive protein (P = 0.02). Diet and physical activity were also improved. CONCLUSIONS AND IMPLICATIONS This pilot study demonstrated the feasibility and acceptability of a remotely-delivered intervention focused on improving cardiovascular risk through plant-based nutrition, physical activity/wellness, social support, and cultural adaptability. Larger scale and longer-term studies are needed.
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Rodriguez de Lisenko NC, Gray HL, Bohn J. Optimizing Outcomes: A Systematic Review of Psychosocial Risk Factors Affecting Perinatal Black/African-American Women with Substance Use Disorder in the United States. Matern Child Health J 2022; 26:2090-2108. [PMID: 35947278 DOI: 10.1007/s10995-022-03503-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Despite studies having examined and discussed the various multifaceted risk factors affecting perinatal women with substance use disorder (SUD), the limited amount of research on Black/African-American (B/AA) women allows health disparities in this population to widen. Segmenting the needs of the low-income B/AA female population with SUD is crucial when creating multi-layered and multi-faceted innovative upstream evidence-based interventions. This review assesses and examines studies that investigate psychosocial, environmental, and systemic level risk factors related to implicit bias, trauma, toxic stress, food issues, and SUD. METHODS The principal investigator (PI) utilized PubMed, Google Scholar, ProQuest Dissertations and Theses Global to perform a systematic scoping review of the published literature. Research focused on risks factors affecting low-income perinatal B/AA women. The literature review examined articles published January 2010 through December 2020. Inclusion criteria incorporated risk factors, health disparities, and SUD. Studies selected for this review have been published in English and conducted in the USA. RESULTS Our research identified 509 articles, of which we chose to include 75. The literature highlights health disparities influenced by risks factors of implicit biases, trauma, and toxic stress, which construct physical and emotional barriers to healthy food and food resources in B/AA women with SUD. CONCLUSION The PI found limited or non-existent research on innovative interventions targeting perinatal B/AA women with SUD. This review recommends deconstructing hidden psychosocial, environmental, and systematic risk factors to assist in developing novel comprehensive strategies and wraparound support services.
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Affiliation(s)
- Norma C Rodriguez de Lisenko
- Innovative Health Solutions, P.O. Box 183, Benicia, CA, 94510, USA.
- College of Public Health, University of South Florida, 13201 Bruce B Downs Blvd, Tampa, FL, 33612, USA.
| | - Heewon L Gray
- College of Public Health, University of South Florida, 13201 Bruce B Downs Blvd, Tampa, FL, 33612, USA
| | - Joseph Bohn
- College of Public Health, University of South Florida, 13201 Bruce B Downs Blvd, Tampa, FL, 33612, USA
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Fox K, Vadiveloo M, McCurdy K, Benjamin-Neelon SE, Østbye T, Tovar A. Maternal Stress and Excessive Weight Gain in Infancy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5743. [PMID: 35565137 PMCID: PMC9105332 DOI: 10.3390/ijerph19095743] [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: 03/15/2022] [Revised: 04/28/2022] [Accepted: 05/04/2022] [Indexed: 12/03/2022]
Abstract
Rapid weight gain in infancy increases the risk of developing obesity early in life and contributes significantly to racial and ethnic disparities in childhood obesity. While maternal perceived stress is associated with childhood obesity, little is known about the impact it has on infant weight gain. Therefore, this study explores the impact of maternal perceived stress on change in weight-for-length (WFL) z-scores and the risk of rapid weight gain in infancy. We conducted a secondary data analysis of the longitudinal Nurture birth cohort (n = 666). Most mothers in the cohort were non-Hispanic/Latinx Black (71.6%). About one-half of mothers had a body mass index (BMI) greater than 25 prior to pregnancy, were unemployed, and had a low income. Most infants in the cohort were born full-term and were of normal weight. Data were collected at 3-, 6-, 9-, and 12-months postpartum. At each assessment, mothers completed the Cohen’s Perceived Stress Scale (PSS), and research assistants weighed and measured each infant. Tertiles were used to compare mothers with high and low perceived stress. A mixed model analysis of repeated measures assessed the associations between baseline perceived stress and the change in infant WFL z-scores over time. Log-binomial models assessed the association between baseline perceived stress and rapid weight gain, defined as a change in WFL z-score > 0.67 standard deviations from three to twelve months. Just under one-half of the infants (47%) experienced rapid weight gain between three and twelve months of age. Birthweight for gestational age (RR = 1.18, 95% CI = 1.08−1.29, p-value = 0.004), gestational age at birth (RR = 1.07, 95% CI = 1.01−1.14, p-value = 0.031), and weeks breastfed (0.99, 95% CI 0.99−1.00, p-value 0.044) were associated with risk of rapid weight gain in unadjusted analyses. WFL z-scores increased significantly over time, with no effect of perceived stress on change in WFL z-score or risk of rapid weight gain. Rapid weight gain in infancy was prevalent in this sample of predominately Black infants in the Southeastern US. We did not find evidence to support the hypothesis that maternal perceived stress influenced the risk of rapid weight gain. More work is needed to identify and assess the risk factors for rapid weight gain in infancy and to understand the role that maternal stress plays in the risk of childhood obesity so that prevention efforts can be targeted.
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Affiliation(s)
- Katelyn Fox
- Department of Nutrition and Food Science, University of Rhode Island, Kingston, RI 02881, USA;
| | - Maya Vadiveloo
- Department of Nutrition and Food Science, University of Rhode Island, Kingston, RI 02881, USA;
| | - Karen McCurdy
- Department of Human Development and Family Science, University of Rhode Island, Kingston, RI 02881, USA;
| | - Sara E. Benjamin-Neelon
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA;
| | - Truls Østbye
- Department of Community and Family Medicine, Duke University Medical Center, Durham, NC 27710, USA;
| | - Alison Tovar
- Department of Behavioral and Social Sciences, Brown University, Providence, RI 02912, USA;
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Binge eating disorder and stress level among patients attending nutrition counseling. NUTR HOSP 2022; 39:638-643. [PMID: 35485375 DOI: 10.20960/nh.03899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
INTRODUCTION binge eating disorder (BED) is characterized by eating much more than what most people would eat under similar circumstances. Inability to cope with stress and emotions may be the reason for BED episodes. OBJECTIVE to assess the level of stress and BED severity based on the number of episodes of compulsive overeating among patients attending nutrition counseling. METHODS a total of 100 people (60 women and 40 men) were taking part in the study. A questionnaire in which subjects answered questions concerning diet, number of meals, and coping with stressful situations was used. A nutritional diary was used to assess the amount of BED episodes and consumed products, and the emotions felt during consumption. PSS-10 was used to measure the response to stressful situations. RESULTS all subjects had episodes of compulsive overeating but the majority of respondents (52 %) had no more than 3 episodes of binge eating per week. During a BED episode patients most often chose sweets (58.2 %). The main way of responding of people on stressful situations was snacking, especially sweets. CONCLUSIONS high levels of stress correlated positively with the number of BED episodes and excessive body weight. The PSS-10 questionnaire could be a useful tool in nutrition counseling.
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Kazmierski KFM, Gillespie ML, Kuo S, Zurita T, Felix D, Rao U. Stress-Induced Eating Among Racial/Ethnic Groups in the United States: a Systematic Review. J Racial Ethn Health Disparities 2021; 8:912-926. [PMID: 32839895 PMCID: PMC7902740 DOI: 10.1007/s40615-020-00849-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 08/11/2020] [Accepted: 08/12/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Racial/ethnic disparities in obesity may be due, in part, to minority groups consuming more energy-rich diets in response to greater stress exposure. The present study systematically reviewed the literature describing the effects of stress on food consumption among various racial/ethnic groups in the US. METHODS PubMed and PsycINFO databases were searched for studies reporting associations between stress and food consumption by different racial/ethnic groups, conducted between January 1, 1999 to November 25, 2019. The search included terms related to food consumption, stress, and race/ethnicity. After screening 3660 records, 30 studies were included for review. RESULTS The selected studies assessed diverse stressors and eating constructs; African-American and Hispanic/Latinx were the most commonly studied minority groups. Studies generally supported that diverse forms of stress exposure are associated with reduced healthy eating patterns and increased obesogenic eating patterns across racial/ethnic groups. However, studies that directly compared stress-eating associations among multiple racial/ethnic groups showed mixed results. CONCLUSION Members of diverse racial/ethnic groups are susceptible to stress-induced unhealthy eating patterns, though evidence is insufficient to conclude whether the degree of susceptibility differs among groups. Additional studies utilizing observational measures of food intake and culturally sensitive measures of stress are needed to identify the most influential stressors on dietary behaviors, to assess whether some stressors are more salient for given racial/ethnic groups, and to examine the extent to which stress-induced eating contributes to racial/ethnic disparities in obesity and obesity-related diseases.
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Affiliation(s)
- Kelly F M Kazmierski
- Department of Psychiatry & Human Behavior, College of Health Sciences, School of Medicine, University of California, Irvine, CA, USA
| | - Marie L Gillespie
- Department of Psychiatry & Human Behavior, College of Health Sciences, School of Medicine, University of California, Irvine, CA, USA
| | - Sabrina Kuo
- Department of Psychiatry & Human Behavior, College of Health Sciences, School of Medicine, University of California, Irvine, CA, USA
| | - Tomas Zurita
- Department of Psychiatry & Human Behavior, College of Health Sciences, School of Medicine, University of California, Irvine, CA, USA
| | - Dania Felix
- Department of Psychiatry & Human Behavior, College of Health Sciences, School of Medicine, University of California, Irvine, CA, USA
| | - Uma Rao
- Department of Psychiatry & Human Behavior, College of Health Sciences, School of Medicine, University of California, Irvine, CA, USA.
- Children's Hospital of Orange County, Orange, CA, USA.
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Alsukait RF, Folta SC, Chui K, Seguin RA, Sinclair CG, Hudson LB. Healthy Hearts for an Abundant Life: Feasibility of a Culturally Adapted Cardiovascular Disease Prevention Curriculum for African American Women. Health Equity 2021; 5:398-407. [PMID: 34235364 PMCID: PMC8237101 DOI: 10.1089/heq.2021.0005] [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] [Accepted: 04/27/2021] [Indexed: 11/13/2022] Open
Abstract
Background: This study tested the feasibility of implementing Healthy Hearts for an Abundant Life (HHAL), a cultural adaptation for African American (AA) women of the evidence-based cardiovascular disease prevention program Strong Women-Healthy Hearts (SWHH). Methods: Using a quasi-experimental pre-post study design, this 12-week program was implemented in four faith-based organizations between 2017 and 2018. Eligible participants were AA women between 40 and 65 years who had a body mass index of 25 or higher and were currently sedentary. HHAL program participants met weekly for 2-h sessions led by program leaders. The curriculum has four modules: total health; relationships, family, and networks; material security and the environment; and emotional wellness. Each class included walking for 30 min, goal-setting session, and a group dialog called "making it work" for building collective efficacy. Results: Of the 27 participants (mean age=54.2±5.9), 24 completed postassessments (93% retention rate). All outcome measures proved feasible and weekly program attendance was 73%. Findings from in-depth interviews show high satisfaction with the program and suggest extending the class time and adding cooking demonstrations. Conclusions: The culturally adapted HHAL proved feasible and was positively received by the participants. Future studies will evaluate the effectiveness of the program.
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Affiliation(s)
- Reem F. Alsukait
- Community Health Department, King Saud University, Riyadh, Saudi Arabia
| | - Sara C. Folta
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA
| | - Kenneth Chui
- Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Rebecca A. Seguin
- College of Agriculture and Life Sciences, Texas A&M University, College Station, Texas, USA
| | - Christine G. Sinclair
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA
| | - Linda B. Hudson
- Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts, USA
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Hill D, Conner M, Clancy F, Moss R, Wilding S, Bristow M, O'Connor DB. Stress and eating behaviours in healthy adults: a systematic review and meta-analysis. Health Psychol Rev 2021; 16:280-304. [PMID: 33913377 DOI: 10.1080/17437199.2021.1923406] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Stress leads to detrimental health outcomes through direct biological and indirect behavioural changes. Stress can lead to disruption to normal eating behaviours, although the strength of these associations is unknown. This is the first meta-analysis to determine the strength of the stress-eating relationship in healthy adults and to explore the impact of potential moderators. Studies included had a clearly defined measure of stress (i.e., any noxious event or episode in one's environment with the exclusion of emotional distress) that was linked to non-disordered eating. Key terms were searched in Medline, PsycInfo and Ovid databases (23,104 studies identified). 54 studies (combined N = 119,820) were retained in the meta-analysis. A small, positive effect size was found for the stress-overall food intake relationship (Hedges' g = 0.114). Stress was associated with increased consumption of unhealthy foods (Hedges' g = 0.116) but decreased consumption of healthy foods (Hedges' g = -0.111). Only one significant moderator (restraint on stress-unhealthy eating) was identified. This meta-analysis identified the magnitude of the effect of stress on eating behaviour outcomes. Significant heterogeneity was observed that was not explained by the moderators examined. Further research on moderators of the stress-eating relationship is required and should distinguish effects for healthy versus unhealthy eating.
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Affiliation(s)
- Deborah Hill
- School of Psychology, University of Leeds, Leeds, LS2 9JT, UK
| | - Mark Conner
- School of Psychology, University of Leeds, Leeds, LS2 9JT, UK
| | - Faye Clancy
- School of Psychology, University of Leeds, Leeds, LS2 9JT, UK
| | - Rachael Moss
- School of Psychology, University of Leeds, Leeds, LS2 9JT, UK
| | - Sarah Wilding
- School of Psychology, University of Leeds, Leeds, LS2 9JT, UK
| | - Matt Bristow
- School of Psychology and Sports Science, Anglia Ruskin University, Cambridge, CB1 1PT, UK
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Molina K, Baskin ML, Long D, Carson TL. Psychological and behavioral pathways between perceived stress and weight change in a behavioral weight loss intervention. J Behav Med 2021; 44:822-832. [PMID: 34003418 DOI: 10.1007/s10865-021-00231-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 05/07/2021] [Indexed: 11/30/2022]
Abstract
Black women have a higher prevalence of obesity and tend to have suboptimal outcomes in behavioral weight loss programs for reasons that are not fully understood. Studies have shown a potential relationship between perceived psychological stress and weight loss in behavioral interventions. This study sought to assess whether baseline stress was directly or indirectly associated with 6-month weight change among Black women participating in a behavioral weight loss study. Indirect pathways of interest included depressive symptoms and dietary intake. A secondary analysis of data (n = 409) collected from a cluster, randomized behavioral weight loss trial was conducted. Demographics, anthropometry, surveys, and dietary data were collected at baseline and 6 months. Path analysis was used to test for direct and indirect effects of baseline stress on 6-month weight change while controlling for sociodemographic factors and intervention group. Baseline stress was not directly associated with 6-month weight change nor was it indirectly associated via depressive symptoms in the adjusted model. However, each of the direct paths linking baseline stress to weight loss were statistically significant. Stress was not associated with 6-month weight change via dietary intake. Baseline stress was positively associated with 6-month depressive symptoms which in turn was associated with less weight change. Depressive symptoms may offer an additional psychosocial target to consider when designing behavioral weight loss interventions for Black women.
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Affiliation(s)
- Kristine Molina
- Department of Psychological Sciences, University of California Irvine, Irvine, CA, USA
| | - Monica L Baskin
- School of Medicine, Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA
- Nutrition Obesity Research Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Dustin Long
- School of Public Health, Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Tiffany L Carson
- Department of Health Outcomes and Behavior, Division of Population Sciences, H. Lee Moffitt Cancer Center & Research Institute, MFC-EDU, 12902 Magnolia Drive, Tampa, FL, 33612, USA.
- Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA.
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Copeland T. Teaching and Learning Through Class Projects: Improving Fruit and Vegetable Consumption Among Schoolchildren. ANNALS OF ANTHROPOLOGICAL PRACTICE 2021. [DOI: 10.1111/napa.12158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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12
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Dietary intake and diet quality by weight category among a racially diverse sample of women in Birmingham, Alabama, USA. J Nutr Sci 2020; 9:e58. [PMID: 33354329 PMCID: PMC7737174 DOI: 10.1017/jns.2020.51] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 10/23/2020] [Accepted: 11/06/2020] [Indexed: 11/07/2022] Open
Abstract
Diet is a modifiable contributor to health. The lack of adherence to recommended dietary guidelines may contribute to the disproportionate burden of obesity and other chronic conditions observed in the Deep South region of the United States. The objective of this cross-sectional study was to describe food group intake and diet quality by race and weight status of women in the Deep South. Study participants were eighty-nine healthy female volunteers (56 % black, 44 % white, mean age 39⋅7 ± 1⋅4 years) recruited from Birmingham, AL, USA. Body Mass Index (BMI) determined weight status (non-obese/obese). Healthy Eating Index-2010 (HEI-2010) calculated from dietary recalls assessed diet quality. Wilcoxon sum-rank test compared HEI-2010 scores by race and weight status. χ 2 analysis compared the percentage of women who achieved maximum points for HEI-2010 index food components by subgroup. Caloric and macronutrient intake did not differ by race or weight status (mean kcal 1863⋅0 ± 62⋅0). Median Total HEI-2010 Score for the sample was 51⋅9 (IQR: 39⋅1-63⋅4). Although there was no statistical difference in diet quality by race, more whites achieved the maximum score for vegetable intake compared to blacks, while blacks reported higher total fruit intake. Non-obese women reported better diet quality (56⋅9 v. 46⋅1; P = 0⋅04) and eating more whole fruits, and more achieved the maximum score for protein from plant and seafood sources. In summary, differences in diet quality were observed by weight status, but not race among this sample. These results point to tailored dietary interventions for women in metropolitan areas of Alabama, USA.
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Nordkap L, Priskorn L, Bräuner EV, Marie Hansen Å, Kirstine Bang A, Holmboe SA, Winge SB, Egeberg Palme DL, Mørup N, Erik Skakkebaek N, Kold Jensen T, Jørgensen N. Impact of psychological stress measured in three different scales on testis function: A cross-sectional study of 1362 young men. Andrology 2020; 8:1674-1686. [PMID: 32621382 DOI: 10.1111/andr.12835] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 05/18/2020] [Accepted: 06/01/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Studies have reported associations between psychological stress and semen quality, but most have been performed on selected populations using different stress measures. Thus, it is uncertain which stress scale best quantifies the effects of stress on testicular function. OBJECTIVE To study the association between three different measures of stress and testicular function in young men. MATERIAL AND METHODS In total, 1362 men (median age 19 years) delivered semen and blood samples. They also answered a questionnaire including information from three stress scales: Stress Symptoms, Stressful Life Events and Perceived Stress. Various statistical analyses for associations between stress and testicular function (semen quality and reproductive hormones) were performed. RESULTS Perceived Stress was negatively associated with sperm concentration, total count and motility and positively associated with serum FSH. Men with the highest scores (>30 points) had 38% (95% CI 3-84%) lower sperm concentration, 42% (95% CI 5-91%) lower total count and 22% (95% CI 2-32%) lower proportion of motile spermatozoa than men with the lowest scores (0-10 points). For the stress symptoms score, men with highest scores (>95th percentile vs. lower) had lower sperm concentration, total sperm count, motility and serum Inhibin-B/FSH-ratio. Although men with highest stress levels were characterized by an unhealthier lifestyle, adjusting for lifestyle factors did not attenuate results suggesting that the associations between stress and testicular function were not mediated by lifestyle. Stressful Life Events were not associated with testicular function. DISCUSSION AND CONCLUSION The linear association between Perceived Stress and semen parameters and lack of dose-response association for the other two stress scales indicated that perceived stress was the most sensitive marker of stress affecting semen quality in young men. The lack of associations between Stressful Life Events and testis function confirmed that the perception of stressful events rather than the stressful event per se matters.
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Affiliation(s)
| | - Laerke Priskorn
- Department of Growth and Reproduction and International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, Denmark
| | - Elvira V Bräuner
- Department of Growth and Reproduction and International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, Denmark
| | - Åse Marie Hansen
- Department of Public Health, University of Copenhagen, Copenhagen K, Denmark.,National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Anne Kirstine Bang
- Department of Growth and Reproduction and International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, Denmark
| | - Stine A Holmboe
- Department of Growth and Reproduction and International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, Denmark
| | - Sofia B Winge
- Department of Growth and Reproduction and International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, Denmark
| | - Dorte L Egeberg Palme
- Department of Growth and Reproduction and International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, Denmark
| | - Nina Mørup
- Department of Growth and Reproduction and International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, Denmark
| | - Niels Erik Skakkebaek
- Department of Growth and Reproduction and International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, Denmark
| | - Tina Kold Jensen
- Department of Growth and Reproduction and International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, Denmark.,Department of Environmental Medicine, University of Southern Denmark, Odense C, Denmark
| | - Niels Jørgensen
- Department of Growth and Reproduction and International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, Denmark
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14
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Pickett S, Burchenal CA, Haber L, Batten K, Phillips E. Understanding and effectively addressing disparities in obesity: A systematic review of the psychological determinants of emotional eating behaviours among Black women. Obes Rev 2020; 21:e13010. [PMID: 32067355 DOI: 10.1111/obr.13010] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 12/21/2019] [Accepted: 01/17/2020] [Indexed: 11/28/2022]
Abstract
Emotional eating may be a particularly important contributor to differences in body weight and weight loss response to behavioural interventions among non-Hispanic Black women. We performed a systematic review on the impact of psychological factors (stress, anxiety, depression, and discrimination) upon emotional eating and weight among non-Hispanic Black women, applying the Preferred Reporting Items for Systematic Reviews and Meta-analysis for relevant studies. The initial search yielded 4593 articles with 15 accepted for review. Based on this review, there is a suggestion that negative emotions, in particular, perceived stress, may be predictive of emotional eating among non-Hispanic Black women. Results from the only two longitudinal studies identified by the review indicate that stress influences emotional eating, and emotional eating predicts weight gain over time. Findings from this review highlight the need for more studies that examine various negative emotions that may lead to emotional eating and weight gain among non-Hispanic Black women. Findings from this review also highlight the need for more rigorous studies to differentiate the effects of emotional eating from that of the physiologic (ie, activation of the hypothalamic-pituitary axis) responses to stress and its impact on high-risk groups.
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Affiliation(s)
- Stephanie Pickett
- School of Nursing, University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Clare A Burchenal
- School of Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Leora Haber
- School of Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Kendra Batten
- School of Health and Human Sciences, University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Erica Phillips
- Division of General Internal Medicine, Weill Cornell Medical College, New York, NY, USA
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15
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Ahola AJ, Forsblom C, Harjutsalo V, Groop PH. Perceived Stress and Adherence to the Dietary Recommendations and Blood Glucose Levels in Type 1 Diabetes. J Diabetes Res 2020; 2020:3548520. [PMID: 32733965 PMCID: PMC7383306 DOI: 10.1155/2020/3548520] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 06/20/2020] [Indexed: 11/17/2022] Open
Abstract
Stress may negatively impact self-management of diabetes and thereby deteriorate glycaemic control. Eating is the most frequently reported stress-release method. In this study, we investigated the association between perceived stress (PS), dietary adherence, and glycaemic control. Data from participants in the FinnDiane Study with type 1 diabetes who had completed a diet questionnaire and Cohen's perceived stress scale (PSS) were included. In addition to using a continuous PSS score, participants were divided into three groups based on the PSS scores: the first PSS quartile, low levels of PS; second and third quartiles, moderate levels of PS; and fourth quartile, high levels of PS. A diet score reflecting the level of adherence to dietary recommendations was calculated. Analyses were conducted in the whole sample and in subgroups divided by body mass index (BMI < 25 kg/m2 vs. BMI ≥ 25 kg/m2). In the whole sample, high PS and continuous stress score were negatively associated with the diet score and with adherence to fish, fresh vegetable, low-fat liquid milk product, and vegetable oil-based cooking fat recommendations. The stress score was negatively associated with the diet score both in lean and in those overweight or obese. However, fish and fresh vegetable recommendations were only affected in those with corpulence. PS was not associated with mean blood glucose concentrations in the whole sample. When divided by BMI status, worse glycaemic control was observed in lean subjects reporting stress. In individuals with overweight or obesity, instead, high glucose concentrations were observed regardless of the level of perceived stress. Interventions to improve stress management could improve dietary adherence and glycaemic control and could thereby have the potential to improve long-term health and well-being of individuals with type 1 diabetes.
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Affiliation(s)
- Aila J. Ahola
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland
- Abdominal Center, Nephrology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Finland
| | - Carol Forsblom
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland
- Abdominal Center, Nephrology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Finland
| | - Valma Harjutsalo
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland
- Abdominal Center, Nephrology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Finland
- Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Per-Henrik Groop
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland
- Abdominal Center, Nephrology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Finland
- Department of Diabetes, Central Clinical School, Monash University, Melbourne, Victoria, Australia
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16
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Sterling SR, Bowen SA. The Potential for Plant-Based Diets to Promote Health Among Blacks Living in the United States. Nutrients 2019; 11:E2915. [PMID: 31810250 PMCID: PMC6949922 DOI: 10.3390/nu11122915] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 11/13/2019] [Accepted: 11/21/2019] [Indexed: 02/07/2023] Open
Abstract
Plant-based diets are associated with reduced risks of various chronic diseases in the general population. However, it is unclear how these benefits translate to Blacks living in the United States, who are disproportionately burdened with heart disease, cancer, diabetes, obesity, and chronic kidney disease. The objectives of this study were to: (1) review the general evidence of plant-based diets and health outcomes; (2) discuss how this evidence translates to Blacks following a plant-based diet; and (3) provide recommendations and considerations for future studies in this area. Interestingly, although the evidence supporting plant-based diets in the general population is robust, little research has been done on Blacks specifically. However, the available data suggests that following a plant-based diet may reduce the risk of heart disease and possibly cancer in this population. More research is needed on cardiovascular disease risk factors, cancer subtypes, and other chronic diseases. Further, attention must be given to the unique individual, familial, communal, and environmental needs that Blacks who follow plant-based diets may have. Interventions must be culturally appropriate in order to achieve long-term success, and providing low-cost, flavorful, and nutritious options will be important.
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17
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Muhammad JN, Fernandez JR, Clay OJ, Saag MS, Overton ET, Willig AL. Associations of food insecurity and psychosocial measures with diet quality in adults aging with HIV. AIDS Care 2018; 31:554-562. [PMID: 30558446 DOI: 10.1080/09540121.2018.1554239] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
People aging with HIV face social stressors which may negatively affect their overall nutrition. Here, we assess relationships between self-reported measures of depression, perceived stress, social support, and food insecurity with diet quality in older adults with HIV. A retrospective analysis of self-reported data from parent study at The University of Alabama at Birmingham 1917 HIV Clinic was performed. The study sample consisted of sixty people living with HIV (PLWH) with controlled HIV infection (<50 copies/mL), aged 50 years or older who participated in a cross-sectional microbiome study. Dietary intake was measured using the NHANES 12-month Food Frequency Questionnaire (FFQ) and three Automated Self-Administered (ASA) 24-hr diet recalls to calculate diet quality scores using the Mediterranean Diet Score (MDS); alternative Healthy Eating Index (aHEI); and the Recommended Food Score (RFS) indices. Food insecurity was measured with the Food Security Questionnaire (FSQ). Participants completed the following psychosocial scales: (1) depression - Patient Health Questionnaire-8 (PHQ8); (2) perceived stress - Perceived Stress Scale (PSS-10); (3) social support - Multidimensional Scale of Perceived Social Support (MSPSS). Linear regression models were used to investigate relationships among variables controlling for gender and income. The cohort was characterized as follows: Mean age 56 ± 4.6 years, 80% African-American, and 32% women. Mean body mass index (BMI) was 28.4 ± 7.2 with 55% reporting food insecurity. Most participants reported having post-secondary education (53%), although 77% reported annual incomes <$20,000. Food insecurity was independently associated with measures of poor dietary intake: aHEI (β = -0.08, p = .02) and MDS (β = -0.23, p < 0.01) and with low dietary intake of fibre (β = -0.27, p = .04), vitamin E (β = -0.35, p = .01), folate (β = -0.31, p = .02), magnesium (β = -0.34, p = .01) and copper (β = -0.36, p = .01). These data indicate food insecurity is associated with poor diet quality among PLWH. Clinical interventions are needed to improve food access for PLWH of low SES.
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Affiliation(s)
- J N Muhammad
- a Department of Nutrition Sciences , The University of Alabama at Birmingham , Birmingham, Alabama , United States
| | - J R Fernandez
- a Department of Nutrition Sciences , The University of Alabama at Birmingham , Birmingham, Alabama , United States
| | - O J Clay
- b Department of Psychology , The University of Alabama at Birmingham , Birmingham, Alabama , United States
| | - M S Saag
- c Department of Infectious Diseases , The University of Alabama at Birmingham , Birmingham, Alabama , United States
| | - E T Overton
- c Department of Infectious Diseases , The University of Alabama at Birmingham , Birmingham, Alabama , United States
| | - A L Willig
- c Department of Infectious Diseases , The University of Alabama at Birmingham , Birmingham, Alabama , United States
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18
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Lower depression scores associated with greater weight loss among rural black women in a behavioral weight loss program. Transl Behav Med 2018; 7:320-329. [PMID: 27909882 DOI: 10.1007/s13142-016-0452-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Depression and stress have been associated with less weight loss among some participants in behavioral weight loss (BWL) programs. The purpose of this study was to (1) measure the levels of depression and stress among a sample of black women living in rural Alabama and Mississippi who were participating in a BWL program and (2) examine the association between these psychosocial variables and weight loss outcomes of participants at 6 months. Overweight and obese black women in a BWL program (n = 409) completed validated surveys to measure depression and stress at baseline and 6 months. Weight and height were also measured at baseline and 6 months. Statistical tests were conducted to examine associations between depression, stress, and weight loss. Mean BMI at baseline was 38.68 kg/m2. Participants achieved a 1.17 kg/m2 reduction in BMI at 6 months. When comparing by baseline depression or stress categories, no significant differences in weight loss outcomes were observed. Analysis of continuous data revealed a significant correlation between baseline depression score and change in BMI. In adjusted models, change in depression score over time was significantly associated with change in weight. No differences in weight loss outcomes at 6 months were observed when comparing participants with and without elevated depressive symptoms or elevated stress at baseline. This suggests that potential participants may not need to be excluded from BWL programs based on pre-specified cut points for these psychological conditions. Greater improvements in depression were associated with better weight loss outcomes suggesting that more emphasis on reducing depression may lead to greater weight losses for black women in BWL programs.
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19
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Sterling SR, Bertrand B, Judd S, Carson TL, Chandler-Laney P, Baskin ML. Longitudinal Analysis of Nut-Inclusive Diets and Body Mass Index Among Overweight and Obese African American Women Living in Rural Alabama and Mississippi, 2011-2013. Prev Chronic Dis 2017; 14:E82. [PMID: 28934081 PMCID: PMC5609494 DOI: 10.5888/pcd14.160595] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Introduction Nuts, when eaten alongside other nutritionally rich foods, may decrease obesity and related chronic disease risks, which are high among African American women in the rural South. We monitored changes in nut intake, other obesity-related foods (fruits, vegetables, red or processed meats, added sugars), and body mass index (BMI) over a 2-year weight loss intervention among 383 overweight and obese African American women in rural Alabama and Mississippi. Methods Two dietary recalls were administered at 4 points over 24 months. Mann–Whitney tests compared differences in median food group intake between nut consumers and non-nut consumers, and t tests identified BMI differences between groups. Mixed linear models tested the relationship between nut intake and intake of the select food groups, and between nut intake and BMI over time. Results Overall nut consumers ate more fruits and vegetables and less red meat than non-nut consumers. Nut consumers had lower BMI values than non-nut consumers. Weight loss by the end of the intervention was significant for nut consumers but not for non-nut consumers, even after accounting for kilocalorie consumption and physical activity engagement. Conclusion Nut consumption is associated with consumption of other nutritionally rich foods and lower BMI among African American women in rural Alabama and Mississippi. Future interventions should target increasing daily nut intake, decreasing added sugar intake, and identifying strategies to encourage positive dietary changes to continue after an intervention.
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Affiliation(s)
- Samara R Sterling
- Department of Nutrition Science, School of Health Professions, University of Alabama at Birmingham, Webb 449 1675 University Blvd, Birmingham, AL 35294-3361. E-mail:
| | - Brenda Bertrand
- Department of Nutrition Science, School of Health Professions, University of Alabama at Birmingham, Birmingham, Alabama
| | - Suzanne Judd
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Tiffany L Carson
- Division of Preventive Medicine, School of Medicine and Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama
| | - Paula Chandler-Laney
- Department of Nutrition Science, School of Health Professions, University of Alabama at Birmingham, Birmingham, Alabama
| | - Monica L Baskin
- Division of Preventive Medicine, School of Medicine and Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama
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20
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Gross TT, Story CR, Harvey IS, Allsopp M, Whitt-Glover M. "As a Community, We Need to be More Health Conscious": Pastors' Perceptions on the Health Status of the Black Church and African-American Communities. J Racial Ethn Health Disparities 2017; 5:570-579. [PMID: 28707267 DOI: 10.1007/s40615-017-0401-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 06/16/2017] [Accepted: 06/20/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Churches are recognized for their potential capacity to provide health services and interventions to address health disparities in African-Americans (blacks). Since pastors are central community leaders, their support and involvement can influence both implementation and outcomes for church-based health programs. The purpose of this qualitative study was to explore pastors' perceptions of congregant health status within the black church. METHODS Semi-structured interviews were conducted with 11 pastors whose female congregants participated in a physical activity intervention. Thematic analysis techniques were used to analyze interview data. RESULTS Three major themes emerged: (1) health risks in the African-American community, (2) health promotion in the black church, and (3) the importance of women in the black family and the church. Pastors noted numerous health disparities affecting their congregants and the African-American community at large, including obesity and infant mortality. They viewed health holistically and included faith in their perspectives. According to pastors, holistic health was promoted through health ministry programming in black churches. Women were described as the cornerstone of the black church, yet faced unique health concerns from their roles as family caretakers and congregants. DISCUSSION Pastors shared their major concerns for congregant health status and the African-American community. Health interventions focusing on African-Americans in church settings should include pastor involvement and should incorporate holistic approaches to address health risks.
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Affiliation(s)
- Tyra Toston Gross
- Public Health Sciences, Xavier University of Louisiana, New Orleans, LA, 70125, USA.
| | - Chandra R Story
- Community and Public Health, Middle Tennessee State University, Murfreesboro, TN, USA
| | - Idethia Shevon Harvey
- Department of Health and Kinesiology, Texas A&M University College, Station, TX, USA.,Transdisciplinary Center for Health Equity Research, Texas A&M University, College Station, TX, USA
| | - Marie Allsopp
- Department of Food Science, Nutrition, and Health Promotion, Mississippi State University, Starkville, MS, USA
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21
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Pickett S, McCoy TP. Effect of Psychosocial Factors on Eating Behaviors and BMI Among African American Women. Clin Nurs Res 2017; 27:917-935. [PMID: 28618835 DOI: 10.1177/1054773817713420] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Psychosocial stress and negative emotions have been associated with the consumption of highly palatable foods and excess weight. Few studies have examined these variable relationships among young African American women. The purpose of this cross-sectional study was to examine the relationship of perceived stress, depressive symptoms, eating behaviors, and body mass index (BMI) among 191 African American women who were 18 to 40 years old. Multivariate analysis indicated that depressive symptoms had a greater impact on highly palatable eating behaviors compared with perceived stress. This study extends understanding of depressive symptoms on eating behaviors among young African American women.
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Affiliation(s)
| | - Thomas P McCoy
- 1 The University of North Carolina at Greensboro, NC, USA
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22
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Sterling S, Judd S, Bertrand B, Carson TL, Chandler-Laney P, Baskin ML. Dietary Patterns Among Overweight and Obese African-American Women Living in the Rural South. J Racial Ethn Health Disparities 2017; 5:141-150. [PMID: 28281179 DOI: 10.1007/s40615-017-0351-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 02/01/2017] [Accepted: 02/06/2017] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Obesity and chronic diseases disproportionately affect African-American women in the rural South (US) and may be influenced by adherence to a typical Southern-style diet. There is a need to examine dietary patterns of this population and to determine if consumption of nutritionally rich foods like nuts is associated with consumption of other nutritious foods. The objectives of this study were to identify (1) dietary patterns of overweight/obese African-American women in the rural South; (2) the role that nuts play in the diet; (3) and adherence to federal food group recommendations across dietary patterns. METHODS Secondary data analysis of two baseline 24-h dietary recalls was performed on 383 overweight/obese African-American women enrolled in a weight loss intervention in Alabama and Mississippi between 2011 and 2013. Cluster analysis identified dietary patterns. t tests and chi-square tests tested demographic and dietary differences across clusters. The proportion of women in each cluster who met federal recommendations for fruit, vegetable, nuts, added sugar, and sodium intake was calculated. RESULTS Two dietary patterns were found. Nut intake frequency was higher in cluster 2 (P < .001), which was characterized by a higher intake frequency of fruits and vegetables, but high mean daily intake of added sugar (12.26 ± 7.67 tsp) and sodium (2800 ± 881 mg). Ninety-two percent of participants in this cluster consumed red/processed meats daily. CONCLUSION Even among women in this population who consume a more plant-based dietary pattern containing nuts, there is still a need to decrease intake of added sugar, sodium, and red meat.
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Affiliation(s)
- Samara Sterling
- Department of Nutrition Sciences, School of Health Professions, University of Alabama at Birmingham, Webb 449 1675 University Blvd, Birmingham, AL, 35294-3361, USA.
| | - Suzanne Judd
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, RPHB 327, 1530 3rd Avenue South, Birmingham, AL, 35294-0022, USA
| | - Brenda Bertrand
- Department of Nutrition Sciences, School of Health Professions, University of Alabama at Birmingham, Webb 534 1720 2nd Avenue South, Birmingham, AL, 35294-3360, USA
| | - Tiffany L Carson
- Division of Preventive Medicine, School of Medicine and Comprehensive Cancer Center, University of Alabama at Birmingham, MT 639 1720 2nd Avenue South, Birmingham, AL, 35294-4410, USA
| | - Paula Chandler-Laney
- Department of Nutrition Sciences, School of Health Professions, University of Alabama at Birmingham, Webb 413 1720 2nd Avenue South, Birmingham, AL, 35294-3360, USA
| | - Monica L Baskin
- Division of Preventive Medicine, School of Medicine and Comprehensive Cancer Center, University of Alabama at Birmingham, MT 618 1717 11th Avenue South, Birmingham, AL, 35294-4410, USA
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23
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Story CR, Gross TT, Harvey IS, Whitt-Glover MC. Pastoral perceptions of the learning and developing individual exercise skills (L.A.D.I.E.S.) intervention: a qualitative study. HEALTH EDUCATION RESEARCH 2017; 32:81-95. [PMID: 28052931 PMCID: PMC5914337 DOI: 10.1093/her/cyw054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Accepted: 11/29/2016] [Indexed: 06/06/2023]
Abstract
African-American women experience higher rates of obesity compared to other racial/ethnic groups. High levels of reported church attendance among African-Americans have led to the proliferation of faith-based health programs. Pastors can influence success for faith-based programs. The purpose of this study was to assess pastors' perceptions of the L.A.D.I.E.S. intervention, designed to increase physical activity levels in sedentary African-American women. For the L.A.D.I.E.S. intervention, 31 churches (n = 418 women) were randomized at the church level to a faith-based, non-faith-based or self-guided program. All 31 pastors were invited by telephone to participate in the current study. Using a qualitative design, semi-structured interviews were conducted with 11 pastors from participating churches. Thematic analysis and the ecological model were used to examine the findings. According to the pastors, women showed heightened awareness of the importance of health and physical activity, and increased levels of fellowship. L.A.D.I.E.S. also encouraged healthy church climates and new health ministries. Lessons learned included the need for an expanded participant base and curriculum. Pastors expressed appreciation for the culturally fitting approach of L.A.D.I.E.S. Findings have implications for faith-based and public agency partnerships.
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Affiliation(s)
- Chandra R. Story
- School of Applied Health and Educational Psychology, Oklahoma State University, Stillwater, OK, USA
| | - Tyra T. Gross
- Public Health Sciences, Xavier University of Louisiana, New Orleans, LA, USA
| | - Idethia S. Harvey
- Transdisciplinary Center for Health Equity Research, Texas A&M University, College Station, TX, USA and
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Sterling SR, Bertrand B, Judd S, Baskin ML. Nut Intake among Overweight and Obese African-American Women in the Rural South. Am J Health Behav 2016; 40:585-93. [PMID: 27561861 DOI: 10.5993/ajhb.40.5.5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Nut consumption decreases risk for obesity and chronic diseases, which are prevalent among African-American women in the rural southeastern United States. The quantity and quality of nut intake in this population is unclear. We examined the amount, source, and quality of nut consumption among overweight and obese African-American women in rural Alabama and Mississippi. METHODS Two 24-hour dietary recalls were administered to 426 women. Mann-Whitney tests, t-tests, and linear regression models identified differences in added sugar and sodium intake between nut consumers and non-consumers, differences in mean nut, added sugar, and sodium intake between stand-alone and incorporated nut sources, and a relationship between nut intake and added sugar and sodium intake. RESULTS Forty-two percent of participants consumed nuts, and 16% met federal recommendations for nut intake. Nut consumption was mainly from incorporated sources (65%), which were higher in added sugar (p < .001) and sodium (p < .001), and lower in nut quantity (p < .001) than stand-alone sources. Nut consumers consumed more daily added sugar (p = .004) and sodium (p = .04) than non-consumers. CONCLUSION Suboptimal quantity and quality of nut intake may impede the health benefits of nut consumption among African-American women in the rural South.
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Affiliation(s)
- Samara R Sterling
- Department of Nutrition Science, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Brenda Bertrand
- Department of Nutrition Science, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Suzanne Judd
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Monica L Baskin
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
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25
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Janczura M, Bochenek G, Nowobilski R, Dropinski J, Kotula-Horowitz K, Laskowicz B, Stanisz A, Lelakowski J, Domagala T. The Relationship of Metabolic Syndrome with Stress, Coronary Heart Disease and Pulmonary Function--An Occupational Cohort-Based Study. PLoS One 2015; 10:e0133750. [PMID: 26274823 PMCID: PMC4537246 DOI: 10.1371/journal.pone.0133750] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 07/01/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND AIMS Higher levels of stress impact the prevalence of metabolic syndrome (MetS) and coronary heart disease. The association between MetS, impaired pulmonary function and low level of physical activity is still pending assessment in the subjects exposed to stress. The study aimed to examine whether higher levels of stress might be related to MetS and the plaque presence, as well as whether MetS might affect pulmonary function. DESIGN AND METHODS The study embraced 235 police officers (mean age 40.97 years) from the south of Poland. The anthropometrics and biochemical variables were measured; MetS was diagnosed using the International Diabetes Federation criteria. Computed tomography coronary angiography of coronary arteries, exercise ECG, measurements of brachial flow-mediated dilation, and carotid artery intima-media thickness were completed. In order to measure the self-perception of stress, 10-item Perceived Stress Scale (PSS-10) was applied. Pulmonary function and physical activity levels were also addressed. Multivariate logistic regression analyses were applied to determine the relationships between: 1/ incidence of coronary plaque and MetS per se, MetS components and the number of classical cardiovascular risk factors, 2/ perceived stress and MetS, 3/ MetS and pulmonary function parameters. RESULTS Coronary artery atherosclerosis was less associated with MetS (OR = 2.62, 95%CI 1.24-5.52; p = 0.011) than with a co-existence of classical cardiovascular risk factors (OR = 5.67, 95% CI 1.07-29.85, p = 0.03; for 3 risk factors and OR = 9.05; 95% CI 1.24-66.23, p = 0.02; for 6 risk factors, respectively). Perceived stress increased MetS prevalence (OR = 1.07, 95% CI 1.03-1.13; p = 0.03), and impacted coronary plaque prevalence (OR = 1.05, 95% CI 1.001-1.10; p = 0.04). Leisure-time physical activity reduced the chances of developing MetS (OR = 0.98 95% CI 0.96-0.99; p = 0.02). MetS subjects had significantly lower values of certain pulmonary function parameters. CONCLUSIONS Exposure to job-specific stress among police officers increased the prevalence of MetS and impacted coronary plaque presence. MetS subjects had worse pulmonary function parameters. Early-stage, comprehensive therapeutic intervention may reduce overall risk of cardiovascular events and prevent pulmonary function impairment in this specific occupational population.
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Affiliation(s)
- Miroslaw Janczura
- Department of Anesthesiology and Intensive Pulmonary Care, The John Paul II Hospital, Krakow, Poland
| | - Grazyna Bochenek
- Department of Internal Medicine, Jagiellonian University School of Medicine, Krakow, Poland
| | - Roman Nowobilski
- Department of Internal Medicine, Jagiellonian University School of Medicine, Krakow, Poland
- Unit of Rehabilitation in Internal Diseases, Faculty of Public Health, Jagiellonian University School of Medicine, Krakow, Poland
| | - Jerzy Dropinski
- Department of Internal Medicine, Jagiellonian University School of Medicine, Krakow, Poland
| | | | - Bartosz Laskowicz
- Department of Radiology and Diagnostic Imaging, The John Paul II Hospital, Krakow, Poland
| | - Andrzej Stanisz
- Department of Bioinformatic and Telemedicine, Jagiellonian University School of Medicine, Krakow, Poland
| | - Jacek Lelakowski
- Department of Electrocardiology, Institute of Cardiology, The John Paul II Hospital, Krakow, Poland
| | - Teresa Domagala
- Department of Internal Medicine, Jagiellonian University School of Medicine, Krakow, Poland
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