Nutritional status and eating habits among public primary school children aged 9-13 years in education districts 2, 3, 4 in St. Lucia as well as food preferences of their parents/guardians

OBJECTIVE: To determine nutritional status and eating habits among public primary school children aged 9-13 years as well as food choices and preferences of their parents/guardians. DESIGN AND METHODS: A total of 555 participants (380 children, 175 parents) took part in the study. Participants, who returned written consent forms were allowed to complete a questionnaire consisting of 17 questions on eating habits; Questionnaires were structured to obtain food preferences and nutrition knowledge where photographs of foods were included. Participants were categorized into percentiles using WHO Body Mass Index (BMI) for age growth charts, where BMI for age was plotted and body fat was categorized with the use of body fat reference curves chart for children 7-18 years. Linear regression was used to analyze the relationship between age, gender, consumption patterns of the participants with BMI. RESULTS: Food consumption patterns and preferences of children were similar to those of their parents except for juice drinks, sugary foods, fatty foods, water, salty foods and whole wheat bread. High preference for energy dense foods both by children and their parents was found. 61.7% of overweight participants were female i.e.; their weight exceeded the WHO suggested ≥85th percentile overweight value. 60.4% of obese participants were female (≥95th percentile as per WHO age and gender specific reference). CONCLUSION: Participants with higher salty food consumption had a higher BMI as compared to those who abstained from the intakes of such foods.

An assessment of dietary and physical activity behaviors of adolescents in selected secondary schools of Guyana

OBJECTIVE: To examine the dietary and physical activity behaviors of adolescents in selected secondary schools of Guyana. DESIGN AND METHODS: A cross-sectional National Youth Physical Activity and Nutrition Survey (NYPANS) was conducted in 12 secondary schools; 2 schools from each of the coastal regions 2, 3, 4, 5 and 6 and Georgetown, the capital city of Guyana. Systematic stratified random sampling technique was used to draw 724 students in Forms 1 to 4. Dietary and physical activity behaviors were assessed by the NYPANS tool, a self-administered questionnaire. RESULTS: Just over half (54%) of students reported participating in physical activity that made them sweat and breathe hard for at least 20 minutes on 3 or more of the previous 7 days. Similarly, half (48.7%) of the students played video or computer games for one or more hours on an average school day. At school 56.3% of students reported not ever attending physical education (PE) classes and 26.4% drank a glass of soda 2 or more times per day during past 7 days. Only 12.6% and 12.9% of students reported eating 2 or more cups of fruit and vegetables respectively each day. CONCLUSION: Participation in healthy dietary and physical activity behaviors among adolescents in selected secondary schools of Guyana is far from optimal.

Mamas voices, mamas choices: understanding maternal beliefs that drive decision making around feeding practices which influence childhood obesity

OBJECTIVE: To explore the beliefs shaping maternal decision-making around feeding practices in early childhood in a subset of Jamaican mothers from rural and urban communities. DESIGN AND METHODS: Focus group discussions guided by semi-qualitative questionnaires were conducted with thirty mothers of infants 6-24 months recruited from health clinics in 2 urban and 2 rural Jamaican communities. Data from discussions transcribed from audio recordings and field notes were categorized and interpreted using pre-set themes through an iterative process to identify emergent themes. Analysis was guided by the Theory of Reasoned Action embedded in the Socio-Ecological Perspective. RESULTS: Rural and urban mothers’ beliefs, and by extension their actions, were influenced by (a) their instincts, (b) their accepted knowledge (from personal and observed experience, credible professional input, and personal experimentation), (c) cultural norms (i.e. views of body weight/health relationship and visual perceptions of ‘healthy’); (d) input of experienced family members; and (e) their accepted concept of infants’ innate ability to express needs. Additionally, rural mothers’ beliefs were influenced by non-family social networks. For all mothers, the use of growth charts in portable health records and reliance on specific local television programs with health segments for health information was salient. The latter presents a unique tool for potentially building maternal confidence for healthy feeding practices. CONCLUSION: Early childhood food choices are predominantly dictated by parental belief-driven actions. Effective interventions targeting the impact of maternal feeding practices on childhood obesity should incorporate supportive, credible professional input, address how and what knowledge influences individual beliefs, increase community-wide knowledge, and target cultural norms.

Reliability and validity of a short form household food security scale in a Caribbean community

BACKGROUND: We evaluated the reliability and validity of the short form household food security scale in a different setting from the one in which it was developed. METHODS: The scale was interview administered to 531 subjects from 286 households in north central Trinidad in Trinidad and Tobago, West Indies. We evaluated the six items by fitting item response theory models to estimate item thresholds, estimating agreement among respondents in the same households and estimating the slope index of income-related inequality (SII) after adjusting for age, sex and ethnicity. RESULTS: Item-score correlations ranged from 0.52 to 0.79 and Cronbach's alpha was 0.87. Item responses gave within-household correlation coefficients ranging from 0.70 to 0.78. Estimated item thresholds (standard errors) from the Rasch model ranged from -2.027 (0.063) for the 'balanced meal' item to 2.251 (0.116) for the 'hungry' item. The 'balanced meal' item had the lowest threshold in each ethnic group even though there was evidence of differential functioning for this item by ethnicity. Relative thresholds of other items were generally consistent with US data. Estimation of the SII, comparing those at the bottom with those at the top of the income scale, gave relative odds for an affirmative response of 3.77 (95% confidence interval 1.40 to 10.2) for the lowest severity item, and 20.8 (2.67 to 162.5) for highest severity item. Food insecurity was associated with reduced consumption of green vegetables after additionally adjusting for income and education (0.52, 0.28 to 0.96). CONCLUSIONS: The household food security scale gives reliable and valid responses in this setting. Differing relative item thresholds compared with US data do not require alteration to the cut-points for classification of 'food insecurity without hunger' or 'food insecurity with hunger'. The data provide further evidence that re-evaluation of the 'balanced meal' item is required.

Mechanisms of homing in the fiddler crab Uca rapax. 2. Information sources and frame of reference for a path integration system

Fiddler crabs Uca rapax are central-place foragers, making feeding excursions of up to several meters from their burrows. This study investigates the sources of directional and distance information used by these crabs when returning to their burrows. We tested the spatial frame of reference (egocentric or exocentric), and the source of spatial information (idiothetic or allothetic) used during homing. We also tested which components of their locomotion they integrated (only voluntary, or voluntary plus reflexive). Fiddler crabs in their natural mudflat habitat were passively rotated during normal foraging behavior using experimenter-controlled disks, before they returned home. Crabs resisted passive rotations on the disk by counter-rotating when the disk turned, which was a compensatory response to unintended movement. Crabs were usually situated eccentrically on the disk, and therefore were also subjected to a translation when the disk rotated. No crab actively compensated for this translation. Crabs that fully compensated for disk rotation made no directional homing error. Crabs that did not fully compensate homed in a direction that reflected their new body orientation. In other words, if we succeeded in reorienting a crab (i.e. it undercompensated for disk rotation), its homing error was equal to the angle by which it had been reoriented, regardless of the magnitude of the optomotor compensation. Computer-modelled crabs, each equipped with a path integrator utilizing different combinations of external (allothetic) and path-related (idiothetic) input, traversed the digitized paths of the real crabs. The home vector computed by the model crab was then compared to the homing direction observed in the real crab. The model home vector that most closely matched that of the real crab was taken to comprise the path integration mechanism employed by fiddler crabs. The model that best matched the real crab gained direction and distance idiothetically (from internal sources such as proprioceptors), and integrated only voluntary locomotory information. Crabs were also made to run home across a patch of wet acetate, on which they slipped and were thus forced to take more steps on the homeward path than theoretically required by the home vector. Crabs whose running velocity across the patch was unusually low also stopped short of their burrow before finding it. Crabs whose running velocity was not impeded by the patch did not stop short, but ran straight to the burrow entrance, as did control crabs that ran home with no slippery patch. We interpret this to mean that the velocity of some crabs was impeded because of slipping, and these therefore stopped short of their burrow after having run out their homing vector. This is positive evidence in support of the hypothesis that path integration is mediated either by leg proprioceptors or by efferent commands, but our data do not allow us to distinguish between these two possibilities.

Mechanisms of homing in the fiddler crab Uca rapax. 1. Spatial and temporal characteristics of a system of small-scale navigation

Fiddler crabs Uca rapax are central-place foragers, making feeding excursions of up to 2 m from their burrows. We describe the natural feeding excursions of path-integrating fiddler crabs and analyze their paths for signs of significant systematic or random navigation errors. No signs of any systematic errors are evident. Random errors are small, probably due to a combination of the short length and low sinuosity of the foraging paths, as well as the fiddler crabs' unique method of locomotion that allows them to remain oriented to their burrows throughout the foraging path and to minimize large body turns. We further examined the extent to which their body orientation during foraging (transverse body axis pointing more or less towards home) accurately represented their stored home vector. By examining sequences of fast escape, we have shown that crabs can correct for deviations of their transverse body axis from home during their escape path. Thus their stored home vector is independent of their moment-to-moment body orientation. Crabs were subjected to passive translational displacements and barrier obstructions. Responses to translational displacements were identical to those observed by previous authors, namely that crabs returned in the correct egocentric direction and distance as though no displacement had occurred. Covering the burrow entrance resulted in crabs returning to the correct position of the burrow, and then beginning to search. When a barrier was placed between foraging crabs and their burrow, crabs oriented their bodies toward the burrow as accurately as with no barrier.

Dietary patterns, nutritional status and activity levels of forth form secondary school children in Trinidad

Proper nutrition during adolescence in important for growth, long-term health promotion, and eating habits and physical inactivity are powerful determinants of some non-communicable chronic disease. The objective was to determine the dietary habits, nutritional status and physical activity patterns of adolescents in 4th form in Trinidad. A cross-sectional design study was used and a random sample of 1512 subjects identified. A qualitative food frequency questionnaire and a physical activity questionnaire were used to determine dietary and physical activity patterns. Weights, heights and triceps skin folds were measured. Adolescents were classified as being thin, normal overweight or obese. 619 girls and 601 boys, ages 14-17 participated. 34 percent was of East Indian descent, 32 percent African, 32 percent of mixed ethnicity and 2 percent other. The results indicated that 14 percent were thin, 74 percent had normal weight, 7 percent overweight and 5 percent obese. More adolescents of East Indian ethnicity were found to be thin. (p>0.001). Although fruits were consumed more regularly than vegetables, few adolescents consumed them daily. Rice and white bread/roti were the most commonly consumed staples. High fibre foods were not frequently eaten. Chicken was the most commonly consumed food from animals. 14 percent ate chicken daily. Fast foods were eaten on a weekly basis. The most important were chicken and chips, hotdogs, doubles, cakes and chocolates. 51 percent consumed alcoholic beverages; 1 percent drank them daily. 12 percent did not participate in any physical activity, while 32 percent exercised less than three hours per week. Walking, weight training, running/jogging and cricket were the most frequently reported activities. 78 percent did not participate in physical education at school. There was no association between body size and exercise, not were there any consistent associations between body size and diet. This study indicated a problem of both thinness and obesity in this population. Eating-related concerns are numerous, and must be addressed. Inclusion of regular physical activity as a tool for enhancing overall health and social values are of paramont importance (AU)

The treatment of mild to moderate hypertension

In clinical practice, the idea of treating hypertension should not be confined to lowering blood pressure alone. Hypertensive patients are often obese, diabetic, and sedentary. A 'global' perspective is therefore important. Such an approach will recognise the need to promote lifestyle modifications, including advice on a healthy diet, exercise, cessation of cigarette smoking, and reduction of alcohol intake. This article is not meant to be a treatise on hypertensive therapy - the aim is to highlight issues relevant to hypertension treatment in the Caribbean (AU)

Food for thought - lessons learned about the eating habits of Barbadian from the Adolescent Health and Fitness study (AHFIT)

OBJECTIVE: To study the eating and exercise habits of adolescent school attenders in Barbados. DESIGN AND METHODS: Four hundred and sixty-two students, randomly selected by class, attending four schools at different points of the "academic rank ladder", were invited to complete a knowledge, attitudes and practices questionnaire, to be measured, and to have their blood drawn. RESULTS: Adolescents whose body mass indices (BMIs) were over 5 kgm-2 were more likely to know of a family member who was overweight or obese (p=0.04) and know of a family member who had diabetes (p=0.03) than were those whose BMIs were less than 25 kgm-2. More of these "bigger" adolescents, compared to their smaller schoolmates, were convinced that they ate in a healthy manner (p<0.001), but did not get enough exercise (p=0.01). CONCLUSIONS: Public health strategies should pay particular attention to the promotion of nutrition and physical activity counselling in adolescents.(Au)

Differences in food and nutrient intake by age, place of birth and patterns of food choice in British African-Caribbean population sample

Epidemiological studies examining differences in disease patterns between migrant and resident populations suggest lifestyle factors including diet may be responsible. This paper reports an exploration of the food and nutrient intake of a randomly selected African-Caribbean (AfC) population sample resident in Manchester, UK. A quantitative food frequency questionnaire developed specifically for this population was interview administered. Over 80 percent of those invited completed the questionnaire (102 men, 153 women; mean age 54 and 49 years, respectively). Subjects following a traditional West Indian diet had a lower percent energy provided by fat compared to those following a non-traditional diet (men: traditional 30.4 percent vs. non-traditional 33.1 percent; women: traditional 32.6 percent vs 31.6 percent non-traditional). Those subjects born in the Caribbean (mean age 59 years) had a lower percent energy provided by fat compared to younger (mean age 30 years) UK born AfC subjects (31 percent vs 35 percent for both men and women). At present the AfC population is consuming a diet lower in fat than the majority white population and one that is in line with Government recommendations that no more than 35 percent of food energy is to be provided by fat. This could be an explanation for the lower rates of coronary heart disease (CHD) seen in the British AfC population. However, as younger AfC are selecting a more European type diet, higher in fat, this could result in change in CHD risk.(AU)

Nutrition and athletic performance

Optimal athletic performance requires adequate nutritional support. This mean getting enough food to meet increased energy needs and a wide variety to ensure adequate nutrient intake. The main energy source should be carbohydrate. Dietary guidelines for healthy eating apply to athletes and diabetics alike. This study evaluated the diets of young athletes for nutritional adequacy and determined the effect on their performance. Sample selection was based on convenience and included normal and diabetic athletes, mainly swimmers and footballers. Attitudes and practices were determined by questionnaire and a 24-hour recall provided data on nutrient intake. BMI and body fat were calculated. Results showed that the nutritional factor most likely to be low was energy. in many cases, this correlated with the athlete's perception of performance. Vitamin and mineral intakes were generally adequate but fibre intake tended to be low. This may be related to the sparsity of fruits and vegetables for many. The main sources of carbohydrate were refined cereals and sugars. Carbohydrate intake ranged from 50-60 percent of calories. Fat intake was relatively high and protein substantial. Most had BMIs above average, with a few underweight and two marginally overweight. Performance was related to quality of diet and importance placed on nutrition. Also critical was the level of training and self-esteem score.(AU)

The dietary fatty acids of patients with coronary artery disease and control in Curacao: implications for primary and secondary prevention

Patients with coronary artery diseases are advised to augment their dietary linoleic acid intakes at the expense of saturated fatty acids. We investigated whether the dietary linoleic acid intake of 57 patients with coronary artery disease (47 males, 10 females; ages 61 ñ 10 years) in Curacao is higher as compared with 77 controls (51 males, 26 females; ages 56 ñ 7 years). For this, we measured plasma cholesterol ester fatty acids, which reflect the dietary fatty acid composition of the preceeding weeks. Patients with coronary artery disease and controls had minor differences in cholesterol ester fatty acids. Their cholesterol ester linoleic acid content suggests that the dietary polyunsaturated/saturated fatty acid ratio is far below 1. Comparison with data reported for the the Netherlands, Greenland and Crete showed that the dietary fatty acid composition in Curacao is typically Western with a high intake of saturated fatty acids, a low intake of monounsaturated fatty acids and the consumption of linoleic acid as the predominant polyunsaturated fatty acid. Intake of long chain polyunsaturated fatty acids from fatty fish is low. Reduction of dietary saturated fatty acids, augmentation of fish consumption, and an increase of the O-linolenic/linoleic acid ratio are likely to be of benefit to both primary and secondary prevention from coronary artery disease in Curaco.(AU)

School breakfast benefits children's nutritional status

There are very few well-designed studies in developing countries to evaluate the benefits of school feeding programmes. The aim of this study was to determine the effects of giving breakfast on rural childrens' nutritional status, breakfast history and amount of money they brought to school. We conducted a randomized controlled trial of providing breakfast to rural primary school children in grade 2 to 5 in 16 schools in Jamaica. 407 undernourished children (weight for age,-ISD NCHS references and 407 adequtely nourished children (weight for age>-ISD) matched for age gender and class were randomly assigned to either breakfast or placebo groups for one school year. Breakfast consisted of bread or spiced bun with cheese and 250 ml flavoured milk which supplied 590-720 kcal and 22.5 g protein per day. The placebo was a small piece of orange. The children heights and weight were measured before and after the intervention. Differences between categorical variables were examined by Chi-squared tests and effects of giving breakfasts were tested by multiple regression analyses. The children receiving breakfast gained significantly more in weight and body mass index (p<.001) and height (p<0.05) than those in the placebo group. Participation in the programme did not reduce the amount of money brought to school, or change their home breakfasts, suggesting no significant income transfer to the families. We subsequently trained teaches to identify undernourished children who could benefit from a school meal using a calibrated measuring stick. (AU)

Diets of Jamaican primary school children and access to school feeding programmes - abstract

There is little information on the diets of school children in Jamaica. We observed food consumption and participation in government school feeding programmes in 415 children in grades 2 and 5 in 16 primary schools in rural Jamaica. All items eaten by children at break and lunch were recorded on two days. During break, the majority of children consumed sweets, snacks or syrup drinks and 25 percent of the children had nothing to eat for lunch and 6 percent had a drink only. Mean intakes at lunch were: energy 366 kcals (SD180), protein 10.4 g (SD 7.6) and iron 1.5 mg (SD1.2). The mean energy intake was 17-20 percent of the daily requirement of this age group. Children who brought lunch to school had significantly higher intakes (p<0.05). Girls had higher intakes than boys, and intakes were positively associated with height-for-age (both p<0.05). Approximately 20 percent of the children participated in the school feeding programmes. Poorer children were more likely to participate in the bun and milk programme (Odds Ratio 2.1, 95 percent CI 1.3-3.5) but children with more money for food were more likely to take part in the more costly Cooked Meal Programme (Odds ratio 2.4, 95 percent CI1.3-4.6). Strategies are needed to improve diet selection in school children and ensure access to school feeding among the poorest groups (AU).