Risk of adult-onset asthma in Mexican-American women employed in food preparation or food service

Existing literature examining the association between occupation and asthma has not been adequately powered to address this question in the food preparation or food service industries. Few studies have addressed the possible link between occupational exposure to cooking fumes and asthma. This secondary analysis of cohort study data aimed to investigate the association between adult-onset asthma and exposure to: (a) cooking fumes at work or (b) longest-held employment in food preparation or food service (e.g. waiters and waitresses, food preparation workers, non-restaurant food servers, etc.). Participants arose from a cohort of Mexican-American women residing in Houston, TX, recruited between July 2001 and June 2007. This analysis used Cox proportional-hazards regression to estimate the hazard ratio of adult-onset asthma given the exposures of interest, adjusting for age, BMI, smoking status, acculturation, and birthplace. We found a strong association between adult-onset asthma and occupational exposure to cooking fumes (hazard ratio [HR] = 1.77; 95% confidence interval [CI], 1.15, 2.72), especially in participants whose longest-held occupation was not in the food-related industry (HR = 2.12; 95% CI, 1.21, 3.60). In conclusion, adult-onset asthma is a serious public health concern for food industry workers. ^

The relationship between supermarket nutrient movements and the mortality rates from fat-associated and non-fat-associated cardiovascular disease: Development of an ecologic method for determining community food patterns

Supermarket nutrient movement, a community food consumption measure, aggregated 1,023 high-fat foods, representing 100% of visible fats and approximately 44% of hidden fats in the food supply (FAO, 1980). Fatty acid and cholesterol content of foods shipped from the warehouse to 47 supermarkets located in the Houston area were calculated over a 6 month period. These stores were located in census tracts with over 50% of a given ethnicity: Hispanic, black non-Hispanic, or white non-Hispanic. Categorizing the supermarket census tracts by predominant ethnicity, significant differences were found by ANOVA in the proportion of specific fatty acids and cholesterol content of the foods examined. Using ecological regression, ethnicity, income, and median age predicted supermarket lipid movements while residential stability did not. No associations were found between lipid movements and cardiovascular disease mortality, making further validation necessary for epidemiological application of this method. However, it has been shown to be a non-reactive and cost-effective method appropriate for tracking target foods in populations of groups, and for assessing the impact of mass media nutrition education, legislation, and fortification on community food and nutrient purchase patterns. ^

Exploring the Association Between Household Food Insecurity, Parental Self-Efficacy, and Fruit and Vegetable Parenting Practices Among Parents of 5- to 8-Year-Old Overweight Children

Background: Food insecurity may negatively impact children’s nutritional status by affecting parenting quality. Because parents have a strong influence on their children’s eating and food choices, examining the effects of food insecurity on parenting may provide important insights into obesity prevention efforts. Objectives: This study explored whether food insecurity was associated with parental self-efficacy and parenting practices related to fruit and vegetable consumption. Methods: Secondary analysis was performed using baseline data from 31 mothers of 5-8 year old overweight or obese children who had participated in a pilot obesity treatment program. Household food security status, fruit and vegetable parental self-efficacy (modeling/socialization, planning/encouraging and availability/accessibility) and fruit and vegetable parenting practices (structure, responsiveness, non-directive control, and external control) were assessed using validated measures. Students' t-test investigated differences in subscales by food security status. Results: There were no significant differences in fruit and vegetable parenting practices and parental self-efficacy between food secure and insecure groups. There was a trend towards a decrease in parental self-efficacy for making fruit and vegetables available in the home among food insecure parents (p=.06). Conclusions: In this small sample no significant associations were found between food insecurity and fruit and vegetable parenting practices and parental self-efficacy. However, the trend observed in this exploratory analysis supports further hypothesis-driven research with a larger sample size able to detect more subtle differences.

Non-sexual household transmission of HCV infection: A cohort study

Objective. This study was designed to determine the prevalence and incidence of HCV infection among non-sexual household contacts of HCV-infected women and to describe the association between HCV infection and potential household risk factors in order to examine whether non-sexual household contact is a route of transmission for HCV infection. ^ Methods. A baseline prevalence survey included 409 non-sexual household contacts of 241 HCV-infected index women in the Houston area from 1994 to 1997. A total of 470 non-sexual household contacts with no evidence of HCV infection at baseline investigation were re-assessed approximately three years after baseline enrollment. Information on potential risk factors was collected through face to face interviews and blood samples were tested for anti-HCV with ELISA-2 and Matrix/RIBA-2. The relationships between HCV infection and potential risk factors were examined by using univariate and multivariate logistic regression analyses. ^ Results. The overall prevalence of anti-HCV positivity among 409 non-sexual household contacts was 4.4%. The highest prevalence of anti-HCV was found in parents (19.5%), followed by siblings (8.1%) and other relatives (5.6%); the children had the lowest prevalence of anti-HCV (1.2%). The univariate analysis showed that IDU, blood transfusion, tattoos, sexual contact with injecting drug users, more than 3 sexual partners in a lifetime, history of a STD, incarceration, previous hepatitis, and contact with hepatitis patients were significantly associated with HCV infection, however, sharing razors, nail clippers, toothbrushes, gum, food or beds with HCV-infected women, and history of dialysis, health care job, body piercing, and homosexual activities were not. Multivariate analysis found that IDU (OR = 221.7 with 95% CI of 22.8 to 2155.7) and history of a STD (OR = 11.7 with 95% CI of 1.2 to 113.1) were the only variables significantly associated with HCV infection. No such associations remained for other risk factors. The three-year cumulative incidence of anti-HCV among 352 non-sexual household contacts of HCV-infected women was zero. ^ Conclusion. This study has provided no evidence that non-sexual household contact is a likely route of transmission for HCV infection. The risk of sharing razors, nail clippers, toothbrushes, gum, food and/or beds with HCV-infected women is not evident and has not been shown to be the likely mode for HCV spread among family members. This study does suggest that IDU is the likely route of transmission for most HCV infection. Association also has been shown independently with a history of STD. The prevalence of anti-HCV among non-sexual household contacts was low. Exposure to common parenteral risk factors and sexual transmission between sexual partners may account for HCV spread among household members of HCV-infected persons. ^

Food advertisements during children's television programming in 2007: Comparison with ads in 1994 and the 2005 dietary recommendations

Childhood overweight and obesity are two major public health problems that are of economic and medical concern in the world today (Lobstein, Baur, & Uauy, 2004). Overweight conditions in childhood are important because they are widely prevalent, serious, and carry lifetime consequences for health and well being (Lobstein et al., 2004). Several studies have shown an association between television viewing and obesity in all age groups (Caroli, Argentieri, Cardone, & Masi, 2004; Harper, 2006; Vandewater & Huang, 2006; Wiecha et al., 2006). One mechanism that potentially links television viewing to childhood obesity is food advertising (Story, 2003). ^ The purpose of this study was to examine the types of foods advertised on children's television programming and to determine if there have been any changes in the number and types of commercials over the last 13 years. In addition, the food content of the advertisements was compared to the 2005 Dietary Guidelines to determine if the foods targeted were consistent with the current recommendations. Finally, each television network was analyzed individually to determine any differences between advertising on cable and regular programming. ^ A descriptive analysis was conducted on the most commonly advertised commercials during children's television programming on Saturday morning from 7 a.m. to 10:30 a.m. A total of 10 major television networks were viewed on three different Saturday mornings during June and July 2007. Commercial advertising accounted for approximately 19% of children's total viewing time. Of the 3,185 commercials, 28.5% were for foods, 67.7% were for non-food items, and 3.8% were PSAs. On average, there were 30 commercial advertisements and PSAs per hour, of which approximately nine were for food. ^ Of the 907 food advertisements, 72.0% were for foods classified in the fats, oils, and sugar group. The next largest group (17.3%) was for restaurant food of which 15.3% were for unhealthy/fast food restaurant fare. The most frequently advertised food product on Saturday morning television was regular cereal, accounting for 43.9% of all food advertisements. ^ Cable and regular programming stations varied slightly in the amount, length, and category of commercials. Cable television had about 50% less commercials and PSAs (1098) than regular programming (2087), but only had approximately 150 minutes less total commercial and PSA time; therefore, cable, in general, had longer commercials than regular programming. Overall, cable programming had more advertisements encouraging increased physical activity and positive nutrition behavior with less commercials focusing on the fats, oils, and sugar groups, compared to regular programming. ^ During the last 13 years, food advertisements have not improved, despite the recent IOM report on marketing foods to children (Institute of Medicine-Committee on Food Marketing and the Diets of Children and Youth, 2005), although the frequency of food advertisements has improved slightly. Children are now viewing an average of one food advertisement every 7 minutes, compared to one food advertisement every 5 minutes in 1994 (Kotz & Story, 1994). Therefore, manufacturers are putting a greater emphasis on advertising other products to children. Despite the recent attention to the issue of marketing unhealthy foods to children through television advertisements, not much progress has been noted since 1994. Further advocacy and regulatory issues concerning the content of advertisements during Saturday morning TV need to be explored. ^

Point-of-sale machines in school cafeterias and parental influence on child food choices

The prevalence of obesity has reached epidemic proportions in the United States. Twenty-five percent of school aged students are overweight. Schools have the opportunity to help slow this epidemic. School cafeterias in the United States feed millions of students every day through the National School Lunch Program.^ Point-of-sale machines are used in most school cafeterias to help streamline the process of purchasing school lunches. The point-of-sale software allows school personnel to place special notes on student's accounts to provide alerts about parental requests. This study investigated what the alerts are used for, who uses the alerts, and if there are any patterns by demographic characteristics. ^ Counts and percentages were used to determine what the alerts were used for and who used them. This study found that students who were white non-Hispanic, paid status, or in elementary school were most likely to have alerts placed on their accounts. Also, the majority of point-of-sale alerts were used as allowances (i.e., allowed to purchase snacks from the balance on the school lunch account), rather than restrictions (i.e., restricted from purchasing high calorie foods or specific food items). Using chi-square analysis, a total of 688 alerts were analyzed. There were significant differences in alert frequencies for intent category by grade level (p=0.000), snack access (p=0.000), and gender (p=0.002). Therefore, the results are significant, and one can conclude there is a significant relationship between gender, grade level, and snack access, and the presence of an alert on the school lunch account.^ Also, school administrators may want to take into consideration possible changes to their program, such as requiring more time to run the software. The results of this study can assist school administrators to better understand that a point-of-sale alert program may help their school lunch programs run more efficiently, while also providing parental influence on students’ food choices at the point-of-sale.^ School food service authorities should consider implementing a structured point-of-sale alert policy to encourage parental input on their children's food choices. When implementing the point-of-sale policy, schools should publicize this policy online, through school lunch menus, and parent communications increase participation throughout the school district.^

A study of the association between timing of solid food introduction in infants and overweight and obesity in pre-school aged children in NHANES 2003-2008

Background. Previous studies suggest an association between timing of introduction of solid food and increased risk of obesity in pre-school aged children, but no study included a representative sample of US children. We sought to examine whether there was any association between the timing of solid food introduction and overweight/obesity in pre-school aged children. Design/methods. Cross-sectional study of a nationally representative sample (N=2050) of US children aged 2 to 5 years with information on infant feeding practices and measured weight and height from the National Health and Nutrition Examination Survey 2003–2008. The main outcome measure was BMI for age and sex ≥ 85th percentile. The main exposure was timing of solid food introduction at < 4, 4–5, or ≥ 6 months of age. Binomial logistic regression was used in the analysis controlling for child's sex, birth weight and breastfeeding status as well as maternal age at birth, smoking status and socio-demographic variables. Results. Two thousand and fifty children were included in the sample; 51% male and 49% female; 57.1% Non-Hispanic White, 21.9% Hispanic, 14.0% Non-Hispanic Black, and 7% other race/ethnicity. Twenty-two percent of the children were overweight or obese. Sixty-nine percent were breastfed or fed breast milk at birth and 36% continued breastfeeding for ≥ six months. Solid foods were introduced before 4 months of age for 11.2% of the children; 30.3% received solid foods between 4 to 5 months; with 58.6% receiving solid foods at 6 months or later. Timing of solid food introduction was not associated with weight status (OR= 1.36, 95% CI [0.83–2.24]). Formula-fed infants and infants breastfed for < 4 months had increased odds of overweight and obesity (OR=1.54, 95% CI [1.05–2.27] and OR= 1.60, 95% CI [1.05–2.44], respectively) when compared to infants breastfed for ≥ 6 months. Conclusion. Timing of solid food introduction was not associated with weight status in a national sample of US children ages 2 to 5 years. More focus should be placed on promoting breastfeeding and healthy infant feeding practices as strategies to prevent obesity in children. ^

Parent modeling and child food consumption

Obesity, among both children and adults, is a growing public health epidemic. One area of interest relates to how and why obesity is developing at such a rapid pace among children. Despite a broad consensus about how controlling feeding practices relate to child food consumption and obesity prevalence, much less is known about how non-controlling feeding practices, including modeling, relate to child food consumption. This study investigates how different forms of parent modeling (no modeling, simple modeling, and enthusiastic modeling) and parent adiposity relate to child food consumption, food preferences, and behaviors towards foods. Participants in this experimental study were 65 children (25 boys and 40 girls) aged 3-9 and their parents. Each parent was trained on how to perform their assigned modeling behavior towards a food identified as neutral (not liked, nor disliked) by their child during a pre-session food-rating task. Parents performed their assigned modeling behavior when cued during a ten-minute observation period with their child. Child food consumption (pieces eaten, grams eaten, and calories consumed) was measured and food behaviors (positive comments toward food and food requests) were recorded by event-based coding. After the session, parents self-reported on their height and weight, and children completed a post-session food-rating task. Results indicate that parent modeling (both simple and enthusiastic forms) did not significantly relate to child food consumption, food preferences, or food requests. However, enthusiastic modeling significantly increased the number of positive food comments made by children. Children's food consumption in response to parent modeling did not differ based on parent obesity status. The practical implications of this study are discussed, along with its strengths and limitations, and directions for future research.^

Description and analysis of variation in dairy product and concomitant nutrient purchases between Hispanic and non -Hispanic households using a panel of shoppers' purchase records

The purpose of this research was development of a method of estimating nutrient availability in populations as approximated by supermarket purchase records. Demographic information describing 12,516 panel households was obtained from a marketing and advertising program operated by H. E. Butt Grocery Company of San Antonio, Texas. A non-probability sample of 2,161 households meeting expenditure criteria was selected and all purchases of dairy products for this sample of households were organized into a database constructed to facilitate the retrieval, aggregation, and analysis of dairy product purchases and their nutrient contents. Two hypotheses were tested: (1) no difference would be found between Hispanic and non-Hispanic purchases of dairy product categories during the study period and (2) no difference would be found between Hispanic and non-Hispanic purchases of nutrients contained in those dairy products during the thirteen-week study period.^ Food purchase records were used to estimate nutrient exposure on a weekly, per capita basis for Hispanic and non-Hispanic households by linking some 40,000 dairy purchase Universal Product code (UPC) numbers with food composition values contained in USDA Handbook 8-1. Results of this study suggest Hispanic sample households consistently purchased fewer dairy products than did non-Hispanic sample households and consequently had fewer nutrients available from dairy purchases. While weekly expenditures for dairy products among the sample households remained relatively constant during the study period, shifts in the types of dairy products purchased were observed. The effect of ethnicity on dairy product and nutrient purchases was significant over the thirteen-week period. A database consisting of customer, household, and purchase information can be developed to successfully associate food item UPC numbers with a standard reference of food composition to estimate nutrient availability in a population over extended periods of time. ^