Race/ethnicity, psychological distress, and fruit/vegetable consumption. The nature of the distress-behavior relation differs by race/ethnicity

Fruit and Vegetable Consumption Among Adolescent Secondary School Students in Boukombe and Natitingou, North Benin

Fruit and vegetables (F&V) are recommended for a healthy life. Adolescence is a critical period for the onset of eating disorders and future health. F&V consumption among adolescents is globally low, making this group a key target for diet/nutrition-related interventions. This cross-sectional study aimed to assess F&V consumption among secondary school students in the food-insecure communes of Boukombe (rural) and Natitingou (urban), Benin. Using probabilistic random sampling, 303 students completed F&V intake frequency questionnaires and 24-h dietary recalls on school and non-school days. Poisson models identified factors associated with F&V consumption. The results showed that only 8.8% (Boukombe) and 11% (Natitingou) of students consumed fruit at least twice per day, and over 80% of students had not eaten fruit in the preceding 24 h; 9.9% and 11.4%, respectively, consumed vegetables at least twice per day. On average, 45.5% of students in Boukombe and 68% in Natitingou consumed at least three types of vegetables on school days. The most commonly consumed fruits were oranges in Boukombe and lemons in Natitingou. Factors influencing fruit consumption included sex (p = 0.005), age (p = 0.04), and mothers' occupation (p = 0.03) on school days/and school or non-school days, while commune (p = 0.00017) and ethnic group affected vegetable consumption. Such low F&V consumption among surveyed students is a matter of public health concern, as it is likely to affect their health-in terms of micronutrient deficiency-and intellectual performance. These results should incentivize nutrition researchers, project managers, public health officials, and policymakers to (re)design and implement broader measures targeting secondary school students' dietary practices to increase their F&V consumption.

Associations of positive and negative affect on health risk behaviors among Latinos

OBJECTIVE

Negative affect is widely emphasized in behavior modification interventions. However, positive affect is associated with smoking cessation, physical activity, and healthy dietary habits and may be an important treatment target. Few studies have examined the relationship between positive affect and health behaviors among Latinos, who disproportionately experience modifiable health risk behaviors. This study examined the independent associations of positive affect and negative affect on modifiable health risk behaviors among Latino adults.

METHOD

Data came from 432 persons who participated in one of two studies examining determinants of modifiable health risk behaviors among Latino adults. Primary outcomes were current smoking, at-risk drinking, insufficient physical activity, and insufficient fruit and vegetable consumption. Predictors were positive and negative affect as measured by the Positive and Negative Affect Schedule. Associations between positive and negative affect and health risk behaviors were examined using multiple logistic regression.

RESULTS

Positive affect was associated with lower odds of insufficient physical activity and insufficient fruit and vegetable consumption and lower odds of engaging in multiple health risk behaviors. Negative affect was associated with higher odds of at-risk drinking and current smoking.

CONCLUSIONS

Emphasis on increasing positive affect may be warranted for multiple health risk behavior interventions targeting Latinos. Intervention development efforts may also consider prioritizing positive affect for physical activity and dietary interventions, and negative affect for at-drinking and smoking cessation interventions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Differences in Dietary Patterns among the Polish Elderly: A Challenge for Public Health

The aim of the study was to assess the diversity of dietary patterns within the elderly, in relation to the region of residence, household structure, and socioeconomic status. The questionnaire was conducted in a group of 427 Polish adults aged 60 and older from June to September 2019. The sample was selected by means of the snowball method in two regions. Principal component analysis (PCA) was used to extract and identify three dietary patterns (factors) from the frequency of eating 32 groups of foods. Logistic regression analysis was used to determine the relationship between the identified dietary patterns (DPs), region, household status, and socioeconomic index (SES). Adherence to the identified DPs, i.e., traditional, prudent, and adverse, was associated with socioeconomic status (SES) and living environment, i.e., living alone, with partner, or with family, while the region did not differentiate them. Less people living with their family were characterized by the frequent consumption of traditional food (the upper tertile of this DP), while more of them often consumed food that was typical for both prudent and adverse DPs (the upper tertiles of these DPs). The presence of a partner when living with family did not differentiate the adherence to DPs. A high SES decreased the chances of adhering to the upper tertiles of the “prudent” and “traditional” DPs, while living with family increased the chances of adhering to both the upper and middle tertiles of the “prudent” DP. Identifying the dietary patterns of the elderly contributes to a better understanding of the food intake of the senior citizens living in different social situations, in order to support public policies and nutritional counseling among this age group.

Exploring Pathways of Socioeconomic Inequity in Vegetable Expenditure Among Consumers Participating in a Grocery Loyalty Program in Quebec, Canada, 2015-2017

Vegetable consumption remains consistently low despite supportive policy and investments across the world. Vegetables are available in great variety, ranging in their processing level, availability, cost, and arguably, nutritional value. A retrospective longitudinal study was conducted in Quebec, Canada to explore pathways of socioeconomic inequity in vegetable expenditure. Data was obtained for consumers who participated in a grocery loyalty program from 2015 to 2017 and linked to the 2016 Canadian census. Vegetable expenditure share (%) was examined as a fraction of the overall food basket and segmented by processing level. Panel random effects and tobit models were used overall and to estimate the stratified analysis by median income split. Consumers allocated 8.35% of their total food expenditure to vegetables, which was mostly allocated to non-processed fresh (6.88%). Vegetable expenditure share was the highest in early winter and lowest in late summer. In the stratified analysis, the low-income group exhibited less seasonal variation, allocated less to fresh vegetables, and spent more on canned and frozen compared to the high-income group. Measures of socioeconomic status were all significant drivers of overall vegetable consumption. Consumers with high post-secondary education in the low-income group spent 2% more on vegetables than those with low education. The complexity of observed expenditure patterns points to a need for more specific vegetable consumption guidelines that include provisions by processing level. Implications for education, marketing, intersectional policies, and the role of government are discussed. Governments can scale present efforts and catalyze health-promoting investments across local, state, national, and global food systems.

Variations in Relationships Between Perceived Stress and Birth Outcomes by Immigration Status

INTRODUCTION

Past research shows that stress during pregnancy predicts adverse birth outcomes. These patterns might differ based on immigration status. Our objective was to analyze differences in relationships between perceived stress during pregnancy and birth outcomes by immigration status.

METHODS

We recruited 81 pregnant women in Canada for a prospective longitudinal study of stress during pregnancy and infant development. Participants completed the Perceived Stress Questionnaire at 16-18, 24-26 and 32-34 weeks of pregnancy. Birth records were available for 73 women, including 24 non-immigrants, 18 long-term immigrants (≥ 5 years), and 31 recent immigrants (< 5 years). We used General Linear Models to test relationships between perceived stress and birthweight, birthweight for gestational age Z-scores, and gestational age, and differences based on immigration status.

RESULTS

Controlling for sociodemographic covariates, we observed interactive relationships between immigration status and perceived stress with birthweight at 16-18 (p = 0.032, partial η² = 0.11) and 24-26 weeks pregnancy (p = 0.012, partial η² = 0.15). Results were similar for birthweight for gestational age Z-scores at 16-18 weeks (p = 0.016, partial η² = 0.13) and 24-26 weeks pregnancy (p = 0.013, partial η² = 0.14). Perceived stress predicted smaller birthweight measurements among long-term immigrants. No relation was found between perceived stress, immigration status and gestational age.

DISCUSSION

Risk of adverse health outcomes, including birth outcomes, tends to increase with duration of residence among immigrants. Stress during pregnancy might represent one risk factor for adverse birth outcomes among long-term immigrant women. Promoting psychosocial health screening and care among immigrant women, and assuring continued care with acculturation, might improve both maternal and infant health outcomes.

Revisiting nutrition backlash: Psychometric properties and discriminant validity of the nutrition backlash scale

OBJECTIVES

Nutrition backlash is a disposition defined by negative feelings about dietary recommendations. Past research has measured nutrition backlash using the nutrition backlash scale (NBS) and found that it is negatively related to the consumption of fruits and vegetables. The aim of this study was to examine several aspects of the NBS, including factor structure, discriminant validity, and relationship to demographic characteristics and health behaviors.

METHODS

Adults were recruited to participate in two studies. Study 1 (N = 480) included measures of nutritional backlash, information overload, worry, fatalism, and nutrition-related behaviors. Study 2 (N = 399) was a follow-up that examined the factor structure of the NBS in a separate sample.

RESULTS

In study 1, a six-item version of the NBS was found to be a good fit for the data and discriminant from overload, worry, and fatalism. NBS was higher for those with less education, non-white participants, and men. Individuals with higher backlash were less likely to look at nutritional labels and to use sunscreen. Study 2 confirmed the factor structure from study 1.

CONCLUSIONS

A six-item version of the NBS was found to be reliable, discriminant from related measures, higher in underserved groups (less-educated, non-white, and male participants), and related to nutrition label use.

Socioenvironmental adversity and risk of prostate cancer in non-Hispanic black and white men

Non-Hispanic black (NHB) men experience higher risk of prostate cancer than other racial/ethnic groups, and it is possible that socioenvironmental (SE) adversity and resulting stress may contribute to this disparity. Data from the Southern Community Cohort Study were used to evaluate associations between SE adversity and perceived stress in relation to prostate cancer risk, overall and by race/ethnicity and grade. Between 2002 and 2009, 26,741 men completed a questionnaire, from which an 8-item SE adversity composite was created (covering socioeconomic status, residential environment, and social support/buffers). Two items from the Perceived Stress Scale were assessed. With follow-up through 2011, 527 prostate cancer cases were diagnosed. In multivariable models, each one-unit increase in the SE adversity composite was associated with increased prostate cancer risk among non-Hispanic white (NHW) men (HR 1.23; 95% CI 1.02-1.48) and reduced risk among NHB men (HR 0.89; 95% CI 0.82-0.95) (p interaction: 0.001). This pattern held for low grade, but not high grade, cancers although power was limited for the latter. Perceived stress variables were associated with increased risk of prostate cancer among NHW men, but not among NHB men. Results do not support the hypothesis that SE adversity my underlay the racial disparity in prostate cancer, over and above that of covariates, including healthcare utilization.

Relationships between psychological distress and health behaviors among Canadian adults: Differences based on gender, income, education, immigrant status, and ethnicity

Objective

Psychosocial health predicts physical health outcomes in both clinical samples and the general population. One mechanism is through relationships with health behaviors. Results might differ based on sociodemographic characteristics such as education, income, ethnicity, and immigrant status. Our objective was to analyze sociodemographic differences in relationships between psychosocial health measures and health behaviors in the general population of Canadian adults.

Methods

We analyzed relationships between non-specific psychological distress, assessed using the Kessler-10 scale, and five key health behaviors: fruit and vegetable intake, screen sedentary behavior, physical activity, alcohol consumption, and cigarette use. Data were collected by Statistics Canada for the Canadian Community Health Survey in 2011–2014. Our sample included 54,789 participants representative of 14,555,346 Canadian adults. We used univariate general linear models on the weighted sample to analyze relationships between distress (predictor) and each health behavior, controlling for age. We entered sex and one of four sociodemographic variable of interest (education, income, ethnicity, immigrant status) into each model to analyze gender and sociodemographic differences in relationships.

Results

Greater distress predicted less fruit and vegetable intake and physical activity, and greater screen sedentary behavior and cigarette use, in the full sample, with small effect sizes (partial η² up to 0.013). Differences by gender and sociodemographic characteristics were evident for all health behaviors.

Conclusions

Psychosocial health might contribute to persistent socioeconomic disparities in health in part through relationships with health behaviors, although relationships in the general population are modest. Health behavior interventions incorporating psychosocial health might need to be tailored based on socioeconomic characteristics, and future research on intersections between multiple sociodemographic risk factors remains necessary.

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Past studies show relationships between psychosocial health and health behaviors.

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Relationships might differ based on sociodemographic characteristics.

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We analyzed distress and five health behaviors in a nationally representative sample.

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Relationships differed based on gender, education, income, immigration status, and ethnicity.

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Modest relationships observed might be important given persistent health disparities.

Associations of psychosocial factors with pregnancy healthy life styles

Healthy behaviors in pregnant women have a major effect on pregnancy outcomes; however, only few studies have explored the relationship of multiple psychosocial factors with healthy lifestyles during pregnancy. The objective of this study was to investigate whether the five psychosocial factors of anxiety, stress, depression, marital dissatisfaction, and social support are associated with six domains of healthy lifestyles in pregnant women, including nutrition, physical activity, health responsibility, stress management, interpersonal relationships, and self-actualization. In this cross-sectional study, 445 pregnant women from the obstetrics clinics of the teaching hospitals of Babol University of Medical Sciences were included. The subjects answered six questionnaires, including the Health-Promoting Lifestyle Profile, Beck Depression Inventory, Prenatal Distress Questionnaire, State-Trait Anxiety Inventory, Social Support Questionnaire, and Marital Satisfaction Scale. We developed a series of simple linear regression models based on each subscale of lifestyle (nutrition, physical activity, health responsibility, stress management, interpersonal relationships, and self-actualization) as the dependent variables and the five psychological variables (anxiety, stress, depression, marital dissatisfaction, and social support) as the independent variables. State and trait anxieties were the strongest negative predictors of all aspects of a healthy lifestyle. Furthermore, depression was negatively associated with all of the six subscales of a healthy lifestyle. Pregnancy-specific stress was the only negative predictor of stress management and self-actualization. Marital dissatisfaction was negatively associated with nutrition, stress management, health responsibility, and self-actualization. Social support had negative and positive associations with healthy behaviors. The study suggests that more attention should be paid to identifying the psychological risk factors in pregnancy in addition to providing suitable interventions for improving the lifestyle of pregnant women.

Stress, sleep, depression and dietary intakes among low-income overweight and obese pregnant women

This study investigated the mediating roles of sleep and depression on the relationships between stress, fat intake, and fruit and vegetable intake among low-income overweight and obese pregnant women by trimesters. Participants (N = 213) completed a self-administered survey including stress (exogenous variable), depression, sleep (mediators), fat intake, and fruit and vegetable intake (endogenous variables). Path analysis was performed to compare mediation effects among pregnant women in each trimester. Consistently across three trimesters, stress was related to depression but not sleep duration, night time sleep disturbance, sleep quality, sleep latency or fat intake. Sleep duration was not associated with depression. Depending on trimester, night time sleep disturbance, sleep quality, and sleep latency were related to depression; night time sleep disturbance and depression affected fat intake; stress influenced fruit and vegetable intake. Sleep duration, sleep disturbance, sleep quality, sleep latency and depression did not mediate the relationships between stress, fat intake, and fruit and vegetable intake in the second and third trimesters. However, depression mediated the relationship between stress and fat intake in the first trimester. Stress management interventions may help low-income overweight and obese pregnant women decrease depressive symptoms and therefore contribute to overall nutritional health.

Stress, shift duty, and eating behavior among nurses in Central Saudi Arabia

OBJECTIVES

To investigate the association between stress, shift work, and eating behavior among non-Saudi female nurses working in Central Saudi Arabia.

METHODS

A sample of 395 non-Saudi female nurses from 2 major hospitals in Riyadh, Kingdom of Saudi Arabia participated in this cross-sectional study. The nurses completed a questionnaire from November 2013 to January 2014 that included items relating to stress and eating behavior using the Dutch Eating Behavior Questionnaire (DEBQ). The questionnaire also contained items pertaining to socio-demographic data, body mass index, shift work, and hours worked per week. 

RESULTS

For all eating styles, stress, and shift duty influenced the amount of food nurses consumed, but was more significant under a restrained eating style. Under this eating style, a significantly higher percentage of nurses reported eating more fast food, snacks, and binging, while fruits and vegetables were the least likely to be eaten under stress. High stressed nurses were more likely to present with abnormal restrained eating (odds ratio [OR]=1.52, p=0.004), emotional (OR=1.24; p=0.001), and external (OR=1.21; p=0.001) DEBQ scores. Working nighttime shift duty was positively associated with restrained eating (OR=1.53; p=0.029) and emotional eating (OR=1.24; p=0.001), but negatively associated with external eating (OR=0.45; p=0.001). 

CONCLUSION

Our findings suggest that stress and shift duty were associated with eating habits.

Correlates of Cancer Information Overload: Focusing on Individual Ability and Motivation

The present study defined cancer information overload (CIO) as an aversive disposition wherein a person is confused and overwhelmed by cancer information, which occurs when he or she fails to effectively categorize new information due to a lack of resources for effective learning. Based on the definition and informed by previous studies on information overload and the cognitive mediation model, we hypothesized that low ability and motivation to process cancer information would lead to CIO. We used education level and trait anxiety as factors related to ability. Cancer history and the use of active media channels (such as the Internet and print media) were adopted as motivational factors. Four samples (three from the United States and one from South Korea) were used to explore the relationship between ability/motivation and CIO. Among them, only Sample 4 participants answered questions about stomach cancer, and other participants were asked about cancer in general. In all four samples, trait anxiety was positively associated with CIO. Health information use from active media channels (print or the Internet) was negatively associated with CIO in three samples. The associations between family history and CIO, and between education and CIO, were found in two samples. In short, the present study demonstrated that CIO partly depends on individual ability and motivation, thereby showing that CIO is influenced by personal characteristics as well as environmental factors.

Disgusted, embarrassed, annoyed: affective associations relate to uptake of colonoscopy screening

BACKGROUND

Uptake of colorectal cancer screening is lower than desired. Screening decision making research has traditionally focused on benefits and barriers to screening. This study examines the relation of affective associations with screening (feelings and emotions associated with screening) to colonoscopy screening uptake.

METHODS

Participants were 103 African American community adults. Participants completed a structured interview assessing perceived benefits of and barriers to colonoscopy screening, affective associations with colonoscopy, colonoscopy screening behavior, and intentions for future screening.

RESULTS

Higher positive and lower negative affective associations with screening were both significant predictors of colonoscopy uptake. Affective associations fully mediated the relation of perceived benefits and barriers to screening uptake. Affective associations were associated with intentions for future screening.

CONCLUSIONS

Incorporation of affective associations into models of screening decision making and intervention approaches to address screening compliance has utility for advancing our understanding of screening adherence as well as increasing screening rates.

Culturally (in)competent? Dismantling health care barriers for sexual minority women

Lesbian and bisexual (LB) women exhibit elevated rates of a variety of behaviors (i.e., smoking, excessive caloric intake, physical inactivity, heavy alcohol consumption) that put them at risk for adverse health consequences. Furthermore, LB women experience numerous barriers to obtaining culturally competent health care. In this article we review risk behaviors and health care barriers and we discuss the role of stress as an important contributing factor in LB women's health outcomes. We suggest future research, health care delivery changes, and training improvements that will prepare social workers to effectively address the needs of their LB clients.

The potential role of fruit and vegetables in aspects of psychological well-being: a review of the literature and future directions

The objective of the present paper was to review the literature investigating the potential relationship between fruit and vegetables (FV) and psychological well-being. The rising prevalence of mental ill health is causing considerable societal burden. Inexpensive and effective strategies are therefore required to improve the psychological well-being of the population, and to reduce the negative impact of mental health problems. A growing body of literature suggests that dietary intake may have the potential to influence psychological well-being. For example, studies have suggested that particular dietary constituents, including vitamins and minerals, might be beneficial to psychological health. However, in order to better reflect normal dietary intake, health-based research has increasingly begun to focus on whole foods and dietary patterns, rather than individual nutrients. One food group that has received increasing attention with regard to psychological health is FV. This is probably a result of the strong evidence base, which exists in relation to their protective association with a number of chronic diseases, as well as the fact that they are a rich source of some of the nutrients which have been linked to psychological health. While some promising findings exist with regards to FV intake and psychological well-being, overall, results are inconsistent. Possible reasons for this, such as methodological issues related to study design and the measurement of psychological well-being and FV intake, are discussed within this review. Based on the predominantly observational nature of existing literature, the present paper concludes that future well-designed randomised controlled trials are required to investigate the relationship further.

Relation between salivary cortisol as stress biomarker and dietary pattern in children

PURPOSE

Psychological stress has been suggested to result in hormonal effects (e.g. changes in cortisol pattern) that may change food selection in unhealthy ways. This study examines whether children's dietary pattern is indeed related to salivary cortisol levels.

METHODS

In 323 children (5-10 years old) participating in the Belgian ChiBS study, salivary cortisol samples, a biomarker for stress, was sampled when waking up, 30 and 60 min after wake up and in the evening on two consecutive weekdays. Data on the children's dietary pattern (frequency of sweet foods, fatty foods, snacks, fruit and vegetables) was collected with a food frequency questionnaire. Multilevel time modelling was used with adjustments for sex, age, body mass index, parental education and wake up time.

RESULTS

Higher overall cortisol levels and a large cortisol awakening response (CAR) were associated with more frequent consumption of sweet foods. A steeper diurnal cortisol decline was associated with a higher sweet, fatty and snack food consumption frequency. No associations with fruit and vegetables consumption were found.

CONCLUSIONS

High cortisol levels were linked to an unhealthier dietary pattern (more fatty food, snacks and especially sweet food). This supports the theory of cortisol-induced comfort food preference and strengthens the stress-diet relation.

Influence of stress in parents on child obesity and related behaviors

OBJECTIVE

To assess associations of the number of parent stressors and parent-perceived stress with obesity and related behaviors in their children.

METHODS

This cross-sectional analysis used data from the 2006 Southeastern Pennsylvania Household Health Survey in which 2119 parents/caregivers answered questions about themselves and their children (ages 3-17 years). Survey data were used to assess the main exposure variables: the number of stressors (measured using a stressor index) and parent-perceived stress (the response to a general stress question); child covariates (age, race/ethnicity, health quality, and gender); adult covariates (education, BMI, gender, poor sleep quality) and study outcomes (child obesity, fast-food consumption, fruit and vegetable consumption, and physical activity). To account for developmental differences, analyses were also stratified by age group (3-5, 6-8, 9-12, and 13-17 years). Analyses used multiple logistic regression, with results expressed as odds ratios and 95% confidence intervals.

RESULTS

The number of parent stressors was related to child obesity in unadjusted (1.12, 1.03-1.22, P = .007) and adjusted models (1.12, 1.03-1.23, P = .010). Parent-perceived stress was related to fast-food consumption in unadjusted (1.07, 1.03-1.10, P < .001) and adjusted (1.06, 1.02-1.10, P < .001) models.

CONCLUSIONS

The number of parent stressors was directly related to child obesity. Parent-perceived stress was directly related to child fast-food consumption, an important behavioral indicator of obesity risk. Clinical care models and future research that address child obesity should explore the potential benefits of addressing parent stressors and parent-perceived stress.

Eating behaviors of older adults participating in government-sponsored programs with different demographic backgrounds

The purpose of this study was to determine the food behaviors of nutritionally high-risk seniors as a function of their racial background, gender, marital status, and education level. A total of 69 seniors were identified to be at high nutritional risk using the Nutrition Screening Initiative (NSI) checklist. A supplemental questionnaire (SQ) was created to examine the risk factors in relation to the participant's demographic background. Key results indicated that Asians practiced healthy food behaviors and women were more likely to eat alone (p?0.05). Married participants (90.9%) were most likely to consume 2 meals or more each day. College educated individuals practiced healthier eating, eating 5 servings or more of fruits and vegetables (p?0.01) and 2 or more servings of milk and milk products (p?0.01). These preliminary findings indicate that more studies should be conducted to focus on the demographic characteristics and food behaviors among older populations.