Cindy Wolff

Maternal Eating Patterns and Birth Weight of Mexican American Infants

Eating patterns of 549 Mexican American mothers were identified using dietary data from the United States Hispanic Health and Nutrition Examination Survey. These eating patterns were then used to investigate the relationship between maternal diet and infant birth weight. Principle components factor analysis was used to determine the structure of the maternal eating patterns. Seven distinct eating patterns were identified: nutrient dense, traditional, transitional, nutrient dilute, protein rich, high fat dairy, and mixed dishes. Stepwise multiple regression analysis was used to identify those eating patterns associated with birth weight. In addition to eating patterns, regression variables included body mass index, hemoglobin, gestational age at delivery, maternal age, infant gender, acculturation, marital status, income, education, and smoking during pregnancy. Regression results indicated that the nutrient dense (fruits, vegetables, low fat dairy, etc.) and protein rich (low fat meats, processed meats, and dairy desserts, etc.) eating patterns were associated with increased birth weight and that the transitional eating pattern (fats and oils, breads and cereals, high fat meats, sugar, etc.) was associated with decreased birth weight. Study findings suggest that the eating pattern methodology may be an appropriate tool for analyzing food frequency data in the investigation of diet and health relationships and for targeting dietary interventions.

Hmong Food Helps Us Remember Who We Are: Perspectives of Food Culture and Health among Hmong Women with Young Children.

OBJECTIVE To examine perspectives on food habits, acculturation, and health among Hmong women with young children in northern California. METHODS Qualitative interviews were conducted with 15 Hmong mothers with young children in a low-income community of northern California. The interviews were transcribed and coded based on the principles of grounded theory. RESULTS The main themes that emerged from the interviews included comparisons between American and Hmong food cultures, food culture preservation, obesity issues, diverse acculturation processes, and intergenerational food habits. Hmong food culture has been identified as the representation of their healthful lifestyle, self-identity, and social support. At the same time, mothers are facing enormous challenges in bridging 2 extreme generations; the less acculturated, immigrant adults and the highly acculturated, US-born children in their households. CONCLUSIONS AND IMPLICATIONS Addressing the healthful aspects of Hmong food culture and healthful options of American food should be a focus of nutrition-related programs.

Cooking up diversity. Impact of a multicomponent, multicultural, experiential intervention on food and cooking behaviors among elementary-school students from low-income ethnically diverse families.

This study evaluated the impact of a pilot intervention promoting ethnic produce through classroom food demonstrations, tastings and home cooking activities among ethnically diverse elementary-school children ages 5-8 years old and their family members in Northern California. A total of 604 intervention students from four schools participated in classroom food demonstrations and tasting activities using seven food recipes. The control group included 600 students from two additional schools. Each recipe featured one vegetable from Latino, Hmong, or mainstream American cultures. Intervention students also received food kits containing ingredients to take home for each recipe. Mixed methods of quantitative student and parent pre-post surveys, parent feedback surveys, and qualitative focus groups were used to evaluate the intervention. Generalized estimating equations were used for survey data analysis. Qualitative data from parent focus groups were analyzed based on the principles of grounded theory. Both quantitative and qualitative results revealed that intervention students increased familiarity, preferences, and consumption of the featured vegetables and significantly increased their involvement in food preparation at home. Qualitative results showed that children were actively involved in food preparation at home. In addition, the intervention helped parents increase their appreciation for new foods and recipes. The results suggest that promoting locally grown ethnic produce to children is effective in increasing their consumption of a variety of vegetables and their involvement in food preparation at home.

Globalization, localization and food culture: perceived roles of social and cultural capitals in healthy child feeding practices in Japan

Objectives: The current study examined parental perceptions of sociocultural factors associated with healthy child feeding practices among parents of preschool-age children in rural Japan. Methods: Fifteen Japanese mothers of preschool-age children participated in this qualitative study. These participants were aged 22–39 years and resided in a rural town in western Japan. We conducted semi-structured qualitative interviews to assess parental perceptions of healthy child feeding practices and their relationships with globalization and localization. These interviews were transcribed, translated into English and coded, based on the principles of grounded theory. A codebook was developed and pre-identified, and the newly-identified themes from this codebook were examined and compared. Results: Overall, local and seasonal foods, along with traditional Japanese foods and simple foods (soshoku), were considered to be beneficial for children. Participants also noted that children were expected to be mindful and exhibit good table manners that reflect cultural values related to meal-time socializing or family bonding, and food appreciation. On the other hand, the majority of the participants stated that foods containing food additives and imported foods were unsuitable for children. Participants noted that strong social capital, especially social support from their mothers or mothers-in-law, as well as social networks for obtaining fresh local foods, contributed to healthy child feeding practices. Cultural capital (including the preservation of traditional Japanese dietary habits, eating rules and inter-generational commensality), was also identified as being key to healthy feeding practices. Conclusions: Identifying and promoting the social and cultural capital that positively support healthy child feeding practices may be an important component of nutrition education programs.

Edutainment and teen modeling may spark interest in nutrition & physical activity in elementary school audiences.

Providing knowledge alone is simply not enough to motivate children to eat fruits and vegetables. Innovative nutrition education strategies are often needed to improve attitudes and behaviors about fruit and vegetable intake. Educational theater for nutrition education is one approach in particular that rarely gets attention from academia. The use of education entertainment, or ‘‘edutainment,’’ is the incorporation of education with entertainment and is known to enhance the overall learning experience for the audience. Although previous theaterbased nutrition education programs exist, the literature concerning the effect of teen-led interventions is limited. The main objective of this research was to guide high school students in developing and evaluating an entertaining and educational performance about nutrition and physical activity for kindergarten-6th grade (K-6) audiences. The main messages that were selected for the performance were to eat more fruits and vegetables and participate in regular physical activity.

Divergent Perspectives on Food, Culture, and Health among Hmong Mothers with Middle-School Children

Abstract This study used Q methodology to uncover the rich and divergent perspectives on food, culture and health and nutrition education among Hmong mothers with middleschool children. Forty participants were asked to rank forty statements using a sevenpoint scale and interviewed immediately after completing the ranking task. Mothers were grouped into three divergent themes based on the Q-factor analysis: traditional food culture preservers (n = 20), financially struggling health-conscious mothers (n = 11), and mothers concerned about a parent-child generational gap (n = 4). While participants shared several similar views regarding food and health issues, including the importance of rice in their lives, they demonstrated divergent perspectives on how acculturation, intergenerational value discrepancies in traditional food culture, and limited financial income contribute to obesity among Hmong, especially children. Our study also suggests that parental engagement in their childrens education provides health benefits for Hmong children.

Birth weight and smoking practices during pregnancy among Mexican‐American women

The smoking practices of a national sample of Mexican-American mothers and the resulting effects of those practices on birth weight were examined. Data were from the Hispanic Health and Nutrition Examination Survey conducted by the U.S. National Center for Health Statistics during 1983-1984. We found that 24% of the mothers had smoked during their pregnancy, with a mean of 11 cigarettes per day. Infants of these women weighed 101 g less at birth than did infants of nonsmoking mothers and had a low birth weight rate of 8.0% compared with the 5.1% low birth weight rate for the sample as a whole. Multiple regression results indicate a 7.4 g decrease in birth weight for each cigarette smoked per day during pregnancy. Cultural factors that promote a low birth weight rate for Mexican-Americans that is comparable to that of non-Hispanic whites despite increased rates of poverty and inadequate health care do not protect against the insidious effects of cigarette smoking.

Impact of the Harvest of the Month Program on Low-Income Hmong and White Middle School Students

Increases in the prevalence of overweight and obesity in children and adolescents are a significant health concern in the United States (US). California is home to the largest Asian population in the US. Children from low-income Asian and Pacific Islander American families are joining other racial/ethnic groups in the obesity epidemic. Specifically, there is a growing body of evidence that obesity rates are higher among Hmong youth than the national averages for Asian or non-Hispanic white middle school-age children. Approximately 24% of the Hmong population in the US resides in California. They are typically first-generation refugees from Southeast Asia, and 55% are under the age of 18. Fruit and vegetable consumption has been associated with the prevention and management of overweight and obesity in children and adolescents, both in northern California and elsewhere. Although little is known about actual fruit and vegetable consumption among Hmong youth who are experiencing dietary transition, there appear to be many perceived barriers to fruit and vegetable consumption among Hmong adults and adolescents from low-income families. Two California studies, including 1 from northern California, identified perceived

Relationships Between Children's Food Consumption and Social and Cultural Capital Levels Among Latino, Hmong, and Non-Hispanic White Parents of K–2 Children

This study examined associations between social and cultural capital levels and childrens food consumption among Latino, Hmong, and non-Hispanic white parents. A total of 292 parents of K–2 children in Northern California completed a survey. Childrens consumption and social and cultural capital levels among Latino, Hmong, and non-Hispanic white parents were measured. Hmong children had significantly higher consumption of vegetables and local produce compared to Latino and non-Hispanic white children. Parents with an open attitude toward food from other ethnic groups fed children significantly more vegetables. Additionally, children of parents with access to professional nutrition education consumed fewer processed and fast foods. Children of parents applying child feeding information from their own family or friends consumed fewer fruits and vegetables and more fast foods. Access to nutrition education from professionals and encouraging bridging cultural capital among parents from different ethnic/cultural groups through local produce promotion may be effective in increasing fruit and vegetable consumption among children.

A Longitudinal Study of Overweight, Elevated Blood Pressure, and Acanthosis Nigricans among Low-Income Middle School Students.

This longitudinal study examined the rates of overweight, elevated blood pressure, acanthosis nigricans, and their associated factors in third through fifth grade students over 4 years. Participants consisted of 279 students who participated in health screenings in 2002 and 2006. Hispanic students had significantly higher rates of overweight and acanthosis nigricans compared to White students. There was a sharp increase in elevated blood pressure from 2002 to 2006 among obese children. While 20% of the matched obese students were above the 90th percentile in 2002, 82% of the same students were above the 90th percentile in 2006. After controlling for sex, ethnicity, and grade, preadolescent obesity in 2002 continued to be a significant factor associated with elevated blood pressure and acanthosis nigricans in 2006. These findings demonstrate that prevention and treatment of obesity during preadolescence is critical for the prevention of elevated high blood pressure in early adolescence.