Colleen M. Doak

Fruit and vegetable intake of schoolchildren in Quetzaltenango, Guatemala

OBJECTIVEnTo determine if fruit and vegetable consumption among high- and low-socioeconomic status (HSES-LSES) urban schoolchildren in Quetzaltenango, Guatemala, was adequate according to World Health Organization (WHO) recommendations.nnnMETHODSnCross-sectional data from 449 third- and fourth-grade girls and boys from 12 elementary schools were collected, analyzed, and presented by socioeconomic status and gender. Public schoolchildren were classified as LSES (n = 219) and private schoolchildren were classified as HSES (n = 230). Dietary fruit/vegetable intake of each student was determined based on a 24-hour recall pictorial record and personal interview. All food items containing fruits or vegetables (including beverages) were classified and tabulated. Frequency of fruit/vegetable intake was calculated based on mentions (number of times a fruit or vegetable item was reportedly consumed), and nutritional adequacy was assessed for each group by mean and median values and compared to WHO daily recommended fruit/vegetable intake (400 g). Based on World Cancer Research Fund (WCRF) exclusion guidelines, the fruit/vegetable contribution to total energy was estimated.nnnRESULTSnOf the 247 different food items identified, 93 (37.7%) contained a fruit or vegetable. Total food mentions (n = 6 512) included 637 fruit items and 701 vegetable items. Although mean fruit/vegetable intake in grams was 461.3 (standard deviation, +/- 332.5), more than half (56.3%) of the subjects fell below the 400-g recommended daily level. Estimated fruit/vegetable contribution to total energy was 21.2% for HSES and 19.1% for LSES.nnnCONCLUSIONnThis study revealed inadequate fruit/vegetable intake among the study sample. For compliance with global recommendations, interventions promoting fruit/vegetable intake are needed.

HIV stigma and disclosure experiences of people living with HIV in an urban and a rural setting.

Human immunodeficiency virus (HIV) remains a highly stigmatised condition for people living with HIV (PLWH) and people living close to them (PLC) globally. The research objectives for this study were to explore and describe how HIV stigma and disclosure experiences impact the lives of PLWH and to explore whether there are differences between experiences in urban and rural settings. A qualitative approach was followed and participants were selected through purposive voluntary sampling. Data collection took place using in-depth interviews with 23 PLWH, 11 of whom resided in an urban setting in North-West, South Africa, and 12 resided in a rural setting in the same province. The data were manually analysed through open coding. The HIV stigma experiences expressed by PLWH depicted negative behavioural patterns and attitudes towards them, fear from the community of being infected by PLWH and lastly negative self-judgement by PLWH themselves. During disclosure, PLWH were unsure and they described it as a stressful event. They cautiously considered to whom to disclose their condition and what benefits disclosure will hold. They further had to handle forced disclosure due to being identifiable in health-care settings. HIV stigma and related disclosure practices remained a problem, which detrimentally affected treatment and support efforts. Recommendations focused on HIV stigma reduction in the community that needed to involve PLWH and PLC.

Food Label Use and Food Label Skills among Immigrants from the Former Soviet Union

OBJECTIVEnTo assess food label use and skills and to identify their correlates among immigrants from the former Soviet Union (FSU).nnnDESIGN/SETTING/PARTICIPANTSnCross-sectional survey of a convenience sample of 200 FSU immigrants residing in New York City.nnnVARIABLES MEASUREDnFood label use and skills; acculturation; and socioeconomic and psychosocial factors.nnnANALYSISnChi-square tests and multivariate logistic regression analysis assessed relationships among the outcomes and socioeconomic and other characteristics.nnnRESULTSnFifty-five percent reported using food labels always/often; only 32% had good label skills. FSU immigrants particularly had difficulty understanding servings per package and percent daily value. Food label use was significantly associated with factors such as positive attitude toward food labels, and importance of recommendations such as avoiding too much salt and saturated fat. However, these factors were not related to food label skills, which was positively associated with longer residency in the United States (> 7 y).nnnCONCLUSIONS AND IMPLICATIONSnThere is a need for nutrition education among FSU immigrants to increase their food label use and skills to promote healthful food selection. Developers of new food labels should consider ways to present percent daily value and servings per package in a more consumer-friendly manner. Simplifying the presentation of this information could improve food label skills in FSU immigrants, among others.

The association of 25(OH)D with blood pressure, pulse pressure and carotid-radial pulse wave velocity in African women.

High susceptibility of the African population to develop cardiovascular disease obliges us to investigate possible contributing risk factors. Our aim was to determine whether low 25(OH)D status is associated with increased blood pressure and carotid-radial pulse wave velocity in black South African women. We studied 291 urban women (mean age: 57.56±9.00 yrs.). 25(OH)D status was determined by serum 25(OH)D levels. Women were stratified into sufficient (>30 ng/ml), and insufficient/deficient (<30 ng/ml) groups. Cardiovascular variables were compared between groups. Women with low 25(OH)D levels had significantly higher SBP (150.8±27.1 vs. 137.6±21.0), DBP (94.7±14.5 vs. 89.3±12.3) and PP (53.15(50.7;55.7) vs. 46.3(29.4;84.6)) compared to women with sufficient levels. No significant difference was observed with regards to c-rPWV. ANCOVA analyses still revealed significant differences between the two groups with regards to SBP, DBP as well as PP. Partial correlations revealed significant inverse association between SBP and 25(OH)D (pu200a=u200a.04;ru200a=u200a−.12). Women with low 25(OH)D levels were ∼2 times more likely to have high SBP (95% CI: 3.23;1.05). To conclude, women with deficient/insufficient 25(OH)D had significantly higher SBP compared to women with a sufficient 25(OH) status.

A comprehensive HIV stigma-reduction and wellness-enhancement community intervention: a case study

&NA; We describe the implementation of a comprehensive HIV stigma‐reduction and wellness‐enhancement community intervention that focused on people living with HIV (PLWH), as well as people living close to them (PLC) from six designated groups. A holistic multiple case study design was used in urban and rural settings in the North West Province, South Africa. Purposive voluntary sampling was used to recruit the PLWH group; snowball sampling was used for the PLCs. Data were analyzed by means of open coding and text document analysis. The comprehensive nature of the intervention ensured enhancement in relationships in all groups. The increase in knowledge about stigma, coping with it, and improved relationships led to PLWH feeling less stigmatized and more willing to disclose. PLCs became aware of their stigmatizing behaviors and were empowered to lead stigma reduction in their communities. Many community members were reached through these initiatives.

Cut-off values of distal forearm bone density for the diagnosis of central osteoporosis in black postmenopausal South African women

Abstract Background: The objective of this study was to establish a triage cut-off point or threshold for peripheral bone mineral density (BMD), applicable to black postmenopausal women, and that could be used as a screening method to differentiate between women with normal BMD, and those with possible central osteoporosis. This was a cross-sectional study design conducted in the North West province. Central and peripheral BMD was measured in 184 black, urban postmenopausal women. Method: Receiver operating curves (ROC) analysis was used to establish cut-off points. Sensitivity, specificity, positive and negative predictive value, odds ratios and likelihood ratios were determined. Results: The results showed a prevalence rate of 41.3% for central osteoporosis. The area under the curve (AUC) for osteoporosis at the hip was 0.818, and for the spine, it was 0.771. Using the optimum cut-off point (0.371 g/cm2), our results showed a misclassification rate of ≈ 49% for spine osteoporosis, and a negative predictive value of 0.825. Women who had a forearm BMD below this threshold were ∼10 times more likely to have osteoporosis of the spine. Conclusion: We recommend using 0.371 g/cm2 as a cut-off point to differentiate between women who have normal BMD, and those with possible osteoporosis of the spine.

Children with moderate-high infection with Entamoeba coli have higher percentage of body and abdominal fat than non-infected children

Intestinal parasites, virus and bacterial infections are positively associated with obesity and adiposity in vitro and in animal models, but conclusive evidence of this relationship in humans is lacking. The aim of this cross‐sectional study was to determine differences in adiposity between infected and non‐infected children, with a high prevalence of intestinal parasitic infection and obesity.