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This study examined gender differences in medical advice related to diet and physical activity for obese African American adults (N = 470) with and without diabetes. Data from the 2007-2008 National Health and Nutrition Examination Survey were analyzed using logistic regression analyses. Even after sociodemographic adjustments, men were less likely to report receiving medical advice as compared with women. Both men and women given dietary and physical activity advice were more likely to follow it. Men were less likely to report currently reducing fat or calories, yet men with diabetes were 5 times more likely to state that they were reducing fat and calories as compared with women with diabetes. Gender- and disease state-specific interventions are needed comparing standard care with enhanced patient education. Moreover, these findings necessitate studies that characterize the role of the health care professional in the diagnosis and treatment of obesity and underscore patient-provider relationships.

Diabetes is a world-wide epidemic associated with multiple environmental factors. Prolonged television viewing (TV) time has been related to increased risk of obesity and type 2 diabetes in several studies. TV viewing has been positively associated with cardiovascular disease risk factors, lower energy expenditure, over-eating high-calorie and high-fat foods. The objective of this study was to assess the associations of hours of TV viewing with dietary quality, obesity and physical activity for three ethnic minorities with and without type 2 diabetes. Diet quality and physical activity were inversely related to prolonged TV viewing. African Americans and participants with type 2 diabetes were more likely to watch more than 4 hours of TV per day as compared to their counterparts. Diet quality was inversely associated with physical activity level. Future studies are needed to establish the risk factors of prolonged TV watching in adult populations for the development of diabetes or diabetes-related complications. Although strategies to reduce TV watching have been proven effective among children, few trials have been conducted in adults. Intervention trials aimed at reducing TV viewing targeting people with type 2 diabetes may be beneficial to improve dietary quality and physical activity, which may reduce diabetes complications.

Prevalence of childhood obesity and its complications have increased world-wide. Parental status may be associated with children's health outcomes including their eating habits, body weight and blood cholesterol. The National Health and Nutrition Examination Survey (NHANES) for the years 1988-1994, provided a unique opportunity for matching parents to children enabling analyses of joint demographics, racial differences and health indicators. Specifically, the NHANES III data, 1988-1994, of 219 households with single-parents and 780 dual-parent households were analyzed as predictors for primary outcome variables of children's Body Mass Index (BMI), dietary nutrient intakes and blood cholesterol. Children of single-parent households were significantly (p < 0.01) more overweight than children of dual-parent households. Total calorie and saturated fatty acid intakes were higher among children of single-parent households than dual-parent households (p < 0.05). On average, Black children were more overweight (p < 0.04) than children of other races. The study results implied a strong relationship between single-parent status and excess weight in children. Further studies are needed to explore the dynamics of single-parent households and its influence on childhood diet and obesity. Parental involvement in the development of school- and community-based obesity prevention programs are suggested for effective health initiatives. Economic constraints and cultural preferences may be communicated directly by family involvement in these much needed public health programs.

Although studies regarding health issues and the obesity epidemic have increased in recent years, few of these studies target college-aged students. The primary purpose of this study was to evaluate the differences in race/ethnicity with respect to prevalence of overweight/obesity (defined by body mass index or BMI) among college students attending an urban university. In addition, the demographic characteristics and cardiovascular risks between the overweight and obese group (n = 138) were compared to the underweight and normal weight group (n = 349). The study included 487 college students under 40 years of age who identified their origin as white (non-Hispanic), black (non-Hispanic), or Hispanic. There were 32.65% white, 33.26% Hispanic, and 34.09% black. The mean and median ages were 21 and 19 years, respectively. The overall prevalence of overweight/obesity was 28.11%, with 23.91% (white), 34.06% (Hispanic), and 42.03% (black). Age-, gender-, and race-/ethnicity-adjusted cardiovascular risk levels (blood pressure, pulse pressure, blood glucose and lipid profiles) significantly varied between two groups. The findings suggest that screening cardiovascular risks among a college-aged population is warranted. Our study further indicates the need for weight management and risk reduction of overweight-related chronic diseases on campus. (Contains 5 tables.)

BACKGROUND: Blacks have a higher incidence of diabetes and its related complications. Self-rated health (SRH) and perceived stress indicators are associated with chronic diseases. The aim of this study was to examine the associations between SRH, perceived stress and diabetes status among two Black ethnicities. MATERIALS AND METHODS: The cross-sectional study included 258 Haitian Americans and 249 African Americans with (n = 240) and without type 2 diabetes (n = 267) (n = 507). Recruitment was performed by community outreach. RESULTS: Haitian-Americans were less likely to report 'fair to poor' health as compared to African Americans [OR = 0.58 (95% CI: 0.35, 0.95), P = 0.032]; yet, Haitian Americans had greater perceived stress than African Americans (P = 0.002). Having diabetes was associated with 'fair to poor' SRH [OR = 3.14 (95% CI: 2.09, 4.72), P < 0.001] but not perceived stress (P = 0.072). Haitian-Americans (P = 0.023), females (P = 0.003) and those participants having 'poor or fair' SRH (P < 0.001) were positively associated with perceived stress (Nagelkerke R(2) = 0.151). CONCLUSION: Perceived stress associated with 'poor or fair' SRH suggests that screening for perceived stress should be considered part of routine medical care; albeit, further studies are required to confirm our results. The findings support the need for treatment plans that are patient-centered and culturally relevant and that address psychosocial issues. [ABSTRACT FROM AUTHOR]

Migration to the United States has been linked to obesity and poor diet quality. We investigated the relationship among diabetes self-management, diet, age and acculturation factors for 182 Cuban-Americans (Females = 110, Males = 72) with type 2 diabetes recruited from a randomized mailing list in South Florida. Inadequate glycemic control ( β = 0.257), BMI ( β = 0.251), total fat intake ( β = 0.251), and smoking ( β = 0.200), were positively associated, while understanding of overall diabetes care ( β = -0.165), was negatively associated with migration ( N = 162, adj.R = 0.286, F = 14.65, p < 0.001). These associations suggest that effective diabetes education targeting acculturation issues is lacking. [ABSTRACT FROM AUTHOR]

Objectives: We investigated the relationship among factors predicting inadequate glucose control among 182 Cuban-American adults (Females=110, Males=72) with type 2 diabetes mellitus (CAA). Study Design: Cross-sectional study of CAA from a randomized mailing list in two counties of South Florida. Methods: Fasted blood parameters and anthropometric measures were collected during the study. BMI was calculated (kg/ m2). Characteristics and diabetes care of CAA were self-reported Participants were screened by trained interviewers for heritage and diabetes status (inclusion criteria: self-reported having type 2 diabetes; age ? 35 years, male and female; not pregnant or lactating; no thyroid disorders; no major psychiatric disorders). Participants signed informed consent form. Statistical analyses used SPSS and included descriptive statistic, multiple logistic and ordinal logistic regression models, where all CI 95%. Results: Eighty-eight percent of CAA had BMI of ≥ 25 kg/ m2. Only 54% reported having a diet prescribed/told to schedule meals. We found CAA told to schedule meals were 3.62 more likely to plan meals (1.81, 7.26), p<0.001) and given a prescribed diet, controlling for age, corresponded with following a meal plan OR 4.43 (2.52, 7.79, p<0.001). The overall relationship for HbA1c < 8.5 to following a meal plan was OR 9.34 (2.84, 30.7. p<0.001). Conclusions: The advantage of having a medical professional prescribe a diet seems to be an important environmental support factor in this sample's diabetes care, since obesity rates are well above the national average. Nearly half CAA are not given dietary guidance, yet our results indicate CAA may improve glycemic control by receiving dietary instructions. [ABSTRACT FROM AUTHOR]

Objective: We investigated metabolic syndrome and its association with high-sensitivity C-reactive protein (hs-CRP) levels in Cuban Americans. Methods: The study included 161 nondiabetic Cuban Americans (55 men and 106 women) aged ⩾30 years living in South Florida. Metabolic syndrome was defined by using Adult Treatment Panel Ill criteria. Elevated hs-CRP level was defined as >3 mg/L. Results: Metabolic syndrome was present in 41% of participants, and no differences were seen by sex. The most common components of metabolic syndrome for women were abdominal obesity and elevated blood pressure, whereas for men they were elevated blood pressure and high triglyceride levels. A higher percentage of women had abdominal obesity and low high-density lipoprotein cholesterol levels, whereas a higher percentage of men had high triglyceride levels and abnormal glucose metabolism. The odds of having elevated hs-CRP levels were ≈4 times higher in participants with metabolic syndrome than in those without it. Mean log hs-CRP increased as number of components of metabolic syndrome increased. Of the components of metabolic syndrome, only abdominal obesity was significantly associated with elevated hsCRP. Conclusions: Metabolic syndrome was highly prevalent in our population of Cuban Americans. Cuban Americans with metabolic syndrome had elevated hs-CRP levels that might be explained by their abdominal obesity, increasing the risk for type 2 diabetes and cardiovascular diseases. [ABSTRACT FROM AUTHOR]

Kuwait, one of the wealthiest countries in the Arabian Gulf and the world, has nutritional problems that vary from undernourishment-related anemia to overnourishment (overweight), associated with health complications such as diabetes, hypertension, and heart diseases (Ministry of Health, 1996). Previous studies reported the prevalence of obesity among Kuwaiti school children as 18 per cent and 27 per cent for boys and girls, respectively (Eid et al., 1986), and anemia in about 75 per cent of children aged 1-24 months and 40.7 per cent for those aged 25-60 months (Mostafa and Nuwayhed, 1979). The purpose of this study was to evaluate the influence of infant feeding practices and mothers' education and occupation on hemoglobin (Hb) levels and obesity among young children in Kuwait. Data previously collected (January through November 2000) by the Department of Food and Nutrition Administration of the Ministry of Health from 254 apparently healthy mothers and their infants (127 boys, 127 girls) aged 2-23 months, in all five Governates was used. The lengths, weights, and Hb levels of infants were measured and mothers were asked about their infant feeding practices, number of pregnancies, educational level, and occupation. The prevalence of anemia among Kuwaiti infants in this study was significantly (p = 0.004) higher (29.5%) than that reported for American infants, 18.4 per cent (DHHS 1997). Formula-fed Kuwaiti infants were significantly (P < 0.001) heavier (9.38 ± 2.35) than the breast and mixed-fed group (7.98 ± 1.75). Our findings suggest that programs for the prevention and control of obesity and anemia in Kuwait should be a priority on the national nutrition and health agenda. [ABSTRACT FROM AUTHOR]

Snacking behavior may affect snack quality, overall diet quality, and body weight; however, the associations between these variables have not been studied among college students. The objective of this study was to associate snacking behaviors with snack quality, diet quality, and weight status among college students with overweight and obesity. We hypothesized that a higher snacking frequency, accessibility and availability of unhealthy snacks, and lack of knowledge would be associated with lower snack and diet quality, and higher weight. Participants (n = 140) completed a snack behavior questionnaire, three 24-hour dietary recalls to assess diet quality using Healthy Eating Index 2015 (HEI-2015), and snack score using an algorithm based on the US DA Smart Snack guidelines and reported weight and height to calculate body mass index (BMI). Analysis of variance and Pearson correlation was used in the analyses. After adjusting for confounders, snack frequency was not associated with snack score, HEI-2015 score, or BMI, but evening snacks had a significantly lower snack score compared with late afternoon snacks (P =.017). Also, those with more accessibility and availability of unhealthy snacks had a lower snack score (P =.001), lower HEI-2015 score (P =.006), and higher BMI (P =.019). Snacking for pleasure was significantly associated with a lower snack score (P =.037). Snack score was positively correlated with HEI-2015 score but not with BMI. In conclusion, late snacking, unhealthy snack environment, and snacking for pleasure were associated with lower snack and diet quality. These findings could be used in future intervention strategies to improve snacking behaviors and the food environment. This study examined the association between snacking behavior with snack and diet quality and body mass index (BMI) in college students with overweight and obesity. Evening snacks and snacking for pleasure were significantly associated with a lower snack quality. Accessibility and availability of unhealthy snacks were significantly associated with lower snack and diet quality and higher BMI. Also, snack quality was positively associated with diet quality, which was inversely associated with BMI. [Display omitted] [ABSTRACT FROM AUTHOR]