Sofia Segura-Millán

A comparison of the nutritional status and food security of drug-using and non-drug-using Hispanic women in Hartford, Connecticut

This study compared food insecurity, nutritional status (as measured through anthropometry and dietary intake), and food preparation patterns of low-income Puerto Rican female out-of-treatment drug users with that of low-income Puerto Rican women who reported no drug use. A convenience sample of 41 drug users was compared with 41 age-matched non-drug-users from inner-city Hartford, Connecticut. A culturally appropriate food frequency questionnaire was administered and anthropometric measurements were taken. The findings suggest a high degree of poverty among all study participants, but in particular among drug users. Drug users were more likely than the controls to be food insecure (P < 0.05) and to be exposed to increasingly severe food sufficiency problems. The daily frequency of consumption of vegetables was lower (P = 0.03) for drug users than non-drug-users. Conversely, the frequency of consumption for sweets/desserts was significantly higher for drug users than the controls (P = 0.0001). Drug users, who were classified as food insecure were less likely to consume vegetables (P = 0.004) and fish (P = 0.03) than were controls who were food insecure. When comparing drug users with controls, the former group reported consuming fewer meals during a usual week than the latter group (P < 0.0001). Drug users were more likely to fry foods (P = 0.02) while the controls were more likely to bake (P = 0.005), boil (P = 0.02), and steam (P = 0.002) foods. All anthropometric measurements, except for height, were significantly lower for drug users. The results show that drug users generally maintain poorer nutritional status than non-drug-users. Nutrition interventions as part of drug treatment are needed.

Determinants of lactation performance across time in an urban population from Mexico

We identified determinants of breastfeeding and full breastfeeding among 165 healthy mothers from Hermosillo, Mexico who planned to breastfeed and delivered vaginally a healthy term infant. Deliveries took place in either a nursery (n = 58) or a rooming-in (n = 107) public hospital where formula supplementation was not allowed. Multivariate analyses indicated that at 1 week full breastfeeding was associated (P < or = 0.05) with early milk arrival, social support for full breastfeeding and planned breastfeeding duration. At 2 months, full breastfeeding was associated with social support for full breastfeeding and early milk arrival. Breastfeeding was positively associated with early milk arrival and inversely associated with early introduction of supplementary bottles, maternal employment, maternal body mass index and infant age. At 4 months, full breastfeeding was positively associated with social support for full breastfeeding and inversely associated with infant age. Breastfeeding was positively associated with planned breastfeeding duration and inversely associated with early introduction of a bottle and urban background. Rooming-in mothers reported that their milk came in earlier (P < or = 0.05) than did the nursery group. Milk arrival was later when a bottle was introduced in the first week; both of these variables might be important in explaining a positive effect of rooming-in on lactation performance.

Prenatal and Perinatal Factors Associated with Breast-Feeding Initiation among Inner-City Puerto Rican Women

OBJECTIVE To identify factors associated with the initiation of breast-feeding in a predominantly Puerto Rican population living in inner-city Hartford, Conn. DESIGN Retrospective study of 144 Latino women (mean +/- standard deviation age = 26.3 +/- 5.7 years) with children at least 1 year old but younger than 6 years old (mean +/- standard deviation age = 3.0 +/- 1.2 years) at the time of the survey. Women were recruited from agencies sponsoring health programs for mothers and children. They were interviewed in their homes (69%) or at the Hispanic Health Council, Hartford, Conn (31%). SUBJECTS/SETTING Low-income Latino women who had at least 1 preschooler at the time of the interview. The women lived in inner-city Hartford, and the overwhelming majority were Puerto Rican and received welfare assistance and food stamps. Seventy-eight percent of the women chose to be interviewed in Spanish; the other 22% were interviewed in English. STATISTICAL ANALYSES Explanatory variables that related to breast-feeding initiation (P < or = .2) in bivariate chi 2 analyses were entered into a multivariate logistic regression model that was reduced using backward stepwise elimination procedures. RESULTS Multivariate analyses indicated that breast-feeding the previous child, shorter length of maternal residence in the United States, not receiving prenatal bottle-feeding advice, more recent birth, and higher birth weight were positively associated with breast-feeding initiation. A major reason for choosing not to breast-feed was that women felt socially uncomfortable doing it. APPLICATIONS Breast-feeding initiation was more likely in Latino women who received prenatal breast-feeding counselling and postpartum support. Mothers of low-birth-weight infants and women breast-feeding for the first time may need additional help. These findings can be used by programs like the Special Supplemental Nutrition Program for Women, Infants, and Children to increase breast-feeding initiation.

Effect of the maternity ward system on the lactation success of low-income urban Mexican women.

We compared the lactation performance of 165 healthy mothers who planned to breastfeed and gave birth by vaginal delivery, without complications to a healthy infant in either a nursery (NUR) (n = 58) or a rooming-in hospital where formula supplementation was not allowed. In the rooming-in hospital, women were randomly assigned to a group that received breastfeeding guidance during the hospital stay (RIBFG) (n = 53) or to a control group (RI) (n = 54). Women were interviewed in the hospital and at 8, 70 and 135 days post-partum (pp). The groups were similar in socio-economic, demographic, anthropometric, previous breastfeeding experience and prenatal care variables. Non-parametric survival analyses adjusting for potential confounding factors show that breastfeeding guidance had a positive impact (P < or = 0.05) on breastfeeding duration among primiparous women who delivered in the rooming-in hospital. Among primiparae, the RI and RIBFG groups had higher (P < or = 0.05) full breastfeeding rates than the NUR group in the short term. In the longer term, only the difference between the RIBFG and the NUR group remained statistically significant. The maternity ward system did not have a statistically significant effect on the lactation performance of multiparae.

Food habits of drug‐using Puerto Rican women in inner‐city Hartford

Research on the impact of heroin, cocaine, and other drugs on the dietary patterns of drug users is limited. This paper presents qualitative data from Project SANA (Salud y Nutricion en Addicion/Health and Nutrition in Addiction) on the food habits of drug‐using Puerto Rican women in inner‐city Hartford, Connecticut. The results indicate that both the quantity and the quality of food intake are inadequate in this group of women. The physiological and psychological effects of drugs, coupled with poverty, homelessness, and difficulty in accessing food assistance, jeopardize the health and well‐being of drug users and their children. The results underscore the importance of integrating nutrition education with drug‐treatment services for drug‐using women in the inner city.

Nutrition knowledge, attitudes, and behaviors among latinos in the USA : Influence of language

The objectives of this study are to: (a) assess Latinos nutrition knowledge, attitudes, behaviors, and sources of nutrition information, and (b) examine the association of these with language use at home. Household‐to‐household interviews were conducted in five predominantly Latino neighborhoods in Hartford, Connecticut in households with at least one child ≤ 12 years of age. The typical Latina respondent was a woman in her early 30s who was the mother of at least one child living in the household (N = 426). The vast majority of Latinos were Puerto Rican (95.8%) and they spoke only Spanish (41.8%), only English (6.1%) or both English and Spanish (52.1%) at home. As many as 73.9% of respondents received food stamps and only 9.2% had more than high school education. Respondents were familiar with the USDAs Food Guide Pyramid (93.4%) and with food labels (93.7%). Fifteen percent knew the recommended servings for breads and cereals and 18.3% reported reading food labels always. Respondents had a positive nutrition attitude but lacked specific knowledge of terms such as “saturated fat” and “neural tube defects”, and were unable to identify good food sources of folate, calcium, and vitamin A. Friends/relatives, doctor, WIC, and television were the main sources of nutrition information. Speaking only Spanish at home (vs English or English and Spanish) was associated with nutrition knowledge and attitudes, and a more traditional pattern of food consumption.

Development of a Color-Coded Bilingual Food Label for Low-Literacy Latino Caretakers

Abstract The purpose of this study was to develop a bilingual, user-friendly food label (UFFL) for low-literacy audiences. The UFFL developed was based on (a) a quantitative and qualitative needs assessment of Food and Drug Administration (FDA) food label understanding and use, (b) the development of a UFFL, and (c) a qualitative evaluation of the UFFL. Subjects consisted of a convenience sample (N = 150) of low-income Latino caretakers living in Hartford with children under 6 years of age, who were recruited from local community agencies.The primary outcomes measured in this study were food label use, knowledge, and understanding. Chi-square analyses were conducted to determine relationships between subjects’ socioeconomic status and demographic characteristics with food label use, knowledge, and understanding. Although 96% of respondents were familiar with the FDA food label, only 30% used it routinely when grocery shopping. FDA food label knowledge was positively associated (p ≤ .05) with younger age, level of education, and being an English speaker. A UFFL was developed that included color coding, bilingual text, and a shaded Food Guide Pyramid. Results indicated that participants found the UFFL easy to understand. The UFFL can be used as a nutrition education tool and the methodology developed may help food policy makers to improve the nutrition education value of the FDA food label.