Caryn Oshiro

Validation of a soy questionnaire with repeated dietary recalls and urinary isoflavone assessments over one year.

This study assessed the validity and reliability of a 12-item soy questionnaire designed for use in cancer prevention research. The questionnaire measures soy intake over the past year. Subjects were 199 healthy 35- to 46-yr-old premenopausal women participating in an ongoing soy intervention study. Soy questionnaire estimates of isoflavone intake over 1 yr were compared with individual and combined estimates from two reference measures covering the same period: three or four repeated 24-h recalls and one or two repeated urine analyses. The sensitivity and specificity of the soy questionnaire in classifying high vs. low exposure (high exposure = soy intervention group membership) were comparable with 24-h recalls and were superior to urine analyses (sensitivity = 94.8%, 97.9%, and 71.1%; specificity = 95.1%, 97.1%, and 90.3% for the soy questionnaire, 24-h recalls, and urine analyses, respectively). Soy questionnaire isoflavone estimates were highly correlated with the combination of the two reference measures for the entire study population. Its brevity, ease of administration, and good measurement properties over a 1-yr period make the soy questionnaire well suited to the needs of researchers who wish to identify high and low consumers of soy foods, especially in populations who consume traditional Asian soy foods.

Prevalence of Childhood Obesity among Young Multiethnic Children from a Health Maintenance Organization in Hawaii

BACKGROUND Pacific Islander, Asian, and mixed-ethnicity children are not described in national nutrition and health surveys. METHODS Data on BMI values of 4608 5- to 8-year-old children available from Kaiser Permanente Hawaii electronic medical records in 2010 were analyzed for prevalence of overweight and obesity and for ethnic differences in BMI and risk for overweight and obesity, controlling for age, sex, neighborhood education level, and on a subset (n=2169) that further controlled for maternal education and maternal age. Kaiser Permanente data allow for reporting of multiple ethnicities. RESULTS Data revealed that 33% of this child population was of mixed ethnic ancestry. Prevalence of overweight and obesity was 32.6% (12.9% overweight and 19.7% obese). However, Samoan children and children of Native Hawaiian, Filipino, and mixed ethnic ancestries had higher levels of overweight and obesity than whites or Asians. Higher neighborhood education level, higher maternal education level, and older maternal age were associated with decreased risk of overweight and obesity, except for children whose mothers were between 21 and 30 years old, who had a higher risk for obesity than those whose mothers were under 20 years of age (odds ratio=1.34). CONCLUSIONS Populations of mixed ethnicities in the Pacific region deserve further study related to healthy body size and acculturation to environment and lifestyle.

US Acculturation Is Associated with Health Behaviors and Obesity, but not Their Change, with a Hotel-Based Intervention among Asian-Pacific Islanders

BACKGROUND Immigration to the United States has been associated with obesity, yet the relationship of acculturation to obesity and energy balance (ie, physical activity/dietary intake) in adults is a complex issue. Limited longitudinal data are available on immigrant Asians and Pacific Islanders. DESIGN Analyses were conducted on baseline data and change data from baseline to 24 months in the hotel-based cluster-randomized Work, Weight and Wellness trial involving 15 control and 15 intervention hotels on the island of Oahu, Hawaii. SAMPLE Participants were adult employees of predominantly Asian and Pacific Islander ancestry who were assessed one or more times over the course of 24 months. The full sample consisted of 4,236 hotel workers (about 40% of hotel workforce) at baseline, 3,502 hotel workers at Year 1 and 2,963 hotel workers at the 24-month follow up. One thousand one hundred fifteen hotel workers had at least two measurements, and were included in the analysis. INTERVENTION The Work, Weight, and Wellness trial was designed to promote weight loss via motivation and support for increases in physical activity and increased access to and consumption of healthy low-fat/low-energy foods. The measure of acculturation consisted of a score that was a compilation of a participants age when he or she immigrated to the United States, country of birth, language spoken at home, and years of education. STATISTICAL ANALYSES We used mixed effect regression models for cross-sectional baseline models and longitudinal multilevel regression analysis of change in diet and physical activity behaviors and obesity over time using a random intercept. Estimates of the intervention effect are expressed as an annual rate of change for all study outcomes. RESULTS At baseline acculturation was positively associated with body mass index; physical activity level; and fruit, meat, and sweetened drink intake level. In analyses of change across 24 months, acculturation did not significantly influence change in dietary intake or indexes of obesity (ie, body mass index or waist-to-height ratio). However physical activity increased significantly more in the intervention group during the course of the intervention compared with the control group, which decreased activity, when sociodemographic factors (including acculturation) and food intake behavior were controlled for.

Urinary isoflavone excretion as a compliance measure in a soy intervention among young girls: a pilot study

Objective:To investigate the compliance of young girls with a soy intervention.Design:An 8-week dietary intervention and urine sample collection.Setting:Free-living girls.Subjects:A convenience sample of 8- to 14-y-old girls (20 started and 17 finished the study) recruited through flyers distributed to staff members and previous study participants.Intervention:The girls consumed one daily serving of soymilk, soy nuts, or tofu, completed 3-day food records, kept daily soy intake logs, and collected weekly urine samples.Main outcome measures:Compliance with the intervention was evaluated by daily soy intake logs, 3-day food records analyzed by the centers Food Composition and Food Groups Servings Databases, and weekly urinary isoflavone excretion using high-pressure liquid chromatography. The statistical analysis included paired t-tests, analysis of variance, and Spearmans rank-order correlation coefficients.Results:Daily soy intake logs indicated a mean intake of 6.28 servings out of a maximum of 7.0 servings per week. The food records revealed a six-fold increase in isoflavone intake during the study period (P<0.01) which was confirmed by an increase in urinary isoflavone excretion of similar magnitude (23.3–142.1 nmol/mg creatinine, P=0.02).Conclusions:This study demonstrated the ability of young girls to consume one daily soy serving and the usefulness of urinary isoflavones as a primary compliance measure. The high urinary isoflavone excretion levels detected in girls as compared to adult women suggest less intestinal degradation and/or greater absorption of isoflavones in nonadult populations. This finding requires further investigations into the pharmacokinetics of isoflavones.

Race/Ethnic Differences in Birth Size, Infant Growth, and Body Mass Index at Age Five Years in Children in Hawaii

BACKGROUND Factors at birth and infancy may increase risk of being overweight in childhood. The aim of this study was to examine the relationship of birth size and infant growth (2-24 months) with BMI at age 5 years in a multiethnic population. METHODS This was a retrospective study (using electronic medical records of a health maintenance organization in Hawaii) of singleton children born in 2004-2005, with linked maternal and birth information, infant weights (n = 597) and lengths (n = 473) in the first 2 years, and BMI measures at age 5 years (n = 894). Multiple regression models were used to estimate the association of BMI at age 5 years with birth size and infant growth. RESULTS Birth weight was positively associated with BMI at age 5 years, adjusting for gestational age, sex, race/ethnicity, and maternal prepregnancy weight, age, education, and smoking. A greater change in infant weight was associated with a higher BMI at age 5 years, though the effect of birth weight on BMI was neither mediated nor modified by infant growth rate. Birth weight, change in infant weight, and BMI at age 5 years varied by race/ethnicity. Change in infant BMI in the first 2 years was higher in other Pacific Islanders and whites (Δ = 0.966; confidence interval [CI] = 0.249-1.684; p = 0.02) than in Asian, other, and part Native Hawaiian race/ethnic groups. CONCLUSIONS Early biological measures of birth weight and infant weight gain varied by race/ethnicity and positively predicted BMI at age 5 years.