The behavioral determinants of breast-feeding in The Netherlands: predictors for the initiation of breast-feeding.

The aim of this study was to evaluate the behavioral determinants of the initiation of breast-feeding at birth. The prospective cohort study used the attitude, social influence, self-efficacy (ASE) model in 373 pregnant women in five child health care centers. Prenatally, 72% of the women had the intention to breast-feed, and 73% actually started with breast-feeding at birth. Mothers who initiated breast-feeding differed in almost all the attitude, social influence, and self-efficacy determinants from others who initiated formula feeding. Intention was a very strong predictor of the initiation of breast-feeding. The components of the ASE model predicted the initiation of breast-feeding. Hence, the results may be used to tailor future interventions aimed at promoting breast-feeding.     

The motivational determinants of breast-feeding: predictors for the continuation of breast-feeding

OBJECTIVE: The aim of this study was to evaluate the motivational determinants of the continuation of breast-feeding until 3 months postpartum. METHODS: A prospective cohort study using the Integrated Change Model in 341 women in 5 child health care centers. RESULTS: At birth, 73% of the mothers started with breast-feeding and 39% of them continued at least 3 months postpartum. Mothers who continued for 3 months differed in almost all the motivational determinants from mothers who discontinued. In the multiple logistic regression analysis, social support for formula feeding from significant others and situational self-efficacy for breast-feeding made a significant independent contribution to the continuation of breast-feeding. Among the predisposing determinants, the strongest positive predictor of continuation was the intention to return to work at 1 month postpartum. CONCLUSION: The Integrated Change Model is valid to explain and predict the continuation of breast-feeding. Hence, the results may be used to tailor future interventions aimed at promoting breast-feeding. In the discussion, we use the results to target interventions.     

Social determinants in food selection.

Responses of 112 low-income homemakers to questions about the food use frequency, availability, and social determinants (convenience, price, and prestige) of fifty-two food items are reported. Results indicate that foods have clear meaning profiles that can be measured on attitudinal scales. Bivariate analysis was used to illustrate the interrelationships between food-use frequency and social determinants. Significant correlations were found between food use and convenience, price, prestige, and availability for fourteen of the fifty-two food items studied.     

Multistate shigellosis outbreak and commercially prepared food, United States

In 2000, shigellosis traced to a commercially prepared dip developed in 406 persons nationwide. An ill employee may have inadvertently contaminated processing equipment. This outbreak demonstrates the vulnerability of the food supply and how infectious organisms can rapidly disseminate through point-source contamination of a widely distributed food item.     

Methionine peptides as potential food supplements: efficacy and susceptibility to Maillard browning

Three experiments were conducted with young chicks fed purified diets to ascertain the bioefficacy of six different methionylmethionine (Met-Met) dipeptides, differing only in isomeric configuration, an oligopeptide (n = 8) of L-methionine, and also N-glycyl-L-methionine. DL/LD-Met-Met (50% D-Met-L-Met and 50% L-Met-D-Met), D-Met-L-Met, L-Met-D-Met, L-Met-L-Met, and N-Gly-L-Met were utilized as well as L-Met based on weight gain per millimole of sulfur consumed from each experimental compound. DD/LL-Met-Met (50% D-Met-D-Met and 50% L-Met-L-Met), D-Met-D-Met and L-oligo-Met were utilized less efficiently for chick growth. When the Met compounds were pretreated to facilitate Maillard browning (incubated at 37.6 degrees with dextrose at pH 9.5), all Met sources (except N-acetyl-L-Met, which was used as a positive control) exhibited reduced efficacy relative to an equivalent dietary addition of unreacted L-Met. The Met-Met peptides which when unreacted had been equivalent in efficacy to L-Met were, however, superior to L-Met when each compound, including L-Met, had undergone browning. N-Gly-L-Met was very reactive when heat-treated with dextrose, producing an almost black color after the 14-day incubation period, and its efficacy after browning was reduced by an even greater extent than was the case for L-Met.     

Socio-demographic determinants of stopping smoking from Italian population-based surveys

Summary Frequency and determinants of smoking cessation were analysed using data from two Italian National Health Surveys, conducted in 1983 and 1986–87 on samples of 89753 and 77155 individuals respectively, randomly selected within strata of region of residence, size of the municipality and of the household, in order to be representative of the general Italian population. Overall stopping ratios or quit ratios (i.e., ratios between ex- and eversmokers) were 20.5% for males and 9.0% for females in the 1983 survey, and rose to 23.2 and 11.9% respectively in 1986–87. With reference to age, stopping rates were slightly higher for females than for males below age 35, but considerably higher for males in each subsequent age group, particularly in middle age. Ratios were apparently higher for the most recent survey for both sexes and each subsequent age group. After standardisation for age, quit ratios in both sexes were directly related with education. Cessation of smoking was more common in northern (and richer) areas of the country, and positively associated with the prevalence of smoking-related chronic diseases. The major, and most discouraging, finding from these analyses is the absolute low rate of stopping in Italy as compared to northern America or northern Europe, although some positive tendency towards increasing cessation was evident between the early and the late 1980s. These tendencies, together with some recent drops in smoking prevalence in younger women, first observed after decades of increase, indicate a change at least in attitudes towards reporting smoking, and hence social acceptance of the habit. Still, women, as well as less educated individuals of both sexes, particularly from the less developed areas of the country, remain major targets for focusing attention and intervention for smoking cessation programmes.

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Zusammenfassung Wie häufig mit Rauchen aufgehört wird sowie diesbezügliche mitbestimmende Determinanten wurden anhand der Daten von zwei Nationalen Health Surveys (NHS) in Italien untersucht. Die Surveys waren 1983 und 1986/87 mit Stichprobengrössen von 89 753, resp. 77155 durchgeführt worden. Die Stichproben waren zufällig ausgewählt worden nach Stratifizierung der Variabeln Region des Wohnorts, Gemeinde- und Haushaltgrösse, um ein repräsentatives Sample der italienischen Bevölkerung untersuchen zu können. Die Raten — Probanden, die aufhörten zu rauchen —(quit ratios, d.h. Rate zwischen Ex- und allen Rauchern) betrugen bei den Männern 20% und bei den Frauen 9,0% im NHS 1983, sowie 23,2% und 11,9% in NHS 1986–87. Unter Berücksichtigung des Alters waren die entsprechenden Raten bei den unter 35jährigen Frauen etwas höher als bei den Männern. In den folgenden Alterskategorien war die entsprechende Rate bei den Männern deutlich höher, vor allem bei der Kategorie middle age. Die Raten waren auch sichtbar höher bei beiden Geschlechtern und jeder Alterskategorie im letzten Survey. Nach der Altersstandardisierung gab es bei beiden Geschlechtern eine quit ratio, die direkt mit der Erziehung/Bildung korreliert war. Mit rauchen wurde häufiger in den nördlicheren (reicheren) Landesteilen aufgehört, wobei sich eine positive Assoziation der Prävalenz von Nikotinabusus bedingten chronischer Erkrankungen ergab. Der bedeutendste und am meisten enttäuschendste Befund der Analysen war, dass in Italien im Vergleich zu nordamerikanischen und-europäischen Ländern eine sehr niedrige Rate von Probanden gefunden wurde, die mit Rauchen aufhörte. Jedoch liessen sich auch in der italienischen Bevölkerung einige positive Tendenzen hinsichtlich dem Stop des Nikotinkonsums zwischen anfangs und Ende der 80iger Jahre finden. Diese Tendenzen sowie die Tatsache, dass seit kürzerem die Raucherprävalenz bei jüngeren Frauen abnimmt — nachdem während Dekaden eine Zunahme zu verzeichnen war — zeigen wenigstens eine Verhaltensänderung bezüglich der Angabe zu Rauchen, und somit auch möglicherweise eine Änderung der sozialen Akzeptanz des Rauchens. Trotzdem bleiben Frauen, und Frauen sowie Männer aus unteren sozialen Schichten, besonders aus weniger entwickelten Landesgebieten, die Hauptzielgruppen bezüglich Aufklärungs- und Interventionsprogrammen zur Raucherinnenentwöhnung.

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Résumé La fréquence et les déterminants pour l'interruption de fumer ont été analysés en utilisant les données de deux études de l'Office de Statistique National Italien, menées en 1983 et en 1986–87 avec des échantillons de 89753 et 77155 individus respectivement, sélectionnés au hasard, dans des strates d'habitation, par région, indépendamment de la grandeur des communes et des ménages, afin qu'ils soient représentatifs de la population italienne en général. Les proportions globales d'interruption (c'est-à-dire les rapports entre les ex-fumeurs et les fumeurs de longue date) étaient de 20.5% pour les hommes et de 9.0% pour les femmes dans l'étude de 1983 et ont augmenté jusqu' à 23.2 et 11.9% respectivement en 1986–87. En ce qui concerne l'âge des personnes, les taux d'interruption étaient légèrement supérieurs chez les femmes comparés avec ceux des hommes en-dessous de 35 ans, mais considérablement plus élevés pour les hommes dans chaque groupe d'âge supérieur, spécialement dans la cinquantaine. Les proportions pour les deux sexes étaient apparemment plus élevées dans la toute dernière étude et pour chaque groupe d'âge. Après standardisation selon l'âge, les proportions d'interruption étaient directement liées au niveau d'éducation dans les deux sexes. L'interruption de fumer était plus répandue dans les régions du nord (plus riches) du pays et indéniablement associée à la prédominance de maladies chroniques dues à la fumée de tabac. Le résultat principal, et le plus décourageant, émanant de cette analyse est le fait que le taux d'interruption est indiscutablement bas en Italie, si l'on fait la comparaison avec l'Amérique du Nord ou le Nord de l'Europe, bien qu'une tendance positive envers une interruption croissante ait été évidente au début et vers la fin des années 1980. Ces tendances indiquent, tout comme une baisse récente dans la tendance à fumer chez les jeunes femmes, observée pour la première fois après des décades de croissance, un changement au moins dans les attitudes vis-à-vis de l'image attribuée à la fumée de tabac et à l'acceptation sociale de l'habitude qui en résulte. Néanmoins, les femmes, et les personnes des deux sexes ayant une éducation plus modeste, spécialement en provenance des régions les moins développées du pays, restent la cible principale sur laquelle nous devons concentrer notre attention en intervenant avec des programmes pour l'interruption de fumer.

     

Gender, socioeconomic status and family status as determinants of food behaviour

This study examines social structural and family status factors as determinants of food behaviour. The data were derived from the FINMONICA Risk Factor Survey, collected in Finland in spring 1992. A multidimensional framework of the determinants of food behaviour was used, including social structural position, family status and gender. The associations between the determinants of food behaviour were estimated by multivariate logistic regression models, adjusted for age and regional differences. Food behaviour was measured by an index including six food items which were chosen based on Finnish dietary guidelines. In general, women's food behaviour was more in accordance with the dietary guidelines than that of men. The pattern of association between educational level and food behaviour was similar for both genders, but slightly stronger for men than women. Employment status was associated only with women's food behaviour, but the tendency was the same for men. Marital status was associated with men's as well as women's food behaviour. The food behaviour of married men and women was more in line with the dietary guidelines than the food behaviour of those who had been previously married. Parental status, however, was only associated with women's food behaviour, that is, the food behaviour of women with young children was more closely in line with the dietary guidelines than that of the rest of the women.     

Utilization of food supplements in The Netherlands

In 1987 and 1988 a dietary survey was carried out in a representative sample of the Dutch population, under the authority of the Ministries of Welfare, Health and Cultural Affairs, and Agriculture and Fisheries. By means of a two day dietary record data were collected on food consumption and the use of dietary supplements. More than seventeen percent of the Dutch population has been using at least one dietary supplement on at least one day of the survey. Age, sex, season, social class, alternative food habits, smoking and diet are related to the use of supplements. In young persons mainly fluoride and vitamin AD preparations are used, while as age progresses a shift towards other supplements, like garlic and brewer's yeast preparations, is observed. The use of single vitamin C supplements is not related to the level of mean daily vitamin C intake from foods.     

Social determinants of food choice

Food choice is influenced by a large number of factors, including social and cultural factors. One method for trying to understand the impact of these factors is through the study of attitudes. Research is described which utilizes social psychological attitude models of attitude-behaviour relationships, in particular the Theory of Planned Behaviour. This approach has shown good prediction of behaviour, but there are a number of possible extensions to this basic model which might improve its utility. One such extension is the inclusion of measures of moral concern, which have been found to be important both for the choice of genetically-modified foods and also for foods to be eaten by others. It has been found to be difficult to effect dietary change, and there are a number of insights from social psychology which might address this difficulty. One is the phenomenon of optimistic bias, where individuals believe themselves to be at less risk from various hazards than the average person. This effect has been demonstrated for nutritional risks, and this might lead individuals to take less note of health education messages. Another concern is that individuals do not always have clear-cut attitudes, but rather can be ambivalent about food and about healthy eating. It is important, therefore, to have measures for this ambivalence, and an understanding of how it might impact on behaviour.     

The consumer cost of calcium from food and supplements

Nutritional authorities encourage consumers to include calcium-rich foods in their daily diets. However, consumer purchases are driven not only by health considerations and dietary preferences, but also by cost. This study assessed the cost of calcium from a wide variety of food sources, as well as supplements, based on retail prices in Seattle, San Francisco, Raleigh, NewYork City, and Washington, D.C., while controlling for seasonal variation. Costs were adjusted based on calcium absorption fractions. Calcium carbonate supplements emerged as the least expensive source of calcium, at roughly one-third the cost of the least expensive food source of calcium. The least expensive food sources of calcium were Total cereal, skim milk, and calcium-fortified orange juice from frozen concentrate. This information is useful for dietitians, health professionals, and consumers in meeting calcium requirements on a budget.     

Recognition of food in weanling rats exposed to alcohol prenatally

Offspring of rats fed a liquid diet containing ethanol during their pregnancies were compared to controls on a caloric discrimination test beginning at 22 days of age. All pups received simultaneous choice between a palatable, noncaloric diet and a similar diet containing starch. Each diet contained a distinctive flavor. To test for flavor preference learning, pups then received an extinction test: a simultaneous choice between two noncaloric diets, identical except for flavor. Prenatal alcohol exposure had no substantial effect on the caloric discrimination, and all groups preferentially ingested the starch diet on all test days. However, during the extinction test, alcohol-exposed pups showed a significantly weaker flavor preference than control pups. These data extend the effects of prenatal alcohol exposure on learning and ingestive behavior to include solid food discriminations at the time of weaning.     

Unintended pregnancy and breast-feeding behavior.

OBJECTIVES: This study assessed the effect of unintended pregnancy on breast-feeding behavior. METHODS: All women delivering a live birth between January 1, 1995, and July 31, 1996 (n = 33,735), in the 15-county central New York region were asked whether they had intended to become pregnant and their breast-feeding plans. RESULTS: Women with mistimed pregnancies, and pregnancies that were not wanted were significantly less likely to breast-feed than were women whose pregnancies were planned. After adjustment for confounding variables and contraindications for breast-feeding, the odds ratios of not breast-feeding remained significant. CONCLUSIONS: Promoting breast-feeding among women with unintended pregnancies is important to improve health status.     

Genetic and environmental determinants of children's food preferences

Omnivores have the advantage of a variety of food options but face a challenge in identifying foods that are safe to eat. Not surprisingly, therefore, children show a relative aversion to new foods (neophobia) and a relative preference for familiar, bland, sweet foods. While this may in the past have promoted survival, in the modern food environment it could have an adverse effect on dietary quality. This review examines the evidence for genetic and environmental factors underlying individual differences in children's food preferences and neophobia. Twin studies indicate that neophobia is a strongly heritable characteristic, while specific food preferences show some genetic influence and are also influenced by the family environment. The advantage of the malleability of human food preferences is that dislike of a food can be reduced or even reversed by a combination of modelling and taste exposure. The need for effective guidance for parents who may be seeking to improve the range or nutritional value of foods accepted by their children is highlighted.     

Bioavailability and antioxidant activity of some food supplements in men and women using the D-Roms test as a marker of oxidative stress.

Most antioxidants show contradictory behaviors because in the biological environment, for unpredictable reasons, they can become prooxidants. Recently, a new simple method to monitor oxidative stress in serum was developed. This test detects the derivatives of reactive oxygen metabolites (D-Roms). Hydroperoxides are converted into radicals that oxidize N,N-diethyl-para-phenylendiamine and that can be detected through spectrophotometric procedures as U.CARR. (Carratelli units). One U.CARR. corresponds to 0.8 mg/L hydrogen peroxide. In normal subjects U.CARR. values range from 250 to 300. Values outside this range indicate a modification of the prooxidant/antioxidant ratio. On the basis of this method, we tested three different formulas of antioxidants (F1, F2, F3) in 14 apparently healthy volunteers (11 men and 3 women). Formula 1 was composed of 5 mg zinc, 48 microg selenium, 400 microg vitamin A (as retinol acetate), 50 microg beta-carotene, 15 mg vitamin E (as dl-alpha-tocopheryl acetate) and 10 mg L-cysteine. Formula 2 was composed of 30 mg bioflavonoids from citrus, 30 mg vitamin C (as L-ascorbic acid), 10 mg coenzyme Q(10) and 1 mg vitamin B-6 (as pyridoxine hydrochloride). Formula 3 was composed of Formula 1 plus Formula 2. Each formula was prepared in dry capsules (formulation D1, D2, D3) or in a fluid form (formulation P1, P2, P3). Each formulation was administered for 1 wk in a crossover design. A 15% deviation of U.CARR. levels was chosen as the cut-off value for a significant change in oxidative stress. Formulas F1 and F3 reduced mean U.CARR. levels in most of the treated subjects (t test, P < 0.05), whereas F2 was not active. Fluid formulations were more active than dry formulations (chi(2) test, P < 0.05). In some cases, a slight increase in oxidative stress was detected. These minimal increases were not related to any particular antioxidant formula. In one subject only, the administration of the dry formulation (D1), increased oxidative stress to a level that reached the cut-off value. In conclusion, when antioxidants are taken in combination at low dosages they reduce oxidative stress, and little relevant prooxidant activity is detectable.     

Effects of food supplements on the safety and quality of seafoods

The safety of foodstuffs from the hydrocoles made with food supplements is considered. The use in the seafoods of sodium benzoate (E 211), a preservative, monosodium glutamate (E 621), an agent enhancing the flavor of the food, does not provide safety of products, the use of which negative influences human health.