Noel Chavez

Evaluation of a brief telephone questionnaire to estimate fruit and vegetable consumption in diverse study populations

We evaluated use of a six-item telephone questionnaire to estimate fruit and vegetable intakes in five diverse populations. Researchers administered the telephone questionnaire to persons who had previously undergone more extensive dietary assessment. The study populations included 553 middle-aged and older adults in Beaver Dam, WI; 252 middle-aged and older women throughout Wisconsin; 150 parents of school children in Augusta, GA; 73 low-income, Hispanic mothers in Chicago, IL; and 51 older adults in Arizona. Spearman correlation coefficients between total fruit and vegetable intakes measured by the brief telephone survey and by more extensive food frequency questionnaires were 0.47 (Augusta), 0.48 (Arizona), 0.56 (Wisconsin), and 0.57 (Beaver Dam). Correlation between intakes measured by the brief telephone survey and by multiple diet records or recalls were 0.29 (Arizona), 0.46 (Chicago), and 0.54 (Beaver Dam). With the exception of Arizona, mean daily fruit and vegetable intakes measured by the telephone survey were similar to intakes estimated by multiple diet records or recalls and lower than those estimated by extensive food frequency questionnaires. Although caution may be needed in interpreting dietary reports from some ethnic subgroups, this brief telephone questionnaire may be useful for surveillance of fruit and vegetable intake in the United States. (Epidemiology 1993;4:455–463)

Dietary beta-carotene, vitamin C, and risk of prostate cancer: Results from the Western Electric Study

&NA; Dietary factors are likely candidates for important determinants of prostatic cancer risk. Among the most investigated nutritional factors have been antioxidants. We evaluated dietary beta‐carotene and vitamin C in relation to subsequent risk of prostate cancer in a prospective study of 1,899 middleaged men. We combined prostate cancer cases diagnosed in the first 24 years of follow‐up with incident cases identified from the Health Care Financing Administration hospitalization and outpatient files during an additional 6‐year follow‐up period. We obtained death certificates for all decedents. During the 30‐year follow‐up, prostate cancer developed in 132 men. There was no indication that consumption of beta‐carotene or vitamin C was related to increased or decreased risk of prostate cancer. Relative risks for highest vs lowest quartiles of betacarotene and vitamin C intake were 1.27 [95% confidence interval (CI) = 0.75‐2.14] and 1.03 (95% CI = 0.59‐1.60), respectively, after adjustment for age, number of cigarettes smoked per day, dietary cholesterol and saturated fat, alcohol consumption, total energy intake, and occupation. Associations between intake of these nutrients and risk of prostate cancer differed depending on whether the cancer was diagnosed during the first 19 years of follow‐up or the next 11 years of follow‐up. Overall survival over the 30 years of follow‐up was positively associated with intake of beta‐carotene and vitamin C.

Prenatal exposure to acetaminophen and respiratory symptoms in the first year of life

BACKGROUND Prevalence of asthma in developed countries increased between the 1970s and the 1990s. One factor that might contribute to the trends in asthma is the increased use of acetaminophen vs aspirin in children and pregnant women. OBJECTIVE To examine relationships between in utero exposure to acetaminophen and incidence of respiratory symptoms in the first year of life. METHODS A total of 345 women were recruited in the first trimester of pregnancy and followed up with their children through the first year of life. Use of acetaminophen in pregnancy was determined by questionnaire and related to incidence of respiratory symptoms. RESULTS Use of acetaminophen in middle to late but not early pregnancy was significantly related to wheezing (odd ratio, 1.8; 95% confidence interval, 1.1-3.0) and to wheezing that disturbed sleep (odds ratio, 2.1; 95% confidence interval, 1.1-3.8) in the first year of life after control for potential confounders. CONCLUSION This study suggests that use of acetaminophen in middle to late but not early pregnancy may be related to respiratory symptoms in the first year of life. Additional follow-up will examine relationships of maternal and early childhood use of acetaminophen with incidence of asthma at ages 3 to 5 years, when asthma diagnosis is more firmly established.

Dietary Vitamin C, Beta-Carotene and 30-Year Risk of Stroke: Results from the Western Electric Study

The relations of dietary antioxidants vitamin C and beta-carotene to 30-year risk of stroke incidence and mortality were investigated prospectively in the Chicago Western Electric Study among 1,843 middle-aged men who remained free of cardiovascular disease through their second examination. Stroke mortality was ascertained from death certificates, and nonfatal stroke from records of the Health Care Financing Administration. During 46, 102 person-years of follow-up, 222 strokes occurred; 76 of them were fatal. After adjustment for age, systolic blood pressure, cigarette smoking, body mass index, serum cholesterol, total energy intake, alcohol consumption, and diabetes, relative risks (and 95% confidence intervals) for nonfatal and fatal strokes (n = 222) in highest versus lowest quartiles of dietary beta-carotene and vitamin C intake were 0.84 (0.57-1.24) and 0.71 (0.47-1.05), respectively. Generally similar results were observed for fatal strokes (n = 76). Although there was a modest decrease in risk of stroke with higher intake of beta-carotene and vitamin-C intake, these data do not provide definitive evidence that high intake of antioxidant vitamins decreases risk of stroke.

Effect of length of U.S. residence on food group intake in Mexican and puerto rican women

Abstract The purpose of this research was to compare the dietary intakes of two ethnic Hispanic groups and to explore within those ethnic groups the relationship of dietary intake to time since migration to the United States. Food frequency questionnaires (FFs) adapted to incorporate ethnic-specific (Mexican and Puerto Rican) food patterns were administered to 112 non-pregnant Mexican and Puerto Rican women attending a community health center WIC clinic. Scores from the FFs were summed within nine food groups, and food group means were then examined by Hispanic ethnicity. Puerto Rican women consumed significantly more protein foods, breads, snack foods, and fats and oils than did Mexican women (p

Involving parents in cancer risk reduction: A program for Hispanic American families.

The authors explored changes in dietary behavior, nutrition knowledge, and parental support among inner-city, low-income, Hispanic American families. Thirty-eight families were randomly assigned to receive a 12-week, culture-specific dietary intervention or be in a control group. Results showed that parental support was related to changes in diet, nutrition knowledge, and attendance for both mothers and children. Dietary behavior changes (e.g., reduction in dietary fat) were seen only in the treatment group. Distribution of health-related pamphlets to the control group may have promoted cognitive changes (e.g., increased nutrition knowledge) seen in this low-literacy sample. Further research is needed to document behavioral changes after ethnic-specific interventions and the maintenance of those changes over time.

Pregnancy discovery and acceptance among low-income primiparous women: a multicultural exploration.

Objectives: As part of a larger study exploring psychosocial factors that influence self-care and use of health care services during pregnancy, we investigated the process of pregnancy discovery and acceptance among a culturally diverse group of women who had given birth to their first child in the year preceding data collection. Methods: Eighty-seven low-income women from four cultural groups (African American, Mexican, Puerto Rican, and white) participated in eight focus groups held in their communities. The focus groups were ethnically homogenous and stratified by early and late entry into prenatal care. A social influence model guided the development of focus group questions, and the study followed a participatory action research model, with community members involved in all phases of the research. Results: Issues that emerged from the focus groups as possible influences on timing of pregnancy recognition include the role of pregnancy signs and symptoms and pregnancy risk perception in the discovery process, the role of social network members in labeling and affirming the pregnancy, concerns about disclosure, “planning” status of the pregnancy, and perceived availability of choices for resolving an unintended pregnancy. Conclusions: The pregnancy discovery process is complex, and when protracted, can potentially result in delayed initiation of both prenatal care and healthful pregnancy behaviors. Enhancing our understanding of pregnancy discovery and acceptance has clear implications for primary and secondary prevention. Future research is needed to further explain the trajectory of pregnancy discovery and acceptance and its influence on health behaviors and pregnancy outcome.

Relationship between prenatal antibiotic use and asthma in at-risk children.

BACKGROUND Asthma prevalence has doubled in developed countries during the past 30 years. Pre- and perinatal events are essential in shaping the development of the immune system and systemic antibiotic use during this time could alter the maternal or placental microbiome, leading to an increase in the childs risk of developing asthma. OBJECTIVE To determine whether prenatal antibiotic use is associated with asthma and wheezing in children at risk for asthma. METHODS Using data from a randomized education intervention of families at risk for asthma from 1998 followed through 2009 in urban Chicago, asthma was defined as ever having a physician asthma diagnosis by year 3 and wheezing in the third year. Logistic regression models controlling for confounders investigated the effect of antibiotic use during pregnancy on these outcomes. RESULTS After adjustment, prenatal antibiotic use was a risk factor for asthma (odds ratio 3.1, 95% confidence interval 1.4-6.8) but was only weakly associated with wheezing (odds ratio 1.8, 95% confidence interval 0.9-3.3). Analyses of the effects of timing of prenatal antibiotic use on asthma and wheezing showed the relation remained consistent for antibiotic use later in pregnancy, but the outcomes were not associated with antibiotic use in the first trimester. CONCLUSION This study suggests prenatal antibiotic use might be associated with the development of asthma in children at risk for asthma. Although the relation with prenatal antibiotics does not hold for wheezing in this study, there might be a trend that could be delineated further within a larger cohort study.

Neighborhood socioeconomic change and diabetes risk: Findings from the Chicago childhood diabetes registry

OBJECTIVE To examine whether patterns in socioeconomic characteristics in Chicago over a 30-year period are associated with neighborhood distribution of youth diabetes risk. RESEARCH DESIGN AND METHODS Incident cases of diabetes in youth aged 0–17 years were identified from the Chicago Childhood Diabetes Registry between 1994 and 2003. Those with a type 2 diabetes–like clinical course or related indicators were classified as non–type 1 diabetic; the remaining cases were considered to have type 1 diabetes. RESULTS Compared with stable diversity neighborhoods, significant associations for type 1 diabetes were found for younger children residing in emerging low-income neighborhoods (relative risk 0.56 [95% CI 0.36–0.90]) and older children residing in emerging high-income neighborhoods (1.52 [1.17–1.98]). For non–type 1 diabetes, older youth residing in desertification neighborhoods were at increased risk (1.47 [1.09–1.99]). CONCLUSIONS Neighborhood socioeconomic characteristics in Chicago may be associated with the risk of diabetes in youth.

Use of herbal therapies among midlife Mexican women.

The cultural traditions of Mexican women living in the United States make it likely that some women promote their health and manage their symptoms using various herbal therapies, yet we know little about this phenomenon. The purpose of this study was to describe and compare midlife Mexican women living in the U.S. who were or were not using herbal therapies with regard to the extent of their acculturation, beliefs about herbs, and factors associated with their utilization of health services. A convenience sample of 30 Mexican women between the ages of 40 and 56 years completed face-to-face interviews in either English or Spanish. Nearly half reported using herbal therapies. With the exception of positive beliefs about herbs, we found few differences between herbal users and nonusers on acculturation or access to, and satisfaction with, health services. Although acculturation did not appear to influence whether the women used herbal therapies, it did relate to the types of herbs selected. Women most commonly reported using herbs popular in traditional Mexican culture, including manzanilla (chamomile), savila (aloe vera), ajo (garlic), uña de gato (cats claw), and yerba buena (spearmint).The cultural traditions of Mexican women living in the United States make it likely that some women promote their health and manage their symptoms using various herbal therapies, yet we know little about this phenomenon. The purpose of this study was to describe and compare midlife Mexican women living in the U.S. who were or were not using herbal therapies with regard to the extent of their acculturation, beliefs about herbs, and factors associated with their utilization of health services. A convenience sample of 30 Mexican women between the ages of 40 and 56 years completed face-to-face interviews in either English or Spanish. Nearly half reported using herbal therapies. With the exception of positive beliefs about herbs, we found few differences between herbal users and nonusers on acculturation or access to, and satisfaction with, health services. Although acculturation did not appear to influence whether the women used herbal therapies, it did relate to the types of herbs selected. Women most commonly reported using herbs popular in traditional Mexican culture, including manzanilla (chamomile), savila (aloe vera), ajo (garlic), uña de gato (cats claw), and yerba buena (spearmint).