Eating attitudes in English secondary school students: influences of ethnicity, gender, mood, and social class

OBJECTIVE: To examine the effects of ethnicity, gender, socioeconomic position, self-esteem, and emotion on eating attitudes in adolescents. METHOD: Questionnaire survey of 722 students in two English schools, using Eating Attitude Test-26 (EAT), Rosenberg Self-Esteem Scale, and Angold vMood and Feeling instruments. RESULTS: EAT scores were significantly higher for Asians and Muslims and for mixed-race subjects than for White or African Caribbean subjects (p =.003). Adjusted odds ratios for having a very high EAT score (>20) were 2.4 (95% confidence interval [CI] 1.0-6.0) in Asians and Muslims and 2.9 (95% CI 1.3-18.6) in mixed-race subjects, compared with White subjects. Having only one parent employed was also independently associated with a very high EAT score, compared with having both parents employed. Similar associations were found for a moderately high EAT score (>10) and for a combination of low self-esteem and high EAT score. Low self-esteem and depressed mood were independently associated with a high EAT score. DISCUSSION: Ethnicity, socioeconomic position, self-esteem, and depression, but not gender, were independently associated with eating attitudes. Effects of cultural and socioeconomic stresses on eating disorders may be mediated through depressed mood and low self-esteem.     

Alcohol drinking patterns by gender, ethnicity, and social class in Bahia, Brazil

OBJECTIVE: To study patterns of alcohol consumption and prevalence of high-risk drinking. METHODS: A household survey was carried out in a sample of 2,302 adults in Salvador, Brazil. Cases of High-Risk Drinking (HRD) were defined as those subjects who referred daily or weekly binge drinking plus episodes of drunkenness and those who reported any use of alcoholic beverages but with frequent drunkenness (at least once a week). RESULTS: Fifty-six per cent of the sample acknowledged drinking alcoholic beverages. Overall consumption was significantly related with gender (male), marital status (single), migration (non-migrant), better educated (college level), and social class (upper). No significant differences were found regarding ethnicity, except for cacha?a (Brazilian sugarcane liquor) and other distilled beverages. Overall 12-month prevalence of high-risk drinking was 7%, six times more prevalent among males than females (almost 13% compared to 2.4%). A positive association of HRD prevalence with education and social class was found. No overall relationship was found between ethnicity and HRD. Male gender and higher socioeconomic status were associated with increased odds of HRD. Two-way stratified analyses yielded consistent gender effects throughout all strata of independent variables. CONCLUSIONS: The findings suggest that social and cultural elements determine local patterns of alcohol-drinking behavior. Additional research on long-term and differential effects of gender, ethnicity, and social class on alcohol use and misuse is needed in order to explain their role as sources of social health inequities.     

高年级小学生营养与食品知识认知及饮食行为调查

目的 了解长治市城区4~6年级小学生营养与食品相关知识知晓情况和饮食习惯,为下一步健康教育提供依据。方法 采用随机整群抽样的方法于2013年9-12月抽取长治市城区8所小学4~6年级的1 265名小学生进行《小学生营养与食品安全知识行为问卷》的自填式问卷调查。结果 调查对象营养与食品安全知识得分偏低,其中营养知识调整得分低于食品知识得分,差异有统计学意义(t=29.37,P<0.001)。营养知识得分六年级学生高于四五年级的学生(F=15.600,P<0.001),独生子女得分高于非独生子女(t=19.280,P<0.001)。食品知识得分女生高于男生(t=2.840,P=0.005)。有70.7%的小学生每天吃早餐;21.7%和36.0%的小学生可以保证每天吃鸡蛋和奶类;53.9%的小学生每天可以吃水果,而39.6%和24.1%小学生会吃油炸食物和腌制食物超过一周一次; 29.0%和29.9%的小学生会吃烧烤食品和膨化食物超过一周一次。小学生实际获得知识途径前两位为电视网络(49.2%)、父母(25.4%)。而小学生更愿意通过讲座(43.5%)、网络途径(40.0%)获得相关知识。结论 调查对象营养与食品安全知识掌握程度偏低,存在一些不良的饮食习惯,亟需通过健康教育来进行干预,提高调查对象的健康水平。     

Relationship of nutrition and physical activity behaviors and fitness measures to academic performance for sixth graders in a midwest city school district

BACKGROUND: To support curriculum and policy, a midwest city school district assessed the association of selected categories of nutrition and physical activity (NUTR/PA) behaviors, fitness measures, and body mass index (BMI) with academic performance (AP) for 800 sixth graders. METHODS: Students completed an adapted Youth Risk Behavior Surveillance Survey (NUTR/PA behaviors), fitness assessments (mile run, curl‐ups, push‐ups, height, and weight) with results matched to standardized scores (Measures of Academic Progress [MAP]), meal price status, and gender. Differences in mean MAP scores (math and reading) were compared by selected categories of each variable utilizing 1‐way analysis of variance. Associations were determined by stepwise multiple regression utilizing mean MAP scores (for math and for reading) as the dependent variable and NUTR/PA behaviors, fitness, and BMI categories as independent variables. Significance was set at α = 0.05. RESULTS: Higher MAP math scores were associated with NUTR (more milk and breakfast; less 100% fruit juice and sweetened beverages [SB]) and PA (increased vigorous PA and sports teams; reduced television), and fitness (higher mile run performance). Higher MAP reading scores were associated with NUTR (fewer SB) and PA (increased vigorous PA, reduced television). Regression analysis indicated about 11.1% of the variation in the mean MAP math scores and 6.7% of the mean MAP reading scores could be accounted for by selected NUTR/PA behaviors, fitness, meal price status, and gender. CONCLUSION: Many positive NUTR/PA behaviors and fitness measures were associated with higher MAP scores supporting the school district focus on healthy lifestyles. Additional factors, including meal price status and gender, contribute to AP.     

Social inequality and depressive disorders in Bahia, Brazil: interactions of gender, ethnicity, and social class

We conducted a study of the association between gender, race/ethnicity, and social class and prevalence of depressive disorders in an urban sample (N = 2302) in Bahia, Brazil. Individual mental health status was assessed by the PSAD/QMPA scale. Family SES and head of household's schooling and occupation were taken as components for a 4-level social class scale. Race/ethnicity (white, moreno, mulatto, black) was assessed with a combination of self-designation and a system of racial classification. The overall 12-month prevalence of depressive symptoms was 12%, with a female:male ratio of 2:1. Divorced/widowed persons showed the highest prevalence and single the lowest. There was a negative correlation with education: the ratio college educated:illiterate was 4:1. This gradient was stronger for women than men. There was no F:M difference in depression among Whites, upper-middle classes, college-educated, or illiterate. Prevalence ratios for single, widowed and Blacks were well above the overall pattern. Regarding race/ethnicity, higher prevalences of depression were concentrated in the Moreno and Mulatto subgroups. There was a consistent social class and gender interaction, along all race/ethnicity strata. Three-way interaction analyses found strong gender effect for poor and working-class groups, for all race/ethnicity strata but Whites. Black poor yielded the strongest gender effect of all (up to nine-fold). We conclude that even in a highly unequal context such as Bahia, Blacks, Mulattos and women were protected from depression by placement into the local dominant classes; and that the social meaning of ethnic-gender-generation diversity varies with being unemployed or underemployed, poor or miserable, urban or rural, migrant or non-migrant.     

Working class matters: socioeconomic disadvantage, race/ethnicity, gender, and smoking in NHIS 2000

OBJECTIVES: We sought to describe the burden of smoking on the US population, using diverse socioeconomic measures. METHODS: We analyzed data from the 2000 National Health Interview Survey. RESULTS: Overall, the prevalence of current smoking was greatest among persons in--and independently associated with--working class jobs, low educational level, and low income. Attempts to quit showed no socioeconomic gradient, while success in quitting was greatest among those with the most socioeconomic resources. These patterns held in most but not all race/ethnicity-gender groups. Finer resolution of smoking patterns was obtained using a relational UK occupational measure, compared to the skill-based measure commonly used in US studies. CONCLUSIONS: Reducing social disparities in smoking requires attention to the complexities of class along with race/ethnicity and gender.     

A pilot study to examine the effects of a nutrition intervention on nutrition knowledge, behaviors, and efficacy expectations in middle school children

BACKGROUND: This was a pilot study to determine the impact of the Michigan Model (MM) Nutrition Curriculum on nutrition knowledge, efficacy expectations, and eating behaviors in middle school students. METHODS: The study was conducted in a large metropolitan setting and approved by the Institutional Review Board. The participants for this study were divided into an intervention group (n = 407) and a control group (n = 169). An MM instructor trained health teachers in the use of the curriculum, and the teacher subsequently taught the curriculum to students in the intervention group. A valid and reliable questionnaire was used to determine pre-post differences. It consisted of 3 subscales assessing eating habits, nutrition knowledge, and efficacy expectations toward healthy eating. Subscale scores were analyzed using a 2 groups (intervention vs control) x 2 times (pre vs post) analysis of variance. RESULTS: The intervention group increased their nutrition knowledge at post. There was also a significant main effect for groups in the subscales "Eating Behaviors" and "Efficacy Expectations Regarding Healthy Eating." Subsequent post hoc analysis revealed that the intervention group was significantly more likely to eat fruits and vegetables and less likely to eat junk food than the control group. Students in the intervention group also felt more confident that they could eat healthy. CONCLUSIONS: The results of this pilot study suggest that the MM Nutrition Curriculum delivered by trained professionals resulted in significant positive changes in both nutrition knowledge and behaviors in middle school children. Further research needs to be conducted to determine the long-term impact.     

Predictors of interest in nutrition topics and willingness to participate in local nutrition programmes

OBJECTIVE: To investigate the predictors of interest in nutrition topics and willingness to participate in weight management courses and nutrition-related chronic disease management courses. METHODS: Data from a cross-sectional survey (n = 1007 Koreans aged >or=30) on nutrition-related conditions, nutrition behaviours, interest in nutrition topics and willingness to participate in two types of nutrition education courses, and general characteristics. Binary logistic regression was used to identify predictors of the participants' interest in the topic and willingness to participate. RESULTS: Younger, richer and more-educated participants were significantly more likely to be willing to participate in 'nutrition-related chronic disease management'. Having a higher income and being male increased the odds of being interested in this topic. Younger, more obese, high-income females and those interested to keep their weight and reduce fatty foods were more likely to be willing to participate in 'weight management'. CONCLUSION: There is a need to increase awareness about the link between nutrition and related health problems, especially regarding 'hidden' health problems to tailor the programmes especially for older, low-income and less-educated people and to focus on increasing their interest in nutrition topics.     

Understanding the interconnections between ethnicity, gender, social class and health:experiences of minority ethnic women in britain

This paper presents the findings of a qualitative study about the impact of ethnicity, gender, and socio-economic status upon health, and use and access to appropriate service provision. A total of 54 interviews were carried out with women who identified themselves as Muslim and Bangladeshi. Health and social care professionals were also interviewed. However, the focus of this paper is upon the ways in which women conceptualised their health and social care needs and concerns. Our findings indicate that individual characteristics serve to mediate the influence of gender and ethnicity on health, but for the women in our study, socio-economic status represents the most potent factor in adversely affecting their health status and access to health care.     

Differences between respondents and nonrespondents in a multicenter community-based study vary by gender and ethnicity

This study provides data on differences between respondents and nonrespondents by gender and ethnicity in a multicenter community-based study that is rarely collected and that may be useful for estimating bias in prevalence estimates in other studies. Demographic, general health, and cardiovascular risk factors were examined in black and white respondents and nonrespondents to the Atherosclerosis Risk in Communities (ARIC) Study, a prospective study investigating cardiovascular risk factors in approximately 16,000 adults that was initiated in 1986 in four U.S. communities. In one of the communities (Jackson, MS) black participants were recruited exclusively; in another (Forsyth County, NC) 12% of the eligible sample were black, whereas the samples in Washington County, MD and the northwestern suburbs of Minneapolis, MN were almost all white. Demographic and health characteristics were collected during a home interview. Subjects who subsequently agreed to complete a clinical examination were defined as respondents, while eligible participants who only took part in the home interview were considered to be nonrespondents. Approxmately 75% of age-eligible individals (45–64 years) in each community completed the home interview. In three of the communities 86–88% of those who took part in the home interview also completed the clinic examination, whereas only 63% did so in Jackson. Among white participants, response rates were similar in men and women and between communities. Among black participants, the response rates were considerably lower, particularly in men. White male respondents reported a higher socioeconomic status, better general health and a lower prevalence of cardiovascular disease and associated risk factors than white male nonrespondents. The difference between white respondents and nonrespondents were greater for men than women despite similar response rates. Among black participants, respondent/nonrespondent differences were usually of smaller magnitude or absent, particularly in women. General health status and recent hospitalization rates were almost identical in black respondents and nonrespondents. Low response rates can bias estimates of prevalence in community-based studies although differences between respondents and nonrespondents tend to exaggerate real differences beween respondents and the eligible population sampled. For example, among white males 25% of respondents and 44% of nonrespondents were current smokers, yet the estimated community prevalence of smoking was 31%. In conclusion, differences observed between respondents and nonrespondents were in the expected direction, but were greater for men than women and for whites than blacks.     

The correlation between nutrition knowledge and eating behavior in an American school: the role of ethnicity

The purpose of this study was to examine the relationship between nutrition knowledge and eating behavior of a sample of middle school children. The participants were 532 students in the sixth, seventh, and eighth grades from Shawnee Middle School in Lima, Ohio. The students were asked to a complete a questionnaire (CANKAP--Comprehensive Assessment of Nutrition Knowledge, Attitudes, and Practices), which measured nutrition knowledge and eating behavior, and is reproduced here. The data were coded and computer-analyzed using the SAS statistical program for analysis by frequency distribution, one-way analysis of variance, Pearson Correlation Coefficients. Data analysis provided the following results: Mean nutrition knowledge scores of sixth grade students (68.4) were higher than mean nutrition knowledge scores of seventh and eighth grade students (58.5 per cent). The relationship between nutrition knowledge and eating behavior was insignificant for sixth grade students, but significant for seventh and eighth grade students. Also, "Caucasians" had higher mean knowledge scores than "Other" ethnic groups combined. The students demonstrated knowledge about the cultural and psychological aspects of nutrition. However, they were not able to identify the food sources of nutrients or nutrient functions, and they did not use a daily food guide to choose foods, although they were aware of the importance of milk and vegetable consumption. Knowledge about nutrition and healthy eating behavior appears to be weak within this group, and it would be beneficial to promote a nutrition curriculum for students in middle schools.     

Effect of ethnicity and gender on performance in undergraduate medical examinations

OBJECTIVE: To assess the effect of ethnicity and gender on medical student examination performance. DESIGN: Cohort study of Year 3 medical students in 2002 and 2003. SETTING: Royal Free and University College Medical School, Imperial College School of Medicine. SUBJECTS: A total of 1216 Year 3 medical students, of whom 528 were male and 688 female, and 737 were white European and 479 Asian. OUTCOME MEASURE: Performance in summative written and objective structured clinical examinations (OSCEs) in July 2002 and 2003. RESULTS: White females performed best in all OSCEs and in 3 out of 4 written examinations. Mean scores for each OSCE and 2 out of 4 written examinations were higher for white students than for Asian students. The overall size of the effect is relatively small, being around 1-2%. CONCLUSION: Students of Asian origin, of both genders, educated in the UK, using English as their first language, continue to perform less well in OSCEs and written assessments than their white European peers.     

Assessment of health issues and concerns of Israeli seventh graders during school physician examinations: a pilot study

BACKGROUND: The AMA Guidelines for Adolescent Preventive Services (GAPS) recommends annual medical evaluations during adolescence, emphasizing screening and counseling regarding psychosocial issues. In Israel, seventh graders undergo medical examinations within the school health services, focusing on the detection of physical conditions. We addressed the psychosocial issues of these students by introducing an expanded school physician evaluation. METHODS: Twelve school physicians performed structured expanded health evaluations for seventh graders in 11 schools. Each student completed a questionnaire (checklist) with 22 health topics "about which s/he may want to receive information." The physician then carried out a biomedical and psychosocial evaluation, physical examination, and offered counseling to the student. RESULTS: Two hundred and seventy-eight students were examined. The questionnaire required 1-2 minutes, and the physician's evaluation 20-25 minutes. Health behaviors revealed included: currently dieting (28%), no physical activity after school (35%), ever smoked cigarettes (3%), ever smoked a water pipe (9%), used alcoholic beverages (6%), and does not always use front (22%) or rear (55%) seat belt. Nine percent rated their mood as being less than 7 (on a scale from 1 to 10). The leading topics about which the students requested information were height (50%), acne (42%), weight (38%), nutrition/diet (37%), physical activity (35%), and menstrual period (29% of the girls). The physicians counseled the students on an average of 3.6 topics per visit. CONCLUSIONS: An expanded school physician examination identifies students with psychosocial problems otherwise undetected during standard physical examinations, and provides the opportunity to address their personal concerns.     

Nurses' intent to leave the profession: issues related to gender, ethnicity, and educational level

BACKGROUND: The increase in demand for registered nurses will exceed supply by 29% by 2020, which is due in part to difficulties in retaining the existing nursing workforce. The researchers postulated that nursing professionals are experiencing a higher level of job dissatisfiers than motivators, and this is causing a high percentage of nurses to consider leaving the profession. Prior research has found that nurses' dissatisfaction with their working environments is a predictor of their intent to leave their professions; however, few have addressed the demographic characteristics of the population as predictors of this intent. PURPOSE: The purpose of this study was to explore issues relating to the retention of the existing nursing workforce. This article describes the results of a research study that was designed to identify and evaluate the variables that contribute to nurses' intent to leave their profession and the relationships of gender, ethnicity, and educational levels to this intent. METHODOLOGY: Data were collected from 284 nurses, of which 46% indicated that they were considering leaving their profession. Using multiple regression analysis, the researchers were able to test whether certain groups (according to gender, ethnicity, and education levels) had a greater intent to leave the profession and what factors were related to each subgroups' intent to leave. FINDINGS: The results of this study revealed that (a) nurses who are male, are White-non-Hispanic, or have less than a master's degree are more inclined to consider leaving the nursing profession, and (b) benefits were a more important consideration to male and White-non-Hispanic nurses regarding their intent to leave the nursing profession. PRACTICE IMPLICATIONS: In today's environment of low reimbursement and high cost containment, health care managers need to focus on those items that will have the greatest impact on retaining high-quality nurses because nurses "make the critical, cost-effective difference in providing safe, high-quality patient care."     

Comparison of attitudes towards breakfast by Turkish fourth graders living in Turkey and Germany

The purpose of this article is to identify and compare Turkish fourth graders attitudes towards breakfast living in Turkey and Germany. A sample group of 882 Turkish students enrolled in fourth grade in Hamburg (Germany, N=422) and Konya (Turkey, N=460) were surveyed. Independent t-tests, chi(2) test and Pearson product-moment correlations were used. More students living in Turkey had breakfast and had enough time before going to school (P<0.01). Students living in Turkey reported that eating breakfast affected them positively (P<0.01). Students living in Germany reported that eating breakfast made them feel tired (P<0.01). The consumption of breakfast cereal (P<0.05) and fruit juice (P<0.01) that had not been consumed widely in Turkey increased in Germany. Students who eat breakfast also eat lunch (r=0.296 and -0.236, P<0.01, students living in Turkey and Turkish students living in Germany, respectively). Nutrition education programs in primary schools may change Student's attitudes about breakfast and offering a breakfast programme in schools may greatly improve breakfast consumption rates.