Intention to Change Dietary Habits, and Weight Loss Among Norwegian-Pakistani Women Participating in a Culturally Adapted Intervention

The aim was to explore the relationships between degree of participation in a culturally adapted lifestyle intervention and stages of change for healthy eating and weight loss among Pakistani immigrant women in Norway. The intervention lasted 7 months and included 198 women, randomized into control and intervention groups. The odds of losing weight from baseline to follow-up, and being in action stages of change (compared to pre-action stages) with regard to intake of amount and type of fat, sugar and white flour at follow-up, increased significantly with number of group sessions attended. Those in action stage of reducing intake of fat and increasing intake of vegetables, as well as of reducing weight, were significantly more likely than others to have experienced weight loss at follow-up. Participation in the culturally adapted intervention was related to increase in intentions to change dietary behaviours and to weight loss

The impact of dietary diversity and seasonality in food availability on the quantile distribution of birth size among pregnant women in rural Malawi – a cross-sectional study

Background: Dietary diversity scores can be used as a proxy for dietary intakes and for assessment of nutrient adequacy. Studies from low-resource settings have found maternal dietary diversity scores to be associated with neonatal birth size. We here investigated the relationship between the dietary diversity score among pregnant mothers and birth size of their offspring across quantiles of the birth size variables; birth weight, length, abdominal circumference, and head circumference. We also investigated if seasonality affects birth size across different quantiles. Methods: Dietary intake and anthropometric data were collected from 190 pregnant women and their neonates in rural Malawi through two agricultural seasons. Dietary data was collected using 24-hour recall interviews and was categorized into the 10-food group dietary diversity score proposed for women by the Food and Agriculture Organization. Neonatal anthropometrics were collected upon delivery at health facilities. Quantile regression analyses were used to investigate associations between dietary diversity scores and birth size, as well as between seasonality and birth size. Results: We found that neonatal abdominal circumference was 0.9 cm larger during the post-harvest season compared to the pre-harvest season among neonates in the 25th quantile. Birth weight was 281.4 g higher for those born during the post-harvest season in the 90th quantile. For a one-unit increase in maternal dietary diversity score, birth weight increased by 56.7 g among those in the 25th quantile and neonatal head circumference increased by 0.2 cm for those in the 70th quantile. However, these findings did not remain significant when considering the cluster effect of the neonatal anthropometric data. Conclusions: Our findings indicate that the relationship between seasonality and birth size differs across the distribution of birth size. Investigating the effect of seasonality across the distribution of birth size could be important to identify vulnerable subgroups and develop better, targeted interventions to improve maternal and child nutrition and health

Diminished mental- and physical function and lack of social support are associated with shorter survival in community dwelling older persons of Botswana

<p>Abstract</p> <p>Background</p> <p>Mortality rates for older persons in Botswana have been unavailable and little is known of predictors of mortality in old age. This study may serve as a precursor for more detailed assessments.</p> <p>The objective was to assess diminished function and lack of social support as indicators of short term risk of death.</p> <p>Methods</p> <p>A national population based prospective survey was undertaken in Botswana; twelve rural areas and three urban centers were included.</p> <p>372 community-dwelling persons aged sixty years and over, were included; 265 were followed-up. Sixteen subjects were deceased at follow-up.</p> <p>Subjects were interviewed and clinically assessed at home. Measures of cognitive function, depression and physical function and sociodemographic information were collected. Subjects were followed-up at average 6.8 months after baseline.</p> <p>Results</p> <p>Overall mortality rate was 10.9 per 100 person years. Age-adjusted odds ratios (OR) for death during follow-up were; 4.2 (CI 1.4–12.5) and 3.6 (CI 1.0–12.7) for those with diminished physical- and cognitive function, respectively.</p> <p>Indicators of limited social support; household with only 1 or 2 persons and eating alone, yielded age adjusted ORs of 4.3 (CI 1.5–12.5) and 6.7 (CI 2.2–20), respectively, for death during follow-up.</p> <p>Conclusion</p> <p>Older community dwelling persons with diminished cognitive- or physical function, solitary daily meals and living in a small household have a significantly increased risk of rapid deterioration and death.</p> <p>Health policy should include measures to strengthen informal support and expand formal service provisions to older persons with poor function and limited social networks in order to prevent premature deaths.</p

Sociodemographic correlates of food habits among school adolescents (12–15 year) in north Gaza Strip

Background: There is little information about meal patterns and food consumption of adolescents in Palestine. The objective of this study was to describe the association between sociodemographic factors and food intake, and meal patterns among Palestinian school adolescents (12–15 year) in North Gaza Strip. Methods: A cross-sectional study was conducted in 2002 comprising 944 subjects in 10 schools in Gaza city, Jabalia village and Jabalia refugee camp. Self-administered questionnaires were filled in by students and parents to obtain data on frequency of meals, food intake and sociodemographic characteristics. Results: High household socioeconomic status (SES) was associated with the increased number of meals and the increased intakes of many nutritious foods such as; animal food items, fruits and vegetables and dairy foods. The percentage of adolescents having breakfast daily of high and low SES was 74.5% vs 55% in boys and 65.6% vs 45% in girls. The percentage of girls with refugee status who had lunch was higher (90.2%) compared to the local citizen girls (83.9%), (p = 0.03). Girls were less likely to skip daily lunch (OR = 0.55, 95% CI = 0.36–0.87, p = 0.01) compared to boys. Risk of skipping lunch was three times higher among adolescents living in the village compared to Gaza well-off area (OR = 3.3, 95% CI = 1.72–6.31, p < 0.001). Adolescents who were having lunch daily were less likely to skip breakfast or dinner. Only 11.6% of boys and 16.2% of girls consumed fruits daily. In multivariate analysis, SES was positively associated with food frequency intake scores in both genders. Boys from the refugee camp and the village had a significant higher consumption of fruits and vegetables than boys from high and low income area in Gaza City, while it was the opposite in girls. Conclusion: Meal skipping is common, particularly among those of low SES and the intakes of many nutritious foods such as animal food items, fruits and vegetables and dairy foods seem to be low among adolescents of low SES. The results of this study could be used as an important baseline for future monitoring of the nutritional situation of adolescents.Abdallah H Abudayya, Hein Stigum, Zumin Shi, Yehia Abed and Gerd Holmboe-Ottese

Diabetes susceptibility in ethnic minority groups from Turkey, Vietnam, Sri Lanka and Pakistan compared with Norwegians - the association with adiposity is strongest for ethnic minority women

<p>Abstract</p> <p>Background</p> <p>The difference in diabetes susceptibility by ethnic background is poorly understood. The aim of this study was to assess the association between adiposity and diabetes in four ethnic minority groups compared with Norwegians, and take into account confounding by socioeconomic position.</p> <p>Methods</p> <p>Data from questionnaires, physical examinations and serum samples were analysed for 30-to 60-year-olds from population-based cross-sectional surveys of Norwegians and four immigrant groups, comprising 4110 subjects born in Norway (n = 1871), Turkey (n = 387), Vietnam (n = 553), Sri Lanka (n = 879) and Pakistan (n = 420). Known and screening-detected diabetes cases were identified. The adiposity measures BMI, waist circumference and waist-hip ratio (WHR) were categorized into levels of adiposity. Gender-specific logistic regression models were applied to estimate the risk of diabetes for the ethnic minority groups adjusted for adiposity and income-generating work, years of education and body height used as a proxy for childhood socioeconomic position.</p> <p>Results</p> <p>The age standardized diabetes prevalence differed significantly between the ethnic groups (women/men): Pakistan: 26.4% (95% CI 20.1-32.7)/20.0% (14.9-25.2); Sri Lanka: 22.5% (18.1-26.9)/20.7% (17.3-24.2), Turkey: 11.9% (7.2-16.7)/12.0% (7.6-16.4), Vietnam: 8.1% (5.1-11.2)/10.4% (6.6-14.1) and Norway: 2.7% (1.8-3.7)/6.4% (4.6-8.1). The prevalence increased more in the minority groups than in Norwegians with increasing levels of BMI, WHR and waist circumference, and most for women. Highly significant ethnic differences in the age-standardized prevalence of diabetes were found for both genders in all categories of all adiposity measures (<it>p </it>< 0.001). The Odds Ratio (OR) for diabetes adjusted for age, WHR, body height, education and income-generating work with Norwegians as reference was 2.9 (1.30-6.36) for Turkish, 2.7 (1.29-5.76) for Vietnamese, 8.0 (4.19-15.14) for Sri Lankan and 8.3 (4.37-15.58) for Pakistani women. Men from Sri Lanka and Pakistan had identical ORs (3.0 (1.80-5.12)).</p> <p>Conclusions</p> <p>A high prevalence of diabetes was found in 30-to 60-year-olds from ethnic minority groups in Oslo, with those from Sri Lanka and Pakistan at highest risk. For all levels of adiposity, a higher susceptibility for diabetes was observed for ethnic minority groups compared with Norwegians. The association persisted after adjustment for socioeconomic position for all minority women and for men from Sri Lanka and Pakistan.</p

Physical activity and associated socio-demographic factors among school adolescents in Jiangsu Province, China

BackgroundObesity prevalence is increasing among adolescents in China, especially in urban areas and among higher socio-economic strata. Physical inactivity may be one of the causes. We examined socio-demographic differences in physical activity among school adolescents in Jiangsu Province.MethodsIn 2002, 824 adolescents (12-14 years) in 8 schools filled in a self administered questionnaire on physical activity, sedentary behaviors and socio-demographic characteristics. RESULTS.: In girls, low SES elicited the highest physical activity score, mainly derived from housework. More boys (49.1%) than girls (41%) had vigorous physical activity (VPA) >or=3 times/week. Associations between VPA and residence, age, SES were not significant. 88% of the adolescents were actively commuting to schools. Boys with high SES or high education fathers had the lowest percentage walking to school. The students spent daily on average 10.8 h on studying, however, little time was spent on watching TV or playing PC games.ConclusionsActive commuting to school was common among the adolescents. However, the sedentary activity level is high. Physical activity was negatively associated with SES.Zumin Shi, Nanna Lien, Bernadette Nirmal Kumar, Gerd Holmboe-Ottese

Diet, nutritional status and school performance among adolescents in Gaza Strip

The associations between dietary intake, nutritional status and school performance among 932 adolescents aged 12–15 years were examined in a cross-sectional survey in 2002 in north Gaza Strip. School performance was obtained from school records and height and weight were measured for body mass index (BMI). Self-administered questionnaires included sociodemographic characteristics and food frequency intakes. Adolescents consuming fruit and vegetables more than 3 times per week were more likely to have good school performance (72.6% versus 59.9%). When adjusting for sociodemographic variables and BMI, fruit and vegetables intake was positively associated with school performance (OR = 1.61, 95% CI: 1.11–2.32) and stunting was negatively associated (OR = 0.53, 95% CI: 0.31–0.90). The findings support a broader implementation of school nutrition programmes.A. Abudayya, Z. Shi, Y. Abed and G. Holmboe-Ottese

Exclusive breastfeeding duration during the first 6 months of life is positively associated with length-for-age among infants 6-12 months old, in Mangochi district, Malawi

OBJECTIVES: To examine the association between breastfeeding pattern and growth in the first year of life. METHODS: A cross-sectional survey was carried out on 349 mothers with infants <12 months in a rural and a semi-urban community in Mangochi district, Malawi. Data on socio-demographic characteristics, infant weight, length and feeding patterns since birth were collected. Multivariate linear regression was performed to test the association between feeding pattern and infant anthropometric status. RESULTS: Exclusive breastfeeding (EBF) until 6 months was practised by 13.1% semi-urban and 1.3% rural mothers. No infant was exclusively breastfed beyond 6 months. Breastfeeding was continued among all infants who had stopped EBF. Among infants 6-12 months of age, duration of EBF during the first 6 months was positively associated with length-for-age Z-score (LAZ) (regression coefficient=0.19, 95% confidence interval: 0.06, 0.31) in a model adjusted for socio-demographic factors. Urban residence and female gender yielded positive associations in the same model. The model explained 27% of the variation in LAZ. Among infants <6 months, duration of EBF was not significantly associated with LAZ, but being female and urban residence yielded positive associations. Breastfeeding patterns were not associated with weight-for-age Z-score (WAZ) or weight-for-height Z-score (WLZ) either in the 0-6-month or in the 6-12-month group. Birth outside a health facility was negatively associated with WAZ and WLZ in the older group. CONCLUSION: EBF in the first 6 months of life was associated with increased linear growth, but not weight gain, in later infancy. Promotion of EBF could reduce the prevalence of chronic child undernutrition in the study area.P Kamudoni, K Maleta, Z Shi, and G Holmboe-Ottese

Predictors of food variety and dietary diversity among older persons in Botswana

We investigated whether food variety and diversity are associated with physical and cognitive functioning in older adults in Botswana and designed a simple set of screening questions that predict food variety in this population. Data were collected (1998) as a national household survey of 1085 subjects 60 y and older. A food variety score, based on a food frequency checklist, was calculated by summing the frequency of weekly intakes of 16 food items (0 to 66). A dietary diversity score was calculated as the number of food groups consumed weekly (0 to 5). A representative subsample ( n = 393) was randomly selected for the clinical component of the survey, and measurements on dependency and cognitive function were conducted. Low food variety was found: 35.2%, 59.3%, and 22.4% of subjects consumed no dairy products, fruits, and vegetables, respectively. A higher food variety score was associated with urban residence, ownership of cattle, higher education, and more frequent meals, and these indicators were used to construct a nutritional risk indicator. Higher food variety score was associated with better self-reported health and better cognitive function. Similarly, a higher score on the nutritional risk indicator screening tool was associated with desirable health outcomes. A limited number of foods is consumed, leading to an overall pattern of poor food variety. Higher food variety was associated with improved physical and cognitive functions. A screening tool that predicts food variety in this population has been developed and is recommended to be incorporated at a primary care level to identify older adults most at risk of a poor quality diet

Egg consumption and the risk of diabetes in adults, Jiangsu, China

BackgroundAlthough egg consumption has been associated with elevated plasma levels of cholesterol and triglyceride and with risk of cardiovascular disease in some populations, epidemiologic studies on egg consumption and the risk of diabetes are extremely sparse, particularly in the Chinese population.MethodData from a household survey in the year 2002 among 2849 adults aged ≥20 y from a nationally representative sample in Jiangsu Province, China, were used. Dietary information was assessed by a validated food frequency questionnaire and 3 d weighed food records. Fasting blood specimens were collected.ResultsAfter the adjustment for age, total calorie intake, education, smoking, family history of diabetes, and sedentary activity, egg consumption was significantly and positively associated with diabetes risk, particularly in women. The odds ratios (OR) (95% CI) of diabetes associated with egg consumption ConclusionEgg consumption was positively associated with the risk of diabetes among the Chinese, particularly in women.Zumin Shi, Baojun Yuan, Cuilin Zhang, Minghao Zhou, Gerd Holmboe-Ottese