Predicting Intentions to Continue Exclusive Breastfeeding for 6 Months: a Comparison Among Racial/Ethnic Groups

The purpose of this study was to explore how mothers of different races/ethnicities make decisions to continue exclusive breastfeeding (EBF) for 6 months under the Theory of Planned Behavior. Participants were recruited from hospitals and WIC clinics in Central Indiana and Southern New Jersey from 2008 to 2009. Mothers (N = 236: 93 non-Hispanic African American, 72 non-Hispanic white, 71 Hispanic/Latina) completed a self-administered questionnaire that measured theoretical constructs and beliefs related to their intention to practice EBF for 6 months. Intentions to continue EBF for 6 months were similar (P = 0.15) across racial/ethnic groups. Significant proportions of the intention (P \u3c 0.001) were explained by the three theoretical constructs (attitude, subjective norm, and perceived behavioral control). The relative importance of each construct in predicting the intention varied by group. The most influential predictors (P \u3c 0.001) were the attitude for white mothers, the subjective norm for African American mothers, and perceived behavioral control for Latina mothers. Latent beliefs strongly associated with attitude in white mothers were ‘bonding with the baby’ and ‘easy feeding.’ Beliefs held by family members and the general public contributed to the subjective norm of African American mothers. Perceived behavioral control in Latina mothers was highly correlated with ‘pumping breast milk’. Development of policy and intervention programs that focus on shaping strong predictors and beliefs within racial/ethnic groups could reduce disparities in EBF rates and establish EBF for 6 months as a cultural norm

Validation of a Short Questionnaire to Assess Mothers’ Perception of Workplace Breastfeeding Support

The purpose of this study was to create and establish the validity of a short questionnaire to measure mothers\u27 perceived support for breastfeeding from the workplace. The items in the workplace breastfeeding support scale (WBSS) were derived from a literature review. The scale was self-administered in central Indiana during the fall of 2005 to a convenience sample of 66 volunteers who were primiparous, 6 to 12 months postpartum, worked outside the home and had initiated breastfeeding prior to the survey. Internal consistency (α) and split-half reliability (r) test and factor analysis were done to establish reliability and construct validity of the scale. The WBSS showed acceptable reliability (α=.77, r=0.86). Content validity was established by review using a panel of experts. Four distinct constructs of the scale were identified that accounted for 62.1% of the total variability of the scale: technical, environmental, facility, and peer support, thus establishing construct validity of the scale. Lactation consultants and worksite lactation program planners can use the WBSS to help mothers returning to work and to assess the needs for improvement of support programs

Validating the Food Behavior Questions from the Elementary School SPAN Questionnaire

Background The School Physical Activity and Nutrition (SPAN) questionnaire were developed as a surveillance instrument to measure physical activity, nutrition attitudes, and dietary and physical activity behaviors in children and adolescents. The SPAN questionnaire has 2 versions. Objective This study was conducted to evaluate the validity of food consumption items from the elementary school version of the SPAN questionnaire. Design Validity was assessed by comparing food items selected on the questionnaire with food items reported from a single 24-hour recall covering the same reference period. Setting 5 elementary schools in Indiana. Participants Fourth-grade student volunteers (N = 121) from 5 elementary schools. Main Outcome Measure Agreement between responses to SPAN questionnaire items and reference values obtained through 24-hour dietary recall. Analysis The agreement between the questionnaire and the 24-hour recall was measured using Spearman correlation, percentage agreement, and kappa statistic. Results Correlation between SPAN item responses and recall data ranged from .25 (bread and related products) to .67 (gravy). The percentage agreement ranged from 26% (bread and related products) to 90% (gravy). The kappa statistic varied from .06 (chocolate candy) to .60 (beans). Conclusions and implications Results from this study indicate that the SPAN questionnaire can be administered in the classroom quickly and easily to measure many previous day dietary behaviors of fourth graders. However, questions addressing the consumption of “vegetables,” “candy,” and “snacks” need further investigation

Ascorbic acid supplementation attenuates exercise-induced bronchoconstriction in patients with asthma

SummaryBackgroundPrevious research has shown that diet can modify the bronchoconstrictor response to exercise in asthmatic subjects.ObjectiveDetermine the effect of ascorbic acid supplementation on pulmonary function and several urinary markers of airway inflammation in asthmatic subjects with exercise-induced bronchoconstriction (EIB).MethodsEight asthmatic subjects with documented EIB participated in a randomized, placebo controlled double-blind crossover trial. Subjects entered the study on their usual diet and were placed on either 2 weeks of ascorbic acid supplementation (1500mg/day) or placebo, followed by a 1-week washout period, before crossing over to the alternative diet. Pre- and post-exercise pulmonary function, asthma symptom scores, fraction of exhaled nitric oxide (FENO), and urinary leukotriene (LT) C4–E4 and 9α, 11β-prostagladin (PG)F2] were assessed at the beginning of the trial (usual diet) and at the end of each treatment period.Results: The ascorbic acid diet significantly reduced (p<0.05) the maximum fall in post-exercise FEV1 (−6.4±2.4%) compared to usual (−14.3±1.6%) and placebo diet (−12.9±2.4%). Asthma symptoms scores significantly improved (p<0.05) on the ascorbic acid diet compared to the placebo and usual diet. Post-exercise FENO, LTC4–E4 and 9α, 11β-PGF2 concentration was significantly lower (p<0.05) on the ascorbic acid diet compared to the placebo and usual diet.ConclusionAscorbic acid supplementation provides a protective effect against exercise-induced airway narrowing in asthmatic subjects

Randomized Controlled Trial of Fish Oil and Montelukast and Their Combination on Airway Inflammation and Hyperpnea-Induced Bronchoconstriction

Both fish oil and montelukast have been shown to reduce the severity of exercise-induced bronchoconstriction (EIB). The purpose of this study was to compare the effects of fish oil and montelukast, alone and in combination, on airway inflammation and bronchoconstriction induced by eucapnic voluntary hyperpnea (EVH) in asthmatics. In this model of EIB, twenty asthmatic subjects with documented hyperpnea-induced bronchoconstriction (HIB) entered a randomized double-blind trial. All subjects entered on their usual diet (pre-treatment, n = 20) and then were randomly assigned to receive either one active 10 mg montelukast tablet and 10 placebo fish oil capsules (n = 10) or one placebo montelukast tablet and 10 active fish oil capsules totaling 3.2 g EPA and 2.0 g DHA (n = 10) taken daily for 3-wk. Thereafter, all subjects (combination treatment; n = 20) underwent another 3-wk treatment period consisting of a 10 mg active montelukast tablet or 10 active fish oil capsules taken daily. While HIB was significantly inhibited (p0.017) between treatment groups; percent fall in forced expiratory volume in 1-sec was −18.4±2.1%, −9.3±2.8%, −11.6±2.8% and −10.8±1.7% on usual diet (pre-treatment), fish oil, montelukast and combination treatment respectively. All three treatments were associated with a significant reduction (p0.017) in these biomarkers between treatments. While fish oil and montelukast are both effective in attenuating airway inflammation and HIB, combining fish oil with montelukast did not confer a greater protective effect than either intervention alone. Fish oil supplementation should be considered as an alternative treatment for EIB

The Function and Alteration of Immunological Properties in Human Milk of Obese Mothers

Maternal obesity is associated with metabolic changes in mothers and higher risk of obesity in the offspring. Obesity in breastfeeding mothers appears to influence human milk production as well as the quality of human milk. Maternal obesity is associated with alteration of immunological factors concentrations in the human milk, such as C-reactive protein (CRP), leptin, IL-6, insulin, TNF-Alpha, ghrelin, adiponectin, and obestatin. Human milk is considered a first choice for infant nutrition due to the complete profile of macro nutrients, micro nutrients, and immunological properties. It is essential to understand how maternal obesity influences immunological properties of human milk because alterations could impact the nutrition status and health of the infant. This review summarizes the literature regarding the impact of maternal obesity on the concentration of particular immunological properties in the human milk

Predictors of Continuation of Exclusive Breastfeeding for the First Six Months of Life

This study aimed to investigate the relative importance of the psychosocial factors underlying mother\u27s decision to continue exclusive breastfeeding (EBF) for 6 months using the theory of planned behavior. A cohort of EBF-mothers (N = 78) completed a questionnaire assessing theoretical constructs at baseline and phone-interviewed at follow-up. Multiple regression analyses were performed to find important predictors of intention, overall and married vs unmarried. Attitude, subjective norm, and perceived behavioral control together explained 50.2% (P \u3c.01) of the variance in mothers\u27 intention to continue EBF for 6 months. Attitude and subjective norm were better predictors of the intention than perceived behavioral control. The role of subjective norm was greater in married than in unmarried women. A strong, positive correlation (\u273 = 0.67, P \u3c.01) was found between intended and actual EBF duration. Intervention programs designed to positively influence mother\u27s attitude and social support may be effective in improving intention, thereby increasing EBF maintenance for 6 months

Carbohydrate Mouth Rinse Improves Cycling Time-Trial Performance without Altering Plasma Insulin Concentration

Rinsing the mouth with a carbohydrate solution has been shown to improve exercise performance in a manner similar to carbohydrate ingestion. However, the underlying mechanisms behind these ergogenic benefits remain unclear. This study evaluated whether rinsing the mouth with a carbohydrate solution alters plasma insulin and glucose concentration during the initial stages of a 40 km cycling time-trial. Eight trained, competitive cyclists [age (mean ± SEM) = 24 ± 2 y; V̇O$_2$max = 64.5 ± 2.2 ml·kg$^{-1}$·min$^{-1}$] completed three simulated 40 km time-trials comprised of a familiarization trial, a carbohydrate condition (CHO) and a placebo mouth rinse condition (PLA). In the two mouth rinse conditions, rinsing was administered prior to onset of exercise and every 5 km throughout exercise. Plasma insulin was collected at 5 km intervals throughout the first 25 km, and glucose samples were collected at 5 km intervals throughout the exercise bout. No change in plasma insulin was detected between conditions (p = 0.638, ES < 0.03) for the first 25 km of the time-trial. Likewise, plasma glucose concentration did not differ between CHO and PLA (p = 0.801, ES < 0.01) and remained relatively stable throughout exercise. Time to complete the 40 km time-trial was significantly faster for CHO (67.1 ± 1.1 min) compared to PLA [67.9 ± 1.0 min; (P = 0.028, ES 0.27)]. Performance time was faster by an average of 1.1% (95% confidence interval range 0.2-2.0%) in the CHO condition. Exercise intensity (% V̇O$_2$max) throughout the trial was similar between conditions (p = 0.846). Respiratory exchange ratio was not significantly different between conditions (0.88 ± 0.01 for PLA, and 0.91 ± 0.01 for GLC; p = 0.081). Performance gains elicited by a carbohydrate mouth rinse occurred independently of changes in plasma insulin concentration

Carbohydrate Mouth Rinse Improves Cycling Time-Trial Performance without Altering Plasma Insulin Concentration

Rinsing the mouth with a carbohydrate solution has been shown to improve exercise performance in a manner similar to carbohydrate ingestion. However, the underlying mechanisms behind these ergogenic benefits remain unclear. This study evaluated whether rinsing the mouth with a carbohydrate solution alters plasma insulin and glucose concentration during the initial stages of a 40 km cycling time-trial. Eight trained, competitive cyclists [age (mean ± SEM) = 24 ± 2 y; V̇O2max = 64.5 ± 2.2 ml·kg-1·min-1] completed three simulated 40 km time-trials comprised of a familiarization trial, a carbohydrate condition (CHO) and a placebo mouth rinse condition (PLA). In the two mouth rinse conditions, rinsing was administered prior to onset of exercise and every 5 km throughout exercise. Plasma insulin was collected at 5 km intervals throughout the first 25 km, and glucose samples were collected at 5 km intervals throughout the exercise bout. No change in plasma insulin was detected between conditions (p = 0.638, ES < 0.03) for the first 25 km of the time-trial. Likewise, plasma glucose concentration did not differ between CHO and PLA (p = 0.801, ES < 0.01) and remained relatively stable throughout exercise. Time to complete the 40 km time-trial was significantly faster for CHO (67.1 ± 1.1 min) compared to PLA [67.9 ± 1.0 min; (P = 0.028, ES 0.27)]. Performance time was faster by an average of 1.1% (95% confidence interval range 0.2-2.0%) in the CHO condition. Exercise intensity (% V̇O2max) throughout the trial was similar between conditions (p = 0.846). Respiratory exchange ratio was not significantly different between conditions (0.88 ± 0.01 for PLA, and 0.91 ± 0.01 for GLC; p = 0.081). Performance gains elicited by a carbohydrate mouth rinse occurred independently of changes in plasma insulin concentration

Do B Vitamins Enhance the Effect of Omega-3 Polyunsaturated Fatty Acids on Cardiovascular Diseases? A Systematic Review of Clinical Trials

Studies have suggested that B vitamins or omega-3 polyunsaturated fatty acids (PUFAs) may deter the development of cardiovascular disease (CVD). This systematic review aims to examine whether the combined supplementation of both B vitamins and omega-3 PUFAs could provide additional beneficial effects to prevent CVD beyond the effect of each supplement based on clinical trials published up to December 2021. The overall findings are inconsistent and inconclusive, yet the combined supplementation of these two nutrients may be more effective at reducing plasma homocysteine, triglyceride, and low-density lipoprotein-cholesterol than the individual components. The underlying mechanisms mainly include alleviating endothelial dysfunction, inhibiting atherosclerosis and lesion initiation, reducing oxidative stress, suppressing activation of pro-inflammatory cytokines, regulating endothelial nitric oxide synthase, and interfering with methylation of genes that promote atherogenesis. Although biologically plausible, the existing literature is insufficient to draw any firm conclusion regarding whether B vitamins can further enhance the potential beneficial effects of omega-3 PUFA intake on either primary or secondary prevention of CVD. The inconsistent findings may be largely explained by the methodological challenges. Therefore, well-designed high-quality trials that will use the combined supplementation of B vitamins and omega-3 PUFAs or dietary patterns rich in these two types of nutrients are warranted