Health Characteristics and Birth Outcomes for "Starting Out Right," a Teen Pregnancy Program.

PURPOSE: To evaluate differences in health characteristics and birth outcomes for participants of a prenatal education and support program for pregnant teens, "Starting Out Right" (SOR) compared to nonparticipant pregnant teens in Pima, Maricopa, and Gila counties in Arizona to gauge benefits of program participation. DESCRIPTION: The SOR program is a community education and support program for pregnant teens based on a structured curriculum. All pregnant teens living in the service area are eligible to participate. ASSESSMENT: Vital statistics birth data from 2014 to 2019 were obtained from three counties in Arizona that identified SOR and non-SOR program participants. Logistic regression was used to calculate multivariable -adjusted odds ratios (aOR) for specific health characteristics (smoking, hypertensive disorders, overweight and obesity, gestational diabetes, sexually transmitted infections) and birth outcomes (C-section, preterm birth, NICU admission, birthweight, and breastfeeding) for SOR participants compared with nonparticipants. Variables in the adjusted models included age, BMI, smoking, gestational diabetes, race, ethnicity, county, WIC participation, insurance type, plurality, and month and year prenatal care began. CONCLUSION: These results suggest that participation in SOR was associated (p ≤ 0.06) with a reduced odds for low birthweight [aOR 0.7(95% CI 0.5,1.0)] and increased odds (p ≤ 0.05) of breastfeeding [aOR 1.3(95% CI 1.0,1.7)] compared to nonparticipants. These results provide evidence that the education components in the SOR program support improved pregnancy and breastfeeding outcomes for pregnant teens.

BMI changes in adolescents treated with bupropion SR for smoking cessation.

OBJECTIVE: Adolescent overweight and obesity and smoking continue to be very important health challenges because of their lasting effects on overall health. Weight gain after smoking cessation is a barrier to quitting as well as a negative consequence to health. This study reports changes in the body mass index (BMI) z-scores of adolescent smokers participating in a dose-ranging clinical trial of bupropion SR (150 mg/day and 300 mg/day) for smoking cessation. METHODS: A total of N = 296 adolescent smokers (placebo n = 100, 150 mg/day n = 101, 300 mg/day n = 95) with a BMI z-score of 0.5 (sd: 1.4), 0.5 (sd: 1.3), and 0.5 (sd: 1.2) in the placebo, 150 mg/day, and 300 mg/day groups, respectively, were followed for 6 months. RESULTS: Adolescents in the 300 mg/day group had a significant reduction in BMI z-score 6 weeks after quitting (ß = -0.16, CI = (-0.29, -0.04), P-value = 0.01). This result was not sustained at the 6-month follow-up. CONCLUSIONS: A reduction in BMI z-score during smoking cessation with bupropion has important implications for the future of adolescent smoking cessation. These results are particularly relevant for adolescents who have either overweight or obesity or who have reservations about quitting for fear of gaining weight or BMI.

The effect of dietary glutamate on fibromyalgia and irritable bowel symptoms.

OBJECTIVES: To examine the effects of a challenge with monosodium glutamate (MSG) as compared to placebo on the symptoms of fibromyalgia (FM), in participants who initially experienced >30% remission of symptoms on an excitotoxin elimination diet. METHODS: Fifty-seven FM patients who also had irritable bowel syndrome (IBS) were placed on a 4-week diet that excluded dietary additive excitotoxins including MSG and aspartame. Thirty-seven people completed the diet and 84% of those reported that >30% of their symptoms resolved, thus making them eligible to proceed to challenges. Subjects who improved on the diet were then randomised to a 2-week double-blind placebo-controlled crossover challenge with MSG or placebo for 3 consecutive days each week. The primary outcome measure was total symptom score. Secondary outcome measures included visual analogue pain scales (VAS for FM and IBS), an IBS Quality of Life Questionnaire (IBS QOL) and the Fibromyalgia Impact Questionnaire-Revised (FIQR). Repeated measures ANOVA was used to analyse crossover challenge results. RESULTS: The MSG challenge, as compared to placebo, resulted in a significant return of symptoms (total symptom score, p<0.02); a worsening of fibromyalgia severity as determined by the FIQR (p<0.03); decreased quality of life in regards to IBS symptoms (IBS QOL, p<0.05); and a non-significant trend toward worsening FM pain based on visual analogue scale (VAS, p<0.07). CONCLUSIONS: These findings suggest that dietary glutamate may be contributing to FM symptoms in some patients. Future research on the role of dietary excitotoxins in FM is warranted.

KAP study of secondary school students towards obesity in Jamaica

A series of focus groups was used to study the knowledge, attitudes and practices of students (ages 11-18 years) towards obesity in Jamaica. Fifteen focus groups with a total of 180 students were drawn from a total of one thousand and twenty-two (1.022) students, from two school: one located in the urban area of Kingston, St. Andrew; and the other located in the rural area of Ewarton, in the parish of St. Catherine. Samples of students from the two schools were divided into three categories: 1. young-for-grade 2. average-for-grade 3. old-for-grade. Students were further grouped into all boys, all girls, and mixed groups of both boys and girls. Group interviews were taped recorded, and all recordings were transcribed verbatim. Notes were also made during each session. Following the standard procedure outlined in grounded method of group interviews open coding of the transcriptions was done. Concepts were identified and developed in terms of their properties and dimensions. Similar questions were labelled and grouped to form categories relating to each research question. Analysis of the sessions showed that there was no significant difference in the knowledge of causes of obesity among students in different grades. The majority of male students showed a negative attitude or feeling toward being obese. Yet many prefered women who were heavier or had a lower body distribution of adipose tissue which was refered to as the a "coca-cola bottle shape" (gynoid obesity, rather than women with an upper-body of abdominal distribution of adipose tissue (android obesity). The majority of female students expressed a positive attitude towards gynoid obesity, but disliked android obesity. In addition many of the females student expressed their dislike for obese men. Students' knowledge about the causes of obesity and prevention measures was not very consistent with their dietary patterns. Most of the students who participated in the focus group sessions did not think of obesity as a nutritional disease, but rather regarded it as a sign of wealth, good living, or access to an abundance of food.