HPV Vaccine Misperceptions Among Hispanics/Latinos in Southern California.

BACKGROUND: Cervical and other vaccine-preventable HPV-associated cancers disproportionately impact Hispanic/Latinos in the USA. HPV vaccine uptake may be impacted by community agreement with common HPV vaccine misperceptions. It is unknown whether Hispanics/Latinos have a greater agreement with these misperceptions relative to non-Hispanic whites. METHODS: HPV vaccine misperceptions were assessed through a 12-item Likert scale included in a population health assessment mailed to households in the southwest United States. Linear regression models assessed the association between identifying as Hispanic/Latino and summed misperception score. RESULTS: Among the 407 individuals in the analytic sample, 111 (27.3%) were Hispanic/Latino and 296 (72.7%) were non-Hispanic white. On average, Hispanics/Latinos had a 3.03-point higher HPV vaccine misperception sum score relative to non-Hispanic whites, indicating greater agreement with misperceptions (95% confidence interval: 1.16-4.88; p < 0.01). DISCUSSION: Culturally relevant interventions are needed to address HPV vaccine misperceptions among Hispanics/Latinos as part of efforts toward HPV-associated cancer health equity.

The Promoting Equity in Stem Cell Genomics Survey.

Aim: This study aimed to determine knowledge and attitudes toward induced pluripotent stem cell technology and biobanking. Methods: A survey instrument was developed to determine individuals' knowledge of and attitudes toward these technologies. Results: Results from 276 ethnically diverse participants who took the online survey demonstrated significant associations (p ≤ 0. 05) in knowledge by ethnicity and race regarding properties of stem cells, different types of stem cells and previous sample donation behavior. Significantly more Whites 39% (n = 53) compared with Blacks or African-Americans 19.2% (n = 14) had previous knowledge of induced pluripotent stem cells (χ2 = 8.544; p = 0.003) Conclusion: Overall, White race was associated with greater knowledge about stem cells and biobanks and greater willingness to donate samples for future research.

Stem cell biobanks have few samples from minorities for genomic studies. We conducted an online survey to understand knowledge and attitudes toward stem cell biobanks and technologies. Overall, we learned that White race was associated with the greatest knowledge about stem cell biobanks and willingness to contribute tissue samples for biobanks. More education is required so that minorities are willing to contribute tissue samples toward stem cell biobanks. This will help researchers study the genomic bases of disease and pursue translational research toward addressing health inequities.

Evaluating Research Centers in Minority Institutions: Framework, Metrics, Best Practices, and Challenges.

The NIH-funded Research Centers in Minority Institutions (RCMI) program is currently funding 18 academic institutions to strengthen the research environment and contribution to health disparities research. The purpose of this multiphase mixed-methods study was to establish a uniform evaluation framework for demonstrating the collective success of this research consortium. Methods included discussions of aims and logic models at the RCMI Evaluators' Workshop, a literature review to inform an evaluation conceptual framework, and a case study survey to obtain evaluation-related information and metrics. Ten RCMIs participated in the workshop and 14 submitted responses to the survey. The resultant RCMI Evaluation Conceptual Model presents a practical ongoing approach to document RCMIs' impacts on health disparities. Survey results identified 37 common metrics under four primary categories. Evaluation challenges were issues related to limited human resources, data collection, decision-making, defining metrics, cost-sharing, and revenue-generation. There is a need for further collaborative efforts across RCMI sites to engage program leadership and community stakeholders in addressing the identified evaluation challenges and measurement. Program leadership should be engaged to apply the Evaluation Conceptual Framework and common metrics to allow for valid inter-institutional comparisons and consortium-wide evaluations. Stakeholders could ensure evaluation metrics are used to facilitate community impacts.

Profiles of a Health Information-Seeking Population and the Current Digital Divide: Cross-Sectional Analysis of the 2015-2016 California Health Interview Survey.

BACKGROUND: Internet use for health information is important, given the rise of electronic health (eHealth) that integrates technology into health care. Despite the perceived widespread use of the internet, a persistent "digital divide" exists in which many individuals have ready access to the internet and others do not. To date, most published reports have compared characteristics of internet users seeking health information vs nonusers. However, there is little understanding of the differences between internet users seeking health information online and users who do not seek such information online. Understanding these differences could enable targeted outreach for health interventions and promotion of eHealth technologies. OBJECTIVE: This study aims to assess population-level characteristics associated with different types of internet use, particularly for seeking online health information. METHODS: The 2015-2016 California Health Interview Survey datasets were used for this study. Internet use was classified as never used the internet (Never use), ever used the internet but not to search for health information in the last 12 months (Use not for health), and ever used the internet and have used it to search for health information in the last 12 months (Use for health). Weighted multinomial logistic regression was used to assess sociodemographic and health characteristics associated with types of internet use. Findings are reported as odds ratios (ORs) with 95% CIs. RESULTS: Among 42,087 participants (weighted sample of 29,236,426), 19% reported Never Use of the internet, 27.9% reported Use not for health, and 53.1% reported Use for health. Compared to Never Use individuals, Use for health individuals were more likely to be younger (OR: 0.1, 95% CI 0.1-0.2 for ≥60 years vs <60 years), female (OR: 1.6, 95% CI 1.3-1.9 compared to males), and non-Hispanic white (OR: 0.54, 95% CI 0.4-0.7 for Latinos and OR: 0.2, 95% CI 0.2-0.4 for African Americans) and have a higher socioeconomic status (>400% of Federal Poverty Guidelines; OR: 1.3, 95% CI 1.4-2.4). Overall, characteristics for the Use not for health and Use for health groups were similar, except for those with lower levels of education and respondents not having visited a physician in the last year. For these two characteristics, the Use not for health group was more similar to the Never Use group. CONCLUSIONS: Our findings indicate that a digital divide characterized by sociodemographic and health information exists across three types of users. Our results are in line with those of previous studies on the divide, specifically with regard to disparities in use and access related to age, race/ethnicity, and socioeconomic status. Disparities in online health-seeking behavior may reflect existing disparities in health care access extending into a new era of health technology. These findings support the need for interventions to target internet access and health literacy among Never Use and Use not for health groups.

The My Body Knows When Program Increased Intuitive Eating Characteristics in a Military Population.

INTRODUCTION: The purpose of this pilot study was to assess the effectiveness of the revised My Body Knows When (MBKW) program to promote intuitive eating behaviors within a sample of a military population through an online or in-person delivery mode. MATERIALS AND METHODS: Fifty-six overweight or obese adults (70% female); military service members (20%), retirees (38%) and family (42%) participated in the 10-week MBKW program at two military installations from 2012 to 2014. Body Mass Index, Intuitive Eating Scale-2 (IES-2; 23-item) and Motivation for Eating scale (MFES; 43-item) were collected at baseline and 10-weeks. Data were stratified by sex. Descriptive data were reported as mean ± standard deviation (SD), frequency, or percentage. A paired t-test was conducted with data at baseline and 10 weeks (α = 0.05, 80% power). RESULTS: Participants were predominantly female (70%); mean age of 51 ± 13 years; and BMI of 34.1 ± 5.5 kg/m2. There were no demographic, MFES, or IES-2 baseline differences between groups (in-person vs. online) or location. All subjects were collapsed into one group for a pre-post MBKW implementation assessment due to small sample size despite the original intent to stratify by online and in-person grouping. At 10 weeks, the remaining 26 participants exhibited a significant improvement (mean ± SD) in BMI (-0.4 ± 0.6 kg/m2; p = 0.012), environmental/social eating score (2.7 ± 0.4 points [pts]; -0.5 pt change; p < 0.001), emotional eating score (2.2 ± 0.5 pts; -0.6 pt change; p = 0.001), unconditional permission to eat score (3.4 ± 0.4 pts; +0.3 pt change; p = 0.017), eating for physical rather than emotional eating score (3.7 ± 0.8 pts; +1.0 pt change; p < 0.001), and reliance on hunger and satiety cues score (3.6 ± 0.5 pts; +0.8 pt change; p = 0.001). High attrition rates at the 10-week follow-up assessment precluded accurate assessment of long-term intervention effects. CONCLUSIONS: The MBKW program was associated with improved intuitive eating behaviors and with less external eating influence on behavior; however, a larger sample is required to assess the effectiveness of MBKW delivery mode. Modest weight loss was attained but testing the efficacy of the MBKW program in a large diverse sample with alternate scenarios may be worthwhile (e.g., primary prevention against weight gain, or during weight maintenance to prevent weight regain).

International migration and dietary change in Mexican women from a social practice framework.

Migration from lower- and middle-income to high-income countries is associated with dietary change, and especially with the adoption of a modern, less healthy diet. In this article we analyze the dietary changes experienced by Mexican migrants, employing as a theoretical framework the concept of social practice. According to this framework, practices integrate material elements, meanings and competences that provide their conditions of possibility. Practices are shared by members of social groups, and interact with other competing or reinforcing practices. Between 2014 and 2015, we conducted semi-structured interviews with 27 women, international return migrants living in Tijuana, Mexico. The interview guide asked about history of migration and dietary change. We found three main areas of dietary change: from subsistence farming to ready meals, abundance vs. restriction, and adoption of new food items. The first one was associated with changes in food procurement and female work: when moving from rural to urban areas, participants substituted self-produced for purchased food; and as migrant women joined the labor force, consumption of ready meals increased. The second was the result of changes in income: participants of lower socioeconomic position modified the logic of food acquisition from restriction to abundance and back, depending on the available resources. The third change was relatively minor, with occasional consumption of new dishes or food items, and was associated with exposure to different cuisines and with learning how to cook them. Public health efforts to improve the migrants' diets should take into account the constitutive elements of dietary practices, instead of isolating individuals from their social contexts.

Intervention Effects on Latinas' Physical Activity and Other Health Indicators.

INTRODUCTION: U.S. Latinas do not engage in sufficient leisure-time physical activity. This study examined whether adding promotor-facilitated healthy lifestyle classes to an exercise intervention would promote exercise session attendance and improve health indicators. METHODS: The Familias Sanas y Activas II (Healthy and Active Families II) study used a within-subjects, longitudinal design, with measures at baseline and at 6 and 12 months post-baseline. The intervention was developed by the San Diego Prevention Research Center and implemented between May 2011 and June 2014 in South San Diego County. Three organizations each hired a part-time coordinator and trained volunteer promotores (six to ten per organization) to deliver the intervention in various community locations. A convenience sample of 442 Latinas were in the evaluation cohort. Measured variables included a step test, blood pressure, waist circumference, height, and weight; physical activity was self-reported. RESULTS: Attendance at healthy lifestyle classes was positively associated with exercise session attendance (p≤0.001). Mixed effects models showed improvements in systolic and diastolic blood pressure (p≤0.001); waist circumference (p≤0.001); weight (p≤0.05); and BMI (p≤0.05) between baseline and 12 months. At 12 months, fewer participants met clinical guidelines for being hypertensive and having an at-risk waist circumference. Exercise session attendance was associated with improved fitness (p≤0.05) and increased self-reported MET minutes of leisure-time physical activity (p≤0.01). CONCLUSIONS: The intervention represents an effective strategy for improving the health status of Latinas, a population with significant health disparities, including high obesity rates. Research efforts are needed to assess methods for scaling up such interventions.

Social network characteristics associated with health promoting behaviors among Latinos.

OBJECTIVE: This study examined the relationship between social network characteristics and health promoting behaviors (having a routine medical check-up, consuming no alcohol, consuming no fast food, and meeting recommendations for leisure-time physical activity and sleep duration) among Latinos to identify potential targets for behavioral interventions. METHOD: Personal network characteristics and health behavior data were collected from a community sample of 393 adult Latinos (73% women) in San Diego County, California. Network characteristics consisted of size and composition. Network size was calculated by the number of alters listed on a name generator questionnaire eliciting people with whom respondents discussed personal issues. Network composition variables were the proportion of Latinos, Spanish-speakers, females, family, and friends listed in the name generator. Additional network composition variables included marital status and the number of adults or children in the household. RESULTS: Network members were predominately Latinos (95%), Spanish-speakers (80%), females (64%), and family (55%). In multivariate logistic regression analyses, gender moderated the relationship between network composition, but not size, and a health behavior. Married women were more likely to have had a routine medical check-up than married men. For both men and women, having a larger network was associated with meeting the recommendation for leisure-time physical activity. CONCLUSION: Few social network characteristics were significantly associated with health promoting behaviors, suggesting a need to examine other aspects of social relationships that may influence health behaviors.

Socioeconomic disparities in elementary school practices and children's physical activity during school.

PURPOSE: To examine school socioeconomic status (SES) in relation to school physical activity-related practices and children's physical activity. DESIGN: A cross-sectional design was used for this study. SETTING: The study was set in 97 elementary schools (63% response rate) in two U.S. regions. SUBJECTS: Of the children taking part in this study, 172 were aged 10.2 (standard deviation (SD) = 1.5) years; 51.7% were girls, and 69.2% were White non-Hispanic. MEASURES: School physical education (PE) teachers or principals responded to 15 yes/no questions on school physical activity-supportive practices. School SES (low, moderate, high) was derived from the percent of students eligible for free and reduced-price lunch. Children's moderate to vigorous physical activity (MVPA) during school was measured with accelerometers. ANALYSIS: School level analyses involved linear and logistic regression; children's MVPA analyses used mixed effects regression. RESULTS: Low-SES schools were less likely to have a PE teacher and had fewer physical activity-supportive PE practices than did high-SES schools (p < .05). Practices related to active travel to school were more favorable at low-SES schools (p < .05). Children attending high-SES schools had 4.4 minutes per day more of MVPA during school than did those at low-SES schools, but this finding was not statistically significant (p = .124). CONCLUSION: These findings suggest that more low- and moderate-SES elementary schools need PE teachers in order to reduce disparities in school physical activity opportunities and that PE time needs to be supplemented by classroom teachers or other staff to meet guidelines.

Family support is associated with behavioral strategies for healthy eating among Latinas.

BACKGROUND: Healthy eating is important for obesity control. Dietary interventions target the adoption of behavioral strategies to increase fiber and decrease fat consumption. However, little is known about the contributions of psychosocial factors to the use of these strategies. PURPOSE: This study examined psychosocial correlates of behavioral strategies for healthy eating among Latinas. METHOD: Participants included 361 Latino mothers living along the U.S.-Mexico border in California. Data included measures of sociodemographics, acculturation, and psychosocial determinants of healthy eating. A 30-item dietary behavioral strategies scale assessed strategies to increase fiber and decrease fat consumption. RESULTS: Family interactions regarding dietary habits (ß = .224, p < .001) and financial status (ß = .148, p = .029) were associated with the use of strategies to decrease fat consumption. Positive family interactions regarding dietary habits (ß = .226, p < .001), fewer barriers to obtaining fruits and vegetables (ß = -.207, p < .001), and more family support for vegetable purchasing (ß = .070, p = .047) were associated with use of strategies to increase fiber consumption. CONCLUSIONS: Future interventions would benefit from improving family systems associated with healthy eating.

What difference can fathers make? Early paternal absence compromises Peruvian children's growth.

Considerable evidence suggests that fathers' absence from home has a negative short- and long-term impact on children's health, psychosocial development, cognition and educational experience. We assessed the impact of father presence during infancy and childhood on children's height-for-age z-score (HAZ) at 5 years old. We conducted secondary data analysis from a 15-year cohort study (Young Lives) focusing on one of four Young Lives countries (Peru, n = 1821). When compared with children who saw their fathers on a daily or weekly basis during infancy and childhood, children who did not see their fathers regularly at either period had significantly lower HAZ scores (-0.23, P = 0.0094) after adjusting for maternal age, wealth and other contextual factors. Results also suggest that children who saw their fathers during childhood (but not infancy) had better HAZ scores than children who saw their fathers in infancy and childhood (0.23 z-score, P = 0.0388). Findings from analyses of resilient children (those who did not see their fathers at either round but whose HAZ > -2) show that a child's chances of not being stunted in spite of paternal absence at 1 and 5 years old were considerably greater if he or she lived in an urban area [odds ratio (OR) = 9.3], was from the wealthiest quintile (OR = 8.7) and lived in a food secure environment (OR = 3.8). Interventions designed to reduce malnutrition must be based on a fuller understanding of how paternal absence puts children at risk of growth failure.

Associations among parent acculturation, child BMI, and child fruit and vegetable consumption in a Hispanic sample.

The objective of this study was to investigate the association of parent acculturation with child fruit and vegetable consumption and obesity, as measured by body mass index (BMI). Participants included 250 Mexican-American and other Hispanic families living within San Diego County. Height and weight measurements were collected to calculate the age- and sex-specific BMI for each child and parent, and parents completed self-administered surveys. Child BMI z-score was significantly related to parent BMI after controlling for parent acculturation and parent birth place (ß = 0.05, p < 0.01). Child fruit consumption was significantly associated with parent acculturation (ß = -0.02, p = 0.01) and parent BMI (ß = 0.02, p = 0.04) after adjusting for the other variables in the model. Child vegetable consumption was not significantly related to parent acculturation. Findings suggest that parental weight status may be more predictive of child obesity than acculturation, and highlight the need to examine culturally relevant behavioral and psychosocial factors related to childhood obesity and dietary behaviors.

Do Latino and non-Latino grocery stores differ in the availability and affordability of healthy food items in a low-income, metropolitan region?

OBJECTIVE: To compare non-ethnically based supermarkets and Latino grocery stores (tiendas) in a lower-income region with regard to the availability, quality and cost of several healthy v. unhealthy food items. DESIGN: A cross-sectional study conducted by three independent observers to audit twenty-five grocery stores identified as the main source of groceries for 80 % of Latino families enrolled in a childhood obesity study. Stores were classified as supermarkets and tiendas on the basis of key characteristics. SETTING: South San Diego County. SUBJECTS: Ten tiendas and fifteen supermarkets. RESULTS: Tiendas were smaller than supermarkets (five v. twelve aisles, P = 0·003). Availability of fresh produce did not differ by store type; quality differed for one fruit item. Price per unit (pound or piece) was lower in tiendas for most fresh produce. The cost of meeting the US Department of Agriculture's recommended weekly servings of produce based on an 8368 kJ (2000 kcal)/d diet was $US 3·00 lower in tiendas compared with supermarkets (P < 0·001). The cost of 1 gallon of skimmed milk was significantly higher in tiendas ($US 3·29 v. $US 2·69; P = 0·005) and lean (7 % fat) ground beef was available in only one tienda (10 %) compared with ten (67 %) supermarkets (P = 0·01). CONCLUSIONS: Barriers remain in the ability to purchase healthier dairy and meat options in tiendas; the same is not true for produce. These results highlight the potential that tiendas have in improving access to quality, fresh produce within lower-income communities. However, efforts are needed to increase the access and affordability of healthy dairy and meat products.

Westernization, intuitive eating, and BMI: an exploration of Jordanian adolescents.

The purpose of this study was to validate the Arabic-version of the adapted Marin Bidimensional Acculturation Scale and investigate the relationship between Westernization, intuitive eating, and body mass index (BMI) in a sample of Jordanian female adolescents. A total of 199 subjects between the ages of 11-18 were surveyed. Participants who scored higher on the Arabic domain exhibited higher Intuitive Eating Scale (IES) intrinsic subscale scores (r = 0.147, P = 0.048) suggesting that those who are more orientated toward Arabic culture may respond more naturally to physical hunger cues than their more Westernized counterparts. Reinforcing intuitive eating attitudes and behaviors and emphasizing body ideals resonant with the Arabic culture may propagate the continuation of intuitive eating in this population, potentially reducing the risk of obesity and other nutrition-related non-communicable diseases.

The nutrition transition in Jordan: the political, economic and food consumption contexts.

This paper describes and analyzes the nutrition transition in Jordan. The nutrition transition is shifting from undernutrition of a population to a diet high in fat, sugar, and refined carbohydrates (overnutrition) and corresponding premature morbidity and mortality from ensuing chronic diseases. The paper reviews and examines secondary data on demographic, epidemiological, economic, social, and dietary changes in the region. Jordan is moving through the nutrition transition at a rapid pace. Demographic, epidemiological, economic, and social changes have been accompanied by changes in diet, food expenditure, and general health. Although mortality rates have dropped significantly, fertility rates still remain high at 3.6 children per woman, especially compared to other countries in the region. Urbanization has increased rapidly from 46% of the population residing in urban areas in 1965 to 75% currently. Declines in real per capita income have created a state in which 27% of families live under the poverty line. Dietary changes in the region, due in part to changes in food availability over the last 40 years, include a general rise in caloric intake (from 2,165 Kcals in 1965 to 3,161 Kcals in 1997) with an increasing percentage of energy supply coming from fats and cereals. Undernutrition and chronic rates of malnutrition are low compared to other developing countries; however, various sources reveal that overweight and obesity are on the rise. Obesity in Jordan tends to be higher among women (16%) than among men (10%), with a much higher prevalence of obesity among uneducated women (50%). In conclusion, overweight and obesity are an emerging problem in Jordan, especially for women. There is a high prevalence of risk factors associated with diet-related non-communicable diseases among both men and women.

Health education's role in framing pornography as a public health issue: local and national strategies with international implications.

Pornography is a public health issue. However, since the US Surgeon General's workshop on pornography and public health reached a consensus statement about the impacts of pornography in 1986, few policy actions have been taken to deal with this public health problem, and intense discussion surrounding the regulation of pornography has continued. This debate spans a continuum between individual rights on one extreme and complete restriction of such material for society's good on the other extreme. However, during this same period much research has been done on the impacts of pornography on children and adults. This paper focuses on reviewing the effects of pornography on society including women, children, and consumers, and includes discussion on the current and failed policies aimed at regulating pornography. The growing phenomenon of Internet pornography use is discussed in depth, and specific policy ideas pertaining to Internet pornography are presented from a public health perspective.

The impact of body mass index and Western advertising and media on eating style, body image and nutrition transition among Jordanian women.

OBJECTIVES: To identify the impact of body mass index (BMI) and Western advertising and media on the stage of the nutrition transition among Jordanian women, and to evaluate their impact on eating styles and body image. DESIGN: A randomised cross-sectional survey that included a variety of culturally measured Likert-type scales and body size images. In addition, BMI was calculated based on measured height and weight. SETTING: In the homes of the participants. The data were collected by female interviewers who worked for the Jordan Department of Statistics. SUBJECTS: The sample was based on a random and representative selection of 800 mostly urban Jordanian women. A pre-test sample of 100 women was also used to validate the instruments. RESULTS: Women tended to agree that they ate based on emotional cues. They had high levels of disordered eating attitudes and behaviours and 42.1% were considered restrained eaters. However, these women also had higher than expected body esteem levels and desired a healthy body size. As expected, being obese was associated with a desire to lose weight, being a restrained and emotional eater, and having more disordered eating attitudes and behaviours. Similarly, Western advertising and media were associated with restrained and emotional eating, desired weight loss, and disordered eating attitudes and behaviours. CONCLUSIONS: There is a need to develop health education materials that explain the influence of obesity on health and the negative psychological and physical consequences of restrained and emotional eating, building on the current cultural preferences of healthy body size. Further implications and suggestions for future research are discussed.

Motivational factors and stages of change for physical activity among college students in Amman, Jordan.

The purpose of this study was to investigate physical activity levels across the five stages of change for physical activity and to identify motivational factors for physical activity according to these stages of change among college students in Amman, Jordan. Analyses were based on a cross-sectional survey of 431 students, with a mean age of 21.1 (SD=0.16) and 67.5% female. Based on the recommendation that physical activity requires at least 30 minutes of physical activity 3 or more days per week, men were more likely than women to classify themselves in later stages: 7.3% vs. 9.5% in the precontemplation stage, 17.4% vs. 14.7% in the contemplation stage, 50.0% vs. 63.5% in the preparation stage, 9.4% vs. 5.6% in the action stage, and 15.9% vs. 6.7% in the maintenance stage [X2(4) = 14.04, p = 0.0072]. Seven potential motivational items for physical activity were assessed using factor analysis: experience better self-worth, prevent chronic disease, relieve stress, stay in shape, longevity, recreation/fun, and social benefits. Two factor groupings were identified from these items. The first factor included the first five items, labeled as "Physical and Mental". The second factor included the last two items, labeled as "Social and Recreational." "Physical and Mental" items compared with "Social and Recreational" items were most likely to motivate physical activity across the stages of change for physical activity. The strongest motivator of physical activity was to stay in shape. The weakest motivator of physical activity was for social reasons. The influence of the intermediate motivational factors was slightly affected by the students' stage of change for physical activity. Motivators for physical activity did not differ according to sex. These results provide important information about the motivational factors for physical activity for college-aged students in Jordan that can be useful in developing effective physical activity intervention programs.

Intuitive eating and the nutrition transition in Asia.

Current models of the nutrition transition focus on demographic changes and economic development. A further influence may be the adoption of western-based perceptions of beauty that lead to potentially harmful eating behaviours which contribute to overweight, obesity, and eating disorders. This paper proposes a comprehensive model of the nutrition transition that includes western influences on perceived attractiveness and subsequent eating styles. An exploratory test of this model for Asian countries explores differences in intuitive eating as a function of economic development and the adoption of western standards of beauty. The intuitive eating scale (IES), a measure of food consumption that is primarily characterized by the satisfaction of physical hunger, was used to evaluate agreement with intuitive eating principles in the US and four Asian countries (Japan, Thailand, the Philippines, and China). Although intuitive eating scores in the US and Thailand failed to follow predicted patterns on two of the four IES subscales, scores for the other two IES subscales and the total IES score followed predicted patterns for Asian countries. Intuitive eating appears to be a valid, measurable concept that is correlated with economic development and levels of western influence in Asian countries. The tentative findings of this exploratory study support further evaluation of cultural influences as an important component of the nutrition transition.