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Objective: To identify perceptions of Lower Mississippi Delta (LMD) residents regarding factors that influence a change in healthful food consumption behavior to assist in planning sustainable nutrition interventions in the LMD. Design: Nine focus groups were conducted with LMD residents in 9 counties in Arkansas, Louisiana, and Mississippi. One focus group was held in each county on the topical area of behavioral change. Setting: Nine counties in Arkansas, Louisiana, and Mississippi. Participants: The study population included 91 persons, 85 females and 6 males (18-60+ years of age), of whom 71 were African Americans, 17 were Caucasians, and 3 were Hispanics, who participated in the focus group discussions. Analysis: Data analyses were completed by general and specific content coding. Data were reviewed for emerging themes for each topic. The Social Cognitive Theory served as the framework for understanding the determinants of a change in healthful food consumption behavior. Results: The study showed considerable variability in perceptions that are influenced by both personal and external factors. These factors include health concerns, family influence, and need for and availability of nutrition information. Participants were interested in learning about healthful eating, food preparation skills, and portion control. Conclusions: Focus groups in the LMD identified many important themes relevant to the development of nutrition interventions in these communities. These data will be used to guide the community-based participatory interventions that will be developed and implemented in the LMD. The findings could be applicable to other researchers designing interventions for similar populations.

Food composition databases and dietary assessment systems are important tools for food and nutrition professionals. The availability and accessibility of data have improved over time along with the technology to convert the information into useful formats for planning diets, writing educational materials, counseling patients, and conducting research. Primary sources of food composition data include government, academic, and other institutional databases; the food industry; and scientific literature. Changes in the marketplace affect food availability and composition and affect the accuracy and adequacy of food composition databases. Improvements in both food composition data and in dietary assessment methods have worked synergistically to improve estimates of dietary intake. The development of databases for food frequency assessment systems requires special considerations for data aggregation for each food or food grouping in the questionnaires. Considerations for selecting a dietary assessment system include appropriateness of the data for the intended audience or purpose, efficiency of the search strategy for retrieving data, content and format of summary information, and cost. Needs for food composition data vary depending on dietetic practice area; however, most food and nutrition professionals will benefit from becoming more informed about food composition data, exploring new ways to educate themselves about databases and database systems, and advocating for what is most needed in dietetic practice.

Objective To determine if measures of diet quality differ between food insecure and food secure adults in a rural high-risk population. Design Random digit dialing telephone survey of a cross-section of the population designed to collect data on food intake, household demographics, and food security status. Setting A representative sample of adults who live in 36 counties in the Lower Mississippi Delta region of Arkansas, Louisiana, and Mississippi. Subjects One thousand six hundred seven adults, both white and African American. Main outcome measures Food security status and diet quality, as defined by adherence to the Healthy Eating Index and Dietary Reference Intakes by determinations from self-reported food intake (1 day intake). Statistical analyses Regression analysis, t tests, Wald statistic, and beta tests were employed. Results Food secure adults scored higher on Healthy Eating Index than food insecure adults (P=0.0001), but the regression model showed no differences when multiple factors were included. Food secure individuals consistently achieved higher percentages of the Dietary Reference Intakes (specifically Estimated Average Requirements and Adequate Intakes) than food insecure individuals, with the greatest differences seen for vitamin A (P<0.0001), copper (P=0.0009), and zinc (P=0.0022) and very little difference for vitamins C (P=0.68) and E (P=0.32). Both populations consumed diets extremely low in fiber. Conclusions Food insecurity is associated with lower quality diets in this population. It is acknowledged that serious limitations are associated with the use of one 24-hour recall and for comparison between food intake and assessment of food security. These findings still suggest a pressing need for nutrition interventions to improve dietary intake in these at-risk impoverished individuals.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jada.2004.08.028 Byline: Beverly J. McCabe-Sellers, Samuel E. Beattie Abstract: Between 250 and 350 million Americans are estimated to suffer acute gastroenteritis annually, with 25% to 30% thought to be caused by foodborne illnesses. Most vulnerable to foodborne diseases are elderly people, pregnant women, immune-compromised people, and children. While bacterial causes such as Salmonella are widely recognized and monitored as foodborne infections, other important bacterial causes such as Clostridium perfringens, Bacillus cereus, and Staphylococcus aureus are less well known. While the majority of cases of foodborne diseases are of unknown cause, bacteria and viruses are the most likely causative agents. Caliciviridae (Norwalk-like) virus cases are more difficult to identify, but represent the most common cause of known and probably unknown cases. Fresh produce has to be added to the traditional list of foods requiring careful selection and handling to prevent foodborne disease. To assess the disease burden in the United States, morbidity and mortality surveillance activities are done by several networks and systems with collaboration among federal agencies and health departments. Not all important causes are being equally monitored. Critical behaviors by food processors, food retailers, foodservice personnel, and consumers can reduce the risk of foodborne illness episodes. Dietetics professionals can more readily monitor new developments and update knowledge and practice through online resources.

CONTEXT. The prevalence of childhood overweight status is increasing. Some have suggested that childhood overweight is associated with food insecurity, defined as limited or uncertain access to enough nutritious food. OBJECTIVES. The purpose of this work was to assess the association of household and child food insecurity with childhood overweight status. METHODS. The National Health and Nutrition Examination Survey 1999-2002 uses a stratified multistaged probability sample and collects a broad array of data from a nationally representative sample of US citizens. All children 3 to 17 years old in this sample are included in these analyses. We measured BMI categorized as at risk for overweight or greater ([greater than or equal to] 85%) or overweight ([greater than or equal to] 95%) and household and child food security/insecurity using the US Food Security Scale. RESULTS. When compared with children from food-secure households, children from food-insecure households were more likely to demonstrate significant associations with being at risk for overweight or greater in the following demographic categories: 12 to 17 years, girls, white, and in households with income 4 times the federal poverty level. Household food insecurity is associated with child overweight status in children aged 12 to 17, girls, and children who live in households with incomes >4 times the federal poverty level. Child food insecurity demonstrated the same associations with being at risk for overweight or greater, as did household food insecurity, but associations were also seen in 3- to 5-year-old children, boys, and Mexican American children. Child food insecurity is significantly associated with child overweight status for children aged 12 to 17, girls, white children, and children in families with income [less than or equal to] 100% poverty level. Controlling for ethnicity, gender, age, and family poverty index level, childhood food insecurity is associated with a child being at risk for overweight status or greater, but not overweight status. CONCLUSIONS. Household and child food insecurity are associated with being at risk for overweight and overweight status among many demographic categories of children. Child food insecurity is independently associated with being at risk for overweight status or greater while controlling for important demographic variables. Future longitudinal research is required to determine whether food insecurity is causally related to child overweight status. KEY WORDS. food insecurity, child health status, overweight children., URL: www.pediatrics.org/cgi/doi/10.1542/peds2006-0097 Patrick H. Casey, MD, Pippa M. Simpson, PhD, Jeffrey M. Gossett, MS, Margaret L. Bogle, PhD, Catherine M. Champagne, PhD, Carol Connell, PhD, David Harsha, PhD, Beverly McCabe-Sellers, [...]

Edited by Donald B. McCormick, Dennis M Bier, and Robert J. Cousins. Palo Alto, CA: Annual Reviews; 2001. Hardcover. Pp 529. Price $135.00. ISBN 0-8243-2821-3. This 2001 edition is an [...]

The US surgeon general issued the first report on osteoporosis in Americans in 2004 with a major emphasis on prevention through better nutrition. The first set of Dietary Reference Intakes in 1997 made recommendations for those nutrients most closely associated with promoting and maintaining bone health: calcium, phosphorus, magnesium, vitamin D, and fluoride. A logical assessment of nutrient intake for bone health would involve these nutrients and has been termed a 'musculoskeletal' index by Sharkey. The purpose of this study was to examine the 24-hour dietary recalls of 572 adults aged 55 to 95 years in a random digitalized dialed telephone survey of a 36-county area in the Lower Mississippi Delta. Calcium (Ca) intake ranged from 60 to 1671 mg, magnesium (Mg) intake ranged from 0.0 to 927 nag, phosphorus (P) intake ranged from 142 to 4628 mg, and vitamin D from 0.0 to 692 I.U. Ten percent (n = 58) had no measurable dietary intake of vitamin D. Wide variation exists in the dietary intake of each of these nutrients. A factor analysis of relative nutrient intakes was used to determine a summary musculoskeletal nutrient intake for Ca, Mg, P, and vitamin D. By summing the quartiles of relative intakes of these 4 nutrients, an assessment of nutrient intake for bone health provides a potential means of examining risks for osteoporosis and other musculoskeletal disabilities. This project was funded by USDA, ARS 6251-53000-004-00D.

Excess body weight is a prominent public health problem, with underserved groups bearing a disproportionate burden of disease (Ogden et al., 2006; Association AH, 2005; Hartley, 2004). Understanding body weight through examining potential predictors is an important step in addressing the current obesity epidemic. A potential predictor that has not been thoroughly examined in relationship to body weight is religion. Americans are very religious (Gallup Poll GP, 2001; Worldwide DN, 2000), with certain underserved subgroups of the population reporting greater religiosity than others. Those living in the rural South and African Americans report higher rates of church attendance and membership (Scandrett, 1996). Religion's prominence in some underserved groups that bear a disproportionate burden of the obesity epidemic may play an important role in determining body weight. Data from FOODS 2000, a representative sample of a rural, impoverished area in the lower Mississippi Delta region of the US, were analyzed (total n=1606; 787 African American and 819 Caucasian adults aged 18+). Religion was hypothesized to be associated with higher body weight; with the relationship being more pronounced in African Americans than Whites. Health behaviors (smoking, nutrition, physical activity) were expected to mediate the relationship. In Whites only, those consuming religious media at least once a week or more were 1.37 BMI units heavier than those consuming religious media less than once a week. Smoking mediated this relationship. There were no significant relationships between religion and body weight in African Americans. [ABSTRACT FROM AUTHOR]

Context. Studies examining the association between food insecurity and obesity in adults have produced conflicting results, and information is limited on the relationship between food insecurity and adult chronic health conditions, particularly in a high-risk population. Objective. To examine the association between household food insecurity and self-reported weight status and chronic disease in the Lower Mississippi Delta. Design. A two-stage stratified cluster sample representative of the population in 36 counties in the Lower Delta. Data were collected in a cross-sectional telephone survey using list assisted random digit dialing telephone methodology. Setting and Participants. A randomly selected sample of 1,457 adults from a free-living population. Main Outcome Measures. US Food Security Survey Module, self-reported height and weight status (obesity = body mass index > 30 kg/m²), and self-reported hypertension, high cholesterol, diabetes, heart disease, stroke, and a marker for metabolic syndrome. Results. In food-insecure adults, 42.3% were obese, a significantly higher rate than food secure adults (33.2%). After controlling for demographic variables, food insecurity was not independently associated with obesity. Income and the interaction between race and gender were significant predictors of obesity. Food insecure adults were significantly more likely to report hypertension (45.1% vs. 29.5%) diabetes (15.0% vs. 9.3%), heart disease (13.5% vs. 6.8%) and metabolic syndrome (10.1% vs. 4.4%). After controlling for demographic variables, food insecurity was associated with high cholesterol (Odds Ratio [OR] 1.65; 95% Confidence Interval [CI], 1.0 to 2.7), heart disease (OR 2.7: 95% CI, 1.5 to 4.8), and metabolic syndrome (OR 2.8; 95% CI, 1.4 to 5.5). Conclusions. The relationship between food insecurity and obesity in a high-risk population, may be due to income and demographic variables. Individuals in a rural high-risk population with high cholesterol, heart disease, and metabolic syndrome have a high likelihood of being food-insecure. Nutritional interventions targeting high-risk populations should address food insecurity. [ABSTRACT FROM AUTHOR]

Collaboratively, the nutritional health problems of the Lower Mississippi Delta (LMD) region were examined and opportunities identified for conducting research interventions. To combat the nutritional health problems in the LMD, community residents yielded to a more comprehensive and participatory approach known as community-based participatory research (CBPR). Community residents partnered with academic researchers and other organizational entities to improve the overall quality of diet and health in their respective communities using CBPR. The collaborative work in the LMD focused on interventions conducted in each of three specific communities across three states: Marvell, Arkansas ( Marvell NIRI), and its surrounding public school district; Franklin Parish in Louisiana (Franklin NIRI); and the city of Hollandale, Mississippi (Hollandale NIRI). This paper examined some of the research interventions conducted in Franklin, Hollandale, and Marvell NIRI respectively, how leadership emerged from each of these communities, and lessons learned as a result of the CBPR model. [ABSTRACT FROM AUTHOR]

Personal and public health information are often obtained from studies of large population groups. Risk factors for nutrients, toxins, genetic variation, and more recently, nutrient-gene interactions are statistical estimates of the percentage reduction in disease in the population if the risk were to be avoided or the gene variant were not present. Because individuals differ in genetic makeup, lifestyle, and dietary patterns than those individuals in the study population, these risk factors are valuable guidelines, but may not apply to individuals. Intervention studies are likewise limited by small sample sizes, short time frames to assess physiological changes, and variable experimental designs that often preclude comparative or consensus analyses. A fundamental challenge for nutrigenomics will be to develop a means to sort individuals into metabolic groups, and eventually, develop risk factors for individuals. To reach the goal of personalizing medicine and nutrition, new experimental strategies are needed for human study designs. A promising approach for more complete analyses of the interaction of genetic makeups and environment relies on community-based participatory research (CBPR) methodologies. CBPR's central focus is developing a partnership among researchers and individuals in a community that allows for more in depth lifestyle analyses but also translational research that simultaneously helps improve the health of individuals and communities. The USDA-ARS Delta Nutrition Intervention Research program exemplifies CBPR providing a foundation for expanded personalized nutrition and medicine research for communities and individuals.

Diuretic therapy (DT) plays a major role in disease management. However, one issue of concern in nutritionally vulnerable elders is that diuretic therapy also increases thiamin excretion, and little attention has been paid to the linkage between DT use and dietary intake of thiamin in this older population. The purpose of this study was to assess the relationship between DT use and dietary intake of thiamin in a randomly recruited sample of 342 homebound older adults. Baseline data, including three 24-hour recalls, were used to identify thiamin intake from food (15% < EAR and 33% < RDA), DT use (49%), and meal pattern (18% not regularly eating breakfast). Independent of sociodemographic and meal pattern variables, DT users (relative to non-users) were at increased odds for dietary thiamin intake < RDA (OR = 2.3) and < EAR (OR = 4.2). Considering the importance of home-delivered meals as a primary source of food assistance to homebound elders and that thiamin deficiency may exacerbate health problems, the results of this study suggest the need to include information on DT use as an integral component of program assessment for the targeting and monitoring of strategies to alleviate the risk for deficiency.