Negotiating a traditional food space for the Gujarati diaspora in New Jersey: Prohibitions, linkages, and acceptances.

Food practices directly or indirectly depend on tradition and the rituals that sustain a commonality of communal purpose. By invoking tradition and embracing accepted values through prescribed participation, a transnational and to a certain extent her or his progeny, are anchored to a cultural community. Émigrés must decide from a pastiche of food choices from "here" or from "home," that will mark family and self-identity. This research seeks to assess the multiplicity of issues affecting the food cultural landscape of Gujarati transnationals and their descendants in New Jersey, US. The overall objective is to understand the motivations behind their overt and potentially covert food behaviors. Twenty-seven self-identified Gujarati Indian transnationals and their descendants were recruited through a non-probability sampling in northern New Jersey, US for five focus groups and follow-up individual interviews. Two Foundational Themes were distilled from the data: Collective Borders and Connectivity to Food, as well as four Emotive Themes: Food and Family Dynamics; Performance; Shame, Guilt & Anxiety; and Strength, Perseverance or Flexibility. Food choices enabled this diasporic community to negotiate between the competing forces of continuity and change, providing them with a template to adapt to their new surroundings while preserving native traditions. The arena of food and food choices was used by the participants to strike a pragmatic balance between individuation and collectivity, stability and change, and tradition and modernity. A clear understanding of the issues facing transnationals as they transition into a new country can help with their planning and processes of adjustment, which includes strategies to overcome pitfalls. The findings of this study can also inform the external community about the benefits of welcoming émigrés into their society.

Effectiveness of Individual Nutrition Education Compared to Group Education, in Improving Anthropometric and Biochemical Indices among Hypertensive Adults with Excessive Body Weight: A Randomized Controlled Trial.

OBJECTIVE: The study aims to compare the effectiveness of individual and group nutrition education methods in improving key anthropometric and biochemical markers in drug-treated, overweight-obese hypertensive adults. METHODS: The randomized trial included 170 patients with pharmacologically well-controlled primary hypertension and body mass index (BMI) ≥ 25 kg/m2. For six months, the patients received six sessions, either one-to-one individual nutrition education (IE, n = 89) or group education (GE, n = 81), developed by dietitians. Anthropometric measurements, body composition, and fasting measures of biochemical parameters were obtained at baseline and after six months of intervention. RESULTS: 150 patients completed the nutrition education program. The IE group significantly improved in many parameters compared to the GE group, including weight (p < 0.001), waist circumference (p < 0.001), BMI (p < 0.001), systolic and diastolic blood pressure (BP) (p < 0.001), fasting plasma glucose (p = 0.011), oral glucose tolerance test (OGGT) (p = 0.030), and insulin resistance (homeostatic model assessment of insulin resistance, HOMA-IR) (p < 0.001). The groups did not differ in terms of total cholesterol, high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) concentrations. CONCLUSION: Individual nutrition education is more effective than group education in terms of improving anthropometric and biochemical indices in overweight-obese hypertensive adults.

The effects of acclimation to the United States and other demographic factors on responses to salt levels in foods: An examination utilizing face reader technology.

The aim of this study was to assess the role of extended time in the United States (as defined as a continuous period greater than two years; referred to hereafter as "US Acclimated"), as well as other demographic factors, on the level of net positive response of consumers to different salt levels in food samples. One hundred panelists were recruited, including 50 meeting our US acclimation criterion. Panelists assessed samples of potatoes with five different levels of salt concentrations, and the levels of their net positive responses were evaluated with FaceReader technology (Noldus). The data of our study showed a significant positive association between US Acclimated participants and the level of net positive response to samples with higher salt contents. This interaction remained statistically significant even when modeling the effects with consideration of race/ethnicity and gender. Another notable outcome was the unexpected significant interaction between gender and US acclimation in regards to evaluated positive response across all salt concentrations (US Acclimated females demonstrating substantially and significant higher levels of positive response than US Acclimated males). The association between living in the United States and showing more positive response to higher salt contents is consistent with many persistent characterizations of the eating habits in the United States, but it is not in fact well explained by the most recent data regarding the observed levels of average sodium consumption across worldwide geographical regions. The results of this study may be demonstrating evidence of underlying as-yet-unknown factors contributing to the responses of consumers to salt levels in foods. Further examination of these possible factors may well be warranted.

Consumer perception of genetically modified organisms and sources of information.

Genetically modified organisms (GMOs) have been available for commercial purchase since the 1990s, allowing producers to increase crop yields through bioengineering that creates herbicide-resistant and insect-resistant varieties. However, consumer knowledge about GMOs has not increased at the same rate as the adoption of GMO crops. Consumers worldwide are displaying limited understanding, misconceptions, and even unfamiliarity with GMO food products. Many consumers report that they receive information about GMO food products from the media, Internet, and other news sources. These sources may be less reliable than scientific experts whom consumers trust more to present the facts. Although many in the United States support mandatory GMO labeling (similar to current European standards), consumer awareness of current GMO labeling is low. A distinction must also be made between GMO familiarity and scientific understanding, because those who are more familiar with it tend to be more resistant to bioengineering, whereas those with higher scientific knowledge scores tend to have less negative attitudes toward GMOs. This brings to question the relation between scientific literacy, sources of information, and overall consumer knowledge and perception of GMO foods.

Workplace lactation support by New Jersey employers following US Reasonable Break Time for Nursing Mothers law.

BACKGROUND: Returning to an unsupportive work environment has been identified as a major reason for avoidance or early abandonment of breastfeeding among working mothers. OBJECTIVE: This study aimed to examine the nature and extent of accommodations offered to breastfeeding employees among New Jersey employers since the US federal Reasonable Break Time for Nursing Mothers law enactment. METHODS: A cross-sectional survey was conducted to measure current lactation support in the workplace in New Jersey. Using convenience sampling, the survey was sent to managerial personnel in hospitals and nonhospitals. The level of support was assessed on company policy, lactation room, and room amenity. A composite lactation amenity score was calculated based on responses about lactation room amenities. RESULTS: Respondents (N = 51) completed a 22-item online questionnaire during fall 2011. The support level was compared by type of organization: hospital (n = 37) versus nonhospital (n = 14). The amenity score of hospitals was significantly higher than nonhospitals (1.44 vs 0.45, P = .002). The mean amenity score (score = 0.95) for all employers was far below comprehensive (score = 3.0). Compared to nonhospitals, hospitals were more likely to offer lactation rooms (81% vs 36%, P = .003), have their own breastfeeding policy (35.1% vs 7.1%, P = .01), and provide additional breastfeeding support (eg, education classes, resources; P < .05). CONCLUSION: Employers, regardless of the type of organization, need to improve their current practices and create equity of lactation support in the workplace.

Consumer knowledge and attitudes about genetically modified food products and labelling policy.

The purpose of this study was to examine the relationship between consumer knowledge, attitudes and behaviours towards foods containing genetically modified organisms (GMOs) and the prevalence of GMO labelling in northern New Jersey supermarkets. This cross-sectional study surveyed 331 adults, New Jersey supermarket customers (mean age 26 years old, 79.8% women). The results show a strong, positive correlation between consumer attitudes towards foods not containing GMOs and purchasing behaviour (Pearson's r = 0.701, p < 0.001) with lesser correlations between knowledge and behaviour (Pearson's r = 0.593, p < 0.001) and knowledge and attitudes (Pearson's r = 0.413, p < 0.001). GMO labelling would assist consumers in making informed purchase decisions.

Lactation accommodation in the workplace and duration of exclusive breastfeeding.

INTRODUCTION: The purpose of this study was to assess current lactation accommodations in a workplace environment and to examine the association between the different dimensions of support and the duration of exclusive breastfeeding. METHODS: A survey was conducted with employees of a higher-education institution and clients of an obstetric hospital in New Jersey. Factor analysis identified dimensions of workplace support. The dimensions were correlated with the duration of exclusive breastfeeding using Pearson's r correlation analysis. RESULTS: One hundred and thirteen working mothers participated in the study. The mean (SD) number of working hours of the participants was 34.3 (2.8) hours per week. Participants were primarily white (89.4%), older (mean age, 33.8 [6.0] years), highly educated (>82% above college graduate), and married (92%). Participants indicated that in their workplaces, breastfeeding was not common, breast pumps were not available, and on-site day care was not always an option. The analysis identified 4 dimensions of breastfeeding accommodation: break time, workplace environment, technical support, and workplace policy. Technical support (r = 0.71, P = .01) and workplace environment (r = 0.26, P = .01) were significantly associated with the duration of exclusive breastfeeding. DISCUSSION: Employers can strengthen technical support and workplace environment to encourage breastfeeding continuation in working mothers. New federal laws should consider specific guidelines for minimum requirements for functional lactation support to achieve comprehensive breastfeeding benefits.

Alternative hospital gift bags and breastfeeding exclusivity.

The type of gift bags given to new mothers at the time of discharge from the hospital can influence their confidence in breastfeeding. Most hospitals in the US continue to distribute commercial gift bags containing formula samples despite the reported negative influence of commercial bags on the duration of breastfeeding. This study compared breastfeeding outcomes in women receiving three different kinds of gift bags at discharge. A prospective intervention study was conducted during 2009-2010 in New Jersey. Three breastfeeding cohorts were recruited and assigned to three groups: COMMERCIAL received discharge bags containing formula samples, BF-INFO received breastfeeding information and supplies, and PUMP received breastfeeding information/supplies plus a manual breast pump. Follow-up contacts were at 2, 4, and 12 postpartum weeks to determine breastfeeding outcome. The mean durations of exclusive (EBF) and partial breastfeeding were compared between groups using ANOVA. A total of 386 participants completed the study. The mean EBF duration (weeks) in the PUMP (n = 138, 8.28 ± 4.86) and BF-INFO (n = 121, 7.87 ± 4.63) were significantly longer (P < 0.01) than COMMERCIAL (n = 127, 6.12 ± 4.49). The rate of EBF through 12 weeks in PUMP was most consistent. The mean duration of partial breastfeeding showed similar results: significantly longer in PUMP and BF-INFO than COMMERCIAL (P < 0.01).

Eating behaviors of older adults participating in government-sponsored programs with different demographic backgrounds.

The purpose of this study was to determine the food behaviors of nutritionally high-risk seniors as a function of their racial background, gender, marital status, and education level. A total of 69 seniors were identified to be at high nutritional risk using the Nutrition Screening Initiative (NSI) checklist. A supplemental questionnaire (SQ) was created to examine the risk factors in relation to the participant's demographic background. Key results indicated that Asians practiced healthy food behaviors and women were more likely to eat alone (p?0.05). Married participants (90.9%) were most likely to consume 2 meals or more each day. College educated individuals practiced healthier eating, eating 5 servings or more of fruits and vegetables (p?0.01) and 2 or more servings of milk and milk products (p?0.01). These preliminary findings indicate that more studies should be conducted to focus on the demographic characteristics and food behaviors among older populations.

Employers' readiness for the mother-friendly workplace: an elicitation study.

Currently over half of mothers of infants under 1-year-old are in the workforce in the United States. These women face challenges to continue breastfeeding when they return to work 3 to 6 months post-partum. This study explored the perspectives of employers on mother-friendly environments to assess their readiness to provide breastfeeding accommodation using the elicitation under the theory of planned behaviour. Researchers conducted phone/in-person interviews with a convenient sample of 20 human resource managers from companies that had 500 or more employees in the New York metropolitan area in 2009. Content analyses identified the common concepts that represent underlying beliefs of the constructs of the theory. The demography of the participants is 40% male and 80% White, with mean ages of 34.3±8.5 years. 'Happy employees' and 'high retention rate and improved loyalty' were the most frequently mentioned (95%) benefits to the company (behavioural beliefs). Supporters of a mother-friendly environment (normative beliefs) in the workplace included 'mothers and expectant mothers (70%)', and 'managers supervising women and new mothers (55%)'. Most frequently mentioned company drawbacks (control beliefs) were 'not cost effective (65%)' and 'time consuming (65%)', followed by 'perception of special favours for some (50%)'. Workplace breastfeeding promotion efforts can be successful by reinforcing positive beliefs and addressing the challenges associated with implementation of breastfeeding accommodation through education and other incentives such as recognition of model companies and tax breaks. The identified beliefs provide a basis for the development of a quantitative instrument to study workplace breastfeeding support further.

An exploratory investigation of the risk of pathogenic contamination at selected New Jersey skilled nursing and assisted living residences.

Elderly populations are vulnerable and generally have the highest incidence of morbidity related to foodborne illnesses and this problem may be aggravated in institutional or communal eating settings. The objective of this investigation was to examine the potential risk of food contamination in selected skilled nursing and assisted-living residences using bacteria indicator tests for Listeria spp., Salmonella spp. and E. coli. Of the 45 samples tested for Listeria, three (6.67 %) were found to be contaminated; Salmonella or E. coli contamination was not found in any of the samples. Reported incidents of foodborne illnesses are increasing in institutional settings, therefore there is an urgent need to collect information on practices that can prevent bacterial contamination of food served in elderly residences.

Determination of malnourishment in the head and neck cancer patient: assessment tools and nutrition education of radiation oncologists.

PURPOSE: The purpose of this study is to evaluate current assessment practices of malnourishment by radiation oncologists among the head and neck cancer patient population. METHODS: A cross-sectional descriptive study was conducted. A 14-question survey was mailed to 333 radiation oncologists self-identified as "interested in the treatment of head and neck cancer." RESULTS: About 87% of radiation oncologists indicated that they used bodyweight as the sole determinant of malnourishment in head and neck cancer patients at initial consultation. Radiation oncologists with 0 to 10 years experience were found to have a higher level of formal nutrition education than those with 11 to 20 years (p=0.0052). A significant difference was found between radiation oncologists with formal nutrition education vs. those without, in answering whether nutrition interventions play a significant role in the prognosis of such cancer patients (p=0.0013). In addition, a significant difference was noted in methods used to determine proper caloric intake when the oncologists were stratified by their beliefs about nutrition being a significant variable affecting the prognosis of head and neck cancer patients (p=0.0024). CONCLUSION: Assessment or screening for malnourishment in the head and neck cancer patient should be a routine part of the initial consultation. Radiation oncologists and their medical team, including nutritionists, should use an appropriate nutrition screening and assessment tool in addition to the body weight as an indicator of malnourishment. Nutrition education provided to radiation oncologists should be improved to better communicate the positive effects of nutrition interventions on prognosis.

Predicting intentions to continue exclusive breastfeeding for 6 months: a comparison among racial/ethnic groups.

The purpose of this study was to explore how mothers of different races/ethnicities make decisions to continue exclusive breastfeeding (EBF) for 6 months under the Theory of Planned Behavior. Participants were recruited from hospitals and WIC clinics in Central Indiana and Southern New Jersey from 2008 to 2009. Mothers (N=236: 93 non-Hispanic African American, 72 non-Hispanic white, 71 Hispanic/Latina) completed a self-administered questionnaire that measured theoretical constructs and beliefs related to their intention to practice EBF for 6 months. Intentions to continue EBF for 6 months were similar (P=0.15) across racial/ethnic groups. Significant proportions of the intention (P<0.001) were explained by the three theoretical constructs (attitude, subjective norm, and perceived behavioral control). The relative importance of each construct in predicting the intention varied by group. The most influential predictors (P<0.001) were attitude for white mothers, subjective norm for African American mothers, and perceived behavioral control for Latina mothers. Latent beliefs strongly associated with attitude in white mothers were 'bonding with the baby' and 'easy feeding.' Beliefs held by family members and the general public contributed to the subjective norm of African American mothers. Perceived behavioral control in Latina mothers was highly correlated with 'pumping breast milk'. Development of policy and intervention programs that focus on shaping strong predictors and beliefs within racial/ethnic groups could reduce disparities in EBF rates and establish EBF for 6 months as a cultural norm.

Measuring the impact of nutrition education and physical activity on older adults participating in government sponsored programs.

A longitudinal, four-year study (2004-2007) with a cohort of 139 older adults (majority women;71%) was conducted to examine the impact of community-based nutrition and physical activity programs on health outcome measures. Demographic and anthropometric data were collected and nutrition screening was performed. Blood pressure, serum cholesterol and glucose levels, and pulse rate were also measured. The blood pressure, both mean systolic and diastolic, 141(± 19.0)/79.3 ± 9.7 (2004) vs. 127.8 ± 10.9/73.8 ± 10.2 mm Hg (2007), were improved (p < 0.05) in women. There were also improvements (p < 0.05 in both men and women) in pulse rate between 2004 and 2007. There is no doubt that nutrition education and exercise programs together enhanced the overall health and well being of these older adults. However, our findings emphasize the need for further systematic study and for appropriate biometric assessments to evaluate the full impact of nutrition education and physical activity interventions in older adults.

Nutritional quality of organic, conventional, and seasonally grown broccoli using vitamin C as a marker.

Organically labeled vegetables are considered by many consumers to be healthier than non-organic or 'conventional' varieties. However, whether the organic-labeled vegetables contain more nutrients is not clear. The purpose of this study is to examine the nutritional quality of broccoli using vitamin C, a fragile and abundant nutrient, in broccoli as a biomarker. The vitamin C content was assayed (2,6-dichlorophenolindophenol method) in broccoli samples obtained from supermarkets that are considered the point of consumer consumption. These samples were obtained during different seasons when the broccoli could be either harvested locally or shipped far distances. The findings indicate that vitamin C could be used as a marker under a controlled laboratory environment with some limitations and, although the vitamin C content of organically and conventionally labeled broccoli was not significantly different, significant seasonal changes have been observed. The fall values for vitamin C were almost twice as high as those for spring for both varieties (P=0.021 for organic and P=0.012 for conventional). The seasonal changes in vitamin C content are larger than the differences between organically labeled and conventionally grown broccoli.