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PubMed1989

Risk factors for Escherichia coli O157:H7 infection in an urban community.

Outbreaks of Escherichia coli O157:H7 have been attributed to meat or meat products, particularly ground meat, and to unpasteurized dairy products. However, the risk factors for sporadic cases have not been clearly delineated. Study data were collected by using a self-administered dietary and historical questionnaire on all patients whose history included bloody diarrhea and who attended one of the participating emergency departments. Designation as "case" or "control" occurred after stool culture results were known, eliminating the possibility for recall bias common to this type of study. Cases (E. coli O157:H7-positive) were further matched with one diarrheal and one healthy community control, and more detailed information on food preparation practices and other data were then taken. Of 266 presentations of bloody diarrhea, 103 (38.7%) were due to E. coli O157:H7. Unmatched analyses with bloody diarrheal controls revealed a seemingly lower risk for E. coli O157:H7 infection in fast food restaurant patrons. No increased risk could be detected for ground meat consumption despite adequate study power, although an association between ingestion of undercooked meat and infection (odds ratio = 3.5, P less than .05) was found when community controls were used. Proper food cooking (and handling) rather than the avoidance of particular food products is the preventive measure of choice.

Alberta↗
PubMed2005

Lunchbox contents of Australian school children: room for improvement.

OBJECTIVE: In light of the increasing prevalence of obesity in children and the potential of schools as a setting for intervention, we aimed to identify the main foods and beverages consumed at primary school and to determine differences in consumption patterns between children who used the school canteen and those who did not. DESIGN: Cross-sectional survey of school foods in 1681 5-12 y old children, 2003-2004. SETTING: Barwon South-Western region of Victoria, Australia. RESULTS: The school food provided an average (+/-s.e.m.) of 3087+/-26 kJ. Bread was the most frequently consumed food and contributed 20% of total energy at school, biscuits 13%, fruit 10%, muesli/fruit bars 8%, packaged snacks 7%, and fruit juice/cordial 6%. About 10% of children used the school canteen and these children obtained more total energy and more energy from cakes, fast foods and soft drink than noncanteen users (P<0.001). In all, 68% of children had fruit in their lunchboxes, however, over 90% of children had energy-dense, micronutrient-poor snacks ('junk food'). CONCLUSIONS: Fruit intake in primary schools seems reasonably high but could be targeted for further increase as part of promoting a healthy diet. Of concern, however, are the excessive amounts of energy-dense foods in school lunchboxes. These should be considered a priority for health promotion efforts along with reducing the consumption of sweetened drinks. These measures are urgently needed to improve the school-based diets of Australian children and attempt to curb the increasing prevalence of childhood obesity.

Age Factors↗
PubMedDate not supplied

[Individual outpatient care versus group education programs. Which leads to greater change in dietary and physical activity habits for obese children?].

OBJECTIVE: To compare two strategies for childhood obesity management: ambulatory assistance (individual) and educational program (in group). METHOD: Children and adolescents from 7 to 13 years of age were selected at random. They were divided into two groups: individually assisted or assisted in groups. An educational program about childhood obesity was created, with monthly meetings that consisted of lectures with parents' participation and group work. Simultaneously, children and teenagers of the other group received individual ambulatory assistance. The program took place for six months. Body composition, eating habits and physical activities were assessed before and after interventions. RESULTS: The sample comprised 38 children and adolescents whose mean age was 9.9 years. The program was more effective in increasing physical activity (p = 0.003), specially walking (p = 0.003), as well as in reducing total cholesterol (p = 0.038). Reduction of body mass index, obesity index and caloric intake was similar in both groups. As for food habits, ambulatory assistance increased the intake of fruits (p = 0.033) and vegetables (p = 0.002) and reduced the amount of French fries and crisps (p = 0.041), while children participating in the program reduced the intake of soft drinks (p = 0.022), sandwiches, pizza and fast food (p = 0.006). CONCLUSIONS: Both strategies for handling childhood obesity were favorable to changes in food and physical activity habits. Group assistance was as effective as individual assistance, consolidating it as an alternative for obesity treatment.

Adolescent↗
PubMedDate not supplied

Obesogenic influences in public housing: a mixed-method analysis.

BACKGROUND: Obesity prevalence is higher among those who live in impoverished environments. This investigation identified obesogenic factors in urban neighborhoods surrounding public housing developments (HDs). DESIGN: Cross-sectional quantitative survey data from 14 HD neighborhoods and qualitative interviews of the HD managers. SETTING: Kansas City, Kansas, and Kansas City, Missouri. SUBJECTS: Environmental data were collected from HDs and surrounding neighborhoods, an area enclosed by an 800-m radius line drawn from the HD centroid. Qualitative data were collected from all 14 HD managers. MEASURES: HDs were rated by a brief environmental audit. HD managers were assessed in a structured 45- to 60-minute interview about neighborhood factors influencing resident obesity. RESULTS: The properties were typically modern and well maintained; however, there were few physical activity (PA) resources and food sources on site. Most HD managers cited the availability of PA resources near the HD; however, there was wide variability in the type and accessibility of the resources. Only two HDs had a store that sold groceries within one block. Interviews identified fast food restaurants as common food sources, with few other food sources available. DISCUSSION: Data suggested that although strides have been made to increase safety and comfort in public housing, there remains poor access to PA resources and healthful food sources. Interventions and policies should consider access to PA resources and food sources.

Cross-Sectional Studies↗
PubMed2002

Individual and environmental influences on adolescent eating behaviors.

Food choices of adolescents are not consistent with the Dietary Guidelines for Americans. Food intakes tend to be low in fruits, vegetables, and calcium-rich foods and high in fat. Skipping meals is also a concern among adolescents, especially girls. Factors influencing eating behaviors of adolescents need to be better understood to develop effective nutrition interventions to change eating behaviors. This article presents a conceptual model based on social cognitive theory and an ecological perspective for understanding factors that influence adolescent eating behaviors and food choices. In this model, adolescent eating behavior is conceptualized as a function of individual and environmental influences. Four levels of influence are described: individual or intrapersonal influences (eg, psychosocial, biological); social environmental or interpersonal (eg, family and peers); physical environmental or community settings (eg, schools, fast food outlets, convenience stores); and macrosystem or societal (eg, mass media, marketing and advertising, social and cultural norms).

Adolescent↗
PubMed1992

Eating patterns and energy and nutrient intakes of US women.

A longitudinal multivariate analysis was used to determine whether differences in energy and nutrient intakes were present for women classified into different eating patterns. Ten multidimensional eating patterns were created based on the proportion of energy consumed at home and at seven away-from-home locations. Data were from 1,120 women aged 19 through 50 years who were surveyed up to six times over a 1-year period as part of the 1985 Continuing Survey of Food Intake by Individuals, US Department of Agriculture. Data from 5,993 days were analyzed. To examine differences in energy and nutrient intakes, longitudinal multivariate analyses were used to control for eating pattern and factors such as demographics, season, and day of week. Younger women in the Fast Food eating pattern consumed the greatest intakes of energy, total fat, saturated fat, cholesterol, and sodium. Well-educated, higher-income women in the Restaurant pattern consumed diets with the highest overall fat density. Nutrient densities for dietary fiber, calcium, vitamin C, and folacin were particularly low in away-from-home eating patterns. In contrast, moderately educated, middle-aged and middle-income women in the Home Mixed eating pattern (70% at home, 30% away from home) consumed the most healthful diets. We conclude that knowledge of demographics such as income and education is not enough to target dietary interventions. Rather, educational efforts must consider both demographics and the location of away-from-home eating. This will allow development of behavioral change strategies that consider food choices dictated by the eating environment as well as personal knowledge and attitude factors related to adoption of healthful food choices.

Adult↗
PubMed2000

Differential response of obese gene expression from fasting in bovine adipose tissues.

To understand the molecular mechanism for intramuscular fat deposition, the expression of the obese gene was examined in response to fasting. Food deprivation for 48 h induced a decrease in the level of obese mRNA in pooled adipose tissues (abdominal, perirenal, subcutaneous, intermuscular and intramuscular). The expression of obese mRNA was examined for individual adipose tissue from several fat depots. It was highly expressed in perirenal adipose tissue, but fasting did not affect its expression level in this tissue. Moderate levels were detected in subcutaneous and intermuscular adipose tissues, and a fasting-induced decrease in obese mRNA was apparent in these tissues. The expression level of the obese gene in intramuscular adipose tissue was very low and did not respond to fasting.

Adipose Tissue↗
PubMed2004

Environmental changes may be needed for prevention of overweight in minority children.

In minority populations, those who do not maintain normal weight outnumber those who do; thus, overweight is often the community norm. Compared to many white populations, minority populations are transitioning from poverty, food scarcity, and jobs that require significant amounts of energy expenditure. This may mean food and activity habits of both black and Latino populations may have been developed during a more physically-active era. Caloric restriction and leisure-time physical activity are not routine in minority communities. In these communities, there are often few supermarkets that carry fresh produce, many fast food establishments and small grocery stores that sell high-fat, energy-dense foods, and high neighborhood crime rates that discourage outdoor activities and limit safe places for walking and bicycling, including school routes. Although specific dietary and activity behaviors related to weight control ultimately are undertaken by individuals, our current environment makes such individual choices difficult when it contains substantial barriers to establishing healthy lifestyles. Substantial environmental changes need to be made, especially in minority communities.

Child↗
PubMedDate not supplied

Dietary intake and risk factors for poor diet quality among children in Nova Scotia.

OBJECTIVE: Public health policies promote healthy nutrition but evaluations of children's adherence to dietary recommendations and studies of risk factors of poor nutrition are scarce, despite the importance of diet for the temporal increase in the prevalence of childhood obesity. Here we examine dietary intake and risk factors for poor diet quality among children in Nova Scotia to provide direction for health policies and prevention initiatives. METHODS: In 2003, we surveyed 5,200 grade five students from 282 public schools in Nova Scotia, as well as their parents. We assessed students' dietary intake (Harvard's Youth Adolescent Food Frequency Questionnaire) and compared this with Canadian food group and nutrient recommendations. We summarized diet quality using the Diet Quality Index International, and used multilevel regression methods to evaluate potential child, parental and school risk factors for poor diet quality. RESULTS: In Nova Scotia, 42.3% of children did not meet recommendations for milk products nor did they meet recommendations for the food groups 'Vegetables and fruit' (49.9%), 'Grain products' (54.4%) and 'Meat and alternatives' (73.7%). Children adequately met nutrient requirements with the exception of calcium and fibre, of which intakes were low, and dietary fat and sodium, of which intakes were high. Skipping meals and purchasing meals at school or fast-food restaurants were statistically significant determinants of poor diet. Parents' assessment of their own eating habits was positively associated with the quality of their children's diets. INTERPRETATION: Dietary intake among children in Nova Scotia is relatively poor. Explicit public health policies and prevention initiatives targeting children, their parents and schools may improve diet quality and prevent obesity.

Child↗
PubMedDate not supplied

Ageing, lifestyle modifications, and cardiovascular disease in developing countries.

Developing countries face the double menace of still prevalent infectious diseases and increasing cardiovascular disease (CVD) with epidemic proportions in the near future, linked to demographic changes (expansion and ageing), and to urbanisation and lifestyle modifications. It is estimated that the elderly population will increase globally (over 80% during the next 25 years), with a large share of this rise in the developing world because of expanding populations. Increasing longevity prolongs the time exposure to risk factors, resulting in a greater probability of CVD. As a paradox, increased longevity due to improved social and economical conditions associated with lifestyle changes in the direction of a rich diet and sedentary habits in the last century, is one of the main contributors to the incremental trend in CVD. The variable increase rate of CVD in different nations may reflect different stages of "epidemiological transition" and it is probable that the relatively slow changes seen in developing populations through the epidemiological transition may occur at an accelerated pace in individuals migrating from nations in need to affluent societies (i.e. Hispanics to the USA, Africans to Europe). Because of restrained economic conditions in the developing world, the greatest gains in controlling the CVD epidemic lies in its prevention. Healthy foods should be widely available and affordable, and healthy dietary practices such as increased consumption of fresh fruits and vegetables, reduced consumption of saturated fat, salt, and simple sugars, may be promoted in all populations. Specific strategies for smoking and overweight control may be regulation of marketed tobacco and unhealthy fast food and promotion of an active lifestyle. Greater longevity and economic progress are accompanied by an increasing burden of CVD and other chronic diseases with an important decrease in quality of life, which should question the benefit of these additional years without quality.

Adolescent↗
PubMed1996

Environmental factors and nutritional status of rural children.

The nutritional status of school-aged children is a growing concern of health care professionals today. In collaboration with a Kellogg Project in the deep south, students from a large university school of nursing participated in a project to improve the nutritional status of rural school-aged children. The project goals focused on educating thd children about the U.S. Department of Agriculture (USDA) Food Guide Pyramid, reading nutritional labels and recognizing foods with high fat content, and the importance of exercise along with diet. The nursing students created a nutritional assessment tool to use with each child to determine their educational needs. The project involved lecture, interactive class discussion, and hands-on activities. Information from the assessment tool revealed that fast food and foods high in fat were the most popular with the children. After project completion, the posttest revealed an increase in cognitive knowledge of nutrition among all the children. In addition to this positive learning experience for the children, improving the health status of children in the community was an excellent educational opportunity for the nursing students.

Child↗
PubMed2000

Burger King, Dunkin Donuts and community mental health care.

This paper describes the patchwork of cottage industries and human warehousing composing Montréal's 'community mental health care' system. It examines the ways in which this system's clients assemble a collage of ad hoc facilities including homeless shelters, rooming houses, food banks and soup kitchens through which they pursue the fragmented task of daily survival. In their various forms of transit around the city, released psychiatric patients, who rotate in and out of the local psychiatric wards, construe the grammar of urban space. In examining their use of key city sites - malls, fast food outlets, churches and the streets - it becomes apparent that the 'mad' have a particular relationship to these places which they pass through and use on certain terms. Examining the nature of their journeys, the scenes on which they are set and the social relationships of space in play, it is evident that the 'mad' have a particular (dialogical) relationship to the city: a relationship which they share with other, multiply disenfranchised people. This raises significant social questions concerning the politics of city space, and the kinds of fragmented lives and forms of subjectivity that they produce.

Adolescent↗
PubMed2005

A comparison of three methods of determination of energy density of elite figure skaters.

Dietary energy density (kcal/g) is defined as available dietary energy per unit weight or volume of food. The consumption of energy-dense foods has been associated with increased obesity risk and with excessive weight gain. The objectives of this study were to compare how dietary energy density, calculated using three different methods relates to food choices and nutrient composition of the diets of elite figure skaters. Participants were 159 elite figure skaters attending training camps. Mean age was 18.4 y for boys (n = 79) and 15.9 y for girls (n = 80). Heights and weights were measured to calculate body-mass indices (BMI). Dietary intakes were based on 3-d food records analyzed using the Nutritionist IV program. Mean energy intakes were 2326 kcal/d for boys and 1545 kcal/d for girls. Dietary energy density,,based on foods and caloric beverages only, was 1.0 kcal/g. Dietary ED was positively associated with percent energy from fat and negatively with percent energy from sugar. The main sources of dietary energy in this group were baked goods, cereals, regular soda, low-fat milk, fruit juices, bagels and pizza. Percent energy from fast foods was associated with higher dietary energy density, whereas percent energy from dairy products, soft drinks, vegetables, and fruit was associated with lower dietary energy density. These results are consistent with past observations; higher energy density diets were higher in fat. In contrast, there was a negative relationship between sugar content and energy density of the diet.

Adolescent↗
PubMed2006

Food choices of young African-American and Latino adolescents: where do parents fit in?

To gain insight into parents' perceptions of the food preferences of their young adolescents, and their negotiating and decision-making strategies around food purchasing and meals, four focus groups were held with 32 African-American parents and three focus groups with 14 Spanish-dominant, first-generation immigrant Latina mothers. Most participants were of low socioeconomic status and were single parents. Many African-American parents emphasized children's growing appetites and preferences for fast food. Many reported making weekday dinner decisions jointly with the child or allowing the child to eat a lunch-like alternative, and allowing serve-yourself meals on weekends. A few prepared traditional ethnic foods. Latina parents reported that their children liked ethnic foods and fast/junk foods. They emphasized buying foods their children wanted, making no eating restrictions, and preparing traditional ethnic dinners without alternatives. African-American and Latina parents displayed concern over whether to place restrictions on young adolescents' eating. Further research is needed on the ways in which socioeconomic inequalities compound barriers to healthful eating, with particular attention to low income and immigrant populations.

Adolescent↗
PubMed2005

Dietary Westernisation: conceptualisation and measurement in Mauritius.

OBJECTIVES: The aims of the study were to provide information that will contribute to conceptualising what is called "dietary Westernisation", and to provide an example of measuring it on an individual level. DESIGN: Food consumption frequency and demographic data on adults in Mauritius were examined in 1988, 1992 and 1998. In 1992, a 24-hour recall was also included. The cross-sectional samples consisted of 1115 (age 25-74 years) Mauritians in 1987/88, 1917 (age 30-74 years) in 1992 and 2239 (age 20-74 years) in 1998. Principal components analysis was carried out on daily consumption frequencies of 10 indicator foods (white rice, white bakery bread, pulses, processed meat, poultry, fresh/frozen fish, butter, margarine, whole milk and skimmed/low-fat milk). Correlations between dietary patterns and selected food consumption frequencies were examined in each survey year. RESULTS: Four dietary patterns were identified as being related to dietary Westernisation. The Traditional dietary pattern was characterised by higher consumption frequencies of Indian breads, salted/smoked fish and sugar-sweetened tea. The Western dietary pattern was characterised by higher consumption frequencies of cakes/pastries, meat and many Western fast foods like burgers, but, surprisingly, also by brown bread, breakfast cereals and salad. The Bread/butter dietary pattern predominantly described more frequent consumption of bread compared with rice. The Margarine/milk dietary pattern was inconsistently related with staple foods. Younger, educated and wealthier Mauritians appeared to adopt Western dietary patterns earlier. CONCLUSIONS: This study suggests that relatively few indicator foods are needed for measuring dietary Westernisation. Dietary Westernisation in a non-Western country may also include shifts towards voluntary consumption of healthier foods.

Adult↗
PubMed1988

Hyperoxic lung injury in mice: effect of neutrophil depletion and food deprivation.

Conflicting data exist on the role of neutrophils (PMNs) in the pathogenesis of hyperoxic lung damage. We examined the contribution of PMNs and the contribution of food deprivation, a frequent complication of the methods used to produced neutropenia, to the lung damage that results when mice are exposed to high concentrations of oxygen. Mice were exposed to either 100% oxygen or air for up to 4 days. Neutropenia was induced by a single tail vein injection of nitrogen mustard (NM) given 1 day before the oxygen exposure. Food deprivation, which induced the same weight loss as that found in NM-treated mice, was achieved by withholding food (fasted) during the oxygen exposure. We examined mortality; weight loss; bronchoalveolar lavage (BAL fluid) protein concentration, cell count, and differential count; the number of PMNs in blood; and lung histologic conditions by light and electron microscopy. NM-treated mice lost approximately 25% of their body weight when exposed to either air or oxygen. They also had more severe lung damage than the saline-treated mice during hyperoxic exposure, despite a marked reduction in the number of PMNs in blood, BAL fluid, and lung tissue. Although a correlation was found between the number of blood PMNs and the BAL protein concentration in the nonneutropenic mice (r = 0.69; P less than 0.001), no correlation was seen in the neutropenic mice (r = 0.26). Fasted, oxygen-exposed mice had the same weight loss as the NM mice, but they had more severe lung damage at an earlier time (day 3 vs. day 4) and greater mortality than the saline-treated and the NM-treated mice. These results indicate that PMNs are not required for either the development or progression of hyperoxic lung damage in mice; fasting increases susceptibility to the lung damage; and differences in nutritional status may explain, in part, the controversial role of PMNs in oxygen-induced lung damage.

Animals↗
PubMed1991

Collagen production in fasted and food-restricted rats: response to duration and severity of food deprivation.

Malnutrition is associated with defects in connective tissue metabolism such as altered growth and wound healing. Because collagen is the major protein in most tissues, we determined the threshold for induction of altered collagen production by partial food restriction in rats. Groups of animals were fasted 2 or 4 d or were fed 20-100% of a predetermined food intake for 4 to 8 d. Collagen and noncollagen protein production in articular cartilage were determined using purified collagenase digestion of collagen labeled for 2 h in vitro with [3H]proline. Significant decreases in collagen (P less than 0.01) were seen in rats after 4 d of 40% (weight-losing rats) or after 8 days of 80% (weight-gaining rats) ad libitum intake. Collagen production decreased with both duration and degree of food deprivation; after 8 d of 20% intake, collagen was less than 10% that of controls fed ad libitum (P less than 0.001). In contrast, noncollagen protein production was significantly decreased only after 4 or 8 d of less than 40% intake (weight-losing rats). Maximum suppression of noncollagen protein was to approximately 65% of levels in controls fed ad libitum (P less than 0.01) and was not further reduced in fasted rats. Insulin-like growth factor-I levels were significantly decreased with duration and severity of diet in parallel with changes in collagen. The degree and sensitivity of altered collagen production to small changes in food intake suggest close regulation of this peptide and a potential role for decreased collagen synthesis in connective tissues during mild states of undernutrition.

Animals↗
PubMed2002

Adolescent vegetarians: how well do their dietary patterns meet the healthy people 2010 objectives?

OBJECTIVES: To examine whether adolescent vegetarians were more likely than nonvegetarian peers to meet the dietary recommendations of the Healthy People 2010 objectives and to examine differences in other nutrients between these 2 groups. DESIGN: A total of 4746 adolescents from 31 middle and high schools in the Twin Cities area of Minnesota. Data were collected via self-report surveys, with a student response rate of 81.5%. SETTING: Urban secondary schools. PARTICIPANTS: Participants were equally divided by sex. The mean age was 14.9 years; 34.3% were in junior high school and 65.7% in high school. The racial/ethnic distribution was 48.5% white, 19.0% African American, 19.2% Asian American, 5.8% Hispanic, 3.5% American Indian, and 3.9% mixed or other. MAIN OUTCOME MEASURES: Questions on vegetarian status and whether particular foods (eggs, dairy foods, chicken, fish) were excluded. Dietary intake was assessed using the Youth and Adolescent Food Frequency Questionnaire. RESULTS: Vegetarian adolescents were significantly more likely than nonvegetarian adolescents to meet the Healthy People 2010 objectives. This was particularly noteworthy for total fat (70% vs 48%), saturated fat (65% vs 39%), daily servings of vegetables (26% vs 14%), and 5 or more servings of fruits and vegetables (39% vs 28%). Vegetarians were also less likely to eat fast food or drink regular soda and fruit drinks. Vegetarians consumed less vitamin B(12), more diet soda, more caffeine, and more iron. CONCLUSION: Adolescent vegetarians have a dietary pattern that is more likely than nonvegetarians to meet the Healthy People 2010 objectives.

Adolescent↗