Jamie Stang

Prevalence of Use of Herbal Products by Adults in the Minneapolis/St Paul, Minn, Metropolitan Area

OBJECTIVES To document the prevalence of use of herbal products among adults in a large metropolitan area and to examine issues surrounding such use. SUBJECTS AND METHODS Of people aged 18 years and older residing in the Minneapolis/St Paul, Minn, metropolitan area, 752 were randomly selected from Minnesota Department of Public Safety Driver and Vehicle Service Division data tapes. Between June and August 1999, surveys were mailed to determine use of any herb and use of 13 specific herbs. Rationale for use, perceived efficacy, and source of product information were assessed for each of the specific herbs. RESULTS Of the initial 752 persons, 580 were eligible, and 376 returned a completed survey, resulting in a response rate of 65%. When asked whether they had used an herb during the past 12 months, 230 respondents (61.2%) reported that they had. Prevalence of use of specific herbs ranged from 30.9% for ginseng to 3.0% for milk thistle. The most commonly reported reasons for using herbs varied by the type of herb, although for 5 of the herbs, the most frequently mentioned reason was to promote general health/well-being. For 11 of the 13 herbs, less than 60% of those who used the herb rated it as effective or very effective. Family, friends, and written materials were the leading sources of product information among those taking 9 of the 13 specific herbs. CONCLUSIONS Herbs are used frequently to treat or prevent an array of health conditions. At present, people who use herbal products appear to rely predominantly on family and friends for information.

Dieting Status and its Relationship to Eating and Physical Activity Behaviors in a Representative Sample of US Adolescents

OBJECTIVE To determine whether adolescents engaging in extreme weight loss methods (i.e., vomiting and diet pills) and those using more moderate methods differ from each other in dietary intake (fruits, vegetables, and higher-fat foods) and physical activity, and to compare these variables in dieting and nondieting adolescents. DESIGN Data were obtained from the 1993 Youth Risk Behavior Survey. SUBJECTS/SETTINGS The survey was administered to a nationally representative sample of 16,296 adolescents in grades 9 through 12 in a school setting. STATISTICAL ANALYSES Data were analyzed for 16,125 adolescents. Associations between weight control behaviors and dietary intake and physical activity were examined using mixed-model logistic regressions, controlling for grade in school, race, parental education, region of the country, and urban vs nonurban residence. RESULTS Differences in dietary and physical activity were found among adolescents who use extreme weight loss methods and moderate methods, and between dieters and nondieters. Adolescents using moderate methods of weight control engaged in more health-promoting eating and exercise behaviors than did extreme dieters or nondieters. Girls categorized as extreme dieters were less likely to eat fruits and vegetables than were moderate dieters (odds ratio [OR] = .56) or nondieters (OR = .75), and were more likely than more moderate dieters (OR = .76) to have consumed 2 or more servings of high-fat foods during the previous day. APPLICATIONS/CONCLUSIONS Our findings suggest the importance of distinguishing between different types of dieting behaviors in clinical settings and research studies. Adolescents engaging in extreme weight control behaviors may be at particular risk for inadequate nutritional intake. In contrast, adolescents using more moderate methods may be consuming a more healthful diet than are nondieters. For all adolescents, nutrition guidance on healthful and safe weight control strategies is needed.

Guess Who's Cooking? The Role of Men in Meal Planning, Shopping, and Preparation in US Families

OBJECTIVES To determine the role of men in meal-related tasks in households with both a male and female head, and to identify households in which the man is more likely to be involved in these tasks. DESIGN Data collected as part of the US Department of Agricultures 1994 Continuing Survey of Food Intakes of Individuals were analyzed. SUBJECTS/SETTING All analyses were restricted to sampled persons who were identified as a male head of household residing in a household that also had a female head (N = 1,204). STATISTICAL ANALYSES Frequency distributions were calculated and logistic regression analyses were conducted. RESULTS Approximately 23%, 36%, and 27% of men reportedly were involved in meal planning, shopping, and preparation, respectively. Men in lower income and smaller households were more likely to be involved in each of the meal activities. Younger men and men in households in which the female head of household worked full-time were more likely to be involved in meal planning and preparation. IMPLICATIONS Current education efforts to improve family nutrition tend to target the female rather than the male head of household. Our findings confirm that this focus is appropriate for most dual-headed households.

Nutrition Education in Minnesota Public Schools: Perceptions and Practices of Teachers

Abstract A random sample of 1890 elementary and secondary teachers in Minnesota public schools was surveyed to determine their perceptions and practices regarding nutrition education. The survey response rate was 47% (n = 894). Data were analyzed using cumulative frequencies and chi-square procedures. Seventy-nine percent of the teachers taught nutrition. Teachers with previous training in nutrition were more likely to teach nutrition than those without training. Teachers who had taken a college course were more likely to teach more than 10 hours of nutrition per year. Other factors related to the amount of nutrition education taught included grade level, subject area, and whether or not nutrition was taught as a separate subject, integrated into other subjects, or both. Less than one-third of teachers collaborated with community resources to provide nutrition education, while 26% collaborated with school food service and 45% tried to involve parents. Barriers to nutrition education included lack of time, training, curriculum materials, and administrative support. Recommendations for increasing nutrition education and collaboration included providing college course work in nutrition for all teachers and providing joint nutrition training programs for teachers and school foodservice staff.

Position of the Academy of Nutrition and Dietetics: Obesity, Reproduction, and Pregnancy Outcomes.

It is the position of the Academy of Nutrition and Dietetics that all women of reproductive age receive education about maternal and fetal risks associated with prepregnancy obesity, excessive gestational weight gain, and significant postpartum weight retention, including potential benefits of lifestyle changes. Behavioral counseling to improve dietary intake and physical activity should be provided to overweight and obese women, beginning in the preconception period and continuing throughout pregnancy, for at least 12 to 18 months postpartum. Weight loss before pregnancy may improve fertility and reduce the risk of poor maternal-fetal outcomes, such as preterm birth, gestational diabetes, gestational hypertension, pre-eclampsia, assisted delivery, and select congenital anomalies. Lifestyle interventions that moderate gestational weight gain may reduce the risk of poor pregnancy outcomes, such as gestational diabetes, gestational hypertension, large for gestational age, and macrosomia, as well as lower the risk for significant postpartum retention. Postpartum interventions that promote healthy diet and physical activity behaviors may reduce postpartum weight retention and decrease obesity-related risks in subsequent pregnancies. Analysis of the evidence suggests that there is good evidence to support the role of diet, physical activity, and behavior changes in promoting optimal weight gain during pregnancy; however, there is currently a relative lack of evidence in other areas related to reproductive outcomes.

Stress, Depression, Social Support, and Eating Habits Reduce Diet Quality in the First Trimester in Low-Income Women: A Pilot Study

Maternal diet quality influences birth outcomes. Yet, little research exists that assesses womens diet quality during the first trimester of pregnancy, a crucial time of placental and fetal development. This cross-sectional study, describing diet quality and its relationship with stress, depression, social support, and eating habits in the first trimester, may identify low-income women needing intensive dietary intervention. Seventy-one low-income women completed validated instruments measuring stress, depression, social support, and eating habits; had their height and weight measured; received training on portion-size estimation; and completed three 24-hour dietary recalls (1 weekend day and 2 nonconsecutive weekdays) from July 2009 to February 2010. Comparative and correlational analyses were done. Women with diet quality scores below the median (n=35) had more depression (9.6±5.1 vs 6.7±5.1) and stress (22.1±5.4 vs 19.3±4.8) and less control over meal preparation (5.0±1.5 vs 4.2±1.5) and support from others (52.0±12.0 vs 57.4±7.2) than did women with high diet quality scores (n=36). Diet quality was negatively related to depression (r=-0.41), stress (r=-0.35), skipping meals (r=-0.41), and control over meal preparation (r=-0.33), and positively related to support from others (r=0.38). Low-income women experiencing life stressors represent an at-risk group for low diet quality and may need intensive dietary intervention before and during pregnancy. More research designed to improve diet quality in low-income pregnant women is needed.

Health Statements Made in Infant Formula Advertisements in Pregnancy and Early Parenting Magazines A Content Analysis

Pregnant women and mothers of infants are the target audience for advertisements of infant formula. The purpose of this pilot study was to assess the prevalence and content of health statements made in infant formula advertisements found in pregnancy and early parenting magazines from August 2006 to August 2007. A total of 173 infant formula advertisements were found in 77 individual issues of 16 different magazines. Forty-two unduplicated advertisements were used for the content analysis. Statistical analysis included kappa scores, frequencies, and percentages. Results showed that 9 of the 16 magazines analyzed contained ads for infant formulas. Of these, more than half of all infant formula advertisements made some type of health statement. Health statements varied greatly but generally advertised improvements in gastrointestinal, brain, or eye health; language development; or reduced incidence of allergies, food intolerances, and gastrointestinal disorders. Such health statements may influence a mother...

Best Practices for Nutrition Care of Pregnant Women in Prison

Approximately 3% to 4% of women are pregnant upon their admission to prison. Pregnant inmates present unique challenges for correctional health providers, including meeting the nutritional needs for healthy pregnancy outcomes. The authors outline six recommendations for nutrition care for pregnant inmates, including (1) test for pregnancy; (2) prescribe prenatal vitamins; (3) follow nutrition recommendations outlined by the Academy of Nutrition and Dietetics; (4) provide additional food, monitor over time, and allow for modifications to meet pregnancy needs; (5) ensure regular access to water; and (6) provide inmates with resources and education on healthy diet. The degree to which correctional facilities address the nutritional needs of pregnant women may have short- and long-term consequences for the health of women and their offspring.

Evaluation of the Nutritional Quality of Commissary Foods Offered in American Women’s Prisons:

Weight gain and obesity among female prisoners is of public health concern. This study analyzed the nutritional quality of commissary food and recipes cooked within eight women’s prisons in the United States. Food items from commissary lists were categorized into the MyPlate food groups. Nutrition Data System for Research was used to analyze the nutritional content of recipes (N = 175). Mean nutrient content, percent Daily Values, and food group servings were calculated. Recipes were generally high in sodium, saturated fat, added sugars, and calories but low in vitamin D. Commissary items and recipes were both low in fruits, vegetables, and whole grains and excessive in refined grains. Additional research is needed to inform policies that ensure commissary offerings better reflect dietary recommendations.

Factors Affecting Nutrition and Physical Activity Behaviors of Hispanic Families With Young Children: Implications for Obesity Policies and Programs

Objective: To determine preferred policies and programs to prevent obesity and diabetes as identified by parents and caregivers of 3‐ to 5‐year‐old Latino children. Design: Constructs from the Social Ecological Model were used to develop 10 focus group and key informant interview questions. Setting: Community venues and schools in St Paul, MN. Participants: A total of 64 parents and caregivers and 20 key informants provided comments. Intervention(s): Community‐based participatory research methods were used to gather opinions regarding appropriate and preferred methods to prevent obesity and diabetes among Latino youth. Native Spanish‐speaking investigators who were members of the community conducted 7 focus groups (60–90 minutes each) and 20 key informant interviews. Main Outcome Measures: Themes and subthemes of preferences based on participant comments. Analysis: Transcript‐based, long‐table qualitative analysis. Results: Five themes were identified: (1) cultural beliefs and practices are inconsistent with obesity prevention; (2) cost and convenience; (3) positive parenting practices; (4) we want to learn more about being healthy; and (5) gardens, parks, gyms, and school meals. At least 1 theme fell within each of the Social Ecological Model domains. Conclusions and Implications: Our results suggest that parents of young Hispanic children prefer that obesity and diabetes prevention programs address multiple levels of influence.