Patricia Zybert

Body Image, Weight, and Food Choices of Latina Women and Their Young Children

OBJECTIVE To investigate body image perceptions of women about themselves and their young children and their relationship to their food choices and those of their children. DESIGN Descriptive and correlational study. PARTICIPANTS AND SETTING 187 low-income, Latina women and their children, ages 5 to 7 years and 52% female, in New York City. VARIABLES MEASURED Body image, food frequency, body mass index (BMI) of mothers and children, and food choice criteria of mothers for their children. ANALYSIS Descriptive statistics and correlations. RESULTS All of the women selected a relatively thin body image as the most desirable, attractive, fit, and healthy (about 2.5 on a scale of 1-7). Body size dissatisfaction or wish to be thinner was significantly associated with more healthful diets. Tertiles (thirds) of children at the 50th and 75th mean BMI-for-age percentiles were thought to be too thin to be attractive or healthy and the third of children with a mean above the 97th percentile only barely too large. Mothers with the highest body mass indices may make the least healthful choices for their children. CONCLUSIONS AND IMPLICATIONS These Latina women preferred a thin figure for themselves but a plumper figure for their children. Culturally competent nutrition education incorporating body image issues needs to assist mothers in understanding the health consequences of childhood obesity, recognizing when their children are overweight, and understanding the importance of healthful food choices for their children.

Electrophysiologic evidence of piriformis syndrome

Piriformis syndrome (PS) is defined by a loose cluster of symptoms arising from entrapment of one or both divisions of the sciatic nerve as they pass the sciatic notch. This paper presents a method of using the H-reflex as an aid in the diagnosis of PS. Forcible pressure from the piriformis muscle on the sciatic nerve can be induced by internal rotation of an affected limb in an adducted, flexed position. This pressure is reflected in a delay of the H-reflex. The length of delay seen in 39 legs of 34 patients who met the criteria for PS is compared with that seen in 13 unaffected contralateral limbs and 14 limbs from able-bodied subjects. Mean delay of H-reflex was 2.66 msec for affected legs and .36 msec for the combined control groups (t = 7.45, p less than .001). There were no differences in the H-reflexes themselves between groups. Physical therapy aimed at reducing mechanical impingement was successful in 11 of 12 patients on followup at three to nine months.

An autoradiographic study of the uptake and distribution of iron by the brain of the young rat.

Rats aged 15, 28, or 42 days were injected intraperitoneally with iron-59 and were sacrificed at varying intervals. Total acquisition of iron-59 by the brain, when compared to levels of iron-59 in blood sampled 48 h after injection, diminished with increasing age at injection. Cerebral levels of iron-59 in animals injected at age 15 days did not change with postinjection interval despite rapidly decreasing serum levels of iron-59. Thus, iron acquired by the brain early in postnatal development becomes sequestered in that organ. However, autoradiography of the brains of animals injected at age 15 days showed definite changes over time in the anatomic distribution of the isotope. This suggests that mechanisms may exist for the translocation of iron from one area of the brain to another.

Promoting the selection of low-fat milk in elementary school cafeterias in an inner-city Latino community: evaluation of an intervention.

OBJECTIVES This study examined the effects of a school-based intervention designed to promote the consumption of low-fat white milk at lunchtime in 6 elementary schools in an inner-city, primarily Latino neighborhood. METHODS A multifaceted intervention based on social marketing techniques was delivered at 3 randomly selected schools. The school was the unit of assignment and analysis; 6902 children were involved in the study. Milk selection and consumption were measured by sampling discarded milk and/or tallying milk carton disappearance at baseline, immediately postintervention, and at 3 to 4 months follow-up. RESULTS Immediately postintervention, the mean proportion of sampled milk cartons that contained low-fat milk increased in the intervention schools, from 25% to 57%, but remained constant at 28% in the control schools. Differences between intervention and control schools remained significant at 3 to 4 months follow-up. The intervention was not associated with a decrease in overall milk consumption. CONCLUSIONS A school-based intervention can lead to significant increases in student consumption of low-fat milk.

The effect of health education on the rate of ophthalmic examinations among African Americans with diabetes mellitus.

OBJECTIVES This study evaluated a multicomponent educational intervention to increase ophthalmic examination rates among African Americans with diabetes. METHODS A randomized trial was conducted with 280 African Americans with diabetes, enrolled from outpatient departments of 5 medical centers in the New York City metropolitan area, who had not had a dilated retinal examination within 14 months of randomization (65.7% female, mean age = 54.7 years [SD = 12.8 years]). RESULTS After site differences were controlled, the odds ratio for receiving a retinal examination associated with the intervention was 4.3 (95% confidence interval = 2.4, 7.8). The examination rate pooled across sites was 54.7% in the intervention group and 27.3% in the control group. CONCLUSIONS The intervention was associated with a rate of ophthalmic examination double the rate achieved with routine medical care.

The availability of low-fat milk in an inner-city Latino community: implications for nutrition education.

Substitution of low-fat for whole milk is an important strategy for reducing saturated fat consumption, but intake of whole milk remains high among Latinos. To assess whether this is related to the unavailability of low-fat milk, we surveyed 251 grocery stores (bodegas) and 25 supermarkets in a predominantly low-income, urban Latino community. Low-fat milk was available in 73% of bodegas and 96% of supermarkets, but it constituted only 15% of total milk volume in bodegas and 37% of that volume in supermarkets. Since lack of availability was not a major obstacle to increasing low-fat milk consumption, public health nutrition campaigns should focus on increasing consumer demand.

Food sources, dietary behavior, and the saturated fat intake of Latino children.

BACKGROUND Recent recommendations for Americans aged 2 and older call for a reduction in the average saturated fat intake to less than 10% of calories. METHODS Using 24-hour dietary recalls collected from mothers of 4- to 7-year-old urban Latino children, we identified foods and dietary behavior patterns that distinguish children with higher and lower mean daily percentages of calories from saturated fat. RESULTS Compared with children in the lowest quintile of intake, children in the highest quintile consumed more than twice as much saturated fat per day from high-fat milk products (18.5 g vs 7.8 g), mostly from whole milk. They did not consume different kinds of milk or different amounts of milk per eating occasion, but on average they consumed milk more frequently (2.8 vs 1.6 eating occasions per day). Even children in the lowest quintile, on average, exceeded the 10% of calories from saturated fat currently recommended. If low-fat (1% fat) milk had been substituted without other dietary changes, all but the highest two quintiles would have been within the recommended level. CONCLUSIONS The substitution of low-fat for whole milk appears to be a key strategy for preschool children for achieving recommended levels of saturated fat intake.

Relationship of Stigma to HIV Risk Among Women with Mental Illness

Urban women with severe mental illness (SMI) are vulnerable to stigma and discrimination related to mental illness and other stigmatized labels. Stigma experiences may increase their risk for negative health outcomes, such as HIV infection. This study tests the relationship between perceived stigma and HIV risk behaviors among women with SMI. The authors interviewed 92 women attending community mental health programs using the Stigma of Psychiatric Illness and Sexuality Among Women Questionnaire. There were significant relationships between personal experiences of mental illness and substance use accompanying sexual intercourse; perceived ethnic stigma and having a riskier partner type; and experiences of discrimination and having a casual or sex-exchange partner. Higher scores on relationship stigma were associated with a greater number of sexual risk behaviors. The findings underscore the importance of exploring how stigma attached to mental illness intersects with other stigmatized labels to produce unique configurations of HIV risk. HIV risk reduction interventions and prevention research should integrate attention to stigmatized identities in the lives of women with SMI.

MATERNAL AGE AND CHILDREN'S ABILITY

Associations of maternal age at birth and subsequent intelligence test scores of children were examined in a series of over 1500 young men from the Netherlands. All subjects were members of 2-child families and were resident in Amsterdam at age 19 yr. Possible confounding by birth order, spacing interval, social class and sex of sibling were considered. Significant correlations between maternal age and childs ability remained in three of the four possible birth order/social class combinations.

Ophthalmic referral rates for patients with diabetes in primary-care clinics located in disadvantaged urban communities

The level of adherence with recommended standards for ophthalmic examinations was assessed in a purposive sample of diabetic patient charts (n = 350) from four clinics in medically underserved areas. All of the clinics referred patients with diabetes to off-site services for comprehensive eye examinations (dilation, visual acuity, and intraocular pressure); adherence with the standard of care was defined as a chart note indicating a referral for an ophthalmic examination. Overall, 86% of the patients were from high-risk minority groups (black or Hispanic) for diabetes and its complications. Mean age and duration of diabetes were 57.7 and 8.8 years, respectively. Referrals for ophthalmic exams were noted in 18% of the charts during the year preceding the review and in 28.6% of the charts during the 2 preceding years. Annual referrals in the preceding 2 years were noted in 3.1% of the charts. Eye disease was noted as a diagnosis in 22%. Patients who had a diagnosis of eye disease noted in their charts had a 7.5-fold increase in the odds of having a referral noted. The increased likelihood of being referred in patients with known eye disease may be due to follow-up of current eye problems.