Biomedical subjects

Gladys Block

Publications and source records attributed to Gladys Block.

At least 19 recordsLinked to original sources

PubMed2006

Validation of a food frequency questionnaire for Hispanics.

INTRODUCTION: The Hispanic population will grow to comprise one fourth of the U.S. population by 2050. Compared with non-Hispanic whites, Hispanics have disproportionately higher rates of obesity, diabetes, and other diet-related conditions. Valid methods for studying the dietary intake of this group are needed. METHODS: From June through September 2000, we conducted a study of low-income Hispanic men and women (n = 89) who were recruited for a validation study of the Spanish-language food frequency questionnaire used in the Study of Women's Health Across the Nation. The mean age of the participants was 36.8 years, 42% were male, and 92% had been born in Mexico. Three 24-hour dietary recalls provided the reference data. The food frequency questionnaire was administered by interview, with a portion-size graphic to aid in quantitation. The questionnaire asked about diet in the previous 12 months. Mean nutrient values, correlation coefficients, and the sensitivity and specificity for identifying people with intakes of less than the recommended levels were calculated. RESULTS: Mean energy and macronutrient intake estimates were significantly higher by the food frequency questionnaire than by the 24-hour dietary recalls. Cholesterol, saturated fat, dietary fiber, iron, vitamin A, and percentage of energy from fat were not significantly different by the two methods. The median of unadjusted correlations was 0.52 and of deattenuated correlations was 0.61. The median sensitivity was 0.62, and the median specificity was 0.76. CONCLUSION: The Study of Women's Health Across the Nation Spanish food frequency questionnaire appears to be reasonably valid in assessing the dietary intakes of Hispanics. Correlations tended to be higher than those found in other validation studies in Hispanic populations. Interviewer administration of questionnaires may be necessary in this population.

Adolescent↗

PubMed2006

Development and reliability of brief dietary assessment tools for Hispanics.

INTRODUCTION: The Hispanic population is the most rapidly growing ethnic group in the United States. Culturally appropriate and efficient strategies for dietary assessment for this population are currently lacking. To address this issue and promote a healthy diet for disease prevention, we developed screening tools to assess the fruit, vegetable, and fat intake of Mexican Americans. METHODS: Brief screening tools (screeners) were developed based on national data on Mexican Americans' dietary intake and were then modified after interviews and field testing. The screeners take less than 10 minutes to administer. A reliability study was conducted from June through September 2000, during which 93 Mexican Americans (39 men, 54 women) completed the screeners twice, 1 month apart. The mean age of the study participants was 36.5 years (range 18-71 years), and 91.4% had been born in Mexico. RESULTS: Correlations between the first and second administration of the screeners were r = 0.64 for fruits and vegetables and r = 0.85 for dietary fat contributors. In addition, estimates of fruit and vegetable consumption frequency were similar to statewide estimates for Hispanics in California. Reproducibility of reported use of vitamin supplements at least once per week was high; 84% were classified in the same way both times (P < .001). CONCLUSION: The screening tools provide a reliable assessment of selected dietary factors among Mexican Americans. The tools can be scored immediately to provide feedback to respondents. They may be useful in situations requiring easily administered and economical assessment tools, such as in large-scale studies or in community situations.

Adolescent↗

PubMed2006

Validity and reliability of the Block98 food-frequency questionnaire in a sample of Canadian women.

OBJECTIVE: To assess the validity and reliability of the most recent adaptation of Block's full-diet food-frequency questionnaire (FFQ) among a sample of Canadian women. DESIGN: Participants completed a self-administered FFQ (FFQ1), two unannounced 24-hour recalls (weekday and weekend) and a second FFQ (FFQ2) between October 2003 and February 2004. FFQs and recalls were analysed for 32 nutrients using Block Dietary Data Systems and the University of Minnesota's Nutrient Data System. Mean and median intakes were computed, along with crude and deattenuated Pearson correlation coefficients between FFQ1 and the average of two recalls (validity) and between FFQ1 and FFQ2 (reliability). SETTING: Ontario, Canada. SUBJECTS: A random population-based sample (n = 166) of women aged 25 to 74 years. RESULTS: One hundred and fifteen (69%) women completed FFQ1, 96 completed FFQ1 and both recalls, and 93 completed both FFQs, about 56 days apart. Mean intakes were similar for most nutrients. FFQ reliability was high, with Pearson correlation coefficients having a median of 0.75, ranging from 0.57 to 0.90 (macronutrients) and from 0.65 to 0.88 (micronutrients from supplements and food). FFQ validity was moderate to high, with deattenuated Pearson correlation coefficients having a median of 0.59, ranging from 0.11 to 0.73 (macronutrients) and from 0.50 to 0.76 (micronutrients from supplements and food). Our micronutrient correlations were similar to or higher than those of other studies that included supplements. Two correlations <0.40 were associated with fats. CONCLUSIONS: The validity and reliability of this full-diet version of the Block FFQ were moderate to high, supporting its use in future studies among Canadian women.

Adult↗

PubMed2006

Does gamma-tocopherol play a role in the primary prevention of heart disease and cancer? A review.

Vitamin E consists of a group of eight isomers, four tocopherols (alpha-, beta-, gamma-, delta-tocopherol) and four tocotrienols (alpha-, beta-, gamma-, delta-tocotrienol). While extensive literature has been published on the potential health benefits of alpha-tocopherol, little is known about gamma-tocopherol, the major form of vitamin E in food in the U.S. gamma-tocopherol has recently received more research attention based on findings from in vitro and animal studies indicating that it has potent anti-inflammatory and antioxidant properties. Based on these recent studies, it is important to investigate the possible health benefits of gamma-tocopherol in humans. In this article, we review publications on dietary gamma-tocopherol intake, plasma gamma-tocopherol levels, cardiovascular disease and cancer risk in humans.

Diet↗

PubMed2006

Associations of body fat and its changes over time with quality of life and prospective mortality in hemodialysis patients.

BACKGROUND: In maintenance hemodialysis (MHD) patients, a larger body size is associated with better survival but a worse self-reported quality of life (QoL). It is not clear whether muscle mass or body fat confers the survival advantage. OBJECTIVE: We hypothesized that both a low baseline body fat percentage and a loss of fat over time were independently associated with higher mortality but with a better QoL score. DESIGN: In 535 adult MHD patients, body fat was measured directly with the use of near infrared interactance and QoL was measured with a Short Form 36 questionnaire. The patients were followed for < or =30 mo. RESULTS: Across four 12% increments of body fat at baseline, the reported QoL scores were progressively lower (P < 0.01). After a multivariate adjustment for demographics and surrogates of muscle mass and inflammation (ie, midarm muscle circumference, serum creatinine, and proinflammatory cytokines), 46 patients with body fat of <12% had a death hazard ratio (HR) 4 times that of 199 patients with body fat content between 24% and 36% (HR: 4.01; 95% CI: 1.61, 9.99; P = 0.003). In 411 MHD patients whose body fat was remeasured after 6 mo, a fat loss (< or =-1%) was associated with a death risk 2 times that of patients who gained fat (> or =1%) after a multivariate adjustment (HR: 2.06; 95% CI: 1.05, 4.05; P = 0.04). CONCLUSIONS: A low baseline body fat percentage and fat loss over time are independently associated with higher mortality in MHD patients even after adjustment for demographics and surrogates of muscle mass and inflammation, whereas a tendency toward a worse QoL is reported by MHD patients with a higher body fat percentage. Obesity management in dialysis patients may need reconsideration.

Adipose Tissue↗

PubMed2006

Relations of glycemic index and glycemic load with plasma oxidative stress markers.

BACKGROUND: Recent data suggest that acute hyperglycemia may increase in vivo free radical production. This increased production has been implicated in many disease processes. OBJECTIVE: The objective was to investigate whether a diet with a high glycemic index (GI) or glycemic load (GL) is associated with greater oxidative stress as measured by 2 lipid peroxidation markers, malondialdehyde (MDA) and F2-isoprostanes (IsoPs). DESIGN: Plasma MDA and IsoP concentrations were measured in 292 healthy adults, and dietary GI and GL were assessed by using a validated food-frequency questionnaire. Cross-sectional associations between GI, GL, and the 2 markers were examined by using multiple regression techniques with adjustment for potential confounding variables. RESULTS: Dietary GI was positively associated with both plasma MDA and IsoPs. The mean multivariate-adjusted MDA concentrations increased from 0.55 to 0.73 micromol/L as GI increased from the lowest to the highest quartile (P for trend = 0.02); the corresponding IsoP concentrations increased from 0.034 to 0.040 ng/mL (P for trend = 0.03). GL was positively associated with both MDA and IsoPs, but the linear relation was significant only for MDA. In addition, a marginally significant interaction between overall GI and body mass index (BMI; in kg/m2) for plasma MDA was observed (P = 0.09). The positive association between overall GI and MDA was stronger in those with a BMI < 26.5 than for those with a BMI > or = 26.5. CONCLUSIONS: Chronic consumption of high-GI foods may lead to chronically high oxidative stress. A low-GI diet, not a low-carbohydrate diet, appears to be beneficial in reducing oxidative stress.

Adolescent↗

PubMed2006

Intraindividual variability of plasma antioxidants, markers of oxidative stress, C-reactive protein, cotinine, and other biomarkers.

BACKGROUND: Within-person variability in biomarkers results in random error that can attenuate estimates of association. Little information on such variability is available for a number of nutrition-related biomarkers. METHODS: Blood samples obtained 2 to 4 weeks apart were analyzed for tocopherols, carotenoids, ascorbate, lipids, cotinine, C-reactive protein, and oxidative stress. Subjects (n = 206 men and women, mean age 45.4 years) were either smokers or passively exposed to smoke. We calculated intraindividual and interindividual variability and the number of measurements required to reduce attenuation. RESULTS: For most biomarkers, 2 measurements would be required to limit the attenuation of correlation coefficients to no lower than 90% of the true correlation. If only one measurement were obtained, observed correlations would be approximately 80-88% of true correlations. For regression coefficients, 3 or 4 measures would be required. Exceptions were ascorbic acid and malondialdehyde, for which a single measure resulted in little attenuation. CONCLUSIONS: For most serum markers, collection of 2 or more measurements per person is desirable to increase the ability to detect associations between biomarkers and health-related variables. If only one measure is possible, sample sizes should be planned to permit detection of associations that are likely to be observed, not the theoretical true associations. The results of this study, in which measurements were obtained 2 to 4 weeks apart, are relevant for epidemiologic research in which the exposure of interest is the subject's baseline or current status. It is likely that within-person variability would be greater over a period of months or years.

Adolescent↗

PubMed2006

Understanding the increased risk of neural tube defect-affected pregnancies among Mexico-born women in California: immigration and anthropometric factors.

Mexico-born women in the United States have an unexplained twofold increased risk of neural tube defect (NTD)-affected pregnancies. We examined whether immigration characteristics were associated with the NTD risk and whether anthropometric factors contributed to the increased risk among Mexico-born women. Data were derived from a large population-based case-control study in California. In-person interviews were conducted with mothers of 538 (88% of eligible) NTD-affected fetuses/infants and mothers of 539 (88%) randomly selected non-malformed control infants. The crude odds ratio (OR) for NTDs among all Mexico-born women, women residing <2 years in the US, and women >16 years old at immigration compared with non-Hispanic white women was 2.4 [95% confidence interval (CI) = 1.8, 3.3], 7.2 [95% CI = 3.7, 14.0] and 3.0 [95% CI = 2.0, 4.4], respectively. Risk for second- or third-generation Mexican-Americans was similar to that of white women. The crude OR for all Mexico-born women was reduced from 2.4 to 2.0 [95% CI = 1.3, 3.0] and for those residing <2 years in the US from 8.4 to 7.1 [95% CI = 3.2, 15.3] after adjustment for maternal body mass index (BMI), height, compromised diet, diabetes, and other known risk factors. In term pregnancies, additional adjustment for pregnancy weight gain reduced the OR in all Mexico-born women and recent immigrants by 16% and 25%, respectively. Low pregnancy weight gain (<10 vs. 10-14 kg) was particularly associated with increased NTD risk among Mexico-born women (OR(ADJ) = 5.8; 95% CI = 2.1, 15.8). Findings indicate that recent Mexican immigrants have a sevenfold increased risk for NTDs. Maternal BMI and height contributed very little, and inadequate weight gain contributed modestly to the NTD risk disparity for Mexican immigrants.

Adolescent↗

PubMed2005

A review: dietary and endogenously formed N-nitroso compounds and risk of childhood brain tumors.

Maternal dietary exposure to N-nitroso compounds (NOC) or to their precursors during pregnancy has been associated with risk of childhood brain tumors. Cured meat is one source of exposure to dietary NOC and their precursors. Most epidemiological studies that have examined the role of maternal consumption of cured meats during pregnancy have found a significant positive association between maternal intake of cured meat and the risk of childhood brain tumor (CBT). NOC consist of two main groups, N-nitrosamines and N-nitrosamides. The carcinogenicity profiles of NOC suggest that N-nitrosamides rather than N-nitrosamines are the compounds that may be associated with CBT and that they should be investigated more closely in epidemiological studies. We present a review of the chemical and carcinogenic properties of NOC in connection with the findings of case-control studies. This approach may be helpful in determining the essential information that must be collected in future epidemiological studies on CBT.

Brain Neoplasms↗

PubMed2005

Associations between apolipoprotein E genotype and circulating F2-isoprostane levels in humans.

Apolipoprotein E (apoE), an important determinant of plasma lipoprotein metabolism, has three common alleles (epsilon2, epsilon3, and epsilon4). Population studies have shown that the risk of diseases characterized by oxidative damage, such as coronary heart disease and Alzheimer's disease, is significantly higher in epsilon4 carriers. We evaluated the association between apoE genotypes and plasma F2-isoprostane levels, an index of lipid peroxidation, in humans. Two hundred seventy-four healthy subjects (104 males, 170 females; 46.9 +/- 13.0 yr; 200 whites, 74 blacks; 81 nonsmokers, 64 passive smokers, and 129 active smokers) recruited for a randomized clinical antioxidant intervention trial were included in this analysis. ApoE genotype was determined by PCR and restriction enzyme digestion. Free plasma F2-isoprostane was measured by GC-MS. Genotype groups were compared using multiple regression analysis with adjustment for sex, age, race, smoking status, body mass index, plasma ascorbic acid, and beta-carotene. Subjects with epsilon3/epsilon4 and epsilon4/epsilon4 genotype (epsilon4-carriers) and with epsilon2/epsilon3 and epsilon3/epsilon3 (non-epsilon4-carriers) were pooled for analysis. In subjects with high cholesterol levels (total cholesterol above 200 mg/dl), plasma F2-isoprostane levels were 29% higher in epsilon4 carriers than in non-epsilon4-carriers (P= 0.0056). High-cholesterol subjects that are epsilon4 carriers have significantly higher levels of lipid peroxidation as assessed by circulating F2-isoprostane levels.

Apolipoproteins E↗

PubMed2005

The effect of folate fortification of cereal-grain products on blood folate status, dietary folate intake, and dietary folate sources among adult non-supplement users in the United States.

OBJECTIVE: Since January 1998, the Federal Drug Administration has required folic acid fortification of all enriched cereal-grain products in the U.S. This program intended to increase folic acid intake among women of childbearing age in order to decrease their risk of pregnancies affected by neural tube defects. The aim of this study was to explore the changes in serum and erythrocyte folate status of the adult U.S. population following folic acid fortification of enriched cereal-grain products and to explore accompanying changes in food sources and dietary total folate intake. METHODS: We compared data from two National Health and Nutrition Examination Surveys (NHANES): NHANES III, conducted during 1988 to 1994, reflecting the time prior to folate fortification, and NHANES 1999-2000, reflecting the time period after fortification. RESULTS: Mandatory folic acid fortification led to significant increases in both serum and erythrocyte folate concentrations in all sex and age groups. In the overall study population the mean serum folate concentration increased more than two-fold (136%), from 11.4 nmol/L to 26.9 nmol/L, and the mean erythrocyte folate concentration increased by 57 percent, from 375 nmol/L to 590 nmol/L. Less than 10% of women of childbearing age reached the recommended erythrocyte folate concentration of greater than 906 nmol/L that has been shown to be associated with a significant reduction in neural tube defect (NTD) risk. After fortification, the category "bread, rolls, and crackers" became the single largest contributor of total folate to the American diet, contributing 15.6% of total intake, surpassing vegetables, which were the number one folate food source prior to fortification. Dietary intake of total folate increased significantly in almost all sex and age groups, except in females over 60 years of age. The mean dietary total folate intake of the study population increased by 76 microg/d (28%), from 275 microg/d to 351 microg/d. CONCLUSIONS: The fortification of enriched cereal-grain products with folic acid led to a significant improvement of blood folate status of the overall adult, non-supplement using, US population. However, women of childbearing age may take folic acid supplements to reach erythrocyte folate levels that have been associated with decreased risk of NTDs.

Adult↗

PubMed2005

Erythrocyte folate and its response to folic acid supplementation is assay dependent in women.

Optimizing folate status requires continued monitoring of erythrocyte (RBC) folate and folate intake. The accuracy of RBC folate assays remains a concern. Therefore, we measured RBC folate with 4 different assays, examined the interassay correlations, and compared RBC folate with folate intake as measured by an abbreviated folate-targeted food/supplement screener. The screener had 21 questions (19 diet, 2 supplement) and measured usual and customary intakes of dietary folate equivalents (DFEs). Our design was a 4 x 2 x 2 factorial, 4 assays in pregnant and nonpregnant women before and after each group received a folic acid supplement (1814 nmol/d) for 30-60 d. Folate assays included L. casei, chemiluminescence, GC-MS, and radioassay (RA). Baseline RBC folate levels ranked low to high by assay (mean +/- SE) were as follows: 1155 +/- 44 nmol/L (L. casei) < 1390 +/- 43 nmol/L (chemiluminescence) < 1531 +/- 39 nmol/L (GC-MS) < 1727 +/- 55 nmol/L (RA) (P < 0.0001). Supplementation raised RBC folate levels (mean +/- SE) as follows: 138 +/- 63 nmol/L (chemiluminescence) < 267 +/- 64 nmol/L (GC-MS) = 285 +/- 75 nmol/L (L. casei) < 351 +/- 87 nmol/L (RA). Pregnant women had higher RBC folate than nonpregnant women using chemiluminescence and RA. Interassay correlations (r) ranged from 0.4679 to 0.8261 (P < 0.001). Correlations of RBC folate with folate intake ranged from 0.2676 to 0.4622 (P < 0.0004). We conclude that RBC folate levels are assay dependent, as is the definition of optimized status; there continues to be a need for an accurate assay of RBC folate. RBC folate correlated with total folate intake using a folate-targeted food/supplement screener.

Dietary Supplements↗

PubMed2005

The nutritional status of astronauts is altered after long-term space flight aboard the International Space Station.

Defining optimal nutrient requirements is critical for ensuring crew health during long-duration space exploration missions. Data pertaining to such nutrient requirements are extremely limited. The primary goal of this study was to better understand nutritional changes that occur during long-duration space flight. We examined body composition, bone metabolism, hematology, general blood chemistry, and blood levels of selected vitamins and minerals in 11 astronauts before and after long-duration (128-195 d) space flight aboard the International Space Station. Dietary intake and limited biochemical measures were assessed during flight. Crew members consumed a mean of 80% of their recommended energy intake, and on landing day their body weight was less (P = 0.051) than before flight. Hematocrit, serum iron, ferritin saturation, and transferrin were decreased and serum ferritin was increased after flight (P < 0.05). The finding that other acute-phase proteins were unchanged after flight suggests that the changes in iron metabolism are not likely to be solely a result of an inflammatory response. Urinary 8-hydroxy-2'-deoxyguanosine concentration was greater and RBC superoxide dismutase was less after flight (P < 0.05), indicating increased oxidative damage. Despite vitamin D supplement use during flight, serum 25-hydroxycholecalciferol was decreased after flight (P < 0.01). Bone resorption was increased after flight, as indicated by several markers. Bone formation, assessed by several markers, did not consistently rise 1 d after landing. These data provide evidence that bone loss, compromised vitamin D status, and oxidative damage are among critical nutritional concerns for long-duration space travelers.

8-Hydroxy-2'-Deoxyguanosine↗

PubMed2005

The association of time in the US and diet during pregnancy in low-income women of Mexican descent.

This study compared nutritional intake during pregnancy among women of Mexican descent according to country of birth (US vs. Mexico) and, for Mexico-born women, according to number of years lived in the US ( or= 11 years). A 72-item food frequency questionnaire (FFQ) was used to assess dietary intake in 474 pregnant Mexico-born immigrants and US-born Mexican-Americans. Mexico-born women had significantly higher intakes of calories (P = 0.02), fibre (P < 0.001), vitamin A (P < 0.001), vitamin C (P = 0.03), vitamin E (P < 0.01), folate (P < 0.01), calcium (P < 0.001) and zinc (P = 0.02) from their diets than US-born women. Intakes of all nutrients except vitamin C and zinc remained significantly higher in Mexico-born women when nutrients from both diet and vitamin supplements were considered. Among Mexico-born women, increasing years of residence in the US was associated with lower intake of calories (P(trend) < 0.01), fibre (P(trend) < 0.01), folate (P(trend) = 0.03), iron (P(trend) = 0.05) and zinc (P(trend) = 0.03), although only the trend for iron remained significant when vitamin supplement sources were included. A large percentage of women had inadequate intake of vitamin E (58%), folate (61%), iron (77%) and zinc (47%) from their diets during pregnancy and these rates were higher in US-born women than Mexico-born women.

Adolescent↗

PubMed2004

Food consumption by children and the risk of childhood acute leukemia.

The possible relation between child's early diet and risk of childhood leukemia has remained largely unexplored. The authors' objective was to determine what particular foods consumed early in life (first 2 years) are associated with risk of childhood leukemia in a 1995-2002 case-control study of a diverse California population. Dietary data were obtained from a questionnaire administered to the child's caregiver. Conditional logistic regression was used to analyze 328 case-control sets matched on age, sex, Hispanic status, and maternal race. Regular consumption of oranges/bananas (odds ratio = 0.49, 95% confidence interval: 0.26, 0.94) and orange juice (odds ratio = 0.54, 95% confidence interval: 0.31, 0.94) during the first 2 years of life was associated with a reduction in risk of childhood leukemia diagnosed between the ages of 2 and 14 years. Restricting the analysis to leukemia diagnosed between the ages of 2 and 5 years reflected a similar pattern of reduced risk. No association between eating hot dogs/lunch meats and risk of leukemia was found. These results suggest that fruits or fruit juices that contain vitamin C and/or potassium may reduce the risk of childhood leukemia, especially if they are consumed on a regular basis during the first 2 years of life.

Adolescent↗

PubMed2004

Demonstration of an E-mailed worksite nutrition intervention program.

INTRODUCTION: Dietary fat and low fruit and vegetable intake are linked to many chronic diseases, and U.S. population intake does not meet recommendations. Interventions are needed that incorporate effective behavior-change principles and that can be delivered inexpensively to large segments of the population. METHODS: Employees at a corporate worksite were invited to participate in a program, delivered entirely by e-mail, to reduce dietary fat and increase fruit and vegetable intake. Behavior-change principles underlying the intervention included tailoring to the participant's dietary lifestyle, baseline assessment and feedback about dietary intake, family participation, and goal setting. Assessment, tailoring, and delivery was fully automated. The program was delivered weekly to participants' e-mail inboxes for 12 weeks. Each e-mail included information on nutrition or on the relationship between diet and health, dietary tips tailored to the individual, and small goals to try for the next week. In this nonrandomized pilot study, we assessed technical feasibility, acceptability to employees, improvement in Stage of Change, increase in fruit and vegetable consumption, and decrease in fat intake. RESULTS: Approximately one third (n = 84) of employees who were offered the 12-week program signed up for it, and satisfaction was high. There was significant improvement in Stage of Change: 74% of those not already at the top had forward movement (P < .001). In addition, results suggest significant increase in fruit and vegetable consumption (0.73 times/day, P < .001) and significant decrease in intake of fat sources (-0.39 times/day, P < .001). CONCLUSION: This inexpensive program is feasible and appears to be effective. A randomized controlled trial is needed.

Adult↗

PubMed2004

Lifestyle and demographic factors in relation to vasomotor symptoms: baseline results from the Study of Women's Health Across the Nation.

Results of recent trials highlight the risks of hormone therapy, increasing the importance of identifying preventive lifestyle factors related to menopausal symptoms. The authors examined the relation of such factors to vasomotor symptoms in the multiethnic sample of 3,302 women, aged 42-52 years at baseline (1995-1997), in the Study of Women's Health Across the Nation (SWAN). All lifestyle factors and symptoms were self-reported. Serum hormone and gonadotropin concentrations were measured once in days 2-7 of the menstrual cycle. After adjustment for covariates using multiple logistic regression, significantly more African-American and Hispanic and fewer Chinese and Japanese than Caucasian women reported vasomotor symptoms. Fewer women with postgraduate education reported vasomotor symptoms. Passive exposure to smoke, but not active smoking, higher body mass index, premenstrual symptoms, perceived stress, and age were also significantly associated with vasomotor symptoms, although a dose-response relation with hours of smoke exposure was not observed. No dietary nutrients were significantly associated with vasomotor symptoms. These cross-sectional findings require further longitudinal exploration to identify lifestyle changes for women that may help prevent vasomotor symptoms.

Adult↗

PubMed2004

A randomized trial of the Little by Little CD-ROM: demonstrated effectiveness in increasing fruit and vegetable intake in a low-income population.

INTRODUCTION: Research indicates that low fruit and vegetable intake is a risk factor for many chronic diseases. Despite large-scale education campaigns, the great majority of Americans do not consume recommended levels. We tested the ability of a single brief interactive experience of the Little by Little CD-ROM to increase fruit and vegetable intake in low-income women. METHODS: A randomized placebo-controlled, parallel-group trial included 481 low-income, female participants: mean age 50.1 years, 48.4% African American, 51.6% non-Hispanic white, and 92.5% below 185% of the federally designated poverty level. Participants received one of three conditions: 1) a one-time experience with the Little by Little CD-ROM, 2) the Little by Little CD-ROM plus two reminder telephone calls, or 3) a stress management CD-ROM (control condition). We assessed baseline and follow-up dietary intake with a modified 24-hour recall. RESULTS: Two months after the one-time experience with the CD-ROMs, both intervention groups reported significantly higher intakes of fruits and vegetables than the control group. The Little by Little group with reminder calls increased daily intake by 1.32 fruits/vegetables, an 86% greater increase than the control group (P = .016). The Little by Little group without reminder calls increased daily intake by 1.20 fruits/vegetables, a 69% greater increase than the control group (P = .052). Significantly greater movement in Stage of Readiness for Change also occurred in the Little by Little groups compared with the control group. CONCLUSION: The Little by Little CD-ROM may be useful in public health and clinical situations to increase fruit and vegetable intake.

CD-ROM↗