Roman Pawlak

Benefits, barriers, self-efficacy and knowledge regarding healthy foods : perception of African Americans living in eastern North Carolina

African Americans in the United States suffer from many health disparities such as obesity, diabetes or hypertension. Lifestyle factors including diet and physical activity play an important role in prevention of these health conditions. The purpose of this research project was to assess beliefs, barriers and self-efficacy of eating a healthy diet and self efficacy of shopping for foods such as whole grains or foods designated as low fat or low sodium. Additionally, the objective was to assess beliefs about healthfulness, appropriate consumption, and protective aspect of specific foods including fruits, vegetables, and whole grains. The assessment was done using a survey instrument developed for this study. Data collection took place at two church locations. Data were obtained from 57 African Americans, mean age 50 years old (SD 12.70) completed the survey. The majority of respondents (58.1%) were females and most (75%) had at least some college education. Generally, benefits of eating healthy foods received considerably higher scores compared to barriers of eating healthy. A belief that healthy foods would help to take care of ones body received the highest mean score while a belief that healthy foods are too expensive had the highest score from all barriers. The results showed high self-efficacy of eating and purchasing healthy foods, high awareness of knowledge regarding foods associated with disease prevention but low awareness of recommendations for fruits and vegetables. The high scores for benefits, self-efficacy and knowledge regarding eating healthy foods did not translate into the perception of intake of such foods. Most participants believed that they do not eat enough of healthy foods. Interventions design to help African Americans make dietary changes should be culturally relevant and should involved working on a community level utilizing messages that are familiar and relevant to African Americans.

Is Vitamin B12 Deficiency a Risk Factor for Cardiovascular Disease in Vegetarians

The goal of this paper is to describe the role of vitamin B12 deficiency in cardiovascular disease development among vegetarians. Vegetarians have a high prevalence of vitamin B12 deficiency. Deficiency of this vitamin is associated with a variety of atherogenic processes that are mainly, but not exclusively, due to vitamin B12 deficiency-induced hyperhomocysteinemia. Each 5-μmol/L increase above 10 μmol/L of serum homocysteine is associated with a 20% increased risk of circulatory health problems. Mean homocysteine concentration >10 μmol/L among vegetarians was reported in 32 of 34 reports. Macrocytosis associated with vitamin B12 deficiency is also associated with fatal and non-fatal coronary disease, myocardial infarction, stroke, and other circulatory health problems. Compared with non-vegetarians, vegetarians have an improved profile of the traditional cardiovascular disease risk factors, including serum lipids, blood pressure, serum glucose concentration, and weight status. However, not all studies that assessed cardiovascular disease incidence among vegetarians reported a protective effect. Among studies that did show a lower prevalence of circulatory health problems, the effect was not as pronounced as expected, which may be a result of poor vitamin B12 status due to a vegetarian diet. Vitamin B12 deficiency may negate the cardiovascular disease prevention benefits of vegetarian diets. In order to further reduce the risk of cardiovascular disease, vegetarians should be advised to use vitamin B12 supplements.

Theory of Planned Behavior and Multivitamin Supplement Use in Caucasian College Females

The objective of this study was to identify predictors of the use of multivitamin supplements (MVS) among Caucasian college females utilizing the Theory of Planned Behavior (TPB). Variables of the TPB and the self-reported use of multivitamin supplements were measured by two separate surveys within 1 week with a convenience sample of 96 Caucasian college student females. Two attitudinal beliefs and one control belief significantly predicted behavioral intention to use multivitamin. A belief that taking multivitamin supplements helps to feel and look good was the most important predictor of the use of multivitamin supplements. Editors’ Strategic Implications: Findings from this study, although in need of replication, suggest that prevention campaigns would be more successful if messages used to reach these females were consistent with perceived beliefs regarding benefits of using MVS. More broadly, TPB appears to offer a useful framework for understanding or predicting behavior based on psychological constructs theorized to influence behavior.

Understanding Vitamin B12

Vitamin B12 (B12) is essential in activating folate needed in DNA synthesis. Inadequate intake results in the impairment of nerve transmission and inadequate synthesis of erythrocytes and other hematological cells. Two separate mechanisms of B12 absorption exist, a receptor-mediated endocytosis that occurs in the distal ileum and the mass-action pharmacologic mechanism. The recommended dietary allowance for B12 for adults issued by the Institute of Medicine is 2.4 µg/d. B12 is only found in meats and other foods of animal origin. B12 deficiency is widespread. Two main causes of deficiency include inadequate absorption and intake. Elderly and vegetarians are at highest risk for deficiency. Prevalence of deficiency ranges from 7% of the US population 3 years and older to 90% among vegans. The best way to assess deficiency is by using methylmalonic acid. Populations at risk could benefit from using B12 supplements and from fortification of flour.

The Use of the Theory of Planned Behavior to Assess Predictors of Intention to Eat Fruits Among 9th‐Grade Students Attending Two Public High Schools in Eastern North Carolina

Objective: The purpose of this study was to identify specific beliefs regarding eating two cups of fruits among ninth-grade youth attending public high schools in easternNorth Carolinautilizing the Theory of Planned Behavior (TPB). Methods: A preliminary open-ended questionnaire was used to elicit beliefs about fruits. These beliefs along with statements adopted from the literature tailored toward fruit intake were used to develop a survey instrument. This survey was subsequently used to measure the variables of the TPB. There were 157 students (103 girls [65.6%], mean ±SD age =14.69 ±0.79 and 54 boys [34.4%], mean ±SD age = 14.74 ±0.89) from two schools who completed the final copy of the survey. Results: Attitude, subjective norms, and perceived behavioral control significantly predicted intention to eat fruits, accounting for 55% of variance. Conclusion: The findings of this research suggest that peer leaders may have a significant influence on intentions to eat fruits.

Predictors of Intention to Eat 2.5 Cups of Vegetables among Ninth-grade Students Attending Public High Schools in Eastern North Carolina

OBJECTIVE To identify beliefs about eating 2.5 cups of vegetables and to assess how well these beliefs predict intention to eat them. DESIGN A survey based on the Theory of Planned Behavior. SETTING Two public high schools in 2 counties in eastern North Carolina. PARTICIPANTS 157 ninth-grade students (mean age = 14.71 years [SD = 0.82]). ANALYSIS Regression analysis was performed to assess how well the variables of the Theory of Planned Behavior predicted behavioral intention to eat 2.5 cups of vegetables. FINDINGS Attitude, subjective norms, and perceived behavioral control predicted 77.2% of variance of intention to eat 2.5 cups of vegetables (F [3, 154] = 178.05, P < .001). Attitude was the strongest predictor (beta = 0.434, P < .001), followed by subjective norms (beta = 0.372, P < .001) and perceived behavioral control (beta = 0.159, P < .021). CONCLUSIONS AND IMPLICATIONS Factors such as impact of parents and peers, availability of vegetables at home and in school, and making sure that vegetables offered to teens are tasty are important in increasing their intention to eat the recommended amount of vegetables. These factors could help education campaigns targeted toward teens be more successful.

REMOVED: Position of the Academy of Nutrition and Dietetics: Vegetarian Diets

It is the position of the Academy of Nutrition and Dietetics that vegetarian diets can provide health benefits in the prevention and treatment of certain health conditions, including atherosclerosis, type 2 diabetes, hypertension, and obesity. Well-designed vegetarian diets that may include fortified foods or supplements meet current nutrient recommendations and are appropriate for all stages of the life cycle, including pregnancy, lactation, infancy, childhood, and adolescence. Vegetarians must use special care to ensure adequate intake of vitamin B-12. Vegetarian diets are primarily plant-based, comprised of grains, legumes, nuts, seeds, vegetables, and fruit; do not include flesh foods (beef, pork, poultry and fowl, wild game, and fish); and may or may not include some animal products, such as dairy (milk and milk products), eggs, and processed foods that contain casein or whey. Although vegetarians may have a higher deficiency risk for some nutrients (eg, vitamin B-12) compared to nonvegetarians, nutritional deficiencies are not the main causes of mortality or morbidity in Western societies. Vegetarian diets are associated with a lower risk of ischemic heart disease, hypertension, type 2 diabetes, obesity, and some types of cancer; low-fat vegetarian diets, in combination with other healthy lifestyle factors, have been shown to be effective in the treatment of these diseases. Vegetarians have lower low-density lipoprotein, better serum glucose control, and lower oxidative stress. Low intake of foods containing saturated fat and cholesterol, and high intake of vegetables, fruits, whole grains, legumes, nuts and seeds, and soy products that are rich in fiber and phytochemicals are components of a vegetarian diet that contribute to reduction of chronic disease.

Vegetarian Diets in the Prevention and Management of Diabetes and Its Complications

IN BRIEF Epidemiological studies have found a lower prevalence of type 2 diabetes among vegetarians compared to nonvegetarians. This reduced risk is likely a function of improved weight status, higher intake of dietary fiber, and the absence of animal protein and heme iron in the diet. Interventional studies have shown that vegetarian diets, especially a vegan diet, are effective tools in glycemic control and that these diets control plasma glucose to a greater level than do control diets, including diets traditionally recommended for patients with diabetes (e.g., diets based on carbohydrate counting). Vegetarian diets are associated with improvement in secondary outcomes such as weight reduction, serum lipid profile, and blood pressure. Studies indicate that vegetarian diets can be universally used in type 2 diabetes prevention and as tools to improve blood glucose management.

Prevalence of vitamin B-12 deficiency among patients with thyroid dysfunction

Due to the non-specificity of symptoms and possibly severe consequences of untreated vitamin B-12 deficiency, screening is important for at-risk patients to ensure the prompt delivery of treatment. In this review, studies assessing the prevalence of vitamin B-12 deficiency in thyroid dysfunction are evaluated to determine whether regular vitamin B-12 screening is necessary. A literature search was conducted using multiple electronic databases. Only original studies assessing the prevalence of vitamin B-12 deficiency in thyroid dysfunction that reported their findings as percentages of the sample were eligible for inclusion. From a total of 7091 manuscripts generated, 6 were included in this review. The prevalence of vitamin B-12 deficiency in hypothyroidism was reported as 10, 18.6, and 40.5% in three separate studies. The prevalence of deficiency in autoimmune thyroid disease was reported as 6.3, 28, and 55.5% in three studies. The prevalence of vitamin B-12 deficiency in hypothyroidism and autoimmune thyroid disease are reflective of the nutrition status of the population. Autoimmune thyroid disease is also associated with the autoimmune disorders pernicious anemia and atrophic gastritis which may lead to malabsorption of vitamin B-12. Vitamin B-12 screening is recommended upon initial diagnosis with autoimmune thyroid disease and then periodically thereafter. There is not enough evidence to recommend regular screening for patients with hypothyroidism unless the underlying cause is autoimmune thyroid disease.

The Impact of Pistachio Consumption on Blood Lipid Profile: A Literature Review

Studies showed that nut consumption is associated with a reduced risk in cardiovascular disease (CVD) mortality and morbidity and an improvement in the modifiable CVD risk factors. Our objective was to review studies that reported the effect of pistachios intake on blood lipid profile. A PUBMED and Loma Linda University Nut Library database search was conducted to identify relevant studies. Eight relevant studies were identified and included in the review. With a few exceptions, the results showed a consistent improvement in serum lipid profile, improving all cholesterol fractions. With one exception, all studies reported a large decrease in the mean LDL-cholesterol ranging from 7.6 to 9.7% of the baseline level. In four of the seven studies that reported a change in HDL-cholesterol level, the mean HDL-cholesterol increased after the intervention. In all but one studies that reported the change in TG, the post-test values were reduced. The majority of the studies reported statistically significant reduction in the mean TC and LDL-cholesterol fractions. Similarly, all studies that reported a change in TC/HDL-cholesterol and LDL-cholesterol/HDL-cholesterol ratios reported a statistically significant improvement. Adding pistachios to a typical diet of normo and hypercholesterolemic individuals have a beneficial effect on blood lipid profile.