Religiosity and spirituality and the intake of fruit, vegetable, and fat: a systematic review

Exploring church members' perceptions towards physical activity, fruits and vegetables consumption, and church's role in health promotion: implications for the development of church-based health interventions

Background

The study explored the perceptions of church members towards physical activity (PA), the consumption of fruits and vegetables (FV), and the church's role in health promotion prior to the development of a church-based intervention for physical activity and fruit and vegetable consumption in Lagos, Nigeria.

Method

Sixteen focus group discussions (FGD) and eleven key Informant Interviews (KII) were conducted. Eight FGDs among adults and four among the youth and the elderly church members. Key informant interviews were held among church leaders and members of the church medical advisory. Study findings were categorized under thematic headings. Based on the data analysis, several key themes were identified: the knowledge of the concept of health and common health problems, opinions of physical activity, opinions of healthy eating and fruit and vegetable consumption, types and attitudes towards existing church-based health programs and the role of the church in health promotion and church-based health programs. Within each theme, several childthemes were noted such as the challenges with fruit and vegetable consumption, biblical support for physical activity and fruit & vegetable consumption, the role of the church leaders, program sustainability and barriers to participation.

Results

The participants perceived health not only as the absence of disease but as general well-being of the body and soul. Health was also related to the ability to perform religious activities. Common health problems included a mix of communicable and non-communicable diseases. They are aware that physical activity, fruits and vegetables are essential for healthy living. The youth saw it as a means of improving their physical appearance however the elderly expressed concerns about the possibility of associated trips and falls. Overall, they viewed fruits and vegetables as healthy foods while processed western foods were perceived as unhealthy. Fruits and vegetables were seen as beneficial primarily to aid food digestion, boost immunity, improve youthfulness, aid weight control and to prevent chronic disease. The study participants agreed that the church, as an institution, has a significant role to play in promoting the health of her members. Instituted health committees embedded within existing church structures often lead church-based health-promoting activities and are imperative for sustainability. Types of health programs included health talks, screening programs for common NCDs, sport competitions, distributions of FV during church ceremonies such as harvests, Lenten seasons, Love feasts and church bazaars. Health outreaches were seen as a means of evangelism, and it was unanimously agreed that the Bible supports PA and healthy eating. Generally, the respondents had positive attitudes towards church-based health programs and they advised that future programs include the use of technology and should be integrated into existing church activities to improve participation. The participants also noted that the opinion of the church leaders influences the behaviours of church members and their support is critical in the development and implementation of church-based health programs.

Conclusion

Church members are aware that physical activity and the consumption of fruits and vegetables are important for healthy living and expressed support for church-based health programs. They believe that the Bible supports the promotion of PA and FV consumption as healthy behaviours. Program integration, the use of technology and support of church leaders and existing church medical advisory groups are imperative for developing and sustaining church-based health programs.

Breast Cancer and Spirituality Among Women in Poland: A Case-Control Study

In this case-control study, we assessed differences in daily spiritual experiences between patients with breast cancer diagnoses and healthy controls in relation to other breast cancer risk factors. The participants were 201 newly diagnosed Polish patients with breast cancer (58 ± 6 years) and 201 age-matched healthy controls. Spiritual experiences were assessed using the Daily Spiritual Experiences Scale (DSES). Adjusted odds ratios (OR) and 95% confidence intervals (CI) of the DSES score for breast cancer diagnosis were calculated with logistic regression. The DSES score was significantly higher in the healthy controls than in the cases. After controlling for alcohol use, education, BMI, and rural residence, higher spirituality was associated with a lower risk of breast cancer (OR 0.98, 95% CI 0.97-1.00). Two DSES item scores differed significantly between cases and controls, being lower in breast cancer cases: "I am spiritually touched by the beauty of creation" (p = 0.01) and "I feel selfless caring for others" (p = 0.049). After controlling for other variables (i.e., hormone replacement therapy, family history, breastfeeding, and diet quality), the DSES score was statistically non-significant (OR 0.99, 95% CI 0.97-1.006). Therefore, the original relationship DSES score and breast cancer was quite weak. Although the study found little relationship between the analyzed variables, presented differences in spirituality may differentiate the patterns of spiritual well-being among breast cancer patients; however, more data are needed from longitudinal study designs to establish causal inferences.

Prevalence and Correlates of Underweight among Women of Reproductive Age in Nepal: A Cross-Sectional Study

This study aimed to examine the prevalence of underweight and determine the sociodemographic and household environmental correlates of underweight among women of reproductive age in Nepal. This study also compared the time trends in the prevalence of underweight with the trends in the prevalence of overweight and obesity. This cross-sectional study was a secondary data analysis of the nationally representative population-based Nepal Demographic and Health Surveys (NDHSs). Firstly, the time trends of the prevalence of underweight (body mass index (BMI) < 18.5 kg/m²) among women aged 15-49 years were examined at five-year intervals, from the 1996, 2001, 2006, 2011, and 2016 NDHSs (n = 33,507). Secondly, the sociodemographic and household environmental correlates of underweight were examined from the latest NDHS 2016 (n = 6165). Univariable and multivariable logistic regression analyses were performed to examine the sociodemographic and household environmental correlates of underweight. From 1996 to 2016, the prevalence of underweight decreased from 25.3% (95% confidence interval (CI) 23.8%, 26.8%) to 16.9% (95%CI 16.0%, 17.8%), while the prevalence of overweight and obesity increased from 1.6% (95%CI 1.2%, 2.1%) to 15.6% (95%CI 14.7%, 16.5%) and 0.2% (95%CI 0.1%, 0.4%) to 4.1% (95%CI 3.6%, 4.6%), respectively. Sociodemographic factors, such as age, educational status, marital status, wealth index, and religion, were independently associated with the risk of underweight. Similarly, household environmental factors, such as province of residence, ecological zone, type of toilet facility, and household possessions, including television and mobile phone, were independently associated with the risk of underweight. Despite the declining trends, the prevalence of underweight among Nepalese women remains a public health challenge. Understanding the key sociodemographic and household environmental correlates of underweight may assist in streamlining the content of health promotion campaigns to address undernutrition and potentially mitigate adverse health outcomes.

Relationship Between Dietary Self-Efficacy and Religiosity Among Seventh-Day Adventists in Peru

Background

Most of the studies involving members of the Seventh-Day Adventist Church (SDA) have been conducted in the United States and Canada.

Aim

The purpose of the study was to explore the relationship between dietary self-efficacy and religiosity among SDA members in Peru.

Methods

In this online cross-sectional study, 403 participants aged 18 to 59 years selected by convenience were included. The data collected included sociodemographic information. In addition, the Dietary Self-Efficacy Scale (DIET-SE) and the Duke University Index of Religion (DUREL) were administered. A correlation analysis was performed and multiple linear regression was used to examine the association between religiosity, dietary self-efficacy, and sociodemographic variables.

Results

Dietary self-efficacy was significantly negatively correlated with all dimensions of religiosity, ie, organized religious activities (ORA), non-organized religious activities (NORA), and intrinsic religiosity (IR). In addition, participants had high dietary self-efficacy and religiosity.

Conclusion

Although religiosity dimensions did not significantly predict dietary self-efficacy, however, the non-organized religious activities dimension was the strongest predictor of dietary self-efficacy among Adventists in Peru. The present study will serve as a basis for future research to further investigate the potential positive effect of religiosity on the improvement a healthy diet and possible changes in the physical and mental health of the population.

Interplay of Nutrition and Psychoneuroendocrineimmune Modulation: Relevance for COVID-19 in BRICS Nations

The consequences of COVID-19 are not limited to physical health deterioration; the impact on neuropsychological well-being is also substantially reported. The inter-regulation of physical health and psychological well-being through the psychoneuroendocrineimmune (PNEI) axis has enduring consequences in susceptibility, treatment outcome as well as recuperation. The pandemic effects are upsetting the lifestyle, social interaction, and financial security; and also pose a threat through perceived fear. These consequences of COVID-19 also influence the PNEI system and wreck the prognosis. The nutritional status of individuals is also reported to have a determinative role in COVID-19 severity and convalescence. In addition to energetic demand, diet also provides precursor substances [amino acids (AAs), vitamins, etc.] for regulators of the PNEI axis such as neurotransmitters (NTs) and immunomodulators. Moreover, exaggerated immune response and recovery phase of COVID-19 demand additional nutrient intake; widening the gap of pre-existing undernourishment. Mushrooms, fresh fruits and vegetables, herbs and spices, and legumes are few of such readily available food ingredients which are rich in protein and also have medicinal benefits. BRICS nations have their influences on global development and are highly impacted by a large number of confirmed COVID-19 cases and deaths. The adequacy and access to healthcare are also low in BRICS nations as compared to the rest of the world. Attempt to combat the COVID-19 pandemic are praiseworthy in BRICS nations. However, large population sizes, high prevalence of undernourishment (PoU), and high incidence of mental health ailments in BRICS nations provide a suitable landscape for jeopardy of COVID-19. Therefore, appraising the interplay of nutrition and PNEI modulation especially in BRICS countries will provide better understanding; and will aid in combat COVID-19. It can be suggested that the monitoring will assist in designing adjunctive interventions through medical nutrition therapy and psychopsychiatric management.

Investigating the Role of Psychological, Social, Religious and Ethical Determinants on Consumers' Purchase Intention and Consumption of Convenience Food

Despite impressive market growth, increasing demand and economic importance of convenience food in emerging economies such as India, comprehensive research regarding the role of psychological and social determinants on convenience food choice is lacking. Therefore, this research aims to investigate the influence of convenience orientation, social status, moral attitude, mood, spiritual concern, religious beliefs and ethical values on purchase intention and consumption of convenience food. The non-probability purposive sampling method was adopted for recruitment of participants. A pre-tested questionnaire was used to collect data from 501 consumers. The descriptive statistics, confirmatory factor analysis and structural equation modeling were carried out to analyse the data. The factor loading, Cronbach’s alpha, composite reliability, average variance extracted, and correlations demonstrated good internal consistency and reliability of scale items as well as convergent and discriminant validity of the constructs. The model fit indices revealed that measurement and structural models fitted well with data. The path analysis of the structural model demonstrated that convenience orientation (β = 0.789 ***, t = 32.462), moral attitude (β = 0.594 ***, t = 20.984), mood (β = 0.586 ***, t = 18.683), spiritual concern (β = 0.145 ***, t = 3.23), religious beliefs (β = 0.451 ***, t = 14.787) and ethical values (β = 0.497 ***, t = 16.678) were positively related with purchase intention and consumption of convenience food (*** Significant at p ≤ 0.01). The path analysis of structural model also indicated that social status was not linked with purchase intention and consumption of convenience food. The convenience orientation was the key determinant influencing purchase intention and consumption of convenience food.

A multilevel analysis of overweight and obesity among non-pregnant women of reproductive age in Malawi: evidence from the 2015-16 Malawi Demographic and Health Survey

BACKGROUND

Overweight and obesity are well-known risk factors for non-communicable diseases such as cardiovascular disease, diabetes, some cancers and musculoskeletal disorders. In Malawi, the proportion of women who are overweight/obese has doubled, from 10% in 1992 to 21% in 2015-16. Therefore we aimed to explore the individual- and community-level factors associated with overweight and obesity among non-pregnant women of child-bearing age.

METHODS

Secondary analysis of the 2015-16 Malawi Demographic and Health Survey was conducted. Overweight was defined as a body mass index (BMI) of 25 to <30 kg/m2, while obesity was defined as a BMI ≥30 kg/m2. Two-level multilevel multivariable logistic regression models were constructed using a logit-link function with a binomial distribution on 7326 women living in 850 different communities.

RESULTS

At the individual level, the adjusted multilevel regression results showed that women 15-19 y of age as well as women from the poorest households had reduced odds of being overweight/obese. However, women with white collar jobs and women who were affiliated with the Church of Central Africa Presbyterian and the Roman Catholic church had increased odds of being overweight/obese. At the community level, women from urban areas and women who resided in communities with a low percentage of media exposure had increased odds of being overweight or obese. While women from poor communities had reduced odds of being overweight and obese, the proportion change in variance showed that 56, 77 and 78% of total variations in the odds of overweight, obese and overweight/obese across the communities were explained by both individual- and community-level factors. The median odds ratio showed that the likelihood of maternal overweight, obese and overweight/obese increased by 63, 39 and 84% when the women moved from low- to high-risk neighbourhoods.

CONCLUSIONS

Older women, Christian women, women with white collar jobs and women from the richest households should be targeted during policy formulation. At the community level, media coverage should be spread evenly so that health awareness messages, consequences and means of overweight and obesity prevention are getting to the targeted women. Our study revealed evidence of clustering effects of overweight and obesity at the community level, hence neighbourhood variations with respect to maternal overweight and obesity should be taken into account when designing nutritional policies.

The Role of Religious Behavior in Health Self-Management: A Community-Based Participatory Research Study

Prevalence of chronic disease, mental health problems, and risk behaviors in San Bernardino (SB) County reflect some of the worst health outcomes in the State of California and the United States. Using the Integrated Theory of Health Behavior Change (ITHBC) as the theoretical framework, this community-based participatory research (CBPR) study aimed to determine how religious self-regulation skills and ability, and religious behaviors, jointly affect health promotion behaviors among socio-economically challenged residents of southwest SB County, California. A convenience sample of adult residents (N = 261) completed a series of inventories to measure the relationship between modified ITHBC constructs of religious self-regulation skills, religious self-management behaviors, and health outcomes. Structural Equation Modeling (SEM) analysis was conducted to validate the strong positive effect of religious self-regulation skills and ability on how frequently individuals engage in both organized and non-organized religious activities. Results also indicated a significant positive impact of religious behaviors towards healthy eating behaviors. However, without the engagement in religious activities, high religious self-regulation skills and ability inhibited the likelihood of healthy food intake. This faith-related theoretical model provides an avenue for faith-based organizations’ capacity for contributing to community health promotion.

The impact of religiosity on dietary habits and physical activity in minority women participating in the Health is Power (HIP) study

African American (AA) and Hispanic/Latina (HL) women report lower rates of physical activity (PA) and poorer dietary habits compared to their white counterparts. Religiosity can act as a protective factor for health; however, the relationship between religiosity, PA, and diet is unclear. This study aimed to investigate the influence of religiosity on PA and fruit and vegetable (FV) and fat consumption in minority women. Health is Power (HIP) was a 6-month intervention where participants (AA: 63%; HL: 37%) were randomized to a PA or FV group. Questionnaires assessed religiosity at baseline and PA, FV and fat consumption at baseline and post-intervention. Hierarchical linear regression models were used to investigate religiosity as a predictor of change in PA, FV and fat, while controlling for demographics. AA women had significantly higher religiosity scores (M = 44.15, SD = 10.66) compared to H/L women (M = 35.11, SD = 12.82; t(251) = 5.86, p < 0.001). Across both groups, PA increased by 15%, FV intake increased by 27%, and consumption of calories by fat decreased by 5%. Religiosity was not a significant predictor of PA or diet (p < 0.05). The results of this study found no association between religiosity and change in PA and diet. More longitudinal studies are needed to explore the role of religiosity in the health of minority women.

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Religiosity or spirituality may influence some health behaviors in minority women.

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Religiosity or spirituality did not influence adoption of physical activity.

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Religiosity or spirituality did not influence adoption of healthy eating.

Rationalizing ethnopharmacological uses of Alternanthera sessilis: A folk medicinal plant of Pakistan to manage diarrhea, asthma and hypertension

ETHNOPHARMACOLOGICAL RELEVANCE

Tribal herbal practitioners of Pakistan use Alternanthera sessilis (Amaranthaceae) to treat diarrhea, asthma and hypertension.

OBJECTIVE

The current study was conducted to provide mechanistic basis for anti-spasmodic, anti- asthmatic and anti-hypertensive use of Alternanthera sessilis.

MATERIALS AND METHODS

The crude ethanolic extract of Alternanthera sessilis (As.Cr) and its fractions were tested in- vitro on isolated rabbit tissue preparations (i.e., jejunum, trachea, and aorta) and in-vivo in ketamin-diazepam anaesthetized normotensive rats.The responses were recorded using isotonic and isometric transducers coupled with Power Lab data acquisition system.

RESULTS

On isolated rabbit jejunum preparations, As.Cr exerted concentration-dependent (0.01-1.0mg/ml) spasmolytic effect and caused relaxation of K(+)(80mM)-induced spastic contractions. Furthermore, there was non-parallel shift in Ca(++)concentration response curves (CRCs) towards right at tissue bath concentrations of 0.1 and 0.3mg/ml. On isolated rabbit trachea, it relaxed carbachol (1μM)- and K(+()80mM)-induced contractions at respective tissue bath concentrations of 5.0 and 1.0mg/ml. On isolated rabbit aorta, it also demonstrated relaxant effect on phenylephrine (1μM)- and K(+()80mM)-induced contractions at tissue bath concentrations of 5.0 and 3.0mg/ml respectively. These findings were found to be comparable with verapamil, a reference Ca(++)channel blocker (CCB). The solvent-solvents fractionation revealed domination of spasmolytic effects in dichloromethane fraction as compared to aqueous fraction. Intravenous administration of As.Cr decreased mean arterial blood pressure, systolic blood pressure and diastolic blood pressure of ketamine-diazepam anaesthetized normotensive albino rats dose-dependently, at dose range of 1-10mg/kg.

CONCLUSION

Our results reflected presence of Ca(++) channel blocking (CCB) activity in As.Cr, thus rationalizing medicinal use of Alternanthera sessilis in diarrhea, asthma and hypertension.