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E A Frongillo

Publications and source records attributed to E A Frongillo.

At least 19 recordsLinked to original sources

Life-course events and experiences: association with fruit and vegetable consumption in 3 ethnic groups.

OBJECTIVE: To examine how life-course experiences and events are associated with current fruit and vegetable consumption in 3 ethnic groups. DESIGN: A theoretic model developed from previous qualitative research guided the development of a telephone survey. Data were collected on fruit and vegetable consumption, sociodemographic characteristics, ethnic identity, and life-course events and experiences, including food upbringing, social roles, food skills, dietary changes for health, and practice of food traditions. SUBJECTS/SETTING: Low- to moderate-income adults living in a northeastern US city were selected randomly from 3 ethnic groups: black (n = 201), Hispanic (n = 191), and white (n = 200). STATISTICAL ANALYSES: Bivariate and multiple linear regression analysis of associations between life-course variables and fruit and vegetable consumption. RESULTS: Black, Hispanic, and white respondents differed significantly in life-course experiences, family roles, socio-demographic characteristics, and place of birth. Explanatory models for fruit and vegetable consumption differed among ethnic groups and between fruits and vegetables. Among black respondents, a college education was positively associated with fruit consumption; education and family roles contributed most to differences in fruit (R2 = .16) and vegetable (R2 = .09) consumption. Among Hispanic respondents, life-course experiences such as liking fruits and vegetables in youth, making dietary changes for health, and food skills were positively associated with fruit (R2 = .25) and vegetable (R2 = .35) consumption. Among white respondents, socio-demographic characteristics, such as being married with a young child or single with no child and having a garden as an adult, were positively associated with fruit (R2 = .20) and vegetable (R2 = .22) consumption. APPLICATIONS/CONCLUSIONS: An understanding of the determinants of food choice in different subcultural groups can be used to design effective nutrition interventions to increase fruit and vegetable consumption. Experiences such as eating fresh-picked fruits and vegetables while growing up or vegetable gardening as an adult may enhance fruit and vegetable consumption among members of some ethnic groups.

Adolescent

Validation of measures of food insecurity and hunger.

The most recent survey effort to determine the extent of food insecurity and hunger in the United States, the Food Security Supplement, included a series of questions to assess this complex phenomenon. The primary measure developed from this Food Security Supplement was based on measurement concepts, methods and items from two previously developed measures. This paper presents the evidence available that questionnaire-based measures, in particular the national food security measure, provide valid measurement of food insecurity and hunger for population and individual uses. The paper discusses basic ideas about measurement and criteria for establishing validity of measures and then uses these criteria to structure an examination of the research results available to establish the validity of food security measures. The results show that the construction of the national food security measure is well grounded in our understanding of food insecurity and hunger, its performance is consistent with that understanding, it is precise within usual performance standards, dependable, accurate at both group and individual levels within reasonable performance standards, and its accuracy is attributable to the well-grounded understanding. These results provide strong evidence that the Food Security Supplement provides valid measurement of food insecurity and hunger for population and individual uses. Further validation research is required for subgroups of the population, not yet studied for validation purposes, to establish validity for monitoring population changes in prevalence and to develop and validate robust and contextually sensitive measures in a variety of countries that reflect how people experience and think about food insecurity and hunger.

Female

Caregiver behaviors and resources influence child height-for-age in rural Chad.

The purpose of this study was to identify caregiver characteristics that influence child nutritional status in rural Chad, when controlling for socioeconomic factors. Variables were classified according to the categories of a UNICEF model of care: caregiving behaviors, household food security, food and economic resources and resources for care and health resources. Sixty-four households with 98 children from ages 12 to 71 mo were part of this study. Caregivers were interviewed to collect information on number of pregnancies, child feeding and health practices, influence on decisions regarding child health and feeding, overall satisfaction with life, social support, workload, income, use of income, and household food expenditures and consumption. Household heads were questioned about household food production and other economic resources. Caregiver and household variables were classified as two sets of variables, and separate regression models were run for each of the two sets. Significant predictors of height-for-age were then combined in the same regression model. Caregiver influence on child-feeding decisions, level of satisfaction with life, willingness to seek advice during child illnesses, and the number of individuals available to assist with domestic tasks were the caregiver factors associated with children's height-for-age. Socioeconomic factors associated with children's height-for-age were the amount of harvested cereals, the sources of household income and the household being monogamous. When the caregiver and household socioeconomic factors were combined in the same model, they explained 54% of the variance in children's height-for-age, and their regression coefficients did not change or only slightly increased, except for caregiver's propensity to seek advice during child illnesses, which was no longer significant. These results indicate that caregiver characteristics influence children's nutritional status, even while controlling for the socioeconomic status of the household.

Aging

Unemployment, depression, and health: a look at the African-American community.

OBJECTIVES: While the unemployment rate of African-American people is more than twice that of the white population, the research on the impact of unemployment on the health of this population is scarce. This study analysed the impact of unemployment on depression and well being among African-American people, and the factors associated with well being. METHODS: Logistic and multiple regression models were used to analyse panel data collected in the National Survey of Families and Households 1987-1992. African-American (1369) and white (6660) respondents were analysed separately. Outcome variables included an index of depression and self reported health status. MAIN FINDINGS: Differences between employment and unemployment groups were less significant for African-Americans than for the white population in predicting depression and well being. Health enhancing factors such as education and wealth were significantly associated with better health and lower depression indices among the white population but not consistently so among African-Americans. Satisfaction with personal relationships was the strongest predictor of well being for both groups. CONCLUSION: Research should focus on the special needs and circumstances of African-Americans, because protective factors may not have the same impact in different groups of the population.

Adolescent

Hunger and food insecurity in the elderly: its nature and measurement.

To better understand the nature of food insecurity in the elderly and to improve its measurement, in-depth interviews were conducted with 41 urban Black and rural White elderly in 35 households, followed by telephone administration of commonly used measures of food insecurity in 24 of these elderly. Elderly food insecurity appears to follow a progression of severity, beginning with compromised diet quality, followed by food anxiety, socially unacceptable meals, use of emergency food strategies, and finally actual hunger. The five quantitative measures tested were compared to each elderly person's food insecurity status based on the in-depth interview. All measures had reasonable specificity, and good sensitivity for those experiencing severe food insecurity. However, the Cornell-Radimer, Community Childhood Hunger Identification Project (CCHIP) and Nutrition Screening Initiative (NSI) measures appeared more sensitive than the USDA food sufficiency or Urban Institute measures in correctly identifying those in the lesser stages of food insecurity.

Aged

Food insufficiency exists in the United States: results from the third National Health and Nutrition Examination Survey (NHANES III).

OBJECTIVES: The purpose of this study was to estimate the prevalence of food insufficiency in the United States and to examine sociodemographic characteristics related to food insufficiency. METHODS: Data were analyzed from the third National Health and Nutrition Examination Survey, a cross-sectional representative sample of the civilian noninstitutionalized population living in households. Individuals were classified as "food insufficient" if a family respondent reported that the family sometimes or often did not get enough food to eat. RESULTS: From 1988 through 1994, the overall prevalence of food insufficiency was 4.1% and was primarily related to poverty status. In the low-income population, food insufficiency was positively associated with being Mexican American, being under the age of 60, having a family head who had not completed high school, participating in the Food Stamp Program, and not having health insurance. It was not related to family type or employment status of the family head. Over half of food-insufficient individuals lived in employed families. CONCLUSIONS: Food insufficiency is not limited to very low-income persons, specific racial/ethnic groups, family types, or the unemployed. Understanding food insufficiency is critical to formulating nutrition programs and policies.

Adolescent

Parity-associated body weight: modification by sociodemographic and behavioral factors.

This research examines the association between parity and body weight and how this relationship is modified by sociodemographic and behavioral factors. Using multiple linear regression analysis, the study assessed the relationship between parity and relative body weight (as Body Mass Index, BMI) and how this relationship interacts with seven sociodemographic and seven behavioral factors in a national sample of 5,707 women from the Second National Health and Nutritional Examination (NHANES II) survey. After adjusting for sociodemographic factors, the amount of weight associated with parity averaged about 0.5 kg per child. However, parity-associated weight differed by sociodemographic and behavioral factors, and was much larger in some subgroups. Among 18-45 year olds, the amount of weight associated with parity was greater in blacks than in whites, less in employed than unemployed white women but greater in employed than unemployed black women, less in smokers than nonsmokers, less in those with a high level of recreational exercise, and differed with the level of nonrecreational physical activity depending on race. Among 46-74 year olds, the amount of weight associated with parity was greater in married than unmarried women, and less in those who were active outside of recreation versus those who were less active. These results suggest that sociodemographic and behavioral variables modify the relationship between parity and body weight, and provide insight for identifying women who are at risk for having greater BMI with higher parity. This information may be applicable to the targeting and design of interventions to prevent postpartum weight retention.

Adolescent

Parity-associated weight gain and its modification by sociodemographic and behavioral factors: a prospective analysis in US women.

OBJECTIVE: To examine how the relationship between parity increase and weight gain is modified by sociodemographic and behavioral factors. DESIGN: Prospective longitudinal data from the first National Health and Nutrition Examination Survey (NHANES I, 1971-75) and its follow-up of those aged 25 y and older, the NHANES I Epidemiologic Follow-up Survey (NHEFS, 1982-84). SUBJECTS: The analytical sample was nationally representative of the United States and included 2952 white or African-American non-pregnant women aged 25-45 y at baseline, who were re-measured approximately 10 y later. MEASUREMENTS: Statistical interactions in multiple linear and logistic regression models were examined to identify how eight sociodemographic and three behavioral factors modified the effect of parity increase on body weight change and risk of substantial weight gain. RESULTS: Factors that increased parity-associated weight gain included being African-American, living in a rural area, not working outside the home, having fewer children, lower income and lower education, and being unmarried. Among white women, being younger and having higher body weight at baseline increased parity-associated weight gain, while among African-American women, being older and having lower body weight increased parity-associated weight gain. African-American smokers gained less weight with an increase in parity, while the interactions between smoking and physical activity with parity-associated weight gain in whites were complex. CONCLUSION: The effects of sociodemographic and behavioral factors on parity-associated weight gain varied by race and parity change, with the most consistent findings being that unmarried and unemployed white women had greater parity-associated weight gain, while both white and African-American women who smoked, had higher education, or higher parity had lower parity-associated weight gain. This information may contribute to better targeting and more effective interventions to prevent postpartum weight retention.

Adult

Socioeconomic and demographic factors are associated with worldwide patterns of stunting and wasting of children.

We estimated the variability among nations in the prevalence of stunting and wasting, evaluated which national factors are associated with stunting and wasting and examined the relationship of stunting with wasting. The World Health Organization Global Database on Child Growth, a comprehensive conceptual model and a database of national factors were used with variance components and regression analyses. There was substantial variability among nations and among provinces within nations. Most national variability for stunting (76%) and wasting (66%) was explained by national factors and geographic region. Higher energy availability, female literacy and gross product were the most important factors associated with lower prevalence of stunting. The association of health expenditures and stunting differed by region. Higher immunization rate and, for Asia only, energy availability were the most important factors associated with lower prevalence of wasting. Regional differences in the relationship between stunting and wasting were accounted for by national factors. Some factors associated with stunting and wasting differ at the national level. Child malnutrition within a household is greatly influenced by issues at national and provincial levels, and intervention should be considered at all three levels.

Child Nutritional Physiological Phenomena

Questionnaire-based measures are valid for the identification of rural households with hunger and food insecurity.

This study assessed the validity of questionnaire-based measures for the identification of rural households with hunger and food insecurity. Data used were from a 1993 survey of 193 households with women and children living at home in a rural county. Two interviews provided data on demographics, factors contributing to food insecurity, coping strategies, fruit and vegetable consumption, disordered eating behaviors, height, weight, dietary recall and household food-stores inventory. This information was used to develop a definitive criterion measure for hunger and food insecurity to compare with hunger and food insecurity items from Radimer/Cornell, the Community Childhood Hunger Identification Project (CCHIP) and the Third National Health and Nutrition Examination Survey (NHANES III). The Radimer/Cornell and CCHIP questionnaire-based measures had good specificity (i.e., percentage of truly food secure correctly classified; 63-71%) and excellent sensitivity (i.e., percentage of truly food insecure correctly classified; 84-89%) when compared with the criterion measure. Estimates of the prevalence of household food insecurity from the criterion, Radimer/Cornell and CCHIP measures were almost identical. The overall agreement of the Radimer/Cornell and CCHIP measures was very good. These measures can be validly used to screen for hunger and food insecurity among rural households similar to those studied and to target subpopulations for food programs. The NHANES III item alone had excellent specificity but poor sensitivity, and underestimated prevalence.

Adaptation, Psychological

Investigating the weanling's dilemma: lessons from Honduras.

When complementary foods should be introduced in the diets of infants in poor environments remains controversial. Resolution has been hampered by inadequate study designs. A study in Honduras has demonstrated an experimental design assessing multiple infant and maternal outcomes and provides information for planning sample size and accounting for dropouts in future studies. Further research to understand the cultural, social, and biologic aspects of complementary feeding is needed.

Breast Feeding

The deterioration in children's nutritional status in rural Chad: the effect of mothers' influence on feeding.

OBJECTIVES: This study examined how maternal influence on child feeding modified the deterioration of child nutritional status in Chad. METHODS: The pattern of height with age was examined in 98 rural Chadian children aged 12 through 71 months from 64 households randomly chosen. RESULTS: Younger children were more stunted than older ones, probably reflecting secular deterioration in weanlings' nutritional status from 1982 to 1987. Children of mothers with influence over child feeding were taller than children of mothers with less influence, but this held only for the youngest children. CONCLUSIONS: Height-for-age can be a useful indicator of recent changes in social and environmental effects on child health. The mother's influence may have buffered the negative impact of socioeconomic conditions on child growth.

Aging

Relationship of hunger and food insecurity to food availability and consumption.

OBJECTIVE: To describe the relationship of new measures of hunger and food insecurity to household food supplies and individual food and nutrient intake. DESIGN AND SETTING: A questionnaire containing the Radimer/Cornell hunger and food insecurity items and questions on eating patterns and the frequency of fruit and vegetable consumption was administered to subjects during a personal interview in their homes. A 24-hour diet recall and a household food inventory were conducted at the initial interview and at a follow-up visit. SUBJECTS: Participants were 193 women drawn from a random sample of 308 women who had completed a previous health census in a rural New York State county. Subjects' ages ranged from 15 to 40 years. All had children living at home and less than 16 years of education. STATISTICAL ANALYSES: Regression analysis was used to test for linear trends across food insecurity groups for the household food inventory scores and for the frequency of consumption of fruits and vegetables. t Tests were used to assess differences between the food secure and food insecure groups for nutrient and food group means. A chi 2 test for trend was used to examine differences in the distribution of nutrient and fruit and vegetable intake between the food secure and food insecure groups. RESULTS: A significant decrease in the frequency of consumption of fruits and vegetables and the amount of food in the household and a significant increase in scores indicative of disordered eating patterns were associated with a worsening of food insecurity status. Potassium and fiber intake and fruit consumption differed significantly between the food secure and food insecure groups. The percentage of respondents consuming less than the Recommended Dietary Allowance for vitamin C and fewer than five fruits and vegetables per day was significantly greater among food insecure respondents than food secure respondents. APPLICATIONS/CONCLUSIONS: The quantity of food available in households and consumption of fruits and vegetables decreased with increasingly severe problems with food insecurity and hunger. In this rural population, the Radimer/ Cornell measures were useful in identifying households experiencing food insecurity and providing information about the nature of the food supply and the dietary intake problems experienced by food insecure households and persons, suggesting that these measures may be useful on community surveys designed to examine food insecurity issues.

Adolescent

Adherence to iron supplementation during pregnancy in Tanzania: determinants and hematologic consequences.

Limited adherence to iron supplementation is thought to be a major reason for the low effectiveness of anemia-prevention programs. In rural Tanzania, women at 21-26 wk of gestation were randomly given either 120 mg of a conventional (Con) iron supplement or 50 mg of a gastric-delivery-system (GDS) iron supplement for 12 wk. Adherence was assessed by using a pill bottle equipped with an electronic counting device. Adherence in the GDS group was 61% compared with 42% for the Con group. In both groups, women experiencing side effects had about one-third lower adherence. Fewer side effects were observed in the GDS group. In a subgroup of women with a low initial hemoglobin concentration (< or = 120 g/L), the response to the iron supplements suggested that both of the applied doses were unnecessarily high for adequate hematologic response in a population with a marginal hemoglobin concentration. The GDS group appeared to require a dose one-fourth as high as that of the Con group for an equal effect on improving hemoglobin to normal concentrations.

Anemia