The Effects of Dietitian Weight and Self-Disclosure About Weight on Women\u27s Evaluations of Registered Dietitians

This study investigated the effects of dietitian weight status, dietitian self-disclosure about personal weight issues, and participant weight status on participants\u27 initial perceptions and evaluations of registered dietitians. The research design was a randomized 2x2x2 factorial design consisting of 2 dietitian weight status conditions (normal weight and obese), 2 dietitian self-disclosure conditions (absence or presence of self-disclosure about personal weight issues), and 2 participant weight status conditions (normal weight and obese). A simulated nutrition counseling situation was developed in which participants were shown a photograph of a dietitian and then listened to an audio recording of an overview of nutrition counseling supposedly prepared by the dietitian. Participants were subsequently asked to evaluate the dietitian on a variety of dimensions related to nutrition counseling. Results of this study were divided into 3 parts. In the first part, the outcome measures were participants\u27 ratings of the dietitian\u27s expertness, trustworthiness, and attractiveness, as measured by the Counselor Rating Form. Statistical analyses included multivariate analysis of variance (MANOVA) and analysis of variance (ANOVA) as appropriate. Results indicated that an obese dietitian who self-disclosed about (i.e., verbally acknowledged) her current overweight status was rated as less expert (p = .0003) and attractive (p = .02) by normal weight participants than an obese dietitian who did not self-disclose. These effects were not observed with obese participants. In the second part, the outcome measures were participants\u27 ratings of their willingness to begin nutrition counseling with the dietitian, perception of the dietitian\u27s knowledgeability, perception of the dietitian\u27s effectiveness (both general effectiveness and effectiveness within a variety of specific nutrition counseling contexts), perception of the dietitian\u27s status as a role model, comfort in discussing personal concerns with the dietitian, and perception of the dietitian\u27s ability to relate to their concerns. Analyses again consisted of MANOVA and ANOVA as appropriate. Results indicated that participants were less willing to begin nutrition counseling with the obese dietitian compared with the normal weight dietitian (p = .01). No effects were observed for participants\u27 ratings of the dietitian\u27s knowledgeability or overall effectiveness as a nutrition counselor. However, the obese dietitian was generally perceived as less effective than the normal weight dietitian in weight-related nutrition counseling contexts (p ≤ .05). The normal weight dietitian who disclosed a past history of overweight was seen as a better role model than the normal weight dietitian who did not self-disclose (p = .02). The obese dietitian who acknowledged her current overweight status was seen as a poorer role model than one who did not self-disclose (p = .0007). Normal weight participants were more comfortable with the normal weight dietitian than with the obese dietitian (p = .01) and also thought that the normal weight dietitian would be better able to relate to their concerns (p = .005). Obese participants were equally comfortable with the normal weight or obese dietitian, but thought that the obese dietitian would be better able to relate to their concerns (p = .009). In the third part, the outcome measures were again participants\u27 ratings of the dietitian\u27s expertness, trustworthiness, and attractiveness, as measured by the Counselor Rating Form. For this part, predictive models were developed for each of these dependent variables using multiple regression procedures with stepwise selection method. Potential predictors in each model were participants\u27 internal, powerful others, and chance health locus of control beliefs, as assessed with the Multidimensional Health Locus of Control (MHLC) Scale. Results indicated that participants\u27 powerful others health locus of control scores were positively related to their evaluations of the dietitian\u27s expertness, trustworthiness, and attractiveness (p ≤ .05 in each model), while their chance health locus of control scores were negatively related to their evaluations (p ≤ .05 in each model), These health locus of control dimensions accounted for small, but significant amounts of variability in each dependent variable (model R2 values of .05 - .07). Some overall conclusions may be drawn from the results of this study. First, in no instance was it beneficial for the obese dietitian to verbally acknowledge her current overweight status; acknowledgement of personal overweight consistently resulted in more negative perceptions of the dietitian by participants. Negative effects of dietitian obesity were observed for some of the outcome variables; most notable was that participants were less willing to begin nutrition counseling with the obese dietitian. Otherwise, when dietitian weight status was important in participants\u27 perceptions, the effects appeared to be context-specific and/or dependent upon the weight status of the participants. Thus, in some situations, obese dietitians may face an additional barrier with clients that normal weight dietitians do not face. Finally, a characteristic of the participants, health locus of control orientation, also played an important role in their perceptions of the dietitian. In conclusion, characteristics and behaviors of the dietitians, as well as characteristics of the participants, were important factors in participants\u27 perceptions and evaluations of registered dietitians

Nutrition Literacy Status and Preferred Nutrition Communication Channels Among Adults in the Lower Mississippi Delta

Introduction The objective of this cross-sectional study was to examine the nutrition literacy status of adults in the Lower Mississippi Delta. Methods Survey instruments included the Newest Vital Sign and an adapted version of the Health Information National Trends Survey. A proportional quota sampling plan was used to represent educational achievement of residents in the Delta region. Participants included 177 adults, primarily African Americans (81%). Descriptive statistics, X(2) analysis, analysis of variance, and multivariate analysis of covariance tests were used to examine survey data. Results Results indicated that 24% of participants had a high likelihood of limited nutrition literacy, 28% had a possibility of limited nutrition literacy, and 48% had adequate nutrition literacy. Controlling for income and education level, the multivariate analysis of covariance models revealed that nutrition literacy was significantly associated with media use for general purposes (F = 2.79, P = .005), media use for nutrition information (F = 2.30, P = .04), and level of trust from nutrition sources (F = 2.29, P = .005). Overall, the Internet was the least trusted and least used source for nutrition information. Only 12% of participants correctly identified the 2005 MyPyramid graphic, and the majority (78%) rated their dietary knowledge as poor or fair. Conclusion Compared with other national surveys, rates of limited health literacy among Delta adults were high. Nutrition literacy status has implications for how people seek nutrition information and how much they trust it. Understanding the causes and consequences of limited nutrition literacy may be a step toward reducing the burden of nutrition-related chronic diseases among disadvantaged rural communities

Overweight and Obesity in the South: Prevalence and Related Health Care Costs Among Population Groups

Overweight and obesity are leading public health concerns in the United States. Although overweight and obesity are preventable conditions in the majority of cases, their prevalence has increased significantly over the past two decades. Recent estimates indicate that 34.1 percent of Americans are classified as overweight, while 32.2 percent are classified as obese [17]. National estimates of obesity-related health care costs are alarming, yet, to date, no such estimates have been published for the Southern region overall or for population groups in the South. The Southern states have some of the highest rates of adult obesity in the nation

Bi-allelic Loss-of-Function CACNA1B Mutations in Progressive Epilepsy-Dyskinesia.

The occurrence of non-epileptic hyperkinetic movements in the context of developmental epileptic encephalopathies is an increasingly recognized phenomenon. Identification of causative mutations provides an important insight into common pathogenic mechanisms that cause both seizures and abnormal motor control. We report bi-allelic loss-of-function CACNA1B variants in six children from three unrelated families whose affected members present with a complex and progressive neurological syndrome. All affected individuals presented with epileptic encephalopathy, severe neurodevelopmental delay (often with regression), and a hyperkinetic movement disorder. Additional neurological features included postnatal microcephaly and hypotonia. Five children died in childhood or adolescence (mean age of death: 9 years), mainly as a result of secondary respiratory complications. CACNA1B encodes the pore-forming subunit of the pre-synaptic neuronal voltage-gated calcium channel Cav2.2/N-type, crucial for SNARE-mediated neurotransmission, particularly in the early postnatal period. Bi-allelic loss-of-function variants in CACNA1B are predicted to cause disruption of Ca2+ influx, leading to impaired synaptic neurotransmission. The resultant effect on neuronal function is likely to be important in the development of involuntary movements and epilepsy. Overall, our findings provide further evidence for the key role of Cav2.2 in normal human neurodevelopment.MAK is funded by an NIHR Research Professorship and receives funding from the Wellcome Trust, Great Ormond Street Children's Hospital Charity, and Rosetrees Trust. E.M. received funding from the Rosetrees Trust (CD-A53) and Great Ormond Street Hospital Children's Charity. K.G. received funding from Temple Street Foundation. A.M. is funded by Great Ormond Street Hospital, the National Institute for Health Research (NIHR), and Biomedical Research Centre. F.L.R. and D.G. are funded by Cambridge Biomedical Research Centre. K.C. and A.S.J. are funded by NIHR Bioresource for Rare Diseases. The DDD Study presents independent research commissioned by the Health Innovation Challenge Fund (grant number HICF-1009-003), a parallel funding partnership between the Wellcome Trust and the Department of Health, and the Wellcome Trust Sanger Institute (grant number WT098051). We acknowledge support from the UK Department of Health via the NIHR comprehensive Biomedical Research Centre award to Guy's and St. Thomas' National Health Service (NHS) Foundation Trust in partnership with King's College London. This research was also supported by the NIHR Great Ormond Street Hospital Biomedical Research Centre. J.H.C. is in receipt of an NIHR Senior Investigator Award. The research team acknowledges the support of the NIHR through the Comprehensive Clinical Research Network. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, Department of Health, or Wellcome Trust. E.R.M. acknowledges support from NIHR Cambridge Biomedical Research Centre, an NIHR Senior Investigator Award, and the University of Cambridge has received salary support in respect of E.R.M. from the NHS in the East of England through the Clinical Academic Reserve. I.E.S. is supported by the National Health and Medical Research Council of Australia (Program Grant and Practitioner Fellowship)

Community Health Advisors\u27 Perceptions of the 2005 Dietary Guidelines and MyPyramid

This article describes knowledge and perception of the 2005 Dietary Guidelines for Americans (DG) and MyPyramid from 106 Community Health Advisors (CHAs) representing underserved, hard-to-reach communities in Alabama and Mississippi. Only 16 (15%) were able to correctly identify the MyPyramid graphic and DG knowledge scores were low. However, most respondents strongly agreed they would like to know more about the DG (86%) and more should be done in their community to raise awareness (81%). The Internet was the least preferred method to communicate DG. More intense efforts and appropriate communication channels are needed to promote the DG and MyPyramid

Current Research - The Relationship of Dietary and Lifestyle Factors to Bone Mineral Indexes In Children

Objective To identify factors related to children\u27s bone mineral indexes at age 8 years, and to assess bone mineral indexes in the same children at ages 6 and 8 years. Design Bone mineral content (BMC [g]) and bone mineral density (BMD; calculated as g/cm(2)) were measured by dual-energy x-ray absorptiometry (DEXA) in children and their mothers when the children were 8 years of age. A subset of children had an earlier DEXA assessment at age 6 years. Children\u27s dietary intake, height, weight, and level of sedentary activity were assessed as part of a longitudinal study from ages 2 months to 8 years. Subjects/setting Fifty-two healthy white children (25 male, 27 female) and their mothers. Main outcome measures Children\u27s total BMC and BMD at age 8 years. Statistical analyses performed Correlations and stepwise multiple regression analyses. Results Factors positively related to children\u27s BMC at age 8 years included longitudinal intakes (ages 2 to 8 years) of protein, phosphorus, vitamin K, magnesium, zinc, energy, and iron; height; weight; and age (P≤.05). Factors positively related to children\u27s BMD at age 8 years included longitudinal intakes of protein and magnesium (P≤.05). Female sex was negatively associated with BMC and BMD at age 8 years (P≤.05). Children\u27s bone mineral indexes at ages 6 and 8 years were strongly correlated (r=0.86, P<.0001 for BMC; r=0.92, P<.0001 for BMD). Conclusions Because many nutrients are related to bone health, children should consume a varied and nutrient-dense diet

Longitudinal Calcium Intake is Negatively Related to Children\u27s Body Fat Indexes

Objective To determine if dietary calcium was negatively related to children\u27s body fat (BF), if BF indexes and calcium intakes changed over time, and to identify variables related to BF and calcium intake. Design Percent BF and kg BF were assessed by dual energy x-ray absorptiometry (DEXA) in 8-year-old children. In a prospective design, height, weight, dietary intakes, and related variables were monitored longitudinally. from ages 2 months to 8 years during in-home interviews. Subjects Fifty-two white children, (n=25 boys, 27 girls) participated in a longitudinal study with their mothers. At 8 years of age, mean BMI was 17.3 +/- 2.1 (standard deviation) for boys and 17.1 +/- 2.5 for girls. Analyses Regression analysis of all variables, followed by further regression analysis on selected models. Results At 8 years, percent BF was 22.7 +/- 6.7 for boys and 26.2 +/- 7.9 for girls, as assessed by DEXA. Dietary calcium (mg) and polyunsaturated fat intake (g) were negatively related to percent BF (P=.02 to.04) in 3 statistical models, which predicted 28% to34% of the variability in BF among children. Variables positively associated with percent BF were total dietary fat (g) or saturated fat (g), female gender, sedentary activity (hours/day), father\u27s BMI, and mothers\u27 percent BF. Calcium intakes were significantly correlated over time. Dietary variety was positively related to calcium intake, and intakes of carbonated beverages and other sweetened beverages were negatively related. Applications/conclusions Children should be strongly encouraged to regularly include calcium-rich foods and beverages in their diets

Prevalence Estimates of Overweight in Head Start Preschoolers

This study estimates prevalence of overweight and at risk of overweight among low-income predominately non-Hispanic Black Head Start Mississippi preschoolers. A two-stage stratified probability design produced a representative sample of 1,250 preschoolers aged 3 to 5 years. Height, weight, age, gender, and race data were obtained. The prevalence of overweight (20.6%) and at risk of overweight (17.9%) combined was 38.5%. Moreover, highest rates were found in boys, non-Hispanic Blacks, and 5-year-olds. The prevalence of overweight in Mississippi Head Start children exceeds national averages, reinforcing the need for early-childhood health promotion and prevention. © 2009 Elsevier Inc. All rights reserved