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PubMed2004

Stages of change for weight management in postpartum women.

OBJECTIVE: This study examined factors related to stages of change for weight-management behaviors in postpartum women. DESIGN: Cross-sectional data, collected at baseline, are reported from the Mothers' Overweight Management Study (MOMS), a randomized, controlled trial conducted in postpartum women who participated in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).Subjects/Setting Subjects were a sample of WIC recipients (N=151) older than 18 years of age with a child younger than 2 years. Statistical analysis The dependent variables were the stages of change for weight-management behaviors (losing weight, avoiding high-fat foods, eating a high-fiber diet, and exercising). Demographic, health, and psychosocial variables were examined as independent variables. One-way analysis of variance was used to compare means, and chi(2) was used for proportions. RESULTS: Whereas 55% of women were in the action stage for weight loss, fewer women were in the action stage for the following weight management behaviors: avoiding high-fat foods (24%), increasing fiber (19%), and exercising three times per week (29%). Identifying pros for weight management was related to stages for losing weight, high-fat food avoidance, and exercise (F=13.4, P<.001; F=10.5, P<.001; F=3.7, P<.007, respectively). Self-efficacy for choosing a low-fat restaurant meal or using food labels was positively related to later stages for avoiding high-fat foods and increasing fiber intake (chi(2)=16.4, P=.003; chi(2)=11.7, P=.02). CONCLUSIONS: Emphasizing the pros for weight-management behaviors, decreasing the cons for exercising, increasing confidence to select low-fat restaurant choices, and improving skills for using food labels are four strategies that nutrition professionals can use to help women become more ready to change behaviors for weight management.

Adolescent↗
PubMed2004

An economic analysis of adult obesity: results from the Behavioral Risk Factor Surveillance System.

This paper examines the factors that may be responsible for the 50% increase in the number of obese adults in the US since the late 1970s. We employ the 1984-1999 Behavioral Risk Factor Surveillance System, augmented with state level measures pertaining to the per capita number of fast-food and full-service restaurants, the prices of a meal in each type of restaurant, food consumed at home, cigarettes, and alcohol, and clean indoor air laws. Our main results are that these variables have the expected effects on obesity and explain a substantial amount of its trend.

Adult↗
PubMed2002

Efficiency of breakfast consumption patterns of ninth graders: nutrient-to-cost comparisons.

OBJECTIVE: To assess the efficiency of breakfast consumption patterns in terms of nutrient-to-cost comparisons. DESIGN: Twenty-four-hour dietary recalls were collected and food items named were priced (prices from local grocery stores and restaurants were averaged). Three breakfast consumption groups were identified: restaurant foods (fast foods), ready-to-eat (RTE) cereal, and other foods. SUBJECTS: Subjects consisted of 567 ninth-grade students (57% female, 86% white, mean age 14.8 years) in New Orleans, La. STATISTICAL ANALYSES: Analysis of variance techniques were used to test statistical significance for total nutrient intake levels, intake levels of nutrients per 1,000 kcal, and nutrient intake levels per dollar spent. Groupings were determined using the Duncan test or pairwise comparisons. RESULTS: Five percent of students ate a fast-food breakfast, 30% ate RTE cereal, and 65% ate other breakfasts. The mean cost of the breakfast meals was significantly (P<.0001) higher for the fast-food breakfast than for the RTE cereal breakfast and the other breakfast (fast>other=RTE). For every dollar spent, the RTE cereal and other breakfasts provided significantly more energy, carbohydrate, fiber, sugar, and protein than the fast-food breakfast. The other breakfast provided significantly (P<.001) more total and saturated fat per dollar than the fast-food or RTE cereal breakfasts. The RTE cereal breakfast provided significantly (P<.001) more, per dollar spent, of folic acid, iron, niacin, vitamins A and D, and zinc than the other 2 breakfast meals. APPLICATIONS: The importance consumers place on taste, cost, and convenience continues to influence types of foods consumed. Yet, their food choices may not be as efficient in terms of the nutrients obtained per dollar spent. With the increasing demands being placed on families and the decreasing amount of time being spent on food preparation, nutrition education programs should continue to promote a higher level of efficient food choices.

Adolescent↗
PubMed1995

Nutrition training for chefs: taste as an essential determinant of choice.

The primary objective of Project LEAN (Low-fat Eating for Americans Now), a social marketing initiative of the Henry J. Kaiser Family Foundation, is to help Americans reduce their fat intake to less than 30% of total energy. In Las Vegas, Nev, one of the 10 community sites selected to implement this goal, Las Vegas LEAN acted to change the food environment for restaurant patrons. This program empowered chefs to use their culinary expertise in developing good-tasting, low-fat menu items. The literature shows that consumers, despite verbalizing health concerns, choose food on the basis of taste. This ambivalence between belief and behavior demonstrates the need for innovative culinary techniques to develop food dishes that consumers will not only accept, but will enjoy and order repeatedly. Entrepreneurial dietitians, thus, have an opportunity to market nutrition skills to restaurants and hotels wishing to implement low-fat cuisine with good taste. Our intervention demonstrated that nutrition education for chefs is the key to long-term and successful menu changes. If taste is what consumers are seeking in low-fat items, and improved taste will finally get ambivalent consumers to change their eating behavior, enlisting the expertise of chefs is key.

Consumer Behavior↗
PubMed2003

Field evaluation of two commonly used slipmeters.

A variety of slipmeters have been used to assess the slipperiness of floor surfaces. International standards for the operation of slipmeters describe the protocol for a single measurement. These standards usually do not cover some of the critical elements in safety assessment such as methods for the selection of measurement locations and the necessary number of repeated measurements at each location. Furthermore, most of the slipmeters were evaluated in laboratory settings with new floor surfaces and artificial contaminants. Two commonly used slipmeters, the Brungraber Mark II and the English XL, were evaluated at actual worksites in this experiment. Four floor tiles in each of four different work areas in the kitchens of 18 fast food restaurants were selected for repeated measurements with these two slipmeters. The results indicated that sanding of footwear materials has a significant effect on the outcomes of friction measurements, and the tile-to-tile variations in friction in the same areas of restaurants were also mostly statistically significant. Significant local variation in friction among tiles in the same area could potentially increase the chances of slip and fall incidents. Both slipmeters used in this experiment could potentially have problems in the areas with grease, such as grill and fryer areas, since the build-up of grease during repeated strikes could alter the outcome of friction measured.

Accidental Falls↗
PubMedDate not supplied

[Consumption and sales of tobacco in public places: evaluation of compliance with the current standards].

OBJECTIVE: To evaluate the compliance with current legislation on smoking and tobacco sale in public places in the city of Sabadell (Barcelona). METHODOLOGY: A sample of 218 sites was randomly selected from a total of 1,224 affected by the legislation, after excluding those where direct, anonymous access was difficult. The existence of signs banning smoking, of areas reserved for smokers and the observation of an indication of smoking presence were analyzed, and also a simulation of the act of smoking was performed. RESULTS: An indication of smoking presence was observed in 61.5% of sites visited, 85.8% and 74.8% did not have a sign banning smoking at the entrance or in the interior, respectively, excluding restaurants and cafeterias. Only 4.1% of sites complied with all requirements established by the Law. Only one restaurant (1.7%) had a nonsmoking section. CONCLUSIONS: Our results show a low level of compliance with the legislation. The Administration should state a coherent and progressive strategy to achieve its complete application.

Commerce↗
PubMed1999

Transmission of calicivirus by a foodhandler in the pre-symptomatic phase of illness.

After a Christmas party in a restaurant, 48 (68%) of the 82 guests contracted calicivirus gastroenteritis. The epidemiological investigation showed that salad was strongly associated with the disease episode (RR = 2.43, P = 0.0005). Similar symptoms occurred among other customers who had had a meal at the same restaurant on the same evening. A foodhandler who had only prepared salad and appetizers became sick about 30 min after the end of his shift. He had been free of symptoms while preparing food. Few outbreak investigations have shown calicivirus transmission by foodhandlers some hours before becoming symptomatic.

Adult↗
PubMed2003

Assessment of quality of life in children with peanut allergy.

Children with a peanut allergy (PA) are faced with food and social restrictions due to the potentially life-threatening nature of their disease, for which there is no cure or treatment. This inevitably impacts upon their quality of life (QoL). QoL of 20 children with PA and 20 children with insulin-dependent diabetes mellitus (IDDM) was measured using two disease-specific QoL questionnaires (higher scores correspond to a poorer QoL). One questionnaire was designed by us and the other was adapted from the Vespid Allergy QoL questionnaire. We gave subjects cameras to record how their QoL is affected over a 24-h period. Response rates for both questionnaires were 100%. Mean ages were 9.0 and 10.4 years for PA and IDDM subjects, respectively. Children with a PA reported a poorer quality of life than children with IDDM: mean scores were 54.85 for PA subjects and 46.40 for diabetics (p = 0.004) in questionnaire 1 and 54.30 and 34.50 (p</=0.001) in questionnaire 2. PA children reported more fear of an adverse event and more anxiety about eating, especially when eating away from home. Photographs fell into seven common categories: food, management, environment, away from home, physical activities, restaurant and people. Most photographs related to food and management issues and revealed difficulties for both groups regarding food restrictions. PA subjects felt more threatened by potential hazards within their environment, felt more restricted by their PA regarding physical activities, and worried more about being away from home. However, they felt safe when carrying epinephrine kits and were positive about eating at familiar restaurants. The QoL in children with PA is more impaired than in children with IDDM. Their anxiety may be considered useful in some situations, promoting better adherence to allergen avoidance advice and rescue plans.

Activities of Daily Living↗
PubMed2006

The association of television and video viewing with fast food intake by preschool-age children.

OBJECTIVE: To examine the extent to which television (TV) and video viewing is associated with consumption of fast food by preschool-age children. RESEARCH METHODS AND PROCEDURES: In a cross-sectional study of 240 parents of children ages 2.0 to 5.9 years, parents reported the number of hours their child watched TV/videos on an average weekday and weekend day in the past month; a daily, weighted average of TV/video viewing was then calculated. The main outcome was parents' report of their children's fast food intake, using the question, "How many times a week does your child eat at fast food restaurants such as McDonald's, Burger King, or Kentucky Fried Chicken?" dichotomized to (never/<1 vs. > or =1 time/wk). The association of TV/video viewing with fast food intake was evaluated by multiple logistic regression before and after adjusting for several potential confounders. RESULTS: Twenty-two percent of parents reported that their child ate at fast food restaurants at least once per week. After adjusting for parents' age, race/ethnicity, and household income as well as child's age and sex, for each 1-hour increase of TV/video watched per day, the odds ratio (OR) for consuming fast food > or =1 time per week was 1.60 (95% confidence interval, 1.03 to 2.49). After further adjustment for socio-environmental factors that might serve as proxies for the availability of healthy food options, such as parental time constraints and the availability and high cost of fresh fruits and vegetables in their neighborhoods, the OR for consuming fast food > or =1 time per week was minimally attenuated (OR, 1.55; 95% confidence interval, 1.04 to 2.31). DISCUSSION: TV/video viewing was correlated with fast food consumption among preschool children in this study. Our findings raise the possibility that greater exposure to TV and videos may influence preschool children's consumption of unhealthful foods.

Body Height↗
PubMed2000

The relation between dietary change and rising US obesity.

OBJECTIVE: To determine if the source from which food is obtained has contributed to the increased obesity of the US population, while controlling for demographic, lifestyle and regional factors. METHODS: Multiple regression was used to estimate the effect of food source on body mass index (BMI) while accounting for other factors which have been shown to affect obesity in a nationally representative sample of the US population. SAMPLE: This study used secondary data from the 1994-1996 Continuing Survey of Food Intake by Individuals (CSFII). The CSFII is a nationally representative sample of 16,103 individuals, obtaining for each respondent 24 h recalls of all food intake on two nonconsecutive days as well as demographics and information on lifestyle choices. RESULTS: For a large number of demographic and lifestyle factors, our results support those which have previously been found to contribute to increased overweight. Our contribution is to examine whether the source from which food is obtained also contributes to increased overweight. Our evidence suggests that this is the case. The average height for males in our sample was 1.77 m. For two such males, one who ate food away from home (FAFH) during the previous 24 h period and the other who did not, results suggest that the first will be about 1 kg heavier, all other factors being equal. For two females of average height (1.63 m) the same is true for those who ate fast food, but not at restaurants. In all cases, except females who ate at restaurants, the effects are significant in the regression (P<0.05). CONCLUSION: The trends in both increased US obesity and in increased consumption of FAFH are unlikely to be coincidental. FAFH, and particularly fast food consumption, are likely to be contributing factors to increased obesity.

Adolescent↗
PubMed1995

Young teenagers and access to alcohol in a Swiss canton: evidence from observational testing and from a telephone survey.

In the first part of the study, the readiness of bartenders and waiters to serve alcoholic beverages to young teenagers was studied. The fieldwork was conducted in a random sample of bars and restaurants in Lausanne and in villages of the canton of Vaud, where 13-year-old and 15-year-old boys ordered either beer or pastis (an aniseed-flavoured aperitif). Results showed that alcoholic beverages were very accessible to 13-year-old and 15-year-old youths although the minimum legal age for purchasing and consuming beer is 16 years and for pastis is 18 years: 81% of the test orders were served. An analysis of interaction of patterns between servers and clients suggested that time necessary to refuse orders may play an important role in explaining this result. In the second part of the study, knowledge and attitudes of owners and managers of bars, restaurants and different kinds of commercial outlet were studied in a telephone interview survey about the minimum legal age for purchasing and consuming alcoholic beverages. Only 17% of the respondents knew the correct minimum legal ages for purchasing and consuming alcoholic beverages.

Adolescent↗
PubMedDate not supplied

Cigarette smoke in enclosed public facilities.

A portable carbon monoxide detector (catalytic electrode) was used to record carbon monoxide concentrations in enclosed public facilities, including night clubs, bars, restaurants, stores, hospitals, and public transit vehicles. The highest concentrations of carbon monoxide were found in night clubs, where evening indoor readings averaged 13.4 ppm, which was 4.1 +/- 1.5 ppm higher than outdoor readings. In one poorly ventilated establishment, values ranged from 20 to 40 ppm, with substantial gradients around the room. Adequate ventilation and screening of restaurant employees for ischemic heart disease should prevent problems from cigarette-induced build-up of carbon monoxide. Unfortunately, much lower concentrations of other constituents of smoke cause symptoms and changes of pulmonary function in the nonsmoker. If carbon monoxide is used as an indicator of cigarette smoke accumulation, concentrations should not exceed ambient readings by more than 5 ppm.

Carbon Monoxide↗
PubMed2006

Smoking, weight loss intention and obesity-promoting behaviors in college students.

OBJECTIVE: To examine whether college smoking was associated with trying to lose weight and other weight-related behaviors. METHODS: We surveyed 300 students at the University of Kansas about smoking (ever, current, and amount), weight loss intention (y/n), weight-related attitudes, and eating and exercise behavior. Weight, height, and body fat were measured. RESULTS: About half the students (49%) self-identified as having ever smoked while 53 (17.6%) self-identified as current smokers. After controlling for sex, age, and ethnicity, ever smoking was not related to weight loss intention but was associated with greater pressure to maintain a healthy weight (p = 0.05), and having engaged in mild exercise on more days in the previous year (p = 0.05). Compared to nonsmokers, current smokers ate more at restaurants serving high calorie foods (p < 0.05) and ate more frequently in front of the TV (p < 0.01). Amount smoked was related to diminished use of exercise facilities (p = 0.03) and more frequent eating at restaurants serving high calorie foods (p < 0.05) and in front of the TV (p = 0.01). CONCLUSIONS: Current smoking among college students was related to weight loss intention. Despite wanting to lose weight, current smoking was concomitant with obesity-promoting behaviors such as eating higher calorie foods and eating in front of the TV. College-based interventions to prevent smoking initiation or promote smoking cessation should include a focus on healthy eating, exercise and healthful ways to lose or maintain weight.

Adolescent↗
PubMed2001

An outbreak of hepatitis A associated with green onions.

Forty-three cases of serologically confirmed hepatitis A occurred among individuals who ate at restaurant A in Ohio in 1998. Serum samples from all restaurant A employees who worked during the exposure period were negative for IgM antibodies to hepatitis A virus (HAV). A matched case-control study determined that foods containing green onions, which were eaten by 38 (95%) of 40 case patients compared with 30 (50%) of 60 control subjects, were associated with illness (matched odds ratio, 12.7; 95% confidence interval, 2.6-60.8). Genetic sequences of viral isolates from 14 case patients were identical to each other and to those of viral isolates from 3 patients with cases of hepatitis A acquired in Mexico. Although the implicated green onions, which could have come from one of 2 Mexican farms or from a Californian farm, were widely distributed, no additional green onion-associated cases were detected. More sensitive methods are needed to detect foodborne hepatitis A. A better understanding of how HAV might contaminate raw produce would aid in developing prevention strategies.

California↗
PubMed1977

Location of food consumption and travelers' diarrhea.

Daily food histories for one month were obtained in summer, 1975, from students attending a Mexican university to determine the influence of food consumption on the development and etiology of diarrhea. In newly-arrived students from the U.S. who ate half or more of their meals in the school cafeteria and public restaurants there were significant increases in diarrhea (p less than 0.005); shigella infection (p less than 0.05) and toxigenic E. coli infection (p less than 0.025) compared to the students eating a comparable number of meals in private homes. In the summer U.S. students there was also an association of diarrhea and eating from street vendors (p less than 0.05). In full-time U.S. students who had lived in Mexico a year or longer as well as in Latin American students a relationship between location of meals and occurrence of enteric disease was not apparent. High numbers of enteric bacteria were recovered from food from the school's cafeteria, public restaurants, street vendors and small grocery stores. Shigella were isolated from cooked and uncooked hamburger patties from the school cafeteria. Four shigella carriers were found among kitchen personnel at the school. This study demonstrates that food serves as a major vehicle through which travelers' diarrhea occurs.

Diarrhea↗
PubMed1980

Epidemic salmonellosis from cheddar cheese: surveillance and prevention.

On August 3, 1976, ongoing Salmonella surveillance in Colorado first detected an epidemic of Salmonella heidelberg infections that eventually totaled 339 isolates. The majority of the cases occurred between July 23 and August 12 in two widely separated cities: Denver and Pueblo. Epidemiologic investigation successively incriminated 1) recent dining at Mexican-style restaurants (p less than 0.001), 2) eating foods containing cheese in these restaurants (p = 0.029), and 3) consumption of cheddar cheese from a single shipment of a single manufacturer (p less than 0.01). The prompt investigation enabled an embargo of 2087 kg (41%) of the contaminated cheese. S. heidelberg was isolated from seven production lots of the incriminated cheese. Surveillance and the epidemiologic investigation may have resulted in prevention of 25,000 diarrheal illnesses.

Adolescent↗
PubMed1981

An outbreak of salmonellosis involving multiple vehicles.

A biphasic outbreaks of salmonellosis affected customers and employees of a restaurant in Maine, in October and November, 1979. Salmonella typhimurium was isolated from 27 customers and nine employees. Ten other individuals were ill but did not have specimens taken for culture, and there were four secondary cases including one affecting a laboratory technician. Fourteen individuals (28%) were hospitalized for up to 45 days, and a total of 416 days of work were lost as a result of the outbreak. Two different food items served at the restaurant at separate times were identified as vehicles. In the first part of the outbreak, 37 persons who consumed either egg-based foods (p = 0.003) or salad (p = 0.006) became ill. In the second phase of the outbreak, in late October and November, nine cases were associated with consumption of inadequately refrigerated salad (p = 0.008), but not with egg-based foods. An infected symptomatic food handler prepared the incriminated salad for some members of this latter group. Use of antacids was also associated with illness (p = 0.03). The occurrence of illness over a seven-week period, the implication of several vehicles, and the demonstration of secondary cases suggest that "sporadic" cases of salmonellosis in the community may be linked.

Adolescent↗
PubMed1982

Foodborne Norwalk virus.

On December 6, 1979, three luncheon banquets were served in a New Jersey restaurant. Thirty-eight of 41 members (92.7%) of the first group became ill as did 25 of 31 members (80.6%) of the second group. None of 12 members of the third group were ill. Illness consisted primarily of diarrhea (76%), nausea, (73%), vomiting (67%), cramps (46%) and fever (18%); the median incubation period was 31 hours and median duration 24 hours. The same foods were served to all three groups, except that cole slaw was substituted for a green salad and mixed vegetables for lima beans for the third group. Consumption of green salad was associated with illness (p less than 0.0001). A total of 118 other persons who ate at the restaurant on the same day were interviewed, 60% of whom reported being ill. Green salad was significantly associated with illness for this group at lunch (p = 0.005) and dinner (p = 0.00007). Serologic studies on seven of 12 patients and on one of four exposed controls showed a fourfold or greater rise in antibody titer to Norwalk virus.

Epidemiologic Methods↗