Tessa M. Pollard

DEVELOPMENT OF A MEASURE OF THE MOTIVES UNDERLYING THE SELECTION OF FOOD - THE FOOD CHOICE QUESTIONNAIRE

A number of factors are thought to influence peoples dietary choices, including health, cost, convenience and taste, but there are no measures that address health-related and non-health-related factors in a systematic fashion. This paper describes the development of a multidimensional measure of motives related to food choice. The Food Choice Questionnaire (FCQ) was developed through factor analysis of responses from a sample of 358 adults ranging in age from 18 to 87 years. Nine factors emerged, and were labelled health, mood, convenience, sensory appeal, natural content, price, weight control, familiarity and ethical concern. The questionnaire structure was verified using confirmatory factor analysis in a second sample (n = 358), and test-retest reliability over a 2- to 3-week period was satisfactory. Convergent validity was investigated by testing associations between FCQ scales and measures of dietary restraint, eating style, the value of health, health locus of control and personality factors. Differences in motives for food choice associated with sex, age and income were found. The potential uses of this measure in health psychology and other areas are discussed.

Stress, social support and health-related behavior: A study of smoking, alcohol consumption and physical exercise

The effects of academic examination stress on health behavior was assessed in university students. It was hypothesized that the anticipation of examinations would lead to increases in cigarette smoking and alcohol consumption, and to decreases in physical activity, and that effects would be particularly salient in students with low social supports. One hundred eighty students were divided into exam-stress (51 women, 64 men) and control (49 women, 16 men) groups, and were assessed at baseline and then within 2 weeks of exams, or an equivalent point for the control group. Perceived stress, emotional well-being and health behaviors were assessed by questionnaire and interview. The exam-stress group reported significant increases in perceived stress and emotional distress between baseline and exam sessions, but responses were not affected by social support availability. The controls showed no systematic changes in health behaviors. In the exam-stress group, smoking increased by an average of 54.7% between sessions in women with few social supports, but remained stable in men. There was a decrease in alcohol consumption of 17.5% in students with high social support between sessions, while those with low social supports showed an average increase of 18.5%. Physical activity decreased between baseline and exam sessions in the exam-stress group, but was not affected by social support. The results are discussed in relation to the effects of naturally occurring episodic stress on health behaviors, and the role of social support in moderating responses.

Validity of age at menarche self-reported in adulthood

Objective: To test the validity of age at menarche self-reported in adulthood and examine whether socioeconomic position, education, experience of gynaecological events and psychological symptoms influence the accuracy of recall. Design: Prospective birth cohort study. Setting: England, Scotland and Wales. Participants: 1050 women from the Medical Research Council National Survey of Health and Development, with two measures of age at menarche, one recorded in adolescence and the other self-reported at age 48 years. Results: By calculating the limits of agreement, κ statistic and Pearson’s correlation coefficients (r), we found that the validity of age at menarche self-reported in middle age compared with that recorded in adolescence was moderate (κ = 0.35, r = 0.66, n = 1050). Validity was improved by categorising age at menarche into three groups: early, normal and late (κ = 0.43). Agreement was influenced by educational level and having had a stillbirth or miscarriage. Conclusions: The level of validity shown in this study throws some doubt on whether it is justifiable to use age at menarche self-reported in middle age. It is likely to introduce error and bias, and researchers should be aware of these limitations and use such measures with caution.

Use of cortisol as a stress marker: Practical and theoretical problems

Human biologists have shown increasing interest in the use of cortisol as an objective marker of stress in recent years. This paper reviews both practical and theoretical problems raised by this approach. The methodology of cortisol assessment using urine, saliva, and plasma is considered. There are many practical problems involved in obtaining good measures of cortisol, although the availability of salivary assays offers a promising way forward. Theoretical issues are of greater concern. Results of laboratory studies led to the hypothesis that cortisol is elevated when an individual is distressed. However, relatively little work has been done on cortisol variation in “real life,” and the results of such studies do not, in general, conform to this hypothesis. It is concluded that the determinants of cortisol variation are not well understood. For example, cortisol level may be as much influenced by positive emotions as by negative emotions usually identified with stress. Further documentation of cortisol variation in everyday life is needed, and at present it is premature to use cortisol level as a marker of stress.

Predictors of age at menarche in the newcastle thousand families study

Several studies have found relationships between early life factors (birth weight, length of gestation, height, weight, duration of breast-feeding, maternal age, social class, periods of infection, presence of adverse life events, and quality of housing conditions in childhood) and age at menarche but none has considered all of these factors in the same study. The follow-up study of the Newcastle Thousand Families birth cohort, established in 1947, provided age at menarche data collected retrospectively at age 50 from 276 women who returned self-completion questionnaires in 1997. Three main independent associations were observed: girls who experienced a shorter gestation, girls whose mothers were younger when they were born, and girls who were heavier at age 9 had earlier menarche. Birth weight, standardized for gestational age, was found to have different relationships with age at menarche depending upon how heavy or light a girl was at age 9. The results of this study support the hypotheses that conditions in fetal and early life are associated with the timing of menarche and that greater childhood growth is associated with earlier menarche. It is suggested that future work should focus on illuminating the mechanisms underlying these statistical relationships.

Epinephrine and cortisol responses to work: A test of the models of Frankenhaeuser and Karasek

Both Frankenhaeuser and Karasek have put forward models describing how job demand and control influence epinephrine and cortisol levels. These models were tested in a sample of 53 women and 51 men in a variety of occupations. They were studied over one rest day and two working days. Subjects reported their perceived demand and control and their mood on each day, as well as providing urine for assessment of urinary excretion rates of epinephrine and cortisol. In men, but not women, epinephrine levels were higher on the working days than on the rest day, and demand was found to covary positively with epinephrine, supporting Frankenhaeusers model with respect to epinephrine variation in men. However, cortisol levels were not elevated on working days compared to the rest day, and no relationship between job control and cortisol was seen which is in contradiction of Frankenhaeusers model with respect to cortisol variation. There was some suggestion that demand was most strongly associated with elevated epinephrine in men when job control was low in accordance with Karaseks model, but there was no evidence for such an effect with respect to cortisol.

Social networks and coronary heart disease risk factors in South Asians and Europeans in the UK

Objectives. To compare the social networks of South Asian (Indians, Pakistanis and Bangladeshis) and European-origin participants in the Newcastle Heart Project, and to examine the relationships between social network sizes and coronary heart disease (CHD) risk factors in both groups, testing the hypothesis that part of the reason for high rates of CHD in the South Asian UK population may be social isolation. Design. Participants were 684 South Asian (259 Indians, 305 Pakistanis, 120 Bangladeshis) and 825 European men and women aged 25–74 years, who completed a questionnaire and were screened for CHD risk factors in a cross-sectional study. Results. South Asians were more likely to be married than Europeans, had bigger households and were more likely to attend a place of worship regularly. Europeans saw more friends and relatives on a regular basis than did South Asians. There was also some heterogeneity between the South Asian groups. Europeans who reported bigger social networks were less likely to smoke than those with smaller networks, but there was little evidence of an association between social network size and waist circumference, blood pressure or TC:HDL ratio in either Europeans or South Asians. Conclusion. The results provided only partial support for the hypothesis that South Asians in the UK are socially isolated, and suggest that South Asians and Europeans in the UK utilise different sources of social support. Future work should acknowledge variation in sources of social support between ethnic groups, and should explore the possibility that different mechanisms link social support and health in different ethnic groups.

Differences in body composition and cardiovascular and Type 2 diabetes risk factors between migrant and British-born British Pakistani women

There is a high prevalence of cardiovascular disease and Type 2 diabetes in people of South Asian origin living in affluent western countries. We do not know whether or how risk factors for these diseases change in subsequent generations born in the west. Findings that birth‐weight is inversely associated with abdominal obesity and risk of cardiovascular disease and Type 2 diabetes in later life suggest that those born in the west may have lower levels of risk than migrants. We assessed 30 migrants from Pakistan to the UK, 30 British‐born British Pakistani women, and 25 British‐born women of European origin. British‐born British Pakistani women were taller (P = 0.05), had a lower waist to hip ratio (P = 0.04), lower mean fasting glucose levels (P = 0.03), lower mean triglyceride levels (P = 0.03), and higher mean HDL levels (P < 0.001) than migrant British Pakistani women. Levels of fasting insulin, HOMA‐IR, and blood pressure were not significantly different in the two British Pakistani groups. Thus, we found healthier levels of several cardiovascular and Type 2 diabetes risk factors in British‐born British Pakistani women than in migrant British Pakistani women. These findings might be related to the effects of early environment or to other factors, such as differences in health behaviors. British‐born British Pakistani women also differed from British‐born European women, having a more adverse body composition, but healthier levels of HDL cholesterol and blood pressure. Am. J. Hum. Biol., 2008.

Patterns of Cortisol and Adrenaline Variation in Australian Aboriginal Communities of the Kimberley Region

Urinary cortisol and adrenaline excretion rates were measured in three Australian Aboriginal communities in the Kimberley region in the north-west of the country. The three communities, Derby, Kalumburu and Kupungarri, differ in size and remoteness and some lifestyle parameters. Cortisol excretion rate is associated with age and urine flow rate, but there is no association with smoking or the consumption of alcohol. All three communities show very high cortisol excretion rates compared to a sample of UK (Oxford) residents and there are also differences between the three communities. Adrenaline excretion rate also shows associations with age and urine flow rate, but not with smoking. Aboriginal people in the Kimberley region excrete adrenaline at a slightly higher rate than that found in Oxford, which itself is high by world standards. There are no marked differences between communities in their adrenaline excretion rates. Alcohol drinkers in Derby, where alcohol is freely available, have higher adrenaline output than non-drinkers.

Sex, Gender and Health

Preface 1. Sex, gender and health: integrating biological and social perspectives Tessa M. Pollard and Susan Brin Hyatt 2. Parental manipulation of postnatal survival and well-being: are parental sex preferences adaptive? Catherine M. Hill and Helen L. Ball 3. Gender bias in South Asia: effects on child growth and nutritional status Emily K. Rousham 4. Sex, gender and cardiovascular disease Tessa M. Pollard 5. Social meanings and sexual bodies: gender, sexuality and barriers to womens health care Lenore Manderson 6. Poverty and the medicalization of motherhood Susan Brin Hyatt 7. The vanishing woman: gender and population health Patricia A. Kaufert 8. Agency, opposition and resistance: a systemic approach to psychological illness in sub-dominant groups Roland Littlewood.