Psychosocial Effects of Physical and Verbal Abuse in Postmenopausal Women

PURPOSE The purpose of this study was to examine the psychological effects of physical and verbal abuse in a cohort of older women.METHODS This observational cohort study was conducted at 40 clinical sites nationwide that are part of the Women’s Health Initiative (WHI) Observational Study. We surveyed 93,676 women aged 50 to 79 years using the mental health subscales and the combined mental component summary (MCS) score of the RAND Medical Outcomes Study 36-item instrument.RESULTS At baseline, women reporting exposure to physical abuse only, verbal abuse only, or both physical and verbal abuse had a greater number of depressive symptoms (1.6,1.6, and 3 more symptoms, respectively) and lower MCS scores (4.6, 5.4, and 8.1 lower scores, respectively) than women not reporting abuse. Compared with women who had no exposure to abuse, women had a greater increase in the number of depressive symptoms when they reported a 3-year incident exposure to physical abuse only (0.2; 95% confidence interval [CI], −0.21 to 0.60), verbal abuse only (0.18; 95% CI, 0.11 to 0.24), or both physical and verbal abuse (0.15; 95% CI, −0.05 to 0.36); and they had a decrease in MCS scores when they reported a 3-year incident exposure to physical abuse only (−1.12; 95% CI, −2.45 to 0.12), verbal abuse only (−0.55; 95% CI, −0.75 to −0.34), and both physical and verbal abuse (−0.44; 95% CI, −1.11 to −0.22) even after adjustment for sociodemographic characteristics.CONCLUSION Exposure to abuse in older, functionally independent women is associated with poorer mental health. The persistence of these findings suggests that clinicians need to consider abuse exposure in their older female patients who have depressive symptoms. Clinicians caring for older women should identify women at risk for physical and verbal abuse and intervene appropriately.     

Mental Health in New Mothers: A Randomised Controlled Study into the Effects of Dietary Flavonoids on Mood and Perceived Quality of Life

The postnatal period is a significant period of physical, physiological and psychological change for mothers, rendering them particularly vulnerable to changes in mood or disorders such as postnatal depression (PND). Previous interventions with foods high in flavonoids have demonstrated beneficial acute and chronic mood effects in healthy child, adolescent and adult populations. It is unclear whether mood effects persist in populations who are potentially at-risk of developing mood disorders, such as postnatal mothers. This exploratory study investigated the effects of a 2-week daily dietary flavonoid intervention on mood (PANAS-NOW), anxiety (STAI), depressive symptoms (PHQ-8) and perceived quality of life (WHOQOL-BREF) in forty-one new mothers in the 0–12-month postnatal period, before and after flavonoid intervention. Mothers either added high flavonoid foods to their daily diet, or did not include additions following a randomised, between-groups, controlled design. Significant effects were observed in the flavonoid group with mothers reporting lower state anxiety and higher perceived quality of physical health at the 2-week timepoint. These findings suggest that regular dietary consumption of flavonoids may benefit mothers’ anxiety and perceived quality of life in the postnatal period. Replication of these results may indicate the potential for dietary flavonoids to promote healthy mood regulation in mothers or prevent the onset or severity of symptoms in postnatal psychological disorders, both of which would be beneficial for women’s health services and public mental health.     

Workplace Lactation Support: A Cross-Sectional Study in a University Hospital and a Perinatal Network

Return to work negatively affects the initiation and duration of breastfeeding. Our study’s objective was to assess the percentage of departments in Auvergne with an appropriate space for pumping milk at work. Our cross-sectional survey investigated the arrangements for facilitating the continuation of breastfeeding on return to work at all departments at the Clermont-Ferrand University Hospital Center and perinatal (obstetric and pediatric) departments in this region. Our principal endpoint was the percentage of departments reporting that they had a lactation room—a room where nursing mothers can express milk—and whether it met the criteria defined by the French Labor Code. Among 98 respondents, 44 departments (44.9%) did not offer lactation rooms; of the remaining 54 departments, only 11 rooms met the legal requirements. All perinatal departments offered lactation rooms. The availability of a lactation room was associated with other breastfeeding support, such as a break period for expressing milk (p < 0.0001) and the availability of a refrigerator to store it (p = 0.01). Almost half the responding departments did not offer a lactation room where mothers could breastfeed or pump their milk. Measures must be envisioned to facilitate the pumping of breast milk by French women returning to work.     

Body Composition Assessment and Mediterranean Diet Adherence in U12 Spanish Male Professional Soccer Players: Cross-Sectional Study

Soccer is the most practiced team sport in the world. Due to the importance of nutrition in soccer performance, controlling the body composition and dietary guidelines of players takes place starting from lower categories. The objective of this study was to evaluate body composition and adherence to the Mediterranean diet of U12 players from a professional soccer team and to identify their dietary weak points. Seventy-one U12 male soccer players participated in the study. Weight, height, percentiles, skinfolds, and body fat were measured by a certified anthropometrist following the procedures recommended by the International Society for the Advancement of Kinanthropometry. The Mediterranean diet adherence test (KIDMED) was the questionnaire used to evaluate eating habits. In addition, a comparison was made among field positions. The results showed percentiles and body fat percentages appropriate for their age. Furthermore, the average score on the KIDMED test showed that the players generally adhered well to the Mediterranean diet, although they should improve their consumption of fruits and vegetables, as well as avoid skipping breakfast. Moreover, goalkeepers and defenders had a higher percentile BMI and percentage of fat than midfielders and forwards. In addition, these players had lower KIDMED values than midfielders and forwards. Although U12 soccer players have an appropriate body composition and adherence to the Mediterranean diet, there are differences between the different field positions that should be assessed by coaches, doctors, and nutritionists/dietitians.     

A Comparison of Self-Reported and Objective Physical Activity Measures in Young Australian Women

Background

The evidence for beneficial effects of recommended levels of physical activity is overwhelming. However, 70% of Australians fail to meet these levels. In particular, physical activity participation by women falls sharply between ages 16 to 25 years. Further information about physical activity measures in young women is needed. Self-administered questionnaires are often used to measure physical activity given their ease of application, but known limitations, including recall bias, compromise the accuracy of data. Alternatives such as objective measures are commonly used to overcome this problem, but are more costly and time consuming.

Objective

To compare the output between the Modified Active Australia Survey (MAAS), the International Physical Activity Questionnaire (IPAQ), and an objective physical activity measure—the SenseWear Armband (SWA)—to evaluate the test-retest reliability of the MAAS and to determine the acceptability of the SWA among young women.

Methods

Young women from Victoria, Australia, aged 18 to 25 years who had participated in previous studies via Facebook advertising were recruited. Participants completed the two physical activity questionnaires online, immediately before and after wearing the armband for 7 consecutive days. Data from the SWA was blocked into 10-minute activity times. Follow-up IPAQ, MAAS, and SWA data were analyzed by comparing the total continuous and categorical activity scores, while concurrent validity of IPAQ and MAAS were analyzed by comparing follow-up scores. Test-retest reliability of MAAS was analyzed by comparing MAAS total physical activity scores at baseline and follow-up. Participants provided feedback in the follow-up questionnaire about their experience of wearing the armband to determine acceptability of the SWA. Data analyses included graphical (ie, Bland-Altman plot, scatterplot) and analytical (ie, canonical correlation, kappa statistic) methods to determine agreement between MAAS, IPAQ, and SWA data.

Results

A total of 58 participants returned complete data. Comparisons between the MAAS and IPAQ questionnaires (n=52) showed moderate agreement for both categorical (kappa=.48, P<.001) and continuous data (r=.69, P<.001). Overall, the IPAQ tended to give higher scores. No significant correlation was observed between SWA and IPAQ or MAAS continuous data, for both minute-by-minute and blocked SWA data. The SWA tended to record lower scores than the questionnaires, suggesting participants tended to overreport their amount of physical activity. The test-retest analysis of MAAS showed moderate agreement for continuous outcomes (r=.44, P=.001). However, poor agreement was seen for categorical outcomes. The acceptability of the SWA to participants was high.

Conclusions

Moderate agreement between the MAAS and IPAQ and moderate reliability of the MAAS indicates that the MAAS may be a suitable alternative to the IPAQ to assess total physical activity in young women, due to its shorter length and consequently lower participant burden. The SWA, and likely other monitoring devices, have the advantage over questionnaires of avoiding overreporting of self-reported physical activity, while being highly acceptable to participants.     

A Moderated Mediation Analysis of Condom Negotiation and Sexual Orientation on the Relationship Between Sexual Coercion and Condom Use in Chinese Young Women: Cross-Sectional Study

BackgroundThe high prevalence of sexual coercion against young women has become a significant public health issue in China and other regions around the world. Young women are also especially vulnerable to engage in inconsistent condom use because of low sexual control. Although the relationship between sexual coercion and condom use has been widely demonstrated, the mechanism of this relationship is still unclear.ObjectiveThe objective of this study was to test condom negotiation as a mediator of the relationship between sexual coercion and condom use in young Chinese women and to investigate whether sexual orientation is a moderator.MethodsData were collected using web-based questionnaires and a total of 402 young Chinese women were included in the analysis. Sexual coercion was measured using a subscale of the Revised Conflict Tactics Scales and condom negotiation was measured using a subscale of the UCLA Multidimensional Condom Attitudes Scale. Sexual orientation was assessed using an item adopted from a previous study and condom use was calculated by the total number of times condoms were used divided by the total number of times sexual intercourse was engaged in during the past 3 months. Moderated mediation analyses were conducted with sexual coercion as the independent variable, condom use consistency as the dependent variable, condom negotiation as the mediator variable, and sexual orientation as a moderator.ResultsThe moderated mediation analysis indicated that the relationship between sexual coercion and condom use was significantly mediated by condom negotiation and moderated by sexual orientation. The indirect effect of condom negotiation was significant in heterosexual women (indirect effect: –0.80, 95% boot CI –1.67 to –0.36) but not in sexual minority women (indirect effect: –0.33, 95% boot CI –0.86 to 0.31).ConclusionsThe results showed that sexual orientation meaningfully affects the relationship between sexual coercion and condom negotiation. The difference in the mechanism of the relation between sexual coercion and sexual behaviors in heterosexual and sexual minority women should be considered for future research and interventions aimed at mitigating the adverse effects of sexual coercion.     

Adherence to the Mediterranean Diet in Association with Self-Perception of Diet Sustainability,Anthropometric and Sociodemographic Factors: A Cross-Sectional Study in Italian Adults

The adoption of sustainable dietary models, such as the Mediterranean Diet (MD), can be a valuable strategy to preserve ecosystems and human health. This study aims to investigate in an Italian adult representative sample the adherence to the MD and to what extent it is associated with the self-perceived adoption of a sustainable diet, the consideration of the MD as a sustainable dietary model, and anthropometric and sociodemographic factors. By applying an online survey (n = 838, 18–65 years, 52% female), an intermediate level of MD adherence (median: 4.0, IR: 3.0–4.0) in a 0–9 range was observed. Only 50% of the total sample confirmed the MD as a sustainable dietary model, and 84% declared no or low perception of adopting a sustainable diet. Being female, having a higher income and education level, considering the MD as a sustainable dietary model, as well as the perception of having a sustainable diet were the most relevant factors influencing the probability of having a high score (≥6) of adherence to the MD. This study suggests a gradual shift away from the MD in Italy and supports the need to address efforts for developing intervention strategies tailored to adults for improving diet quality. Furthermore, a public campaign should stress the link between a diet and its environmental impact to foster nutritionally adequate and eco-friendly dietary behaviors.     

Increasing Fruit and Vegetable Variety over Time Is Associated with Lower 15-Year Healthcare Costs: Results from the Australian Longitudinal Study on Women’s Health

Healthcare costs are lower for adults who consume more vegetables; however, the association between healthcare costs and fruit and vegetable varieties is unclear. Our aim was to investigate the association between (i) baseline fruit and vegetable (F&V) varieties, and (ii) changes in F&V varieties over time with 15-year healthcare costs in an Australian Longitudinal Study on Women’s Health. The data for Survey 3 (n = 8833 women, aged 50–55 years) and Survey 7 (n = 6955, aged 62–67 years) of the 1946–1951 cohort were used. The F&V variety was assessed using the Fruit and Vegetable Variety (FAVVA) index calculated from the Cancer Council of Victoria’s Dietary Questionnaire for Epidemiological Studies food frequency questionnaire. The baseline FAVVA and change in FAVVA were analysed as continuous predictors of Medicare claims/costs by using multiple regression analyses. Healthy weight women made, on average, 4.3 (95% confidence interval (CI) 1.7–6.8) fewer claims for every 10-point-higher FAVVA. Healthy weight women with higher fruit varieties incurred fewer charges; however, this was reversed for women overweight/obese. Across the sample, for every 10-point increase in FAVVA over time, women made 4.3 (95% CI 1.9–6.8) fewer claims and incurred $309.1 (95% CI $129.3–488.8) less in charges over 15 years. A higher F&V variety is associated with a small reduction in healthcare claims for healthy weight women only. An increasing F&V variety over time is associated with lower healthcare costs.     

Diet Quality and Risk of Parkinson’s Disease: The Rotterdam Study

The Mediterranean diet has been associated with the risk of Parkinson’s disease (PD), but limited research has been performed on other dietary patterns. We studied the relationship between overall diet quality and PD risk in the general population. We included 9414 participants from the Rotterdam Study, a prospective population-based study in the Netherlands. Diet was defined using a Dutch diet quality score, a Mediterranean diet score and data-driven dietary patterns constructed with principal component analysis (PCA). During an average follow-up of 14.1 years, PD was diagnosed in 129 participants. We identified a ‘Prudent’, ‘Unhealthy’ and ‘Traditional Dutch’ pattern from the PCA. We found a possible association between the Mediterranean diet (Hazard ratio (HR) per standard deviation (SD) 0.89 (95% confidence interval (CI) 0.74–1.07)), the ‘Prudent’ pattern (HR per SD 0.81 (95% CI 0.61–1.08)) and the risk of PD. However, no associations with PD risk were found for the Dutch diet quality score (HR per SD 0.93 (95% CI 0.77–1.12)), the ‘Unhealthy’ pattern (HR per SD 1.05 (95% CI 0.85–1.29)) or the ‘Traditional Dutch’ pattern (HR per SD 0.90 (95% CI 0.69–1.17)). In conclusion, our results corroborate previous findings of a possible protective effect of the Mediterranean diet. Further research is warranted to study the effect of other dietary patterns on PD risk.     

Milk and Dairy Products: Good or Bad for Human Bone? Practical Dietary Recommendations for the Prevention and Management of Osteoporosis

Osteoporosis affects women twice as often as men. Additionally, it is estimated that 0.3 million and 1.7 million people have hip fractures in the USA and Europe, respectively. Having a proper peak bone mass and keeping it as long as possible is especially important for osteoporosis prevention. One of the most important calcium sources is milk and dairy products. Breast milk is the best infant food, but milk should not be avoided later in life to prevent losing bone mass. On the other hand, more and more people limit their milk consumption and consume other dairy or non-dairy products. For example, they are usually replaced with plant beverages, which should be consumed carefully in several age groups. Additionally, an important element of milk and dairy products, as well as plant beverages, are probiotics and prebiotics, which may modulate bone turnover. Dietary recommendations focused on milk, and dairy products are an important element for the prevention of osteoporosis.     

Maternal Diet,Nutritional Status,and Birth-Related Factors Influencing Offspring’s Bone Mineral Density: A Narrative Review of Observational,Cohort, and Randomized Controlled Trials

There is growing evidence that bone health may be programmed in the first years of life. Factors during the prenatal period, especially maternal nutrition, may have an influence on offspring’s skeletal development and thus the risk of osteoporosis in further life, which is an increasing societal, health and economic burden. However, it is still inconclusive which early life factors are the most important and to what extent they may affect bone health. We searched through three databases (PubMed, Google Scholar, Cochrane Library) and after eligibility criteria were met, the results of 49 articles were analyzed. This narrative review is an overall summary of up-to-date studies on maternal diet, nutritional status, and birth-related factors that may affect offspring bone development, particularly bone mineral density (BMD). Maternal vitamin D status and diet in pregnancy, anthropometry and birth weight seem to influence BMD, however other factors such as subsequent growth may mediate these associations. Due to the ambiguity of the results in the analyzed studies, future, well-designed studies are needed to address the limitations of the present study.     

Use of Menstrual Sanitary Products in Women of Reproductive Age: Korea Nurses’ Health Study

ObjectivesThe use of menstrual hygiene products and its effect on women’s health remains under studied. Patterns of menstrual hygiene product use and the rationale behind choices among Korean women aged 18–45 years were examined.MethodsThis cross-sectional study was a part of the Korea Nurses’ Health Study. A total of 20,613 nurses participated, and 8,658 nurses participated in Module 7 which included a menstrual hygiene products-related survey. The data were collected through the mobile survey using a self-reported questionnaire. Participants’ use of menstrual hygiene products and related characteristics were analyzed using frequency (percentage) or mean (SD).ResultsThe most common types of menstrual hygiene products across all age groups were disposable menstrual pads (89.0%), followed by cloth menstrual pads (4.5%), tampons (4.2%), and only 1.6% used a menstrual cup. Disposable menstrual pads were the most common across all age groups, but in those aged under 30 years this was followed by tampon use (6%). The most important criteria when choosing a menstrual hygiene product was comfort for disposable menstrual pads (31.3%) and tampons (41.5%), natural ingredients or organic products for cloth menstrual pads (51.4%), and custom fit for the menstrual cup (50.7%). However, for all menstrual hygiene products (except cloth menstrual pads), there was a higher proportion of anxiety than perception of safety, and low awareness of toxic shock syndrome.ConclusionIt is important for women to use menstrual hygiene products with confidence. More research is needed to better understand potential health effects of menstrual hygiene products.     

PUFAs,Bone Mineral Density,and Fragility Fracture: Findings from Human Studies

Osteoporosis is a global health problem that leads to an increased incidence of fragility fracture. Recent dietary patterns of Western populations include higher than recommended intakes of n–6 (ω-6) polyunsaturated fatty acids (PUFAs) relative to n–3 (ω-3) PUFAs that may result in a chronic state of sterile whole body inflammation. Findings from human bone cell culture experiments have revealed both benefits and detriments to bone-related outcomes depending on the quantity and source of PUFAs. Findings from observational and randomized controlled trials suggest that higher fatty fish intake is strongly linked with reduced risk of fragility fracture. Moreover, human studies largely support a greater intake of total PUFAs, total n–6 (ω-6) fatty acid, and total n–3 (ω-3) fatty acid for higher bone mineral density and reduced risk of fragility fracture. Less consistent evidence has been observed when investigating the role of long chain n–3 (ω-3) PUFAs or the ratio of n–6 (ω-6) PUFAs to n–3 (ω-3) PUFAs. Aspects to consider when interpreting the current literature involve participant characteristics, study duration, diet assessment tools, and the primary outcome measure.     

Influence of Mediterranean Diet Adherence and Physical Activity on Bone Health in Celiac Children on a Gluten-Free Diet

We aimed to assess the influence of the Mediterranean Diet adherence and physical activity (PA) on body composition, with a particular focus on bone health, in young patients with celiac disease (CD). The CD group (n = 59) included children with CD with a long (>18 months, n = 41) or recent (<18 months, n = 18) adherence to a gluten-free diet (GFD). The non-celiac group (n = 40) included non-celiac children. After adjusting for potential confounders, the CD group showed lower body weight (p = 0.034), lean mass (p = 0.003), bone mineral content (p = 0.006), and bone Z-score (p = 0.036) than non-celiac children, even when the model was further adjusted for adherence to a GFD for at least 18 months. Among CD children, spending greater time in vigorous physical activity was associated with higher lean mass (p = 0.020) and bone mineral density with evidence of statistical significance (p = 0.078) regardless of the time they followed a GFD. In addition, a greater Mediterranean Diet adherence was associated with a higher bone Z-score (p = 0.020). Moreover, lean mass was strongly associated with bone mineral density and independently explained 12% of its variability (p < 0.001). These findings suggest the importance of correctly monitoring lifestyle in children with CD regarding dietary habits and PA levels to improve lean mass and, consequently, bone quality in this population.     

Adherence to the Mediterranean Diet and Its Association with the Level of Physical Activity in Fitness Center Users: Croatian-Based Study

The Mediterranean diet (MD) is based on the traditional cuisine of south European countries, and it is considered one of the healthiest dietary patterns worldwide. The promotion of combined MD and physical activity has shown major benefits. However, the association between physical activity and the MD in regular fitness center users is still insufficiently investigated. This cross-sectional survey-based study was conducted on 1220 fitness center users in Croatia. The survey consisted of three parts: general information, the Mediterranean Diet Serving Score (MDSS) and the International Physical Activity Questionnaire Short Form (IPAQ-SF). The results showed that 18.6% of fitness center users were adherent to the MD, and there was a significant positive correlation between the level of physical activity and the MDSS score (r = 0.302, p < 0.001). Moreover, after dividing the sample into tertiles based on the IPAQ-SF score, the third tertile (MET > 3150 min/wk) had the most fitness center users (34.4%) adherent to the MD, while the first tertile (MET < 1750 min/wk) had the least (6.1%). These outcomes emphasize the importance of physical activity as they imply that, with higher levels of physical activity, people are also possibly more aware of the importance that a healthy and balanced diet has on their well-being.     

Social Capital and Self-Perceived Quality of Life-Interrelated Predictors of Mediterranean Diet Adherence in Older Adults

Living a healthy life in a supporting environment are key elements towards higher diet quality in older age. The Mediterranean Diet in Older Adults (MINOA) study collected cross-sectional data from adults ≥65 years old (n = 436) from April 2014 to November 2015 in rural Crete, aiming to understand the interrelations between Mediterranean Diet adherence, Social Capital and Health-Related Quality of Life (HRQL). Multivariate linear regression, carried out using SPSS 20.0, revealed that both Social Capital and HRQL has a positive impact on Mediterranean Diet adherence after adjustment for confounders and independently of each other. Total Social Capital as well as its Value of Life/Social Agency component (β = 0.04 and β = 0.1, p < 0.05, respectively) had a positive relationship with Mediterranean Diet adherence. As far as HRQL is concerned, only the Physical Health components were found to have a positive association with Mediterranean Diet adherence (β = 0.09, p < 0.001). At the same time Total Social Capital was also seen to have a positive relationship with perceived Physical and Mental Health (β = 0.21 and β = 0.28, p < 0.001, respectively). In a population of older adults Social Capital, HRQL and Mediterranean Diet adherence seem to share intricate interrelations that impact both diet quality and quality of life overall.     

Diet in Intestinal Fibrosis: A Double-Edged Sword

The natural history of inflammatory bowel diseases, especially Crohn’s disease, is frequently complicated by intestinal fibrosis. Because of the lack of effective treatments for intestinal fibrosis, there is an urgent need to develop new therapies. Factors promoting intestinal fibrosis are currently unclear, but diet is a potential culprit. Diet may influence predisposition to develop intestinal fibrosis or alter its natural history by modification of both the host immune response and intestinal microbial composition. Few studies have documented the effects of dietary factors in modulating IBD-induced intestinal fibrosis. As the mechanisms behind fibrogenesis in the gut are believed to be broadly similar to those from extra-intestinal organs, it may be relevant to investigate which dietary components can inhibit or promote fibrosis factors such as myofibroblasts progenitor activation in other fibrotic diseases.