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Kohanmoo A, Hashemzadeh M, Teymouri M, Zare M, Akhlaghi M. Food insecurity is associated with low diet quality and unhealthy cooking and eating habits in Iranian women. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2024; 43:42. [PMID: 38486251 PMCID: PMC10941397 DOI: 10.1186/s41043-024-00533-3] [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: 12/19/2022] [Accepted: 03/02/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND Food insecurity affects diet and nutrition intakes. We explored the relationship between food insecurity and dietary intakes in a group of Iranian women. METHODS The cross-sectional study was performed on 190 healthy females aged 20-55 years attending primary healthcare centers in Shiraz. Food insecurity was evaluated by Household Food Insecurity Access Scale, which is a validated tool for assessing food insecurity in developing countries. Diet was assessed using a food frequency questionnaire. The association of dietary patterns and food insecurity was assessed by linear regression. RESULTS Assessment of dietary intakes revealed that consumption of red meat, poultry, fish, dairy, fruits, non-starchy vegetables, and nuts decreased whereas that of grains, processed meats, potato, and sugary foods increased with increasing food insecurity. Among nutrients, carbohydrates, fiber, vitamin A, vitamin C, folic acid, potassium, calcium, and magnesium decreased while fat and sodium increased as food insecurity increased. Three major dietary patterns were detected. Healthy dietary patterns showed inverse associations with food insecurity in the crude (β = -0.422 and - 0.435, P < 0.001) and adjusted (adjusted for age, marital status, and educational level) (β = -0.475 and - 0.341, P < 0.001) models of regression analysis but unhealthy pattern did not show an association with food insecurity. Compared to food secure participants, a higher percentage of food insecure individuals indicated unhealthy eating habits, such as skipping breakfast, lower snack ingestion, more fast and fried food consumption, and using unhealthy cooking methods. CONCLUSION Overall, this study showed that food insecurity was associated with less healthy diet and unhealthy cooking and eating habits.
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Affiliation(s)
- Ali Kohanmoo
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maral Hashemzadeh
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Teymouri
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Morteza Zare
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoumeh Akhlaghi
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
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Nagai K, Komine T, Ikuta M, Gansa M, Matsuzawa R, Tamaki K, Kusunoki H, Wada Y, Tsuji S, Sano K, Shinmura K. Decline of instrumental activities of daily living is a risk factor for nutritional deterioration in older adults: a prospective cohort study. BMC Geriatr 2023; 23:480. [PMID: 37558989 PMCID: PMC10413727 DOI: 10.1186/s12877-023-04185-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 07/20/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND The association between functional capacity and the subsequent risk of nutritional deterioration is yet to be understood. The purpose of this study was to elucidate the relationship between functional capacity, comprising instrumental activities of daily living (IADL), intellectual activity, and social function, and future decline in nutritional status. METHODS The current study is a two-year prospective cohort study. A total of 468 community-dwelling older adults without nutritional risks were enrolled. We used the Mini Nutritional Assessment Screening Form. Functional capacity, including IADL, intellectual activity, and social function, was assessed using the Tokyo Metropolitan Institute of Gerontology Index of Competence at baseline. The nutritional status was reassessed at a 2-year follow-up. Risk ratios (RR) of functional capacity for the incidence of nutritional decline were estimated. RESULTS Low functional capacity was significantly associated with future deterioration of nutritional status (RR 1.12, 95% confidence interval [CI] 1.02-1.25). Of the subdomains of functional capacity, IADL decline (adjusted RR 2.21, 95% CI 1.18-4.13) was an independent risk factor for the incidence of nutritional risk. Intellectual and social activities were not significant. CONCLUSION Decline in functional capacity, especially IADL, is a risk factor for future deterioration in nutritional status. Further studies are required to elucidate the effect of interventions for IADL decline on maintaining nutritional status in older adults.
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Affiliation(s)
- Koutatsu Nagai
- Department of Physical Therapy, School of Rehabilitation, Hyogo Medical University, 1-3-6 Minatojima, Chuo-ku, Kobe, Hyogo, 650-8530, Japan.
| | - Takuya Komine
- Department of Physical Therapy, Hyogo Rehabilitation Center, 1080,Akebono-cho,Nishi-ku, Kobe, Hyogo, 651-2181, Japan
| | - Miho Ikuta
- Department of Therapy, Hakuhokai Central Hospital, 4-23-1 Higashisonodacho, Amagasaki, Hyogo, 661-0953, Japan
| | - Mako Gansa
- Department of Physical Therapy, School of Rehabilitation, Hyogo Medical University, 1-3-6 Minatojima, Chuo-ku, Kobe, Hyogo, 650-8530, Japan
- Department of Therapy, Amagasaki Central Hospital, 1-12-1 Sioe, Amagasaki, Hyogo, 661-0976, Japan
| | - Ryota Matsuzawa
- Department of Physical Therapy, School of Rehabilitation, Hyogo Medical University, 1-3-6 Minatojima, Chuo-ku, Kobe, Hyogo, 650-8530, Japan
| | - Kayoko Tamaki
- Department of General Medicine, Hyogo Medical University, 1-1 Mukogawa, Nishinomiya, Hyogo, 663-8501, Japan
| | - Hiroshi Kusunoki
- Department of General Medicine, Hyogo Medical University, 1-1 Mukogawa, Nishinomiya, Hyogo, 663-8501, Japan
- Department of Internal Medicine, Osaka Dental University, 1-8 Kuzuha-hanazono, Hirakata, Osaka, 573-1121, Japan
| | - Yosuke Wada
- Roppou Clinic, 1-465 Imamori, Toyooka, Hyogo, 668-0851, Japan
| | - Shotaro Tsuji
- Department of Orthopaedic Surgery, Hyogo Medical University, 1-1 Mukogawa, Nishinomiya, Hyogo, 663-8501, Japan
| | - Kyoko Sano
- Department of Therapy, Takarazuka Rehabilitation Hospital, 2-22 Tsuruno-so, Takarazuka, Hyogo, 665-0833, Japan
| | - Ken Shinmura
- Department of General Medicine, Hyogo Medical University, 1-1 Mukogawa, Nishinomiya, Hyogo, 663-8501, Japan
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Lou SP, Han D, Kuczmarski MF, Evans MK, Zonderman AB, Crews DC. Health Literacy, Numeracy, and Dietary Approaches to Stop Hypertension Accordance Among Hypertensive Adults. HEALTH EDUCATION & BEHAVIOR 2023; 50:49-57. [PMID: 35272527 DOI: 10.1177/10901981221079742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Health literacy (HL) and health numeracy (HN), the ability to interpret and act on quantitative health information, are important for hypertension self-management such as limiting sodium intake. We examined associations of HL, HN, and Dietary Approaches to Stop Hypertension (DASH) diet accordance. PARTICIPANTS Among 1,073 hypertensive adults enrolled in a Baltimore, Maryland-based cohort study, we performed a cross-sectional analysis. Rapid Estimate of Adult Literacy in Medicine (REALM) measured HL and Test of Functional Health Literacy in Adults (TOFHLA) numeracy score measured HN. METHOD DASH accordance was based on nine key nutrients. Linear regression models estimated associations of HL and HN with DASH total and sodium score, inclusive of dietary supplement data. RESULTS In our sample, 39% of participants were male, 66% were Black, 40.2% lived in poverty, and 29.5% reported food insecurity. Fully, 32.5% had limited HL and 14.5% had limited HN. Mean DASH score overall was 2 (range = 0-7.5); only 6.9% were DASH accordant (score ≥4.5). In age and sex adjusted models, higher REALM was associated with a higher DASH score in the overall sample; the relationship of HN with DASH was statistically significant among White but not Black participants. Educational attainment appeared to explain both findings. There were no significant associations between HL or HN and DASH sodium scores. CONCLUSION Differences in educational attainment explained the relation of higher HL and greater accordance to the DASH diet in a population of hypertensive adults. Understanding these factors is vital to reducing disparities in hypertension and its sequelae.
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Affiliation(s)
- Sophia P Lou
- Johns Hopkins University, Baltimore, MD, USA.,National Institutes of Health, Baltimore, MD, USA
| | - Dingfen Han
- Johns Hopkins University, Baltimore, MD, USA
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Khampang R, Kloyiam S, Butchon R. Relationship between socioeconomic, demographic, health and social characteristics and ability to access reliable information on herbal and food supplements: analysis of Thai Health Literacy Survey 2019. BMC Public Health 2022; 22:1054. [PMID: 35619106 PMCID: PMC9137100 DOI: 10.1186/s12889-022-13454-9] [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: 08/13/2020] [Accepted: 05/18/2022] [Indexed: 11/23/2022] Open
Abstract
Background The consumption of herbal and food supplements attributing to health expenditures in Thailand has been increasing over the years. However, information on herbal and food supplement products can make it difficult for some people with limited health literacy to use. Evidence from previous studies outside Thailand shows that SES disadvantaged groups are more likely to have limited health literacy compared with their counterparts with advantaged SES. The present study adds to this body of knowledge through an exploration of health literacy competencies related to herbal and food supplement consumption to determine what competency would be most problematic among Thai people. The study also investigated the influences of demographic and socio-economic factors on the most problematic health literacy competency on herbal and food supplements. Methods The THL-S used a stratified three-stage-sampling to draw a sample of Thais aged 15 years and above. Participants were interviewed with a questionnaire of 34 items measuring health literacy and 8 items measuring behavioural practices. Responses to questions on accessing, understanding, communicating, and making decisions related to herbal and food supplement consumption were analysed. A logistic regression model was used to explore the association between having difficulties in accessing information and participant’s socio-economic factors. Results Levels of difficulties the participants experienced varied among their health literacy competencies. Accessing reliable information was found to be the most problematic health literacy competency faced by respondents (48%), followed by asking healthcare providers about herbal products and food supplements (41%). Significant differences in the ability to access reliable information on herbal and food supplements were found to be based on differences in: education, income levels, occupation, insurance scheme coverage, age, sex, reading ability, writing ability, chronic diseases, wearing eyeglasses or lenses, hearing impairment, and having a community leading role. Conclusions Accessing reliable information on herbal and food supplements has been found to be the most difficult health literacy competency among respondents to the survey, particularly vulnerable consumers in the society such as people with hearing impairment or having limited overall literacy competencies. Therefore, health literacy programs might be developed to build health literacy competencies and empower vulnerable consumers for reasonable use of herbal and food supplements.
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Affiliation(s)
- Roongnapa Khampang
- Health Intervention and Technology Assessment Program, Ministry of Public Health, Nonthaburi, Thailand.
| | - Saichon Kloyiam
- Department of Health, Ministry of Public Health, Office of DoH 4.0 and Health Literacy, Nonthaburi, Thailand
| | - Rukmanee Butchon
- Health Intervention and Technology Assessment Program, Ministry of Public Health, Nonthaburi, Thailand
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Lampignano L, Donghia R, Sila A, Bortone I, Tatoli R, De Nucci S, Castellana F, Zupo R, Tirelli S, Giannoccaro V, Guerra V, Panza F, Lozupone M, Mastronardi M, De Pergola G, Giannelli G, Sardone R. Mediterranean Diet and Fatty Liver Risk in a Population of Overweight Older Italians: A Propensity Score-Matched Case-Cohort Study. Nutrients 2022; 14:nu14020258. [PMID: 35057439 PMCID: PMC8779579 DOI: 10.3390/nu14020258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 12/31/2021] [Accepted: 01/05/2022] [Indexed: 12/21/2022] Open
Abstract
Hepatic steatosis, often known as fatty liver, is the most common hepatic disease in Western countries. The latest guidelines for the treatment of nonalcoholic fatty liver disease emphasize lifestyle measures, such as changing unhealthy eating patterns. Using a propensity score-matching approach, this study investigated the effect of adhering to a Mediterranean diet (MedDiet) on fatty liver risk in an older population (≥65 years) from Southern Italy. We recruited 1.403 subjects (53.6% men, ≥65 years) who completed a food frequency questionnaire (FFQ) and underwent clinical assessment between 2015 and 2018. For the assessment of the liver fat content, we applied the Fatty Liver Index (FLI). To evaluate the treatment effect of the MedDiet, propensity score matching was performed on patients with and without FLI > 60. After propensity score-matching with the MedDiet pattern as treatment, we found a higher consumption of red meat (p = 0.04) and wine (p = 0.04) in subjects with FLI > 60. Based on the FLI, the inverse association shown between adherence to the MedDiet and the risk of hepatic steatosis shows that the MedDiet can help to prevent hepatic steatosis. Consuming less red and processed meat, as well as alcoholic beverages, may be part of these healthy lifestyle recommendations.
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Affiliation(s)
- Luisa Lampignano
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy; (L.L.); (R.D.); (A.S.); (I.B.); (R.T.); (S.D.N.); (F.C.); (R.Z.); (S.T.); (V.G.)
| | - Rossella Donghia
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy; (L.L.); (R.D.); (A.S.); (I.B.); (R.T.); (S.D.N.); (F.C.); (R.Z.); (S.T.); (V.G.)
| | - Annamaria Sila
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy; (L.L.); (R.D.); (A.S.); (I.B.); (R.T.); (S.D.N.); (F.C.); (R.Z.); (S.T.); (V.G.)
| | - Ilaria Bortone
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy; (L.L.); (R.D.); (A.S.); (I.B.); (R.T.); (S.D.N.); (F.C.); (R.Z.); (S.T.); (V.G.)
| | - Rossella Tatoli
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy; (L.L.); (R.D.); (A.S.); (I.B.); (R.T.); (S.D.N.); (F.C.); (R.Z.); (S.T.); (V.G.)
| | - Sara De Nucci
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy; (L.L.); (R.D.); (A.S.); (I.B.); (R.T.); (S.D.N.); (F.C.); (R.Z.); (S.T.); (V.G.)
| | - Fabio Castellana
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy; (L.L.); (R.D.); (A.S.); (I.B.); (R.T.); (S.D.N.); (F.C.); (R.Z.); (S.T.); (V.G.)
| | - Roberta Zupo
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy; (L.L.); (R.D.); (A.S.); (I.B.); (R.T.); (S.D.N.); (F.C.); (R.Z.); (S.T.); (V.G.)
| | - Sarah Tirelli
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy; (L.L.); (R.D.); (A.S.); (I.B.); (R.T.); (S.D.N.); (F.C.); (R.Z.); (S.T.); (V.G.)
| | | | - Vito Guerra
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy; (L.L.); (R.D.); (A.S.); (I.B.); (R.T.); (S.D.N.); (F.C.); (R.Z.); (S.T.); (V.G.)
| | - Francesco Panza
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, 11, 70125 Bari, Italy; (F.P.); (M.L.)
| | - Madia Lozupone
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, 11, 70125 Bari, Italy; (F.P.); (M.L.)
| | - Mauro Mastronardi
- Inflammatory Bowel Disease Unit, National Institute of Gastroenterology, “Saverio De Bellis” Research Hospital, 70013 Bari, Italy;
| | - Giovanni De Pergola
- Unit of Geriatrics and Internal Medicine, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy;
| | - Gianluigi Giannelli
- Scientific Direction, National Institute of Gastroenterology, “Saverio De Bellis” Research Hospital, 70013 Bari, Italy;
| | - Rodolfo Sardone
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Bari, Italy; (L.L.); (R.D.); (A.S.); (I.B.); (R.T.); (S.D.N.); (F.C.); (R.Z.); (S.T.); (V.G.)
- Correspondence:
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Kuczmarski MF, Beydoun MA, Zonderman AB, Evans MK. Intakes of Total and Branched-Chain Essential Amino Acids are Positively Associated with Handgrip Strength in African American and White Urban Younger and Older Adults. J Nutr Gerontol Geriatr 2022; 41:140-159. [PMID: 35502538 PMCID: PMC9733588 DOI: 10.1080/21551197.2022.2070321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Essential amino acids (EAAs) initiate amino acid-induced stimulation of muscle protein synthesis. Study objectives were to calculate intake of EAAs after creating an EAA database, to explore the association of EAAs and branched-chain amino acids (BCAAs) with handgrip strength (HS) in a younger (<50 y) and older (≥50 y) sample, and to identify major food groups contributing EAAs. The sample consisted of African American and White adults aged, 33-71 years from the Healthy Aging in Neighborhoods of Diversity across the Life Span study, 2009-2013. Intake of total EAAs and BCAAs/kg body weight were positively associated (p < 0.001) with HS per body mass index (HS/BMI) ratio. Being male, African American, a nonsmoker, physically active, euglycemic, and normotensive were associated with higher HS/BMI ratio. EAAs were mainly obtained from red meats/poultry and mixed dishes groups. Findings support the role of high-quality proteins and being active in promoting HS.
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Affiliation(s)
- Marie Fanelli Kuczmarski
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIH, 251 Bayview Blvd. Suite 100, Baltimore, MD 21224-6825, United States,Corresponding author: Ph: +1-410-995-3639; Fax: +1-410-995-3639,
| | - May A Beydoun
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIH, 251 Bayview Blvd. Suite 100, Baltimore, MD 21224-6825, United States
| | - Alan B. Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIH, 251 Bayview Blvd. Suite 100, Baltimore, MD 21224-6825, United States
| | - Michele K. Evans
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIH, 251 Bayview Blvd. Suite 100, Baltimore, MD 21224-6825, United States
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Lowe SM, Nobriga CV. Head and Neck Cancer in a Rural U.S. Population: Quality of Life, Coping, Health Care Literacy, and Access to Services. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:1116-1133. [PMID: 33970685 DOI: 10.1044/2021_ajslp-20-00223] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose The aim of this study was to explore the beliefs, access, and motivations of individuals with head and neck cancer (HNC) living in a rural community in the United States, regarding their speech and swallowing deficits. Method A convenience sample of nine patient participants with HNC and nine caregiver participants completed in-depth, semistructured interviews regarding their experiences with HNC diagnosis and treatment. The researchers utilized a thematic networks approach to analyze the qualitative data obtained. Results Primary results of the study were a set of common themes emerging from 735 units for analysis, arranged into 34 basic themes, nine organizing themes, and four global themes. The resulting networks centered around quality of life impact, coping, health literacy, and access. Direct quotes from the participants are utilized to illustrate response categories. Conclusions Individuals with HNC and their caregivers living in rural communities in the United States appear to represent a unique subset of the HNC population. While they present similarly in most areas, they display unique tendencies in the areas of psychological coping, health literacy, and access. Provision of practical, pertinent information that can be accessed by patients and caregivers alike outside the hospital is suggested to better serve this community.
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Affiliation(s)
- Shawn M Lowe
- Department of Communication Sciences and Disorders, Loma Linda University, CA
| | - Christina V Nobriga
- Department of Communication Sciences and Disorders, Loma Linda University, CA
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Shahavandi M, Ghorbaninejad P, Mohammadpour S, Djafari F, Shahinfar H, Sheikhhossein F, Djafarian K, Shab-Bidar S. Higher health literacy score is associated with better healthy eating index in Iranian adults. Nutrition 2021; 90:111262. [PMID: 33975063 DOI: 10.1016/j.nut.2021.111262] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 03/01/2021] [Accepted: 03/29/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Although there is some evidence for the importance of health literacy (HL), many health complications and nutrition knowledges such as portion size assessment, knowing the food labels, and choosing the nutrition sources affecting diet quality, data about HL and healthy eating index (HEI) are limited and controversial. The aim of this study was to evaluate the associations between HL and HEI in adults. METHODS This cross-sectional study included 261 adults 18 to 65 y of age from five districts of Tehran, Iran. HL was estimated using the Health Literacy for Iranian Adult (HELIA) questionnaire. Dietary intake, sociodemographic data, physical activity, and anthropometric measurements were collected using validated questionnaires. Diet quality was assessed based on HEI-2015 scores using data from a food frequency questionnaire. RESULTS Despite components of HEI-2015, the association between HEI-2015 and HL tertiles was significant (P of crude model = 0.007) even after adjustment for possible confounders. Multivariate regression showed a positive relationship between HL and HEI-2015 that was significant before (β = 0.12, P = 0.04) and after controlling for the confounding effect in model 1 (β = 0.14, P = 0.03). Additionally, a positive association between physical activity and HL was shown (β = 0.12, P = 0.03) and finally among the HEI components, only saturated fats were significantly related to HL (β = -0.11, P = 0.01). CONCLUSION Findings from the present study confirmed a considerable association between HL and HEI and shows HL levels have an important role in adherence to the Iranian Dietary Guidelines.
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Affiliation(s)
- Mahshid Shahavandi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Parivash Ghorbaninejad
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Saba Mohammadpour
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Farhang Djafari
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Hossein Shahinfar
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Sheikhhossein
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Kurosh Djafarian
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
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Socio-economic and racial/ethnic disparities in the nutritional quality of packaged food purchases in the USA, 2008-2018. Public Health Nutr 2021; 24:5730-5742. [PMID: 33500012 DOI: 10.1017/s1368980021000367] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To determine whether disparities exist in the nutritional quality of packaged foods and beverage purchases by household income, education and race/ethnicity and if they changed over time. DESIGN We used Nielsen Homescan, a nationally representative household panel, from 2008 to 2018 (n = 672 821 household-year observations). Multivariate, multilevel regressions were used to model the association between sociodemographic groups and a set of nutritional outcomes of public health interest, including nutrients of concern (sugar, saturated fat and Na) and calories from specific food groups (fruits, non-starchy vegetables, processed meats, sugar-sweetened beverages and junk foods). SETTING Household panel survey. PARTICIPANTS Approximately 60 000 households each year from the USA. RESULTS Disparities were found by income and education for most outcomes and widened for purchases of fruits, vegetables and the percentage of calories from sugar between 2008 and 2018. The magnitude of disparities was largest by education. Disparities between Black and White households include the consumption of processed meats and the percentage of calories from sugar, while no disparities were found between White and Hispanic households. Disparities have been largely persistent, as any significant changes over time have been substantively small. CONCLUSIONS Policies to improve the healthfulness of packaged foods must be expanded beyond SSB taxes, and future research should focus on what mediates the relationship between education and diet so as not to exacerbate disparities.
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The efficacy of 'high in' warning labels, health star and traffic light front-of-package labelling: an online randomised control trial. Public Health Nutr 2020; 24:62-74. [PMID: 33019950 DOI: 10.1017/s1368980020003213] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To examine the impact of front-of-package (FOP) labels on perceived healthfulness, purchasing intentions and understanding of common FOP systems. DESIGN A parallel, open-label design randomised participants to different FOP labelling conditions: 'high in' warning labels (WL), multiple traffic light labelling (TLL), health star ratings (HSR) (all displayed per serving) or control with no interpretive FOP labelling. Participants completed a brief educational session via a smartphone application and two experimental tasks. In Task 1, participants viewed healthy or unhealthy versions of four products and rated healthiness and purchasing intention on a seven-point Likert-type scale. In Task 2, participants ranked three sets of five products from healthiest to least healthy. SETTING Online commercial panel. PARTICIPANTS Canadian residents ≥ 18 years who were involved in household grocery shopping, owned a smartphone and met minimum screen requirements. RESULTS Data from 1997 participants (n 500/condition) were analysed. Task 1: across most product categories, the TLL and HSR increased perceived healthiness of healthier products. All FOP systems decreased perceived healthiness of less healthy products. Similar, albeit dampened, effects were seen regarding purchasing intentions. Task 2: participants performed best in the HSR, followed by the TLL, WL and control conditions. Lower health literacy was associated with higher perceived healthiness and purchasing intentions and poorer ranking task performance across all conditions. CONCLUSIONS All FOP labelling systems, after a brief educational session, improved task performance across a wide spectrum of foods. This effect differed depending on the nutritional quality of the products and the information communicated on labels.Trial Registration: NCT03290118.
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Agarwal P, Morris MC, Barnes LL. Racial Differences in Dietary Relations to Cognitive Decline and Alzheimer's Disease Risk: Do We Know Enough? Front Hum Neurosci 2020; 14:359. [PMID: 33100990 PMCID: PMC7497764 DOI: 10.3389/fnhum.2020.00359] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 08/06/2020] [Indexed: 01/08/2023] Open
Abstract
The elderly population in the US is increasing and projected to be 44% minority by 2060. African Americans and Hispanics are at increased risk of cognitive impairment and Alzheimer’s disease compared to non-Hispanic whites. These conditions are associated with many other adverse health outcomes, lower quality of life, and substantial economic burden. In the past few decades, diet has been identified as an important modifiable risk factor for cognitive decline and Alzheimer’s disease. Some studies report poor diet quality among African American and Hispanic older adult populations compared to their white counterparts. We have a limited understanding of how diet affects brain health in different racial-ethnic groups. One primary reason for our lack of knowledge is that most cohort studies are of majority non-Hispanic white participants. Moreover, those that do include minority participants do not publish their findings stratified by racial-ethnic groups, and likely have a less accurate measurement of dietary intake among minority groups. In this review, we summarize the current, albeit limited, literature on racial/ethnic differences in dietary relations to dementia outcomes. We will also discuss methodological issues in conducting nutrition studies in diverse cultures, and suggestions for future research directions. Overcoming the gaps will make it possible to make dietary recommendations for Alzheimer’s prevention that are more relevant for different racial/ethnic groups and set us on a faster track to reduce health disparities.
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Affiliation(s)
- Puja Agarwal
- Department of Internal Medicine, Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL, United States
| | - Martha C Morris
- Department of Internal Medicine, Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL, United States
| | - Lisa L Barnes
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, United States.,Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, United States
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12
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Sultana S, Lina NN, Hasan MT, Ferdaus MJ, Dash BK, Ahmad T, Roy RK. Dietary Diversity and Associated Health Status of Newly Diagnosed Type 2 Diabetic Patients in Jashore Region of Bangladesh. CURRENT RESEARCH IN NUTRITION AND FOOD SCIENCE JOURNAL 2020. [DOI: 10.12944/crnfsj.8.2.09] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Lack of adequate dietary diversity may contribute to the deterioration of health and nutritional status of newly diagnosed type 2 diabetes mellitus (T2DM) patients. This cross-sectional study was designed to assess the dietary diversity and related health status of 110 newly diagnosed T2DM patients. The diabetes history of the subjects was collected from the hospital’s e-database. IDDS (individual dietary diversity score) was measured based on the FFQ (food frequency questionnaire) according to the FAO guidelines for measuring household and individual dietary diversity. BMI (body mass index), FBG (fasting blood glucose) level, 2h-PG (two-hour plasma glucose) level, serum creatinine level, and any signs of macro and microvascular diseases were recorded. The mean±SD of IDDS was moderate, 5.74±0.85. About half of the newly diagnosed diabetic patients consumed foods with high diversity. All respondents consumed starchy foods and about half of them did not consume any green leafy vegetables. Younger patients had a lower tendency to take high IDDS diets than the older. About half of individuals were overweight or obese. Higher IDDS and lower BMI, hypertension, serum creatinine, FBG, and 2-HPG were found among males than that of the females. Approximately 35% and 20% patients had microvascular and macrovascular complications respectively.The BMI and serum creatinine level of newly diagnosed diabetic patients were negatively affected by the IDDS. Dietary diversity and varied socio-demographic determinants were found to be related to the health status of diabetics.
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Affiliation(s)
- Sharmin Sultana
- Department of Food and Nutrition Technology, Jashore University of Science and Technology, Jashore-7408, Bangladesh
| | - Nazia Nawshad Lina
- Department of Food and Nutrition Technology, Jashore University of Science and Technology, Jashore-7408, Bangladesh
| | - Md. Tarek Hasan
- Department of Food and Nutrition Technology, Jashore University of Science and Technology, Jashore-7408, Bangladesh
| | - Md. Jannatul Ferdaus
- Department of Food and Nutrition Technology, Jashore University of Science and Technology, Jashore-7408, Bangladesh
| | - Biplab Kumar Dash
- Department of Genetic Engineering and Biotechnology, Jashore University of Science and Technology, Jashore-7408, Bangladesh
| | - Tanvir Ahmad
- Department of Applied Nutrition and Food Technology, Islamic University, Kushtia-7003, Bangladesh
| | - Rajib Kanti Roy
- Department of Applied Nutrition and Food Technology, Islamic University, Kushtia-7003, Bangladesh
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13
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Rosenbaum DL, Clark MH, Convertino AD, Call CC, Forman EM, Butryn ML. Examination of Nutrition Literacy and Quality of Self-monitoring in Behavioral Weight Loss. Ann Behav Med 2019; 52:809-816. [PMID: 30124757 DOI: 10.1093/abm/kax052] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Background Few have examined nutrition literacy (i.e., capacity to process and make informed nutritional decisions) in behavioral weight loss. Nutrition literacy (NL) may impact necessary skills for weight loss, contributing to outcome disparities. Purpose The study sets out to identify correlates of NL; evaluate whether NL predicted weight loss, food record completion and quality, and session attendance; and investigate whether the relations of race and education to weight loss were mediated by NL and self-monitoring. Methods This is a secondary analysis of 6-month behavioral weight loss program in which overweight/obese adults (N = 320) completed a baseline measure of NL (i.e., Newest Vital Sign). Participants self-monitored caloric intake via food records. Results NL was lower for black participants (p < .001) and participants with less education (p = .002). Better NL predicted better 6-month weight loss (b = -.63, p = .04) and food record quality (r = .37, p < .001), but not food record completion or attendance (ps > 0.05). Black participants had lower NL, which was associated with poorer food record quality, which adversely affected weight loss. There was no indirect effect of education on weight loss through NL and food record quality. Conclusions Overall, results suggest that lower NL is problematic for weight loss. For black participants, NL may indirectly impact weight loss through quality of self-monitoring. This might be one explanation for poorer behavioral weight loss outcomes among black participants. Additional research should investigate whether addressing these skills through enhanced treatment improves outcomes. Clinical trial information NCT02363010.
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Affiliation(s)
- Diane L Rosenbaum
- Department of Psychology, Drexel University, Philadelphia, PA, USA.,Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Margaret H Clark
- Department of Psychology, Drexel University, Philadelphia, PA, USA
| | | | - Christine C Call
- Department of Psychology, Drexel University, Philadelphia, PA, USA
| | - Evan M Forman
- Department of Psychology, Drexel University, Philadelphia, PA, USA
| | - Meghan L Butryn
- Department of Psychology, Drexel University, Philadelphia, PA, USA
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14
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Dietary factors are associated with serum uric acid trajectory differentially by race among urban adults. Br J Nutr 2018; 120:935-945. [PMID: 30168404 DOI: 10.1017/s0007114518002118] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Serum uric acid (SUA), a causative agent for gout, is linked to dietary factors, perhaps differentially by race. Cross-sectional (SUAbase, i.e. baseline SUA) and longitudinal (SUArate; i.e. annual rate of change in SUA) associations of SUA with diet were evaluated across race and sex-race groups, in a large prospective cohort study of urban adults. Of 3720 African American (AA) and White urban adults participating in the Healthy Aging in Neighborhoods of Diversity across the Life Span study, longitudinal data (2004-2013, k=1·7 repeats, follow-up, 4·64 (sd 0·93) years) on n 2138 participants were used. The main outcome consisted of up to two repeated measures on SUA. Exposures included the dietary factors such as 'added sugar', 'alcoholic beverages', 'red meat', 'total fish', 'legumes', 'total dairy product', 'caffeine', 'vitamin C' and a composite measure termed 'dietary urate index'. Mixed-effects linear regression models were conducted, stratifying by race and by race×sex. A positive association between legume intake and SUArate was restricted to AA, whereas alcohol intake was positively associated with SUAbase overall without racial differences. Added sugars were directly related to SUAbase among White men (P<0·05 for race×sex interaction), whereas dairy product intake was linked with slower SUArate among AA women, unlike among White women. Nevertheless, dairy product intake was associated with a lower SUAbase among Whites. Finally, the dietary urate index was positively associated with both SUAbase and SUArate, particularly among AA. In sum, race and sex interactions with dietary intakes of added sugars, dairy products and legumes were detected in determining SUA. Similar studies are needed to replicate these findings.
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15
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Solhi M, Jormand H. Assessment of health literacy of municipal employees in Shemiranat, Iran. Electron Physician 2018; 9:6072-6077. [PMID: 29560162 PMCID: PMC5843436 DOI: 10.19082/6072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Accepted: 07/03/2017] [Indexed: 11/23/2022] Open
Abstract
Background Health literacy is one of the major determinants of health promotion among individuals and within society. Objective The present study is aimed to determine the health literacy status of office employees in Shemiranat using the native instruments of health literacy for Iranian adults (HELIA). Methods The present descriptive-analytical cross-sectional study was done in 2016–17. It was conducted on 360 office employees in Shemiranat. The samples were selected using a multi-stage simple random sampling method. Data collection tools in this study included HELIA questionnaire. The data were imported into SPSS v.18 software and then analyzed using descriptive statistical indices (mean, SD, number, and percentage) and inferential statistics (Chi-square, Pearson’s correlation coefficient, Spearman’s correlation coefficient, and Kruskal-Wallis test). Written informed consent was obtained from the employees participating in the study and they were assured about confidentiality. Also, they were informed that participation was voluntary. Results The mean and standard deviation of the total health literacy score among the studied individuals was 125.99±16.01. The mean score of health literacy in the areas of reading (15.36±2.89) and evaluation (5.01±2.8) among the studied individuals was lower than other dimensions of health literacy. Based on the Chi-square test, there was a statistically significant relationship between health literacy and education level, occupational rank, work place, and work experience (p=0.0001 in all the cases). The individuals with medium and good levels of health literacy acquired most of their health-related information through the Internet, friends, relatives, physicians, and health staff. Conclusion Health literacy status was not sufficient among the studied staff. Thus, it is recommended to perform promotional interventions in order to improve the health literacy status and its dimensions among these staff.
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Affiliation(s)
- Mahnaz Solhi
- Ph.D. of Health Education and Health Promotion, Associate Professor, Department of Health Services and Health Education, School of Health, Iran University of Medical Sciences, Tehran, Iran
| | - Hanieh Jormand
- Ph.D. Candidate in Health Education and Health Promotion, Department of Public Health, School of Health, Hamadan University of Medical Sciences, Hamadan, Iran
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16
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Zheng J, Merchant AT, Wirth MD, Zhang J, Antwi SO, Shoaibi A, Shivappa N, Stolzenberg-Solomon RZ, Hebert JR, Steck SE. Inflammatory potential of diet and risk of pancreatic cancer in the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial. Int J Cancer 2018; 142:2461-2470. [PMID: 29355939 DOI: 10.1002/ijc.31271] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 12/30/2017] [Accepted: 01/09/2018] [Indexed: 01/28/2023]
Abstract
Inflammation plays a central role in pancreatic cancer etiology and can be modulated by diet. We aimed to examine the association between the inflammatory potential of diet, assessed with the Dietary Inflammatory Index (DII®), and pancreatic cancer risk in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial prospective cohort. Our study included 101,449 participants aged 52-78 years at baseline who completed both baseline questionnaire and a diet history questionnaire. Energy-adjusted DII (E-DII) scores were computed based on food and supplement intake. Cox proportional hazards models and time dependent Cox models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) with participants in the lowest E-DII quintile (most anti-inflammatory scores) as referent. After a median 8.5 years of follow-up, 328 pancreatic cancer cases were identified. E-DII scores were not associated with pancreatic cancer risk in the multivariable model (HRQ5vsQ1 = 0.94; 95% CI = 0.66-1.35; p-trend = 0.43). Time significantly modified the association (p-interaction = 0.01). During follow up <4 years, there was suggestive evidence of an inverse association between E-DII and pancreatic cancer (HRQ5vsQ1 = 0.60; 95% CI = 0.35-1.02; p-trend = 0.20) while there was a significant positive trend in the follow up ≥4 years (HRQ5vsQ1 = 1.31; 95% CI = 0.83-2.08; p-trend = 0.03). Similar results were observed for E-DII from food only. Our study does not support an association between inflammatory potential of diet and pancreatic cancer risk; however, heterogeneous results were obtained with different follow-up times. These divergent associations may result from the influences of undetected disease in the short-term.
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Affiliation(s)
- Jiali Zheng
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC.,Cancer Prevention and Control Program, University of South Carolina, Columbia, SC.,Department of Epidemiology, Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Anwar T Merchant
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Michael D Wirth
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC.,Cancer Prevention and Control Program, University of South Carolina, Columbia, SC.,Connecting Health Innovations, LLC, Columbia, SC
| | - Jiajia Zhang
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Samuel O Antwi
- Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic, Jacksonville, FL
| | - Azza Shoaibi
- Biomedical Informatics Center, Medical University of South Carolina, Charleston, SC
| | - Nitin Shivappa
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC.,Cancer Prevention and Control Program, University of South Carolina, Columbia, SC.,Connecting Health Innovations, LLC, Columbia, SC
| | - Rachael Z Stolzenberg-Solomon
- Division of Cancer Epidemiology and Genetics, Metabolic Epidemiology Branch, National Cancer Institute (NCI/DCEG), Rockville, MD
| | - James R Hebert
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC.,Cancer Prevention and Control Program, University of South Carolina, Columbia, SC.,Connecting Health Innovations, LLC, Columbia, SC
| | - Susan E Steck
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC.,Cancer Prevention and Control Program, University of South Carolina, Columbia, SC
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17
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Fanelli Kuczmarski M, Bodt BA, Stave Shupe E, Zonderman AB, Evans MK. Dietary Patterns Associated with Lower 10-Year Atherosclerotic Cardiovascular Disease Risk among Urban African-American and White Adults Consuming Western Diets. Nutrients 2018; 10:E158. [PMID: 29385036 PMCID: PMC5852734 DOI: 10.3390/nu10020158] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 01/09/2018] [Accepted: 01/28/2018] [Indexed: 02/07/2023] Open
Abstract
The study's objective was to determine whether variations in the 2013 American College of Cardiology/American Heart Association 10-year risk for atherosclerotic cardiovascular disease (ASCVD) were associated with differences in food consumption and diet quality. Findings from the baseline wave of Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study 2004-2009, revealed participants consumed a Western diet. Diet quality measures, specifically the Healthy Eating Index (HEI)-2010, Dietary Approaches to Stop Hypertension (DASH) diet and the Mean Adequacy Ratio (MAR), based on two 24-h recalls collected during follow-up HANDLS studies from 2009-2013, were used. Reported foods were assigned to 27 groups. In this cross-sectional analysis, the participants (n = 2140) were categorized into tertiles based on their 10-year ASCVD risk. Lower and upper tertiles were used to determine significantly different consumption rates among the food groups. Ten groups were used in hierarchical case clustering to generate four dietary patterns (DPs) based on group energy contribution. The DP with the highest HEI-2010 score included sandwiches along with vegetables and cheese/yogurt. This DP, along with the pizza/sandwiches DP, had significantly higher DASH and MAR scores and a lower 10-year ASCVD risk, compared to the remaining two DPs-meats/sandwiches and sandwiches/bakery products; thus, Western dietary patterns were associated with different levels of ASCVD 10-year risk.
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Affiliation(s)
| | - Barry A Bodt
- College of Health Sciences, STAR, University of Delaware, Newark, DE 19716, USA.
| | - Emily Stave Shupe
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE 19716, USA.
| | - Alan B Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institute of Health, Baltimore, MD 21224, USA.
| | - Michele K Evans
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institute of Health, Baltimore, MD 21224, USA.
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18
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Hart AR, Dillard R, Perkins MM, Vaughan CP, Kinlaw K, McKay JL, Waldrop-Valverde D, Hagen K, Wincek RC, Hackney ME. The DREAMS Team: Creating community partnerships through research advocacy training for diverse older adults. EDUCATIONAL GERONTOLOGY 2017; 43:440-450. [PMID: 30581249 PMCID: PMC6301041 DOI: 10.1080/03601277.2017.1321449] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The DREAMS Team research advocacy training program helps clinical faculty and health students introduce basic clinical research concepts to diverse older adults to galvanize their active involvement in the research process. Older adults are frequently underrepresented in clinical research, due to barriers to participation including distrust, historical mistreatment, and their lack of health literacy. The DREAMS Team program aims to involve diverse older adults throughout all phases of research and increase research participation, thereby contributing to the growth of quality patient-centered, evidence-based health care. This course was developed for clinical faculty to deliver to diverse adults aged 55+ in eight 50-minute lectures, followed by half-hour small group discussions moderated by health students. A pilot cohort of 24 individuals was assessed for satisfaction post-program, and self-efficacy before and after the program. Older adult participants improved on a survey measure of self-efficacy, and indicated satisfaction on a post-program questionnaire. All agreed or strongly agreed that they enjoyed participating, and that classes enhanced knowledge/skills about the topics, were high quality, and provided useful information. Twenty-two out of 24 individuals who completed the program indicated they planned to get involved as research advocates. The DREAMS Team program can be offered either on its own, or as a follow-up program to a general health education course led by health students and/or professional researchers or clinicians. Educating older adults about the research process and advocacy through interactive seminars led by congenial and respectful researchers and health students may remove some barriers to research participation and involvement among diverse older adults.
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Affiliation(s)
- Ariel R. Hart
- Department of Medicine, School of Medicine, Emory University, Atlanta, GA, USA
| | - Rebecca Dillard
- Department of Medicine, School of Medicine, Emory University, Atlanta, GA, USA
| | - Molly M. Perkins
- Department of Medicine, School of Medicine, Emory University, Atlanta, GA, USA
| | - Camille P. Vaughan
- Department of Medicine, School of Medicine, Emory University, Atlanta, GA, USA
| | - Kathy Kinlaw
- Emory University Center for Ethics and Department of Medicine, School of Medicine, Emory University, Atlanta, GA, USA
| | - J. Lucas McKay
- Wallace H. Coulter Department of Biomedical Engineering, Emory University and the Georgia Institute of Technology, Atlanta, GA, USA
| | - Drenna Waldrop-Valverde
- Nell Hodgson Woodruff School of Nursing (NHWSN), Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Kimberley Hagen
- Emory Center for AIDS Research, Department of Behavioral Science and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Ron C. Wincek
- DREAMS Program, School of Medicine, Emory University, Atlanta, GA, USA
- Parkinson’s Advocates in Research (PAIR), Parkinson’s Disease Foundation, New York, NY, USA
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