Correlates of socio-economic inequalities in women's television viewing: a study of intrapersonal,social and environmental mediators

Introduction  

Socio-economically disadvantaged women are at a greater risk of spending excess time engaged in television viewing, a behavior linked to several adverse health outcomes. However, the factors which explain socio-economic differences in television viewing are unknown. This study aimed to investigate the contribution of intrapersonal, social and environmental factors to mediating socio-economic (educational) inequalities in women's television viewing.     

Effect of potassium citrate supplementation or increased fruit and vegetable intake on bone metabolism in healthy postmenopausal women: a randomized controlled trial

BACKGROUND: Alkali provision may explain why fruit and vegetables benefit bone health. OBJECTIVE: We aimed to determine the effects of alkali-providing potassium citrate (double-blind) and fruit and vegetable intake (single-blind) on bone turnover over 2 y. DESIGN: We conducted a randomized placebo-controlled trial in 276 postmenopausal women (aged 55-65 y). Women were randomly assigned to 4 groups: high-dose potassium citrate (55.5 mEq/d), low-dose potassium citrate (18.5 mEq/d), placebo, and 300 g additional fruit and vegetables/d (equivalent of 18.5 mEq alkali). Serum and fasted urine for bone markers were collected at baseline and at 3, 6, 12, 18, and 24 mo. An additional urine sample was collected at 4-6 wk. Bone mineral density (BMD) was measured at baseline and 2 y. RESULTS: Repeated-measures ANOVA showed no difference between groups for urinary free deoxypyridinoline cross-links relative to creatinine (fDPD/Cr), serum N-terminal propeptide of type 1 collagen, or beta C-terminal telopeptide, although, at 4-6 wk, fDPD/Cr was lower in the high-dose potassium citrate group (P = 0.04). Mean +/- SD spine BMD loss in the placebo group (1.8 +/- 3.9%) did not differ significantly from that in the treatment groups (2.1 +/- 3.2%; P = 0.88). Hip BMD loss in the placebo and low-dose potassium citrate groups was 1.3 +/- 2.3% and 2.2 +/- 2.3%, respectively (P = 0.14). CONCLUSIONS: Two-year potassium citrate supplementation does not reduce bone turnover or increase BMD in healthy postmenopausal women, which suggests that alkali provision does not explain any long-term benefit of fruit and vegetable intake on bone.     

A comparison of the accuracy of self-reported intake with measured intake of a laboratory overeating episode in overweight and obese women with and without binge eating disorder

Purpose

Research has demonstrated significant underreporting of food intake in obese individuals with and without binge eating disorder (BED). An improved understanding of the accuracy of self-reported food intake is central to diagnosis of eating disorders and monitoring response to treatment. The purpose was to: (1) confirm those with BED consume significantly more kilocalories (kcal) than overweight/obese controls when instructed to overeat in the laboratory and (2) compare dietary recall data with measured intake.

Methods

Fifteen women fulfilling BED criteria and 17 controls participated in an overeating episode and completed a 24-h dietary recall.

Results

BED participants consumed significantly more kilocalories according to both methodologies. The BED group self-reported 90% of the measured intake compared to 98% for the control group. Mean differences between the methods indicated that on average both groups underreported intake; however, the mean difference between methods was significantly greater in the BED group.

Conclusions

Findings confirm that those with BED consume significantly more than controls during a laboratory binge and controls tended to be more accurate in recalling their intake 24 h later.     

A comparison of energy intake and food selection during laboratory binge eating episodes in obese women with and without a binge eating disorder diagnosis

OBJECTIVE: The purpose of the study was to compare energy intake and food selection of laboratory binge eating episodes in obese women with and without binge eating disorder (BED). METHOD: Twenty women, 12 meeting BED criteria, and 8 BMI and age matched obese controls, engaged in a laboratory binge eating episode. RESULTS: BED participants consumed significantly more total food in kilocalories than the non-BED obese group and more kilocalories of fat. However, there were no differences between the groups in the proportion of calories from any macronutrient. There was a nonsignificant trend for the BED group to consume more total grams of food. During the binge, the BED group consumed more dairy products. CONCLUSION: Results of the study confirmed that women with BED consumed significantly more total food in kilocalories than the non-BED obese women when they were allowed to have a binge eating episode in a laboratory setting.     

Social desirability, not dietary restraint, is related to accuracy of reported dietary intake of a laboratory meal in females during a 24-hour recall

Underreporting in self-reported dietary intake has been linked to dietary restraint (DR) and social desirability (SD), however few investigations have examined the influence of both DR and SD on reporting accuracy and used objective, rather than estimated, measures to determine dietary reporting accuracy. This study investigated accuracy of reporting consumption of a laboratory meal during a 24-hour dietary recall (24HR) in 38 healthy, college-aged, normal-weight women, categorized as high or low in DR and SD. Participants consumed a lunch of four foods (sandwich wrap, chips, fruit, and ice cream) in a laboratory and completed a telephone 24HR the following day. Accuracy of reported energy intake of the meal = ((reported energy intake − measured energy intake) / measured energy intake) × 100 [positive numbers = overreporting]. Overreporting of energy intake occurred in all groups (overall accuracy rate = 43.1 ± 49.9%). SD-high as compared to SD-low more accurately reported energy intake of chips (19.8 ± 56.2% vs. 117.1 ± 141.3%, p < 0.05) and ice cream (17.2 ± 78.2% vs. 71.6 ± 82.7%, p < 0.05). SD-high as compared to SD-low more accurately reported overall energy intake (29.8 ± 48.2% vs. 58.0 ± 48.8%, p < 0.05). To improve accuracy of dietary assessment, future research should investigate factors contributing to inaccuracies in dietary reporting and the best methodology to use to determine dietary reporting accuracy.     

Laboratory assessment of feeding behavior in bulimia nervosa and healthy women: methods for developing a human-feeding laboratory.

We have designed a human-feeding laboratory to be used to study feeding behavior in patients with eating disorders. Twenty-one normal-weight bulimic subjects consumed 29.711 +/- 39.940 MJ (range 0.862-178.632 MJ; 7101 +/- 9546 kcal, range 206 to 42,694 kcal) in 24 h. In comparison, 11 healthy volunteer women, when instructed to eat ad lib for 48 h, ate 7.715 +/- 2.590 MJ (1844 +/- 619 kcal) during the first 24 h and 7665 +/- 1828 MJ (1832 +/- 437 kcal) during the second 24 h. Bulimics and control subjects had a similar number of eating intervals (6.6 +/- 2.6 vs 5.0 +/- 1.7); 72% of the bulimic subjects' meals were similar in size to the meals of the controls [167-4100 kJ (40-980 kcal)] but these meals were higher in carbohydrate and lower in fat in bulemic patients. Excessive caloric intake by bulimic subjects was because 28% of their meals were very large [range 4.427-28.150 MJ (1058-6728 kcal)]. Data gathered in a laboratory setting appears to be a reasonable replication of naturalistic feeding and suggest that such a laboratory may prove useful for future studies of feeding behaviors in humans.     

Daily caloric intake of normal-weight adults: response to changes in dietary energy density of a luncheon meal

The extent and time course of caloric compensation for surreptitious dilutions and supplements to the energy value of the diet were examined in free-living normal-weight adults. Ten subjects were provided lunches containing approximately 66% more or less calories than their customary midday meal for 2-wk periods which were interposed between 1-wk baseline or recovery periods. Diet records were kept throughout the study. Total energy intakes did not differ among the three control periods (weeks 1, 4, and 7) or between any of these periods and when subjects were provided the low-calorie meal. Total energy intake was significantly higher relative to all other periods when subjects ingested the high-calorie meal. To the extent that compensation occurred, it was apparent immediately and did not appear to change over the 2-wk study periods. The results suggest that humans compensate more readily for decreases than for increases in caloric intake.     

Concentrations versus amounts of biomarkers in urine: a comparison of approaches to assess pyrethroid exposure

Background

In 2005, 84% of Wayana Amerindians living in the upper marshes of the Maroni River in French Guiana presented a hair mercury concentration exceeding the limit set up by the World Health Organization (10 μg/g). To determine whether this mercurial contamination was harmful, mice have been fed diets prepared by incorporation of mercury-polluted fish from French Guiana.

Methods

Four diets containing 0, 0.1, 1, and 7.5% fish flesh, representing 0, 5, 62, and 520 ng methylmercury per g, respectively, were given to four groups of mice for a month. The lowest fish regimen led to a mercurial contamination pressure of 1 ng mercury per day per g of body weight, which is precisely that affecting the Wayana Amerindians.

Results

The expression of several genes was modified with mercury intoxication in liver, kidneys, and hippocampus, even at the lowest tested fish regimen. A net genetic response could be observed for mercury concentrations accumulated within tissues as weak as 0.15 ppm in the liver, 1.4 ppm in the kidneys, and 0.4 ppm in the hippocampus. This last value is in the range of the mercury concentrations found in the brains of chronically exposed patients in the Minamata region or in brains from heavy fish consumers. Mitochondrial respiratory rates showed a 35–40% decrease in respiration for the three contaminated mice groups. In the muscles of mice fed the lightest fish-containing diet, cytochrome c oxidase activity was decreased to 45% of that of the control muscles. When mice behavior was assessed in a cross maze, those fed the lowest and mid-level fish-containing diets developed higher anxiety state behaviors compared to mice fed with control diet.

Conclusion

We conclude that a vegetarian diet containing as little as 0.1% of mercury-contaminated fish is able to trigger in mice, after only one month of exposure, disorders presenting all the hallmarks of mercurial contamination.     

Nutritional status of women in Bangladesh: comparison of energy intake and nutritional status of a low income rural group with a high income urban group

This study evaluated the influence of socio-economic status on energy intake (EI), anthropometric characteristics and body composition (BC) of premenopausal Bangladeshi women in two socio-economic groups. This cross-sectional study measured height, weight, biceps and triceps skinfolds by standard procedures. A three-day dietary record was used to estimate EI. The biceps and triceps skinfolds were used to calculate total body fat (TBF), fat-free mass (FFM) and body fat percentage (BF%) according to Durnin and Womersley. FAO/WHO/UNU equations were used to calculate basal metabolic rates (BMR). Two locations in Bangladesh were studied; the Dhaka city area and the west region of the subdistrict Nandail (Betagair Union) in the district of Mymensingh. Study subjects were premenopausal women (N =191) aged 16(40 years. The high socio-economic group (group H, N =90) consisted of women with high income and educational level. The low socio-economic group (group L, N =101) consisted of rural, low income, illiterate women. Both groups contained three subgroups (non-pregnant, non-lactating =1, pregnant =2, lactating =3). Socio-economic status had a significant effect on body weight, height, biceps and triceps skinfolds, BMI, TBF, FFM and BF% (P<0.001). These variables were significantly higher (P<0.001) in all subgroups of group H than in the corresponding subgroups of group L. The influence of physiological status on most of these variables was not significant. EI was, however, influenced by both socio-economic (P<0.001) and physiological(P<0.05) status. The mean EI was significantly lower (P<0.001) in all subgroups of group L than in the corresponding subgroups of group H. The contributory sources were different in high and low income groups. In both groups, EI was lower than the recommended level. Based on the dietary and anthropometric results, we conclude that malnutrition is a common feature among low income rural women. This contradicts findings in western countries, where obesity is prevalent in low income groups.     

Fat distribution in European women: a comparison of anthropometric measurements in relation to cardiovascular risk factors

In this study in 437 women born in 1948 selected from five European towns we show that several anthropometric measurements are consistently and significantly associated with a metabolic risk profile in premenopausal women of 38 years of age. Among the circumferences, breast and waist circumference were, after adjustment for body mass index positively correlated with diastolic blood pressure, serum total cholesterol, HDL-cholesterol (negative associations), serum triglycerides, and serum insulin. The optimal level for measuring waist circumference was determined as being midway between the lower rib margin and the superior anterior iliac crest. Circumference ratios generally did show less consistent and similar or lower correlations with diastolic blood pressure, serum cholesterol and serum insulin. Waist/thigh circumference ratio showed the strongest partial associations with HDL-cholesterol and serum triglycerides among all anthropometric variables studied. The authors conclude that, independently of the degree of fatness, indicators of truncal fat distribution (in the region of the breast as well as the abdomen) are related to an unfavourable risk profile in European premenopausal women. The study gives a rationale for selecting the most informative anthropometric measurements to be added to height and weight in epidemiological studies.     

Comparison of a transdermal contraceptive patch with a newly sourced adhesive component versus EVRA patch: A double-blind,randomized, bioequivalence and adhesion study in healthy women

ObjectiveTo evaluate the bioequivalence of norelgestromin and ethinyl estradiol (NGMN-EE) and adhesion of a transdermal contraceptive patch containing a newly sourced adhesive component (test) compared with the marketed (reference) patch.Study designIn this randomized, double-blind, 2-way crossover study, healthy women received single 7-day application of both test and reference patches. Treatment phase included two treatment periods of 11 days each separated by a 21-day washout period starting from day of patch removal (day 8) of treatment period 1. Assessments included NGMN and EE pharmacokinetics (PK), adhesion using European Medicines Agency (EMA) 5-point scale, irritation potential and application-site reactions, and safety. Patches were bioequivalent if 90% CIs of ratios of means of test/reference for AUC_168h, AUC_inf, and C_ss fell within 80–125%. Patch adhesion was comparable if ratios of mean cumulative adhesion percentage values of test/reference were ≥90.0%.ResultsSeventy women were randomized; 57 completed both treatments with ≥80% adhesion (score 0–1). Bioequivalence of test and reference patches was demonstrated as 90% CI of ratio of geometric means for AUC_168h, AUC_inf, and C_ss for NGMN and EE fell within 80–125%. Both patches had similar adhesion properties (geometric mean ratio was 100.3% [90% CI, 93.2–107.9]). Similar rates of mild-to-moderate itching (11% vs 10%) and erythema events (79% vs 74%) were reported for test and reference patches, respectively, on day 8.ConclusionsThe test patch with the newly sourced adhesive component is bioequivalent to the currently marketed NGMN-EE transdermal patch and has similar adhesion and irritation potential.Implications statementThe norelgestromin and ethinyl estradiol transdermal patch containing a newly sourced adhesive component is bioequivalent to the currently marketed patch for both active moieties. Both patches had similar adhesion, irritation potential, and safety profiles.     

A healthy mistrust: how worldview relates to attitudes about breast cancer screening in a cross-sectional survey of low-income women

Background  

Perceived racial discrimination is one factor which may discourage ethnic minorities from using healthcare. However, existing research only partially explains why some persons do accept health promotion messages and use preventive care, while others do not. This analysis explores 1) the psychosocial characteristics of those, within disadvantaged groups, who identify their previous experiences as racially discriminatory, 2) the extent to which perceived racism is associated with broader perspectives on societal racism and powerlessness, and 3) how these views relate to disadvantaged groups' expectation of mistreatment in healthcare, feelings of mistrust, and motivation to use care.     

Facilitators of and barriers to healthy eating and physical activity for Black women: a focus group study in Florida,USA

Black women’s experiences of, perceptions of, and attitudes to healthy eating and physical activity have been suggested as contributors to their high rates of obesity. This paper uses data from four focus groups with Black women aged 18–45?years in Broward County, Florida, to explore their views. Findings suggest that participants were aware of the importance of healthy eating and physical activity, and motivated by wanting to model healthy behaviors for their families, but that ‘healthy’ behavior was perceived as requiring considerable ‘pre-planning’ and commitment. Programs addressing Black women that incorporate their perceptions and work with them to overcome challenges are needed.     

AIDS and behavioural risk factors in women in inner city Baltimore: a comparison of telephone and face to face surveys.

STUDY OBJECTIVE--The study aimed to investigate the influence the mode of administration of a questionnaire (telephone or face to face) on reports of sexual behaviour and attitudes of HIV risk among woman of reproductive age. DESIGN--Two cross sectional surveys--one, a modified random digit dialing telephone survey, the second, a face to face street sample--were carried out by the same interviewers using similar questionnaires in the same neighbourhoods. SETTING AND PARTICIPANTS--Two socially deprived, inner city neighbourhoods of Baltimore City were assessed in early 1990 before a community health intervention was carried out in one of them. Women between 17 and 35 years were surveyed. MAIN RESULTS--Altogether 775 and 416 women in the target age group were interviewed by telephone and face to face methods: the response rates were 66.4% and 77% respectively. Telephone respondents tended to be older, had more education, were more often married, were less likely to live in subsidised housing, and were more likely to report HIV testing. The proportions of respondents who reported a previous abortion and had had a surgical sterilisation were higher among the telephone respondents (34.7% v 24.1% and 26.4% v 20.6%, respectively). With regard to sexual risk behaviour, the only statistically significant differences were found in the proportion who reported having used drugs (10.6% of the face to face v 2.4% of the telephone sample) or alcohol (30.5% v 16.3%) at last sexual intercourse. The observed method effect on these variables remained unchanged after adjusting for age, education, employment, and marital status. This effect was even stronger for a subgroup of face to face respondents who reported not having a telephone at home. The adjusted odds ratios for reporting alcohol consumption and use of drugs at the last sexual encounter in this group compared with the telephone respondents were 3.7 (2.1, 6.6) and 14.1 (5.7, 34.5) respectively. CONCLUSIONS--Despite the socioeconomic bias associated with the mode of data collection, there are only a few differences between the telephone and personal survey methods in reports of sexual behaviour. These differences are mostly concentrated in young women (under 20 years), and in a particularly socioeconomically deprived subgroup identified through telephone ownership.     

Protocol for Physiotherapy OR Tvt Randomised Efficacy Trial (PORTRET): a multicentre randomised controlled trial to assess the cost-effectiveness of the tension free vaginal tape versus pelvic floor muscle training in women with symptomatic moderate to severe stress urinary incontinence

Background  

Stress urinary incontinence is a common condition affecting approximately 20% of adult women causing substantial individual (quality of life) and economic (119 million Euro/year spent on incontinence pads in the Netherlands) burden. Pelvic floor muscle training (PFMT) is regarded as first line treatment, but only 15-25% of women will be completely cured. Approximately 65% will report that their condition improved, but long term adherence to treatment is problematic. In addition, at longer term (2-15 years) follow-up 30-50% of patients will end up having surgery. From 1996 a minimal invasive surgical procedure, the Tension-free Vaginal Tape (TVT) has rapidly become the gold standard in surgical treatment of stress urinary incontinence. With TVT 65-95% of women are cured. However, approximately 3-6% of women will develop symptoms of an overactive bladder, resulting in reduced quality of life. Because of its efficacy the TVT appears to be preferable over PFMT but both treatments and their costs have not been compared head-to-head in a randomised clinical trial.