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PubMed2000

Diet and childhood asthma in a society in transition: a study in urban and rural Saudi Arabia.

BACKGROUND: The causes of the worldwide increases in asthma and allergic diseases in childhood, which seem to relate to increasing prosperity, are unknown. We have previously hypothesised that a reduction in the antioxidant component of the diet is an important factor. An investigation was undertaken of dietary and other risk factors for asthma in Saudi Arabia where major lifestyle differences and prevalences of allergic disease are found in different communities. METHODS: From a cross sectional study of 1444 children with a mean age of 12 (SD 1) years in Jeddah and a group of rural Saudi villages, we selected 114 cases with a history of asthma and wheeze in the last 12 months and 202 controls who had never complained of wheeze or asthma, as recorded on the ISAAC questionnaire. Risk factors for asthma and allergies (family history, social class, infections, immunisations, family size, and diet) were ascertained by questionnaire. Atopy was assessed by skin prick testing. RESULTS: In univariate analyses, family history, atopy, and eating at fast food outlets were significant risk factors for wheezy illness, as were the lowest intakes of milk and vegetables and of fibre, vitamin E, calcium, magnesium, sodium, and potassium. These differences were present also in the urban children considered separately. Sex, family size, social class, infections, and parental smoking showed no relationship to risk. In multiple logistic regression analysis, urban residence, positive skin tests, family history of allergic disease, and the lowest intakes of vitamin E, magnesium and sodium related significantly and independently to risk. The lowest tertile of intake of vitamin E was associated with a threefold (95% CI 1.38 to 6.50) increase in risk when adjusted for the other factors. Intake of milk and vegetables both showed inverse linear relationships to being a case. CONCLUSIONS: This study suggests that dietary factors during childhood are an important influence in determining the expression of wheezy illness, after allowing for urban/rural residence, sex, family history, and atopy. The findings are consistent with previous studies in adults and with the hypothesis that change in diet has been a determinant of the worldwide increases in asthma and allergies.

Analysis of Variance↗
PubMed2004

Secular trends in dietary intake in the United States.

This review focuses on dietary intake and dietary supplement use among the U.S. population age 1-74 based on four National Health and Nutrition Examination Surveys conducted in 1971-74, 1976-80, 1988-94, and 1999-2000. Secular trends in intake of energy, macronutrients, cholesterol, sodium, calcium, iron, folate, zinc, vitamins A and C, fruits, vegetables, and grain products are summarized. During the 30-year period, mean energy intake increased among adults, and changed little among children age 1-19, except for an increase among adolescent females. Factors contributing to increases in energy intake include increases in the percentage of the population eating away from home (particularly at fast-food restaurants), larger portion sizes of foods and beverages, increased consumption of sweetened beverages, changes in snacking habits, and improved dietary methodology. Dietary supplement use increased among adult men and women, decreased among children age 1-5, and was stable for children age 6-11 and adolescents.

Adolescent↗
PubMed1999

The case of the red lingerie - chromhidrosis revisited.

Chromhidrosis or the production of coloured sweat is a rare clinical finding. A 26-year-old female presented with marked pink staining of her uniform and lingerie. Extractions of clothing, skin surface samples, eccrine sebum, urine and a fast food product were spectrophotometrically analysed to identify the pink staining pigment. Three water-soluble colouring agents have been identified. An eccrine route of excretion probably produced chromhidrosis. An overview is presented.

Adult↗
PubMed1999

Reduced postprandial serum paraoxonase activity after a meal rich in used cooking fat.

Paraoxonase is an enzyme associated with HDL in human serum that hydrolyzes oxidized phospholipids and inhibits LDL oxidation, which is an important step in atherogenesis. In animals, addition of oxidized lipids to the circulation reduces paraoxonase activity, and diets rich in oxidized fat accelerate the development of atherosclerosis. The current randomized, crossover study was designed to compare the effect of a meal rich in oxidized lipids in the form of fat that had been used for deep-frying in a fast food restaurant and a control meal rich in the corresponding unused fat on postprandial serum paraoxonase (arylesterase) activity and peroxide content of LDL and its susceptibility to copper ion catalyzed oxidation in 12 healthy men. Four hours into the postprandial period, serum paraoxonase activity had decreased significantly after the used fat meal (-17%, P=0.005) and had increased significantly after the meal rich in unused fat (14%, P=0. 005). These changes were significantly (P=0.003) different. A time-course study indicated that serum paraoxonase activity remained lower than baseline for up to 8 hours after the used fat meal. Serum apoA1 concentration tended to decrease after the unused fat meal and tended to increase after the used fat meal. These changes were different at a marginal level of significance (P=0.07). Also, a significantly (P=0.03) greater decrease in apoA1 content of postprandial HDL was recorded after the unused fat meal. The peroxide content of LDL tended to decrease after the used fat meal and tended to increase after the control meal. These changes were significantly (P=0.04) different. Susceptibility of isolated LDL to copper ion oxidation and plasma levels of malondialdehyde were unchanged during the study. These data suggest that in the postprandial period after a meal rich in used cooking fat, the enzymatic protection of LDL against accumulation of peroxides and atherogenic oxidative modification may be reduced, possibly due to factors associated with apoA1, without acutely affecting the intrinsic resistance of LDL to in vitro oxidation.

Adult↗
PubMed2005

Factors affecting nutritional status of Malaysian primary school children.

This paper investigates the nutritional status of a randomly selected cohort of school children and the factors affecting it. This random survey was conducted in the state of Selangor, involving 1,405 primary students (aged 9-10 years from 54 national primary schools). Physical examination was carried out on all the students. Information on the students was also obtained from the parents. Blood samples were taken by using the finger pricking technique. Body mass index (BMI) was used as a measure of physical growth. The students were mainly from urban areas (82.9%). The mean age was 9.71 years and a higher proportion was females (51%). Malays constituted 83.6%, Indians 11.6% and Chinese 4.2% of the study population. The mean weight and height were 32.30 kg and 135.18 cm respectively. The mean BMI was 17.42 kg/m2, with 1.2% of the students underweight, 76.3% normal BMI, 16.3% overweight and 6.3% were obese. Nutritional status was significantly related to blood pressure, history of breast feeding, eating fast food, taking canned/bottled drinks, income and educational level of parents. Significant differences in nutritional status between sexes and locations (rural/urban) were also found. The prevalence of overweight and obese children was of concern. There is thus an urgent need for the School Health Program to periodically monitor the school children's eating habits and physical growth. Appropriate counselling on nutritional intake and physical activities should be given not only to schoolchildren but also to their teachers and parents or caregivers.

Child↗
PubMed1989

The role of parents and older peers in school-based cardiovascular prevention programs: implications for program development.

This article describes a set of studies which compare the effectiveness of innovative interventions led by older peers and which included a parent component with teacher-led interventions for nutrition, blood pressure, and smoking prevention. Information about the agreement between parents' and children's (grades six through eight) perception of the children's health behavior and family interaction was also found, by surveying parents and children in 1051 households. Both teacher-led and older peer-led interventions were successful in increasing behavioral capabilities for nutrition and blood pressure, measured one year after the interventions. Results of the parent-child survey showed reasonable agreement between parents and children for reports of the child's exercise, dieting, and fast food consumption, but poorer agreement for smoking and perceptions of family interaction. Results are discussed in relation to the planning of future programs designed to address the importance of peer and parental role models.

Adolescent↗
PubMed2005

Perspectives on obesity and barriers to control from workers at a community center serving low-income Hispanic children and families.

Community center workers serving children and families in a predominantly Hispanic, low-income neighborhood were interviewed qualitatively, to ascertain their perspectives on obesity and barriers to control and prevention, to design a practical and culturally appropriate intervention for obesity control. All 19 respondents recognized obesity as a problem, identified healthy eating and physical activity as requisites for controlling obesity, and mentioned fast food and cultural influences in Hispanic families as contributory factors. Lack of time emerged as a major barrier to all preventive practices related to eating healthy or being physically active. Safety concerns and lack of safe places for walking and running were mentioned as a barrier to being physically active. Further studies have to be conducted with parents of at-risk children, to understand time constraints. Community health workers should be sensitive to issues of time constraints and incorporate time management recommendations into obesity prevention and education.

Adult↗
PubMed2006

Some ethical reflections on accountability.

Wait times have come to dominate the health reform agenda and have captured the public imagination. Waiting for any service--from fast food to e-mail--is difficult for contemporary Canadians; this is especially true for healthcare. Addressing wait times is part of a much larger initiative essential for the health system and dependent on a culture shift from the "blame game" to a sustained, meaningful accountability. Achieving this goal in such a value-laden endeavour as healthcare will be no small task. Accountability for the fair provision of access to and quality of services in healthcare is complex and demanding, in large part because of the nature of health need and the social meaning of healthcare. Failure of progress on this issue is related to a lack of clarity about the locus, meaning and scope of accountability. Without such clarity the term runs the risk of becoming useless or dangerous. Ethically, the key lies in understanding the profoundly value-laden nature of both healthcare and public policy.

Canada↗
PubMed1990

Dealing with labor shortages in long-term care: a marketing problem.

A recent analysis of data from the Bureau of Labor statistics raise serious implications for the long-term care industry. The human resource problems faced by managers in long-term care will escalate into a fullblown crisis by the end of this century. This will result from a decrease in the number of young workers available to work in unskilled and semiskilled occupations. The effect of this shortage will be exaggerated by an expansion of other sectors of the service industry. Long-term care facilities will be forced to compete with the fast food and retail industry as well as other sectors of the health industry for scarce workers. This article briefly examines the causes, consequences of this problem and suggests several strategies to mitigate the effect of the coming labor shortage.

Data Collection↗
PubMed2005

Unraveling health disparities: examining the dimensions of hypertension and diabetes through community engagement.

The contexts of people's lives can perpetuate racial and ethnic health disparities. In this work, community members from four racial/ethnic groups (Hispanic, Native American, African American, Asian) engaged in an investigative process to analyze their own life conditions, and to explore dimensions of their health behaviors and lifestyles when managing diabetes and/or hypertension. Principal conclusions of the researchers: (1) Respondents were knowledgeable about their health conditions, but had no knowledge of health disparities. (2) Respondents felt the media portrays members of racial/ethnic minorities as hopeless and helpless; this discourages them from believing they can live healthier or better lives. (3) The over-abundance of fast food and unhealthy food eateries in minority communities contradicts the advice of the public health industry. (4) The majority of all respondents were in one of two stages relative to their willingness to change unhealthy behaviors: not interested or already doing it.

Adolescent↗
PubMedDate not supplied

Preventing and treating obesity: pediatricians' self-efficacy, barriers, resources, and advocacy.

OBJECTIVE: With respect to obesity prevention and treatment, to determine pediatricians' 1) treatment self-efficacy; 2) perceived barriers and relationships to management self-efficacy; 3) desired resources; and 4) willingness to be involved in advocacy. METHODOLOGY: A cross-sectional, self-administered mail survey queried members of the North Carolina Pediatrics Society and the American Academy of Pediatrics who were practicing routine care. RESULTS: The adjusted response rate was 71% (n = 356). Only 12% of respondents reported high self-efficacy in obesity management, yet 39% believed that physicians could potentially be effective. The most frequently encountered barriers to obesity management included availability of fast food (97%) and soft drinks (95%). However, some practice-based barriers were most strongly associated with self-efficacy. Odds of high self-efficacy were lower for respondents who reported lack of non-MD staff reimbursement (odds ratio [OR] = 0.73; 95% confidence interval [CI] = 0.58, 0.92), lack of on-site dietitian (OR = 0.65; 95% CI = 0.50, 0.83), or lack of patient educational materials (OR = 0.67; 95% CI = 0.50, 0.89), compared with those who reported encountering these barriers infrequently. Respondents chose better counseling tools (96%) as the most helpful clinical resource for obesity management. Most (89%) were willing to take at least a small role in advocacy efforts. CONCLUSIONS: Most pediatricians reported feeling ineffective in their ability to treat obesity. Some practice-based barriers were specifically associated with low self-efficacy. However, pediatricians welcomed multiple clinical resources for obesity management and expressed willingness to advocate for policy change. Practice-based tool kits and efforts to engage willing participants in advocacy may help pediatricians combat this epidemic.

Analysis of Variance↗
PubMed2004

[Dietary and physical activity factors as determinants of the increase in overweight/obesity in Brazil].

Data from Brazilian national surveys conducted since the 1970s have indicated an increase in the prevalence of overweight/obesity. The two most frequently cited causes of this trend have been dietary changes and reduction in physical activity, characterizing a "contemporary Western lifestyle". The objective of this paper is to identify and assess some indicators associated with changes in eating habits and physical activity patterns in the Brazilian population in the last 30 years. Despite the lack of detailed data, the following factors appear to play an important role in the process: internal migration; dining out; increased consumption of fast food; labor changes; transportation; and the use of home appliances. More information on dietary and physical activity patterns in association with anthropometric data on the Brazilian population are needed for a better understanding of each factor's role in these relationships. Meanwhile, inter-sector programs and projects with well-defined targets and outcomes are needed for the population's adherence to a healthier lifestyle, in order to control the increase in overweight/obesity.

Adolescent↗
PubMed1980

Small group behavioral training to improve the job interview skills repertoire of mildly retarded adolescents.

Four retarded adolescents, enrolled in a short-term residential treatment program, received behavioral job interview skills training. Although potentially employable, each was unable to present himself effectively in standard employment interviews. Treatment consisted of a series of behavioral group sessions using instructions, modeling and rehearsal procedures to increase, in multiple baseline fashion, such skills as the adolescents' ability to disclose positive information about their experience and background, convey interest in the position and direct relevant questions to an interviewer. Effectiveness of treatment for each client was assessed by: (1) Objective ratings of performance during individual, structured role-play job interviews following each treatment group; (2) objective ratings of pre- and posttraining performance during tape recorded in vivo generalization job interviews at a fast-food restaurant; and (3) global evaluations of pre- and posttraining in vivo generalization interviews made by experienced personnel interviewers unfamiliar with the nature of the treatment. The results indicated that potentially employable retarded citizens can be successfully taught appropriate job interview behavior using a small group behavioral procedure. The need for such techniques in community and rehabilitation centers for retarded citizens and other clinical populations is discussed.

Adolescent↗
PubMed1997

Assessment-based intervention for severe behavior problems in a natural family context.

Functional assessments and assessment-based interventions were conducted with a boy with disabilities and severe problem behavior in the context of two family routines: using the bathroom in the family home and dining in a fast-food restaurant. A multiple baseline design demonstrated the effectiveness of the intervention package as implemented by the boy's mother in the two routines. The results provide a systematic replication and extension of behavior-analytic interventions in natural family contexts.

Behavior Therapy↗
PubMed1997

Hamburger-associated Escherichia coli O157:H7 infection in Las Vegas: a hidden epidemic.

OBJECTIVES: This study sought to determine whether a multistate fast food hamburger-associated outbreak of Escherichia coli O157:H7 infection involved Las Vegas residents as well and, if so, why public health officials had not detected it. METHODS: A matched case-control study was conducted among persons with bloody diarrhea and their healthy meal companions. Hamburger production, distribution, and cooking methods were reviewed. Unused hamburger patties were cultured, and E. coli O157:H7 isolates were characterized. Local laboratory stool culture practices were reviewed. RESULTS: Fifty-eight cases of bloody diarrhea were identified. Illness was associated with eating regular hamburgers (matched odds ratio [OR] = 9.0, 95% confidence interval [CI] = 1.02,433.4), but 25% of ill persons reported eating only jumbo hamburgers. Regular and jumbo hamburger patties yielded E. coli O157:H7 indistinguishable from the lone clinical isolate. No local laboratory cultured routinely for E. coli O157:H7 until after the outbreak. CONCLUSIONS: A large outbreak of E. coli O157:H7 infections escaped timely notice in Las Vegas because local laboratories did not culture for this pathogen. Health officials should encourage laboratories to screen at least all bloody stools on sorbitol-MacConkey medium.

Adolescent↗
PubMed1999

An exploratory study of recreational drug use and nutrition-related behaviors and attitudes among adolescents.

This study examined drug use and eating behaviors among adolescents. The data were collected by phone interviews from 401 northern Nevadan students in grades seven to twelve. Students were divided for comparison into three groups according to their involvement with drugs: Abstainers, conventional users, and high-risk users. Analyses indicated that high-risk users less frequently ate lunch, meals at home, and with their families, and ate more often at convenience stores, fast food restaurants, and with friends. In addition, female high-risk users had significantly more negative perceptions regarding their food choices than the other female groups, and were more concerned with dieting than their high-risk using male peers. Male and female high-risk users believed that their drug use affected their eating habits. Implications for prevention programming and future research are discussed.

Adolescent↗
PubMed1999

A comparison of memory for and attitudes about alcohol, cigarette, and other product advertisements in college students.

The purpose of this study was to compare the attitude ratings and recall scores of cigarette, alcohol, automobile, deodorant, jeans, soft drink, athletic shoe, breakfast cereal, and fast food restaurant advertisements. Male and female college students rated the advertisements of these product groups on a number of traits--adventurous, eye-catching, appealing, informative, believable, good times, recreational, effectiveness, romantic, athletic, buy product, and honesty. Drawing on their everyday experience, the students also were asked to recall as much about the advertisements from these product groups as they could. The results revealed that the rating and recall scores of the alcohol advertisements were significantly higher than those for the cigarette advertisements and among the highest of all of the advertisement groups. The female recall scores generally were significantly higher than the male recall scores. In contrast to the cigarette advertisements, the high scores of the alcohol advertisements were interpreted to be due in part to the wider distribution alcohol advertising has had. That alcohol advertising ranked among the highest of all of the advertising groups indicates that college students view alcohol advertising very favorably.

Adolescent↗
PubMed1983

Diet, exercise, and physical discomfort in college students.

778 students in a 4-yr. urban commuter college were tested to determine the effects of exercise and diet on self-reported discomfort. High exercisers reported significantly less physical discomfort than moderate or low exercisers. Greater consumption of sweets and fast food were significantly related to reported physical discomfort regardless of levels of exercise. High levels of fruit and vegetable consumption were associated with less discomfort in high exercisers. High dairy consumption was significantly related to fewer symptoms for high exercisers. Men who reported high ingestion of caffeine had significantly more discomfort than those who reported moderate to lower ingestion of caffeine.

Adult↗