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Reicks M, Lora KR, Jin Y, Anderson AK, Monroe-Lord L, Jones BL, Topham GL, Banna J, Gunther C, Hopkins LC, Richards R, Wong SS. Parenting Practices Are Associated With Adolescent Food Choices During Independent Eating Occasions. J Acad Nutr Diet 2023; 123:1479-1487.e4. [PMID: 37196979 DOI: 10.1016/j.jand.2023.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 05/06/2023] [Accepted: 05/10/2023] [Indexed: 05/19/2023]
Abstract
BACKGROUND Frequency of independent eating occasions (iEOs) has been linked to intake of unhealthy foods and overweight or obesity among adolescents. Parenting practices involving modeling healthy food intake and making healthy foods available have been associated with healthy food intake among adolescents; however, little is known about these associations during iEOs. OBJECTIVE To determine whether parenting practices involving structure (monitoring, availability, modeling, and expectations), lack of structure (indulgence), and autonomy support reported by adolescents or parents were associated with adolescent iEO intake of junk foods, sugar-sweetened beverages (SSBs), sugary foods, and fruit and vegetables. DESIGN Cross-sectional study measuring parenting practices and adolescent iEO food choices via an online survey and adapted food frequency questionnaire. PARTICIPANTS/SETTING Parent/adolescent dyads (n = 622) completed surveys (November-December 2021) using a national Qualtrics panel database. Adolescents were 11 to 14 years of age and had iEOs at least weekly. MAIN OUTCOME MEASURES Primary measures included parent- and adolescent-reported frequency of food parenting practices and adolescent-reported iEO intake of junk foods, sugary foods, SSBs, and fruits and vegetables. STATISTICAL ANALYSES PERFORMED Multivariable linear regression models were used to examine associations between parenting practices and iEO intake of foods/beverages, adjusting for adolescent's age, sex, race and ethnicity, iEO frequency, parent's education and marital status, and household food security status. Bonferroni multiple comparison corrections were conducted. RESULTS More than half of parents were female (66%) and 35 to 64 years of age (58%). Adolescents/parents identified as White/Caucasian (44%/42%), Black/African American (28%/27%), Asian (21%/23%), and Hispanic ethnicity (42%/42%). Positive associations were observed among adolescent-reported and parent-reported autonomy support, monitoring, indulgence and expectations parenting practices, and adolescent-reported daily iEO intake frequencies of junk foods, sugary foods, and fruits and vegetables (P < 0.001). CONCLUSIONS Structural and autonomy support parenting practices were positively associated with both healthy and unhealthy iEO food intake by adolescents. Interventions to improve adolescent iEO intake could promote positive practices associated with healthy food consumption.
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Gunther C, Banna J, Jones BL, Park C, Reicks M, Richards R, Schier H, Topham GL, Wong SS, Anderson AK, Ballejos M, Hopkins LC, Lora KR, Monroe-Lord L. Adolescent Independent Eating Occasions, Dietary Intake, and Parenting Practices During the COVID-19 Pandemic: A Qualitative Study of Parents and Adolescents From Households With Low Income. J Nutr Educ Behav 2023; 55:634-643. [PMID: 37422758 DOI: 10.1016/j.jneb.2023.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 04/28/2023] [Accepted: 05/01/2023] [Indexed: 07/10/2023]
Abstract
OBJECTIVE Examine how experiencing the coronavirus disease 2019 (COVID-19) pandemic influenced adolescent independent eating occasions (iEOs) and iEO-related parenting practices from the perspective of parents and adolescents METHODS: Cross-sectional remote interviews were conducted for this basic qualitative research study. Participants were a purposive sample of multiracial/ethnic adolescents aged 11-14 years and their parents from households with low income (n = 12 dyads) representing 9 US states. The main outcome measures were iEOs and iEO-related parenting practices. Data were analyzed using directed content analysis. RESULTS About half of the parents indicated that their adolescents had more iEOs during the COVID-19 pandemic and that there were changes in the types of foods consumed during iEOs. In contrast, most adolescents indicated their iEOs had not changed remarkably in frequency or foods consumed since the onset of the pandemic. Most parents reported no change in how they taught their adolescents about healthy food, the rules for foods/beverages permitted during iEOs, or how they monitored what their adolescents ate during iEOs; adolescent reports were in general agreement. Most parents indicated that family members were home together more often during the pandemic, which increased cooking frequency. CONCLUSIONS AND IMPLICATIONS The effect of the COVID-19 pandemic on adolescents' iEOs varied, and the parenting practices used to influence iEOs remained stable during the pandemic. Families experienced having more time together and cooking at home more often.
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Affiliation(s)
- Carolyn Gunther
- Martha S. Pitzer for Women, Children, and Youth, College of Nursing, The Ohio State University, Columbus, OH.
| | - Jinan Banna
- Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawaii at Manoa, Honolulu, HI
| | - Blake L Jones
- Department of Psychology, Brigham Young University, Provo, UT
| | - Catherine Park
- Department of Biochemistry and Molecular Biology, Oregon State University, Corvallis, OR
| | - Marla Reicks
- Department of Food Science and Nutrition, University of Minnesota, Minneapolis, MN
| | - Rickelle Richards
- Department of Nutrition, Dietetics, and Food Science, Brigham Young University, Provo, UT
| | - Heather Schier
- Department of Human Sciences, The Ohio State University, Columbus, OH
| | - Glade L Topham
- Department of Applied Human Sciences, Kansas State University, Manhattan, KS
| | - Siew Sun Wong
- School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR
| | - Alex K Anderson
- Department of Nutritional Sciences, University of Georgia, Athens, GA
| | | | - Laura C Hopkins
- Department of Public Health and Prevention Science, Baldwin Wallace University, Berea, OH
| | - Karina R Lora
- Department of Exercise and Nutrition Sciences, The George Washington University, Washington, DC
| | - Lillie Monroe-Lord
- Center for Nutrition, Diet and Health, University of the District of Columbia, Washington, DC
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Lavelle MA, Knopp M, Gunther CW, Hopkins LC. Youth and Peer Mentor Led Interventions to Improve Biometric-, Nutrition, Physical Activity, and Psychosocial-Related Outcomes in Children and Adolescents: A Systematic Review. Nutrients 2023; 15:2658. [PMID: 37375562 DOI: 10.3390/nu15122658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 05/25/2023] [Accepted: 06/02/2023] [Indexed: 06/29/2023] Open
Abstract
The utilization of youth (older) and peer (same age) mentor-led interventions to improve nutrition and physical activity has been an emerging trend in recent years. This systematic review is intended to synthesize the effectiveness of these intervention programs on participants and mentors based on biometric, nutrition, physical activity, and psychosocial outcomes of youth and peer mentor-led interventions among children and adolescents. Online databases, including PubMed, ScienceDirect, EBSCOhost and Google Scholar, were searched, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. A three-step screening process was used to meet the proposed eligibility criteria, and the risk-of-bias tool for randomized trials (RoB 2) was used to assess bias for the included studies. Nineteen unique intervention programs and twenty-five total studies were deemed eligible when considering the criteria required for review. Multiple studies demonstrated positive evidence of the biometric and physical activity outcomes that were considered significant. The findings regarding the nutritional outcomes across the included studies were mixed, as some studies reported significant changes in eating habits while others did not find a significant change. Overall, the utilization of youth and peer mentor-led models in nutrition- and physical-activity-related interventions may be successful in overweight and obesity prevention efforts for those children and adolescents receiving the intervention and the youths and peers leading the interventions. More research is needed to explore the impact on the youths and peers leading the interventions and disseminating more detailed implementation strategies, e.g., training mentors would allow for advancements in the field and the replicability of approaches. Terminology: In the current youth- and peer-led nutrition and physical activity intervention literature, a varying age differential exists between the targeted sample and the peers, and varying terminology with regards to how to name or refer to the youth. In some instances, the youth mentors were individuals of the same grade as the target sample who either volunteered to serve in the peer role or were selected by their fellow students or school staff. In other cases, the youth mentors were slightly older individuals, either in high school or college, who were selected based upon their experience, leadership skills, passion for the project, or demonstration of healthy lifestyle behaviors.
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Affiliation(s)
- Margaret A Lavelle
- Department of Communication Sciences and Disorders, College of Education and Health Sciences, Baldwin Wallace University, Berea, OH 44017, USA
| | - Miriam Knopp
- Department of Health Sciences, College of Education and Human Ecology, The Ohio State University, Columbus, OH 43210, USA
| | - Carolyn W Gunther
- College of Nursing, The Ohio State University, Columbus, OH 43210, USA
| | - Laura C Hopkins
- Department of Public Health and Prevention Science, College of Education and Health Sciences, Baldwin Wallace University, Berea, OH 44017, USA
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Neuerer R, Settonni R, Hopkins LC. An Exploration of the Health of Hispanic Immigrants and Puerto Rican-born Individuals Based on Time Lived in the United States. Journal of Hunger & Environmental Nutrition 2022. [DOI: 10.1080/19320248.2022.2032899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Rachel Neuerer
- Department of Public Health and Prevention Science, School of Health Sciences, College of Education and Health Sciences, Baldwin Wallace University, Berea, Ohio, United States
| | - Rocco Settonni
- Department of World Languages, Literatures and Cultures, School of Humanities, College of Arts and Sciences, Baldwin Wallace University
| | - Laura C. Hopkins
- Department of Public Health and Prevention Science, School of Health Sciences, College of Education and Health Sciences, Baldwin Wallace University, Berea, Ohio, United States
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Hopkins LC, Sharn AR, Remley D, Schier H, Olak R, Drakeford D, Pannell C, Gunther C. Caregiver Perceptions of Environmental Facilitators and Barriers to Healthy Eating and Active Living during the Summer: Results from the Project SWEAT Sub-Study. Int J Environ Res Public Health 2021; 18:ijerph182111396. [PMID: 34769918 PMCID: PMC8583590 DOI: 10.3390/ijerph182111396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 10/22/2021] [Accepted: 10/25/2021] [Indexed: 11/21/2022]
Abstract
Objective: The aim of this study was to examine caregiver perceptions of summertime neighborhood-level environmental barriers and facilitators to healthy eating and active living in their elementary-age racial minority children. Methods: Caregivers with students in the prekindergarten–fifth grade were recruited from two schools located in low-income urban neighborhoods of Columbus, OH, with a predominantly Black population. Participants engaged in the research portion of the Healthy Eating Active Living: Mapping Attribute using Participatory Photographic Surveys (HEALth MAPPSTM) protocol, which included (1) orientation; (2) photographing and geotagging facilitators and barriers to HEALth on daily routes; (3) in-depth interview (IDI) discussing images and routes taken; (4) focus groups (FG). IDIs and FGs were transcribed verbatim. Analyses were guided by grounded theory and interpretive phenomenology and were coded by researchers (n = 3), who used comparative analysis to develop a codebook and determine major themes. Results: A total of 10 caregivers enrolled and 9 completed the IDIs. Five caregivers participated in focus groups. A majority (77.8%, n = 7) of caregivers identified as Black, female (88.9%, n = 8), and low income (55.6%, n = 5). IDI and FG themes included (1) walkway infrastructure crucial for healthy eating and active living; (2) scarce accessibility to healthy, affordable foods; (3) multiple abandoned properties; (4) unsafe activity near common neighborhood routes. Conclusions: Caregivers perceived multiple neighborhood-level barriers to healthy eating and activity during the summer months when school is closed. Findings from this study provide initial insights into environmental determinants of unhealthy summer weight gain in a sample of predominantly racial minority school-age children from low-income households.
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Affiliation(s)
- Laura C. Hopkins
- Department of Public Health and Prevention Sciences, College of Education and Health Sciences, Baldwin Wallace University, 328D Malicky Center, 275 Eastland Road, Berea, OH 44017, USA; (L.C.H.); (R.O.); (D.D.)
| | - Amy R. Sharn
- Department of Human Sciences, The Ohio State University, Human Nutrition Program, Campbell Hall, 1787 Neil Avenue, Columbus, OH 43210, USA; (A.R.S.); (H.S.); (C.P.)
| | - Daniel Remley
- Family and Consumer Sciences, The Ohio State University, OSU Extension, 1864 Shyville Road, Piketon, OH 45661, USA;
| | - Heather Schier
- Department of Human Sciences, The Ohio State University, Human Nutrition Program, Campbell Hall, 1787 Neil Avenue, Columbus, OH 43210, USA; (A.R.S.); (H.S.); (C.P.)
| | - Regan Olak
- Department of Public Health and Prevention Sciences, College of Education and Health Sciences, Baldwin Wallace University, 328D Malicky Center, 275 Eastland Road, Berea, OH 44017, USA; (L.C.H.); (R.O.); (D.D.)
| | - Dorsena Drakeford
- Department of Public Health and Prevention Sciences, College of Education and Health Sciences, Baldwin Wallace University, 328D Malicky Center, 275 Eastland Road, Berea, OH 44017, USA; (L.C.H.); (R.O.); (D.D.)
| | - Cara Pannell
- Department of Human Sciences, The Ohio State University, Human Nutrition Program, Campbell Hall, 1787 Neil Avenue, Columbus, OH 43210, USA; (A.R.S.); (H.S.); (C.P.)
| | - Carolyn Gunther
- Department of Human Sciences, The Ohio State University, Human Nutrition Program, Campbell Hall, 1787 Neil Avenue, Columbus, OH 43210, USA; (A.R.S.); (H.S.); (C.P.)
- Correspondence: ; Tel.: 614-292-5125
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Webster A, Banna J, Lim E, Gibby CLK, Rose AM, Hopkins LC, Kennel JA, Orchard TS, Bomser JA, Gunther C. Knowledge, Attitudes, and Practices Regarding Dietary Sodium in College Students. J Nutr Educ Behav 2020; 52:1139-1147. [PMID: 33308515 DOI: 10.1016/j.jneb.2020.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 09/10/2020] [Accepted: 09/10/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Test a dietary sodium survey in a US adult population of college students using a survey previously validated in a non-US adult population. METHODS Cross-sectional study of a convenience sample of college students from a Midwest (n = 168) and Pacific Island (n = 152) university. Main outcome measures were knowledge, attitudes, and practices regarding dietary sodium (38 items). Sum scores and percentages for constructs were calculated. A score <75% was considered unfavorable; t test or ANOVA were used to examine group differences. RESULTS Midwest students were primarily non-Hispanic White individuals (81%) and 65% female. Pacific Island students were predominantly Asian (51%) and 66% female. Mean ± SD construct scores (percentage) for knowledge, attitudes, and practices were 58.69 ± 10.62, 63.96 ± 16.18, 66.00 ± 12.34 (Midwest) and 57.54 ± 10.93, 64.84 ± 14.96, 64.94 ± 13.18 (Pacific Island), respectively; there were no significant differences between schools or race. CONCLUSIONS AND IMPLICATIONS College students scored low in knowledge, attitudes, and practices regarding sodium. Results from this formative study may inform assessment strategies in future dietary sodium interventions.
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Affiliation(s)
- Alison Webster
- Department of Human Sciences, Human Nutrition Program, The Ohio State University, Columbus, OH
| | - Jinan Banna
- Department of Human Nutrition, Food and Animal Sciences, University of Hawai'i at Mānoa, Honolulu, HI
| | - Eunjung Lim
- Department of Quantitative Health Sciences, Biostatistics Core Facility, University of Hawai'i at Mānoa, Honolulu, HI
| | - Cheryl L K Gibby
- Department of Human Nutrition, Food and Animal Sciences, University of Hawai'i at Mānoa, Honolulu, HI
| | - Angela M Rose
- Department of Human Sciences, Human Nutrition Program, The Ohio State University, Columbus, OH
| | - Laura C Hopkins
- Department of Public Health and Prevention Science, Baldwin Wallace University, Berea, OH
| | - Julie A Kennel
- Department of Human Sciences, Human Nutrition Program, The Ohio State University, Columbus, OH
| | - Tonya S Orchard
- Department of Human Sciences, Human Nutrition Program, The Ohio State University, Columbus, OH
| | - Joshua A Bomser
- Department of Human Sciences, Human Nutrition Program, The Ohio State University, Columbus, OH
| | - Carolyn Gunther
- Department of Human Sciences, Human Nutrition Program, The Ohio State University, Columbus, OH.
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Mollalo A, Vahedi B, Bhattarai S, Hopkins LC, Banik S, Vahedi B. Predicting the hotspots of age-adjusted mortality rates of lower respiratory infection across the continental United States: Integration of GIS, spatial statistics and machine learning algorithms. Int J Med Inform 2020; 142:104248. [PMID: 32871492 PMCID: PMC7442929 DOI: 10.1016/j.ijmedinf.2020.104248] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 07/25/2020] [Accepted: 08/10/2020] [Indexed: 12/21/2022]
Abstract
Lower respiratory infections (LRI) are the cause of a significant number of hospitalizations in the US. No previous nationwide study examined geographic variations of LRI mortality rates and their association with underlying factors. There was a shift in the location of LRI hotspots from west coast to southeast over time. Decision tree classifiers could predict LRI mortality hotspots with high accuracies. Higher spring temperature and increased precipitation during winter were among the most substantial predictors of presence or absence of LRI hotspots.
Objective Although lower respiratory infections (LRI) are among the leading causes of mortality in the US, their association with underlying factors and geographic variation have not been adequately examined. Methods In this study, explanatory variables (n = 46) including climatic, topographic, socio-economic, and demographic factors were compiled at the county level across the continentalUS.Machine learning algorithms - logistic regression (LR), random forest (RF), gradient boosting decision trees (GBDT), k-nearest neighbors (KNN), and support vector machine (SVM) - were employed to predict the presence/absence of hotspots (P < 0.05) for elevated age-adjusted LRI mortality rates in a geographic information system framework. Results Overall, there was a historical shift in hotspots away from the western US into the southeastern parts of the country and they were highly localized in a few counties. The two decision tree methods (RF and GBDT) outperformed the other algorithms (accuracies: 0.92; F1-scores: 0.85 and 0.84; area under the precision-recall curve: 0.84 and 0.83, respectively). Moreover, the results of the RF and GBDT indicated that higher spring minimum temperature, increased winter precipitation, and higher annual median household income were among the most substantial factors in predicting the hotspots. Conclusions This study helps raise awareness of public health decision-makers to develop and target LRI prevention programs.
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Affiliation(s)
- Abolfazl Mollalo
- Department of Public Health and Prevention Science, School of Health Sciences, Baldwin Wallace University, Berea, OH, USA.
| | - Behrooz Vahedi
- Department of Mathematics, University of Trento, Trento, Italy.
| | | | - Laura C Hopkins
- Department of Public Health and Prevention Science, School of Health Sciences, Baldwin Wallace University, Berea, OH, USA.
| | - Swagata Banik
- Department of Public Health and Prevention Science, School of Health Sciences, Baldwin Wallace University, Berea, OH, USA.
| | - Behzad Vahedi
- Department of Geography, University of Colorado Boulder, Boulder, CO, USA.
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Hopkins LC, Tiba S, Westrick M, Gunther C. The Diet Quality of a Sample of Predominantly Racial Minority Children From Low-Income Households Is Lower During the Summer vs School Year: Results From the Project Summer Weight and Environmental Assessment Trial Substudy. J Acad Nutr Diet 2020; 121:112-120. [PMID: 32800759 DOI: 10.1016/j.jand.2020.06.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 06/01/2020] [Accepted: 06/07/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Little is known about the diet quality of racial minority children during the summertime when school is out of session and there is risk of accelerated weight gain. Project Summer Weight and Environmental Assessment Trial was an observational, prospective study exploring child weight status and health trends during the summer. OBJECTIVE The objective of this substudy of Project Summer Weight and Environmental Assessment Trial was to examine the diet quality of elementary-aged racial minority children during the summertime vs school year. DESIGN This observational, prospective substudy was conducted from June to September 2017. PARTICIPANTS/SETTING Students in prekindergarten through fifth grade were recruited from 2 schools located in low-income urban neighborhoods of Columbus, OH, with a predominantly Black population. Sixty-two children (39 families) enrolled. MAIN OUTCOME MEASURES Twenty-four-hour dietary recalls (2 weekdays, 1 weekend day) were collected at 3 time points: (1) beginning of summer (T0); (2) midsummer (T1); and (3) beginning of subsequent school year (T2). Healthy Eating Index (HEI)-2015 total and component scores were calculated to assess diet quality. Daily calories (kilocalories) and servings of types of foods within food groups were also assessed. STATISTICAL ANALYSES Repeated measures analysis of variance and Tukey's post hoc analyses were performed. RESULTS Retention was 76% (n = 47). Mean age was 7.0 ± 0.3 years, 79% (n = 37) were African American, and 58% of participants (n = 26) reported annual household incomes ≤$20,000. HEI-2015 total score was significantly lower during the summertime vs school year (P = .02). HEI-2015 component score for whole fruits (P = .04) was also lower in the summer vs school year, along with total vegetables (P < .001), greens and beans (P < .001) specifically, and legumes (P < .001). The HEI-2015 component score for added sugars (P = .04) was significantly lower in the summer vs the school year as well, indicating a higher intake of added sugars during the summer. On the other hand, whole grains were higher during the summer vs school year (P < .01), specifically snack chips (P = .03) and popcorn (P < .01). Total daily calories did not differ between the summertime vs school year. CONCLUSIONS In a small sample of predominantly racial minority school-aged children from low-income households, child diet quality is better during the school year vs summer. Future research is needed to determine if and to what extent summer vs school year diet quality may be associated with differences in weight status.
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Gunther C, Rogers C, Holloman C, Hopkins LC, Anderson SE, Miller CK, Copeland KA, Dollahite JS, Pratt KJ, Webster A, Labyk AN, Penicka C. Child diet and health outcomes of the simple suppers program: a 10-week, 2-group quasi-experimental family meals trial. BMC Public Health 2019; 19:1657. [PMID: 31823753 PMCID: PMC6902334 DOI: 10.1186/s12889-019-7930-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 11/08/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Racial minority children, particularly from low-income households, are at risk for obesity. Family meals have a protective effect on child nutritional health. However, the current evidence is limited in racial and socioeconomic diversity. The objective of this study was to evaluate the impact of a family meals intervention, Simple Suppers, on improvements in diet and health outcomes from baseline (T0) to post-intervention (T1) in intervention compared to waitlist control participants, and determine retention of change in outcomes among intervention participants at 10-week follow-up (T2). METHODS Simple Suppers was a 10-week family meals intervention implemented as a 2-group quasi-experimental trial. Ten 90-min lessons were delivered weekly. Data were collected at T0 and T1, and from intervention participants at T2. Participants were racially diverse 4-10 year-old children from low-income households. Setting was a faith-based community center. Main outcomes were daily servings of fruit, vegetables, and sugar-sweetened beverages and diet quality; z-scores for body mass index (BMI), waist circumference, systolic and diastolic blood pressure (BP); weight status categories; food preparation skills; and family meals (frequency of dinner, breakfast, TV viewing during meals, meals in dining area). Generalized linear mixed models (GLMMs) and mixed-effects ordinal regression models were used to assess intervention impact (T0:T1). Paired t-tests examined retention of change among intervention participants (T1:T2). RESULTS One hundred forty children enrolled and 126 completed T1 (90% retention); 71 of 87 intervention participants completed T2(79% retention). Mean (SD) age was 6.9(1.9) yr, 62% female, 60% Black, and 42% low-income. Intervention vs waitlist controls had higher food preparation skills (p < 0.001) and lower TV viewing during meals (p = 0.04) at T1.There were no group differences in dietary intake or quality or z-scores for BMI, waist circumference, or BP, however intervention versus waitlist controls experienced a greater change toward healthy weight (p = 0.04) At T2, intervention participants demonstrated a retention of improved food preparation skills. CONCLUSIONS Simple Suppers led to improvements in children's weight status, food preparation skills, and TV viewing during meals, but not diet or z-scores for BMI, waist circumference, or BP. Future research should examine the preventive effects of healthy family mealtime routines in children at greatest risk for obesity. TRIAL REGISTRATION NCT02923050; Simple Suppers Scale-up (S3); Retrospectively registered on Oct 2016; First participant enrolled on Jan 2015.
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Affiliation(s)
- Carolyn Gunther
- Department of Human Sciences, The Ohio State University, 1787 Neil Ave, 313 Campbell Hall, Columbus, OH 43210 USA
| | - Catherine Rogers
- Department of Human Sciences, The Ohio State University, 1787 Neil Ave, 313 Campbell Hall, Columbus, OH 43210 USA
- Present Address: Department of Nutrition, Case Western Reserve University, 10900 Euclid Ave, Wood Building, Cleveland, OH 44106 USA
| | - Christopher Holloman
- Department of Statistics, The Ohio State University, Columbus, USA
- Present Address: Information Control Company (ICC), 2500 Corporate Exchange Dr, Columbus, OH 43231 USA
| | - Laura C. Hopkins
- Department of Human Sciences, The Ohio State University, 1787 Neil Ave, 313 Campbell Hall, Columbus, OH 43210 USA
| | - Sarah E. Anderson
- Division of Epidemiology, The Ohio State University, 1841 Neil Avenue, Cunz Hall, Columbus, OH 43210 USA
| | - Carla K. Miller
- Department of Human Sciences, The Ohio State University, 1787 Neil Ave, 313 Campbell Hall, Columbus, OH 43210 USA
| | - Kristen A. Copeland
- Division of General and Community Pediatrics, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati, 3333 Burnet Avenue, Cincinnati, OH 45229 USA
| | - Jamie S. Dollahite
- Division of Nutritional Sciences, Cornell University, 408 Savage Hall, Ithaca, NY 14853 USA
| | - Keeley J. Pratt
- Department of Human Sciences, The Ohio State University, 1787 Neil Ave, 313 Campbell Hall, Columbus, OH 43210 USA
| | - Alison Webster
- Department of Human Sciences, The Ohio State University, 1787 Neil Ave, 313 Campbell Hall, Columbus, OH 43210 USA
- Present Address: Food Directions, 1101 K St NW #650, Washington, DC 20005 USA
| | - Allison N. Labyk
- Department of Human Sciences, The Ohio State University, 1787 Neil Ave, 313 Campbell Hall, Columbus, OH 43210 USA
| | - Christine Penicka
- Department of Human Sciences, The Ohio State University, 1787 Neil Ave, 313 Campbell Hall, Columbus, OH 43210 USA
- Present Address: Albany Medical Center, 43 New Scotland Ave, Albany, NY 12208 USA
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Gunther C, Reicks M, Banna J, Suzuki A, Topham G, Richards R, Jones B, Lora K, Anderson AK, da Silva V, Penicka C, Hopkins LC, Cluskey M, Hongu N, Monroe-Lord L, Wong SS. Food Parenting Practices That Influence Early Adolescents' Food Choices During Independent Eating Occasions. J Nutr Educ Behav 2019; 51:993-1002. [PMID: 31221526 DOI: 10.1016/j.jneb.2019.05.597] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 05/03/2019] [Accepted: 05/16/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To identify practices that parents use to influence early adolescents' food choices during independent eating occasions (iEOs) from parent and child perspectives. DESIGN In-depth interviews. PARTICIPANTS Low-income parents (n = 49) and early adolescent children (aged 10-13 years; n = 44) from 10 US states and the District of Columbia. PHENOMENON OF INTEREST Parent and child perspectives on parenting practices that influence food choices during iEOs. ANALYSIS Audio-recorded interviews transcribed verbatim, NVivo coding, and directed content analysis. RESULTS Parents reported setting rules and expectations and managing availability or accessibility as the most common practices used to influence iEOs. Other practices included teaching, pressuring to eat, monitoring, and modeling. Children reported that their parents had rules about what they could or could not eat during iEOs and that they used specific strategies (eg, call or text) to monitor their iEOs. CONCLUSIONS AND IMPLICATIONS Additional studies are needed to confirm findings from this exploratory study. Future cross-sectional and longitudinal studies could determine whether and to what extent food parenting practices identified in the current study are associated with healthy dietary intake during iEOs, as well as potential racial and ethnic differences.
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Affiliation(s)
- Carolyn Gunther
- Department of Human Sciences, Human Nutrition Program, The Ohio State University, Columbus, OH.
| | - Marla Reicks
- Department of Food Science and Nutrition, University of Minnesota, St. Paul, MN
| | - Jinan Banna
- Department of Human Nutrition, Food, and Animal Sciences, University of Hawaii at Manoa, Manoa, HI
| | - Asuka Suzuki
- Department of Human Nutrition, Food, and Animal Sciences, University of Hawaii at Manoa, Manoa, HI
| | - Glade Topham
- School of Family Studies and Human Services, Kansas State University, Manhattan, KS
| | - Rickelle Richards
- Department of Nutrition, Dietetics, and Food Science, Brigham Young University, Provo, UT
| | - Blake Jones
- Department of Psychology, Brigham Young University, Provo, UT
| | - Karina Lora
- Department of Exercise and Nutrition Sciences, George Washington University, Washington, DC
| | | | - Vanessa da Silva
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ
| | - Christine Penicka
- Department of Human Sciences, Human Nutrition Program, The Ohio State University, Columbus, OH
| | - Laura C Hopkins
- Department of Human Sciences, Human Nutrition Program, The Ohio State University, Columbus, OH
| | - Mary Cluskey
- School of Biological and Population Health Sciences Nutrition, Oregon State University, Corvallis, OR
| | - Nobuko Hongu
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ
| | - Lillie Monroe-Lord
- Department of Center for Nutrition, Diet, and Health, University of the District of Columbia, Washington, DC
| | - Siew Sun Wong
- School of Biological and Population Health Sciences Nutrition, Oregon State University, Corvallis, OR
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Hopkins LC, Webster A, Kennel JA, Purtell KM, Gunther C. Youth Mentor Dietary Outcomes and Waist Circumference Improvement: Camp NERF Study Findings. Health Promot Pract 2019; 21:962-971. [PMID: 30819010 DOI: 10.1177/1524839919833989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background. The health impact of youth mentors serving in the delivery of child nutrition and physical activity (PA) interventions on youth mentors themselves has been understudied. Objective. The primary objective of the current study was to examine the impact of engaging youth mentors in the delivery of a summertime childhood obesity prevention intervention on youth mentors' behavioral health. Method. Data were collected at baseline and postintervention. A survey of validated nutrition, mental health, PA, and psychosocial questionnaires was administered. Diet was assessed via 24-hour recall. Height, weight, and waist circumference (WC) were measured. In-depth interviews were conducted with youth mentors. Results. Eleven youth mentors enrolled: 60% were female, mean age was 16.1 ± 0.38 years, and 100% were Black. Mean kilocalories (p = .05), sugar-sweetened beverage intake (p = .08), and waist circumference (p = .04) decreased. In-depth interviews were conducted with 11 youth mentors, and three themes emerged: perceived improvement in nutrition, PA, and mental health-related behaviors; formation of a positive role modeling relationship with the child campers; and strengthening of higher education goals and future career aspirations. Conclusions. Youth mentor staffing may be an important intervention strategy for changing health behaviors among youth mentors. Results from this study can be used to inform utilization of youth mentors in the delivery of this and similar health behavior interventions in the future.
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Affiliation(s)
| | - Alison Webster
- The Ohio State University, Columbus, OH, USA.,The Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
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Hopkins LC, Fristad M, Goodway JD, Melnyk B, Eneli I, Holloman C, Kennel JA, Webster A, Sharn AR, Gunther C. Feasibility and acceptability of technology-based caregiver engagement strategies delivered in a summertime childhood obesity prevention intervention: results from an internal pilot of the Camp NERF (Nutrition, Education, Recreation, and Fitness) study. Pilot Feasibility Stud 2018; 4:153. [PMID: 30275966 PMCID: PMC6158889 DOI: 10.1186/s40814-018-0340-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 09/12/2018] [Indexed: 11/21/2022] Open
Abstract
Background The most efficacious childhood obesity prevention interventions have involved caregivers directly or indirectly. Due to the high reliance on technology, research examining technological intervention approaches is warranted, particularly during the summer when parents may be more difficult to engage and the risk for excess weight gain among children is high. Methods The feasibility and acceptability of a multi-component childhood obesity prevention intervention incorporating a caregiver component utilizing technology-based approaches—texting and social media—was explored. This was an internal pilot of the Camp Nutrition Education Recreation and Fitness (NERF) study, a group RCT for school-age children coupled to the USDA Summer Food Service Program. Feasibility and acceptability of the technology caregiver engagement component were assessed via process outcomes (participation rates) and in-depth interviews. Results Participants (n = 37) were 91.9% female, 91.8% Black, 58.7% low-income, and 75.0% overweight/obese. Participation rates in texting and social media were 62.2% and < 3%, respectively. Themes emerged from the in-depth interviews were texting provides connection; desire more involvement with program; fear social media privacy intrusion. Conclusions Results will be used to inform changes to technology-based caregiver engagement strategies to be tested in future interventions. Trial registration Clinical Trials, NCT02908230/09-19-2016. Registered 20 September 2016
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Affiliation(s)
- Laura C Hopkins
- 1Interdisciplinary PhD Program in Nutrition, Department of Human Sciences, Human Nutrition Program, The Ohio State University, 262B Campbell Hall, 1787 Neil Avenue, Columbus, OH 43210 USA
| | - Mary Fristad
- 2Department of Psychiatry and Behavioral Health, The Ohio State University, 1670 Upham Drive, Suite 460G, Columbus, OH 43210 USA
| | - Jacqueline D Goodway
- 3Department of Human Sciences, Kinesiology Program, College of Education & Human Ecology, The Ohio State University, A244 305 Annie & John Glenn Ave, Columbus, OH 43210 USA
| | - Bernadette Melnyk
- 4The Ohio State University, 1585 Neil Avenue, Rm. 145, Columbus, OH 43210 USA
| | - Ihuoma Eneli
- 5Nationwide Children's Hospital, The Ohio State University, 700 Children's Drive, Columbus, OH 43205 USA
| | - Chris Holloman
- 6Department of Statistics, The Ohio State University, 404 Cockins Hall, 1958 Neil Ave, Columbus, OH 43210 USA
| | - Julie A Kennel
- 7Department of Human Sciences, Human Nutrition Program, The Ohio State University, 315 Campbell Hall, 1787 Neil Avenue, Columbus, OH 43210 USA
| | - Alison Webster
- 8Department of Human Sciences, Human Nutrition Program, The Ohio State University, 319 Campbell Hall, 1787 Neil Avenue, Columbus, OH 43210 USA
| | - Amy R Sharn
- 9Department of Human Sciences, Human Nutrition Program, The Ohio State University, 262B Campbell Hall, 1787 Neil Avenue, Columbus, OH 43210 USA
| | - Carolyn Gunther
- 10Department of Human Sciences, Human Nutrition Program, The Ohio State University, 313 Campbell Hall, 1787 Neil Avenue, Columbus, OH 43210 USA
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Hopkins LC, Penicka C, Evich C, Jones B, Gunther C. Project SWEAT (Summer Weight and Environmental Assessment Trial): study protocol of an observational study using a multistate, prospective design that examines the weight gain trajectory among a racially and ethnically diverse convenience sample of economically disadvantaged school-age children. BMJ Open 2018; 8:e021168. [PMID: 30158223 PMCID: PMC6119428 DOI: 10.1136/bmjopen-2017-021168] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 07/17/2018] [Accepted: 07/26/2018] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Racial/ethnic minority school-age children are at risk for unhealthy weight gain during the summer, and there is a dearth of information regarding the underlying behavioural and environmental factors. The study objective is to provide an in-depth examination of dietary and physical activity behaviours and food, physical activity, and social environments of African American and Hispanic school-age children during the summer. METHODS AND ANALYSIS An observational study will be conducted using a multistate (Ohio and Indiana, USA) prospective design examining the weight gain trajectory among a racially/ethnically diverse convenience sample of economically disadvantaged school-age children. In addition, a subset of these children will be evaluated to learn their daily health behaviours and food, physical activity, and social environments during the summer. Comparisons will be made between children who routinely attend programming and those who do not, both in the larger sample and subset. Determinants of programme participation and factors that may enhance the beneficial effects of programme participation will also be identified. Data collection at the Indiana site is planned for summer 2018. ETHICS AND DISSEMINATION This study is approved by The Ohio State University Behavioral and Social Sciences Institutional Review Board. Results from this study will be disseminated in publications for practitioners, scientists and stakeholders. TRIAL REGISTRATION NUMBER NCT03010644; Pre-results.
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Affiliation(s)
- Laura C Hopkins
- Interdisciplinary PhD Program in Nutrition, The Ohio State University, Columbus, Ohio, USA
| | - Christine Penicka
- Department of Human Sciences, Human Nutrition Program, The Ohio State University, Columbus, Ohio, USA
| | - Carly Evich
- Department of Human Development and Family Science, Purdue University, West Lafayette, Indiana, USA
| | - Blake Jones
- Department of Human Development and Family Science, Purdue University, West Lafayette, Indiana, USA
| | - Carolyn Gunther
- Department of Human Sciences, Human Nutrition Program, The Ohio State University, Columbus, Ohio, USA
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Henry JL, Trude ACB, Surkan PJ, Anderson Steeves E, Hopkins LC, Gittelsohn J. Psychosocial Determinants of Food Acquisition and Preparation in Low-Income, Urban African American Households. Health Educ Behav 2018; 45:898-907. [PMID: 29589482 DOI: 10.1177/1090198118760686] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Psychosocial factors are important determinants of health behaviors and diet-related outcomes, yet relatively little work has explored their relation to food-purchasing and preparation behaviors in low-income populations. AIM To evaluate the psychosocial factors associated with food-related behaviors. METHODS Cross-sectional data collected from 465 low-income African American adult caregivers in the baseline evaluation of the B'more Healthy Communities for Kids obesity prevention trial. Questionnaires were used to assess household sociodemographic characteristics, food sources frequently used, and food preparation and food acquisition behaviors. Multiple linear regression models explored the associations between caregiver psychosocial variables and food-related behaviors, controlling for caregivers' age, sex, household income, household size, and food assistance participation. RESULTS Caregivers purchased prepared food at carry-outs on average 3.8 times (standard deviation [ SD] = 4.6) within 30 days. Less healthy foods were acquired 2 times more frequently than healthier foods ( p < .001). Higher food-related behavioral intention and self-efficacy scores were positively associated with healthier food acquisition (β = 0.7; 95% confidence interval [CI] [0.09, 1.4]; β = 0.04; 95% CI [0.02, 0.06]) and negatively associated with frequency of purchasing at prepared food sources (β = -0.4; 95% CI [-0.6, -0.2]; β = -0.5; 95% CI [-0.7, -0.3]), respectively. Higher nutrition knowledge was associated with lower frequency of purchasing food at prepared food venues (β = -0.7; 95% CI: [-1.2, -0.2]). DISCUSSION Our findings indicate a positive association between psychosocial determinants and healthier food acquisition and food preparation behaviors. CONCLUSION Interventions that affect psychosocial factors (i.e., food-related behavioral intentions and self-efficacy) may have the potential to increase healthier food preparation and food-purchasing practices among low-income African American families.
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Affiliation(s)
| | - Angela C B Trude
- 2 Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Pamela J Surkan
- 2 Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | - Joel Gittelsohn
- 2 Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Hopkins LC, Holben DH. Food insecure community gardeners in rural Appalachian Ohio more strongly agree that their produce intake improved and food spending decreased as a result of community gardening compared to food secure community gardeners. Journal of Hunger & Environmental Nutrition 2017. [DOI: 10.1080/19320248.2017.1364193] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | - David H. Holben
- Department of Nutrition & Hospitality Management, The University of Mississippi, Mississippi, USA
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Hopkins LC, Hooker NH, Gunther C. Securing a Stop to the Summer Setback: Policy Considerations in the Future Expansion of the Summer Electronic Benefit Transfer for Children. J Nutr Educ Behav 2017; 49:692-699.e1. [PMID: 27998694 DOI: 10.1016/j.jneb.2016.10.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 10/10/2016] [Accepted: 10/17/2016] [Indexed: 06/06/2023]
Abstract
The Summer Electronic Benefits Transfer for Children (SEBTC) has been proposed as a solution to address the problem of child food security during the summer. Initial SEBTC findings from a demonstration project show promise and the federal government has approved substantial funding for its continuation. This report reviews empirical assessments of SEBTC and Electronic Benefits Transfer research, and presents policy considerations in the program's future expansion.
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Affiliation(s)
- Laura C Hopkins
- Department of Human Sciences, Human Nutrition Program, Ohio State University, Columbus, OH
| | - Neal H Hooker
- John Glenn College of Public Affairs, Ohio State University, Columbus, OH
| | - Carolyn Gunther
- Department of Human Sciences, Human Nutrition Program, Ohio State University, Columbus, OH.
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Hopkins LC, Sattler M, Steeves EA, Jones-Smith JC, Gittelsohn J. Breakfast Consumption Frequency and Its Relationships to Overall Diet Quality, Using Healthy Eating Index 2010, and Body Mass Index among Adolescents in a Low-Income Urban Setting. Ecol Food Nutr 2017; 56:297-311. [PMID: 28604287 PMCID: PMC5725744 DOI: 10.1080/03670244.2017.1327855] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The aim of this study was to describe the relationship of breakfast frequency to diet quality and BMI among low-income, predominantly African American adolescents aged 9-15 (n = 239). Mean frequency of breakfast consumption was 5.0 ± 0.15 times per week. A significant, positive relationship was seen between HEI scores and frequency of breakfast consumption (p = .01). Dairy (p = .02) and whole grains (p < .01) HEI component scores were significantly related to breakfast frequency. No relationship was seen between breakfast frequency and BMI. Research with more rigorous designs should be conducted to assess the potential effects of breakfast consumption on diet quality in this population.
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Affiliation(s)
- Laura C. Hopkins
- Department of Human Sciences, Ohio State University, Columbus, Ohio, USA
| | - Melissa Sattler
- Agaston Urban Nutrition Initiative, Philadelphia, Pennsylvania, USA
| | | | - Jessica C. Jones-Smith
- Department of Health Services, Department of Epidemiology, School of Public Health, University of Washington, Seattle Washington, USA
| | - Joel Gittelsohn
- Global Obesity Prevention Center at Johns Hopkins, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Yamaguchi M, Steeves EA, Shipley C, Hopkins LC, Cheskin LJ, Gittelsohn J. Inconsistency between Self-Reported Energy Intake and Body Mass Index among Urban, African-American Children. PLoS One 2016; 11:e0168303. [PMID: 27977776 PMCID: PMC5158042 DOI: 10.1371/journal.pone.0168303] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 11/30/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND To prevent obesity, it is important to assess dietary habits through self-reported energy intake (EI) in children. We investigated how EI is associated with body mass index and which elements of dietary habits and status are associated with EI among African-American (AA) children. METHODS We assessed and included data from 218 10-14-year-old AA children in Baltimore, MD, USA. EI was calculated using a food frequency questionnaire. The basal metabolic rate (BMR) was used as the predicted minimal rate of energy expenditure of children. A fully adjusted multiple logistic regression was used to determine the prevalence of obesity (≥ 95th BMI-for-age percentile) among the quartiles of EI/BMR ratio using the third quartile for the reference. The differences in the age-adjusted mean EI/BMR among the categories of dietary habits, social support, and socio economic status were analyzed using a general linear model. RESULTS Children with the lowest EI/BMR had significantly higher adjusted odds ratio (aOR) of obesity as compared to those in the third quartile of EI/BMR (boys aOR 4.3; 95% confidence interval 1.08, 20 and girls aOR 4.1; 1.02, 21). In girls, the adjusted mean EI/BMR in the group that prepared food less than the means (3.8 times/week) was significantly lower than the group that prepared food over the means (P = 0.03). Further, the group that reported eating breakfast under 4 times/week indicated an adjusted mean EI/BMR lower than the group that ate breakfast over 5 times/week in both sexes. CONCLUSIONS When EI was under-reported with reference to BMR, we may observe high prevalence of obesity. Further, food preparation by children and frequent consumption of breakfast may instill food cognition with usual dietary habits. Therefore, holistic assessments including dietary habits are required to examine self-reported food intake especially among overweight/obese children.
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Affiliation(s)
- Miwa Yamaguchi
- Department of Nutritional Science, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Elizabeth Anderson Steeves
- Department of International Health, Global Obesity Prevention at Johns Hopkins, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Cara Shipley
- Department of International Health, Global Obesity Prevention at Johns Hopkins, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Laura C. Hopkins
- Department of International Health, Global Obesity Prevention at Johns Hopkins, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Lawrence J. Cheskin
- Department of International Health, Global Obesity Prevention at Johns Hopkins, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Joel Gittelsohn
- Department of International Health, Global Obesity Prevention at Johns Hopkins, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
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Hopkins LC, Fristad M, Goodway JD, Eneli I, Holloman C, Kennel JA, Melnyk B, Gunther C. Camp NERF: methods of a theory-based nutrition education recreation and fitness program aimed at preventing unhealthy weight gain in underserved elementary children during summer months. BMC Public Health 2016; 16:1122. [PMID: 27784290 PMCID: PMC5080748 DOI: 10.1186/s12889-016-3765-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 10/12/2016] [Indexed: 01/12/2023] Open
Abstract
Background The number of obese children in the US remains high, which is problematic due to the mental, physical, and academic effects of obesity on child health. Data indicate that school-age children, particularly underserved children, experience unhealthy gains in BMI at a rate nearly twice as fast during the summer months. Few efforts have been directed at implementing evidence-based programming to prevent excess weight gain during the summer recess. Methods Camp NERF is an 8-week, multi-component (nutrition, physical activity, and mental health), theory-based program for underserved school-age children in grades Kindergarten - 5th coupled with the USDA Summer Food Service Program. Twelve eligible elementary school sites will be randomized to one of the three programming groups: 1) Active Control (non-nutrition, physical activity, or mental health); 2) Standard Care (nutrition and physical activity); or 3) Enhanced Care (nutrition, physical activity, and mental health) programming. Anthropometric, behavioral, and psychosocial data will be collected from child-caregiver dyads pre- and post-intervention. Site-specific characteristics and process evaluation measures will also be collected. Discussion This is the first, evidence-based intervention to address the issue of weight gain during the summer months among underserved, school-aged children. Results from this study will provide researchers, practitioners, and public health professionals with insight on evidence-based programming to aid in childhood obesity prevention during this particular window of risk. Trial Registration NCT02908230/09-19-2016
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Affiliation(s)
- Laura C Hopkins
- Department of Human Sciences, Human Nutrition Program, The Ohio State University, 262B Campbell Hall, 1787 Neil Avenue, Columbus, OH, 43210, USA
| | - Mary Fristad
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, 1670 Upham Drive Suite 460G, Columbus, OH, 43210-1250, USA
| | - Jacqueline D Goodway
- Department of Human Sciences, Kinesiology Program, College of Education & Human Ecology, The Ohio State University, A244 305 Annie & John Glenn Ave, Columbus, OH, 43210, USA
| | - Ihuoma Eneli
- Nationwide Children's Hospital; The Ohio State University, 700 Children's Drive, Columbus, OH, 43205, USA
| | - Chris Holloman
- Department of Statistics, The Ohio State University, 404 Cockins Hall, 1958 Neil Ave, Columbus, OH, 43210, USA
| | - Julie A Kennel
- Department of Human Sciences, Human, The Ohio State University, 315 Campbell Hall, 1787 Neil Avenue, Columbus, OH, 43210, USA
| | - Bernadette Melnyk
- College of Nursing, The Ohio State University, 1585 Neil Avenue, Rm. 145, Columbus, OH, 43210, USA
| | - Carolyn Gunther
- Department of Human Sciences, Human Nutrition Program, The Ohio State University, 313 Campbell Hall, 1787 Neil Avenue, Columbus, OH, 43210, USA.
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20
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Hopkins LC, Gunther C. A Historical Review of Changes in Nutrition Standards of USDA Child Meal Programs Relative to Research Findings on the Nutritional Adequacy of Program Meals and the Diet and Nutritional Health of Participants: Implications for Future Research and the Summer Food Service Program. Nutrients 2015; 7:10145-67. [PMID: 26690207 PMCID: PMC4690075 DOI: 10.3390/nu7125523] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 11/17/2015] [Accepted: 11/26/2015] [Indexed: 11/16/2022] Open
Abstract
Background: The USDA child meal programs (CMPs) (National School Lunch Program (NSLP), School Breakfast Program (SBP), and Summer Food Service Program (SFSP) were established in 1946 (NSLP) and 1975 (SBP and SFSP) to improve the diet and nutritional health of US children. There is concern that participation in these programs may in fact be a contributor to the current childhood obesity epidemic. Objective: The purpose of this study was to determine if the CMPs are meeting their intended goal by reviewing the historical changes to nutrition standards of the CMPs in correspondence with the literature that examines the nutritional adequacy of meals served as part of these programs, as well as the dietary intakes and nutritional status of participants. Methods: Public Law and the Federal Register were reviewed and websites and online databases were systematically searched. Results: NSLP and SBP first underwent updates to the nutrition standards in 1994 and subsequently 2010, whereas SFSP last underwent modifications in 2000. The majority of data, all collected prior to 2010, demonstrate that meals served as part of the NSLP and SBP are not meeting nutrition standards. In addition, the dietary intakes of NSLP and SBP participants are high in calories, fat, saturated fat, and sodium, and low in fiber. Studies examining the weight status and other nutrition-related health outcomes of NSLP and SBP participants have produced mixed results. In contrast, no studies published in the peer-reviewed literature have been conducted examining the nutritional adequacy of SFSP meals or the dietary intakes or nutritional health of SFSP participants. There are public reports available on the nutritionally adequacy of SFSP meals, however, they are severely outdated (1988 and 2003). Due to this dearth of information, a case study on a sample SFSP menu from summer 2015 was conducted; results showed that the meals are high in carbohydrate and protein content and insufficient in vegetable servings. Conclusions: There is critical need for policy change that would enable updates to the SFSP nutrition standards to match those of the NSLP and SBP. In addition, strategies are needed to facilitate development of CMP menus that meet current nutrition standards. Finally, rigorously designed studies are needed to understand the direct impact of CMP participation on child diet and health, particularly the SFSP for which there is limited published data.
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Affiliation(s)
- Laura C Hopkins
- Department of Human Sciences-Human Nutrition, College of Education and Human Ecology, The Ohio State University, 1787 Neil Avenue, RM 262B, Columbus, OH 43210, USA.
| | - Carolyn Gunther
- Department of Human Sciences-Human Nutrition, College of Education and Human Ecology, The Ohio State University, 1787 Neil Avenue, RM 313, Columbus, OH 43210, USA.
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Gittelsohn J, Anderson Steeves E, Mui Y, Kharmats AY, Hopkins LC, Dennis D. B'More Healthy Communities for Kids: design of a multi-level intervention for obesity prevention for low-income African American children. BMC Public Health 2014; 14:942. [PMID: 25209072 PMCID: PMC4168194 DOI: 10.1186/1471-2458-14-942] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 09/03/2014] [Indexed: 11/17/2022] Open
Abstract
Background Childhood obesity rates in the U.S. have reached epidemic proportions, and an urgent need remains to identify evidence-based strategies for prevention and treatment. Multi-level, multi-component interventions are needed due to the multi-factorial nature of obesity, and its proven links to both the social and built environment. However, there are huge gaps in the literature related to doing these kinds of interventions among low-income, urban, minority groups. Methods The B’More Healthy Communities for Kids (BHCK) intervention is a multi-level, multi-component intervention, targeting low-income African American youth ages 10–14 and their families in Baltimore, Maryland. This intervention prevents childhood obesity by working at multiple levels of the food and social environments to increase access to, demand for, and consumption of healthier foods. BHCK works to create systems-level change by partnering with city policy-makers, multiple levels of the food environment (wholesalers, corner stores, carryout restaurants), and the social environment (peers and families). In addition, extensive evaluation will be conducted at each level of the intervention to assess intervention effectiveness via both process and impact measures. Discussion This project is novel in multiple ways, including: the inclusion of stakeholders at multiple levels (policy, institutional, and at multiple levels of the food system); that it uses novel computational modeling methodologies to engage policy makers and guide informed decisions of intervention effectiveness; it emphasizes both the built environment (intervening with food sources) and the social environment (intervening with families and peers). The design of the intervention and the evaluation plan of the BHCK project are documented here. Trial registration NCT02181010 (July 2, 2014).
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Affiliation(s)
- Joel Gittelsohn
- Johns Hopkins Global Obesity Prevention Center, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe St, Baltimore, MD 21205-2179, USA.
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Hopkins LC, Sladky JT. Teaching in the field: the model of a one-day trip to an outreach clinic. Semin Neurol 2001; 21:359-69. [PMID: 11774051 DOI: 10.1055/s-2001-19407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
A trip to an outreach clinic in a 15-passenger van is presented as part of the answer to the forces negatively affecting the practice of academic medicine today. Any subspecialist in a medical center can use the model if a community can be identified that has a hospital or clinic building able to host the university group. County- or state-funded facilities are well suited to a periodic clinic, and public health nurses are well trained in their management. The Muscular Dystrophy Association is a private supporter of clinics like this, allowing specialty doctor visits close to home for patients with disabling weakness who might otherwise be excluded from our increasingly restricted health care system.
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Affiliation(s)
- L C Hopkins
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia 30322, USA
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Abstract
Emery-Dreifuss muscular dystrophy (EDMD) is the third most common X-linked muscular dystrophy. This disorder is characterized by childhood onset of early contractures, humeroperoneal muscle atrophy, and cardiac conduction abnormalities. Weakness is slowly progressive, but there is a broad spectrum of clinical severity. Patients and carriers are at risk of sudden death. Regular cardiac evaluation is mandatory to assess the risk of cardiac arrhythmias. Unique atrial pathology is seen at autopsy. The mutated gene in EDMD is localized to the long arm of the X chromosome. Mutations in the gene lead to abolished synthesis of the gene product, emerin. Emerin is localized to the nuclear membrane of skeletal, cardiac, and smooth muscle. The term Emery-Dreifuss syndrome describes patients who have the EDMD phenotype without X-linked inheritance. There is no treatment for the underlying disease, but early placement of pacemakers may be lifesaving.
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Affiliation(s)
- A S Zacharias
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia 30322, USA
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Affiliation(s)
- L C Hopkins
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
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Abstract
OBJECTIVES To report and characterize two forms of disabling progressive peripheral neuropathy in patients with diabetes mellitus, which respond to anti-inflammatory and/or anti-immune treatment. DESIGN Review of clinical, electrophysiologic, and pathologic findings and results of treatment. SETTING University medical center. PATIENTS Twenty-one patients with diabetes mellitus to whom we gave anti-inflammatory and/or anti-immune treatment for progressive peripheral neuropathy during the past 6 years. MAIN OUTCOME MEASURES Patients were interviewed and examined at intervals before and after beginning treatment with intravenous immunoglobulin (n = 15), prednisone (n = 13), cyclophosphamide (n = 5), plasma exchange (n = 3), and azathioprine (n = 1) (alone or in combination). RESULTS Fifteen patients had evidence of axonal neuropathy by electrophysiologic studies (group A). All 15 patients had non-insulin-dependent diabetes mellitus, 10 patients had weight loss, and 13 patients had prominent involvement of thighs and/or thoracic bands consistent with diabetic amyotrophy or mononeuropathy multiplex. Small vessel disease was seen in all 10 patients who underwent biopsy, with perivascular or vascular inflammation seen in seven patients. Six patients had demyelinating neuropathy by electrophysiologic criteria (group B). All these patients had insulin-dependent diabetes mellitus, and no one had weight loss. The process was asymmetric in three patients and involved thoracic or abdominal regions in two patients. Onion bulbs were seen in all four patients who underwent biopsy, but no vascular inflammation or occlusion was seen. In all patients in both groups, worsening of their conditions stopped and improvement started after beginning treatment. CONCLUSION Neuropathies responsive to anti-inflammatory and/or anti-immune therapy in patients with diabetes mellitus include (1) multifocal axonal neuropathy caused by inflammatory vasculopathy, predominantly in patients with non-insulin-dependent diabetes mellitus, indistinguishable from diabetic proximal neuropathy or mononeuropathy multiplex, and (2) demyelinating neuropathy indistinguishable from chronic inflammatory demyelinating polyneuropathy, predominantly in patients with insulin-dependent diabetes mellitus.
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Affiliation(s)
- D A Krendel
- Department of Neurology, Emory University School of Medicine, Atlanta, Ga, USA
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Affiliation(s)
- G D Riebel
- Department of Neurology, Emory Clinic Spine Center, Atlanta, Georgia 30322, USA
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Abstract
A cross-sectional study was performed to assess the utility of vibrotactile thresholds (VTs) obtained before and after a 10-minute period of wrist flexion as a method for detection of carpal tunnel syndrome (CTS) among adult subjects. Subjects with hand discomfort were recruited from patients referred to a university-based electromyography laboratory. Asymptomatic subjects were recruited from among office and technical staff at a professional school. In addition to electrophysiologic evaluation (EP), all subjects were offered VT measurement of the index and small fingers, bilaterally, before and after a 10-minute period of wrist flexion. A total of 144 subjects were recruited, and three hand-condition groups were established: 57 hands had symptoms and EP results compatible with CTS (Group 1), 58 hands had symptoms compatible with CTS and normal EP results (Group 2), and 123 hands had no symptoms and normal EP results (Group 3). Group 1 was considered the "disease-positive" group, and Groups 2 and 3 were both considered "disease-negative" groups. Analyses were performed separately for dominant and nondominant hands, and results were pooled when appropriate. Outcomes of interest were the VTs obtained from the index and small fingers before and after 10 minutes of maximal voluntary wrist flexion as well as variables calculated from them. Significant differences in mean VT were observed between the three hand-condition groups for most of the outcomes evaluated. At any given level of specificity, the sensitivity of vibrometry performed after 10 minutes of wrist flexion was approximately two times that obtained before wrist flexion for detection of electrophysiologically confirmed CTS.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- F Gerr
- Division of Environmental and Occupational Health, Emory University School of Public Health, Atlanta, GA 30322, USA
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Hopkins LC. Clinical features of myasthenia gravis. Neurol Clin 1994; 12:243-61. [PMID: 8041340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Myasthenia gravis (MG) is an antibody-mediated muscle disease in which any skeletal muscle can be affected. MG may produce numerous symptoms and signs. To doctors and patients, it may seem like lung disease, stroke, heart disease, or the effects of emotional stress. This article explores the "territory" between MG and diseases of the heart and lungs as well as the other neuromuscular diseases.
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Affiliation(s)
- L C Hopkins
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia
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Abstract
OBJECTIVE To report a sudden death in a female carrier of Emery-Dreifuss muscular dystrophy and to describe the cardiac abnormalities associated with this disease. STUDY DESIGN Case series. SETTING University hospital. PATIENTS A 45-year-old carrier who died suddenly and two affected men who also died of cardiac manifestations of Emery-Dreifuss muscular dystrophy. MEASUREMENTS Post-mortem gross pathologic and histopathologic study of the heart. RESULTS All three hearts showed a unique pattern of pathologic findings. Marked loss of atrial myocardium had occurred. Myocardium had been replaced by adipose and fibrous tissue. The conduction system showed no significant abnormalities. Varying degrees of interstitial and replacement fibrosis were present in the ventricular myocardium. CONCLUSIONS Emery-Dreifuss muscular dystrophy is associated with characteristic pathologic changes in the heart that can cause death in female carriers and affected men. Female carriers should be identified and evaluated because of the risk for sudden cardiac death.
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Consalez GG, Thomas NS, Stayton CL, Knight SJ, Johnson M, Hopkins LC, Harper PS, Elsas LJ, Warren ST. Assignment of Emery-Dreifuss muscular dystrophy to the distal region of Xq28: the results of a collaborative study. Am J Hum Genet 1991; 48:468-80. [PMID: 1998333 PMCID: PMC1682981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Emery-Dreifuss muscular dystrophy (EDMD) is an X-linked humeroperoneal dystrophy associated with cardiomyopathy that is distinct from the Duchenne and Becker forms of X-linked muscular dystrophy. Linkage analysis has assigned EDMD to the terminal region of the human X chromosome long arm. We report here further linkage analysis in two multigenerational EDMD families using seven Xq28 marker loci. Cumulative lod scores suggest that EDMD is approximately 2 cM from DXS52 (lod = 15.67) and very close to the factor VIII (F8C) and the red/green color pigment (R/GCP) loci, with respective lod scores of 9.62 and 10.77, without a single recombinant. Several recombinations between EDMD and three proximal Xq28 markers suggest that the EDMD gene is located in distal Xq28. Multipoint linkage analysis indicates that the odds are 2,000:1 that EDMD lies distal to DXS305. These data substantially refine the ability to perform accurate carrier detection, prenatal diagnosis, and the presymptomatic diagnosis of at-risk males for EDMD by linkage analysis. The positioning of the EDMD locus close to the loci for F8C and R/GCP will assist in future efforts to identify and isolate the disease gene.
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Schubert EF, Kuo JM, Kopf RF, Jordan AS, Luftman HS, Hopkins LC. Fermi-level-pinning-induced impurity redistribution in semiconductors during epitaxial growth. Phys Rev B Condens Matter 1990; 42:1364-1368. [PMID: 9995549 DOI: 10.1103/physrevb.42.1364] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Wallace DC, Zheng XX, Lott MT, Shoffner JM, Hodge JA, Kelley RI, Epstein CM, Hopkins LC. Familial mitochondrial encephalomyopathy (MERRF): genetic, pathophysiological, and biochemical characterization of a mitochondrial DNA disease. Cell 1988; 55:601-10. [PMID: 3180221 DOI: 10.1016/0092-8674(88)90218-8] [Citation(s) in RCA: 340] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
A large MERRF pedigree permitted the direct testing of the predictions for a mitochondrial DNA (mtDNA) mutation. A mtDNA mutation was demonstrated by proving maternal inheritance and by identifying specific deficiencies in muscle energetics and mitochondrial respiratory complexes I and IV. mtDNA heteroplasmy (a mixture of mutant and wild-type mtDNAs) was demonstrated by showing variation in the mitochondrial energetic capacity between family members. The phenotypic consequences of differential tissue-specific reliance on mitochondrial ATP was shown by correlating individual respiratory deficiency with the nature and severity of patients' clinical manifestations. The observed spectrum of clinical manifestations resulting from this heteroplasmic mtDNA mutation implies that mtDNA disease may be much more prevalent than previously anticipated.
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Affiliation(s)
- D C Wallace
- Department of Biochemistry, W. M. B., Emory University School of Medicine, Atlanta, Georgia 30322
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Abstract
Two brothers and an unrelated man had serum creatine kinase values of 3000-8000 units when they were asymptomatic, and there was no weakness on examination. EMG and muscle biopsy showed changes indicative of myopathy. Years later, all three developed weakness that was limited to the gastrocnemius. Because siblings were affected, the disorder can be regarded as a form of muscular dystrophy. The distribution of weakness, serum enzyme changes, and histologic changes resembled an autosomal recessive distal myopathy first described by Miyoshi and differed from many other reported cases of distal myopathy. Our cases also indicate that myopathy may be asymptomatic.
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Thomas NS, Williams H, Elsas LJ, Hopkins LC, Sarfarazi M, Harper PS. Localisation of the gene for Emery-Dreifuss muscular dystrophy to the distal long arm of the X chromosome. J Med Genet 1986; 23:596-8. [PMID: 3100805 PMCID: PMC1049843 DOI: 10.1136/jmg.23.6.596] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The linkage relationships of the gene for Emery-Dreifuss muscular dystrophy have been analysed in a large American kindred using DNA probes from different regions of the X chromosome. Close linkage was found with the locus for factor VIII, with no recombinants in 12 opportunities (maximum lod score 4.3), and with locus DXS15 (two recombinants in 17 opportunities, maximum lod score 2.9 at 0 = 10 cM). No linkage was found with probes pERT87 and 754, which are closely linked to Duchenne and Becker muscular dystrophies at Xp21. These results confirm a separate localisation on the distal part of the long arm at q27-28 for Emery-Dreifuss muscular dystrophy and should provide the basis for prenatal diagnosis and improved carrier detection in this disorder if the linkage is confirmed to be close.
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Abstract
A patient with the Lambert-Eaton syndrome (LES) and small cell lung cancer developed respiratory failure several hours after verapamil was given. Improvement in respiratory function did not occur when guanidine was given, but was delayed until verapamil was discontinued 3 days later. Although other factors may have contributed to the clinical deterioration of our patient, the temporal relationship to verapamil and the theoretical danger of calcium channel blockade lead us to believe that the drug should be used cautiously in LES.
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Abstract
A family is described with familial myoclonic epilepsy associated with mitochondrial myopathy. The disorder follows a maternal inheritance pattern consistent with a mitochondrial DNA (mtDNA) mutation. The large kindred permitted exclusion of autosomal dominant, recessive, and X-linked patterns of transmission. Several characteristics of the inheritance and variability of expression within the pedigree are consistent with recently acquired knowledge about the genetics of human mtDNA. The clinical spectrum of disease is compatible with a proportionality model of mutant and wild-type mtDNAs. Muscle biopsies of affected patients showed an increased number of abnormal muscle mitochondria. Serum levels of pyruvate or pyruvate and lactate were elevated. The most severely affected patient had constant myoclonic jerking, dementia, ataxia, spasticity, hearing loss, and hypoventilation. Cerebral dysfunction in patients with mild involvement was marked by prominent photic driving seen on electroencephalograms and high-amplitude visual and somatosensory evoked responses but no myoclonus, ataxia, or dementia. The individual clinical features of the disease worsen over time for all patients; however, mildly affected patients have not become moderately affected and moderately affected patients have not become severely affected.
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Hopkins LC, Jackson JA, Elsas LJ. Emery-dreifuss humeroperoneal muscular dystrophy: an x-linked myopathy with unusual contractures and bradycardia. Ann Neurol 1981; 10:230-7. [PMID: 7294729 DOI: 10.1002/ana.410100306] [Citation(s) in RCA: 61] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Clinical, electromyographic, and muscle biopsy findings in the two largest known families with Emery-Dreifuss humeroperoneal muscular dystrophy indicate that this is an X-linked recessive muscle disease with stereotyped clinical manifestations but with variable pathological and electromyographic characteristics. Elbow contractures, involvement of humeral muscles, hyporeflexia, and abnormal electrocardiograms are present in our patients. The disorder is associated with a potentially lethal cardiac arrhythmia that should be managed by pacemaker insertion. The skeletal muscle disease is slowly progressive and is usually not life threatening. Muscle biopsy commonly shows type I fiber atrophy. Electromyography usually indicates myopathy, though the classic findings of myopathy may not be present in every muscle.
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Kaufman MD, Hopkins LC, Hurwitz BJ. Progressive sensory neuropathy in patients without carcinoma: a disorder with distinctive clinical and electrophysiological findings. Ann Neurol 1981; 9:237-42. [PMID: 6261671 DOI: 10.1002/ana.410090306] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Seven patients with severe progressive impairment of kinesthetic sense, mild dysfunction of cutaneous sense, and sparing of motor function were examined during a 3-year period. The clinical and electrophysiological findings are described in detail. None of these seven has had evidence of cancer despite a thorough investigation and a 3- to 16-year (average, 7 years) period of symptoms. These patients' symptoms were indistinguishable from those of patients with sensory neuropathy and coexistent carcinoma, suggesting that progressive sensory neuropathy is not invariably associated with carcinoma.
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Abstract
Disorders characterized by both neurologic (ataxia, ophthalmoplegia, ptosis, neuromyopathy) and cardiologic (heart block, cardiomyopathy) abnormalities have been previously called the "ophthalmoplegia plus" syndromes. Most are not due to a specific enzyme defect or metabolic abnormality and thus may be similar phenotypic expressions of diverse causes. We studied seven patients with progressive external ophthalmoplegia and variable ataxia, with mitral valve prolapse and mitral regurgitation that progressed in severity as did the neuromuscular manifestations. Abnormal skeletal muscle biopsies showed "ragged-red" fibers or congenital fiber type disproportion; serum alanine levels were elevated; in-vivo and in-vitro tests of pyruvate metabolism gave abnormal results; C4 complement was decreased; and the patients' fibroblasts bound immunoglobulin when incubated with autologous serum. These data suggest a distinct neuromuscular disorder with metabolic and immunologic features associated with mitral valve prolapse and progressive mitral regurgitation.
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Abstract
Eleven patients with hypertrophic obstructive cardiomyopathy and eight patients with idiopathic congestive cardiomyopathy underwent extensive neuromuscular studies to determine if a skeletal myopathy is associated with uncomplicated primary cardiomyopathy. The clinical examination revealed peripheral neuropathies in six patients, but no evidence of muscle weakness or atrophy. Nerve conduction studies demonstrated a neuropathy in five of these six and in one other patient: three were in the hypertrophic group and three in the congestive group. Seven patients had abnormal electromyography, but none had characteristic myopathic changes. Of these seven patients, muscle biopsies showed denervation in two patients in the congestive group and type II atrophy in two patients in the hypertrophic group. We found no evidence of primary skeletal muscle involvement; however, neuropathic features and biopsy changes of denervation were present in both groups.
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Abstract
To characterize an unusual, sex-linked recessive neuromuscular disease, we studied two families with 37 males who had involvement of distal leg and proximal arm muscle groups. Electromyography and muscle biopsy in five subjects showed features of both neuropathy and myopathy. Bradycardia and syncope in 15 involved subjects were associated with early death (before the age of 50 years). Electrocardiograms in 15 others showed a spectrum of atrial abnormalities that ranged from abnormal P waves to permanent atrial paralysis and from first-degree atrioventricular block to complete heart block. No patient exhibited clinical muscle disease without electrocardiographic atrial disease. Dilated, hypertrophied left ventricles with normal indexes of function were found in three cases with permanent atrial paralysis and chronic junctional bradycardia. Cardiomegaly and cardiac failure were not present in the other cases. We conclude that permanent ventricular pacing (instituted four patients) is indicated in many of these patients to prevent serious sequelae.
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Abstract
Three cases of mild lead poisoning were discovered among instructors at an indoor pistol range. These cases were characterized by blood lead levels greater than 100 mug/100 ml, free erythrocyte protoporphyrin levels greater than 450 mug/100 ml of red blood cells, abdominal pain, and, in one instance, by slowing of motor and sensory nerve conduction velocity. Exposure to airborne lead produced during revolver-firing and bullet-molding accounted for the lead absorption. Ventilation in the range was inadequate.
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