September 2010
Dietary Intake Patterns of Low-Income Urban African-American Adolescents
YOUFA WANG, MD, PhD, MS; LISA JAHNS, PhD, RD; LISA TUSSING-HUMPHREYS, PhD, RD; BIN XIE, MD, PhD; HELAINE ROCKETT, MS, RD, FADA; HUIFANG LIANG, MD, PhD; LUANN JOHNSON, MS
The purpose of this study was to describe dietary patterns including energy, nutrients, food groups, and diet quality of low-income, urban African-American adolescents, and to identify areas to guide future interventions. A cross-sectional analysis of dietary intake of 382 participants aged 10-14 years (mean: 11.5 ± 1.1 years, 98.4% African American, 72% from low-income families, all attending Chicago public schools) was completed. Dietary intake was assessed using the Harvard Youth/Adolescent Questionnaire, a 152-item, semi-quantitative food frequency questionnaire. In addition to asking how often participants consumed listed food items, the FFQ also included questions about serving sizes when a discrete serving size existed (ie a cup of yogurt, a hamburger, or a piece of fruit) was available, as well as questions concerning the frequency of fried food consumption and the number of snacks consumed.
Nutrient intakes were compared to the national Dietary Reference Intakes. Diet quality was assessed using the 1995 USDA HEI so that the diet quality of the study participants could be compared to those published in other national samples using the same HEI. The HEI consists of 10 dietary components that represent various aspects of a healthy diet, including intakes of grains, vegetables, fruit, dairy, meat, and avoidance of overconsumption of total and saturated fat, cholesterol, and sodium, as well as a component reflecting dietary variety. Individuals receive a score for each component and then all scores are summed to derive an overall score between 0 and 100. Participants’ height and weight were directly measured at the schools by trained interviewers, then converted to BMI scores and compared to CDC Growth Charts to determine weight status.
Results showed participants consumed large amounts of sodium, cholesterol, added sugars, snack foods, sweetened beverages, and fried foods. Only a small proportion met recommendations for fruits and vegetables. Overall prevalence of overweight and obesity was 40.3%. Mean energy intake was 3,144 ± 1575 kcal/day. Compared to a national sample of 14,000 middle to high socioeconomic status, mostly (95%) white adolescents ages 9 to 14, this study’s participants had lower HEI scores (66.4 vs 69.7), signifying lower diet quality.
This study concludes by emphasizing the need for school-based interventions that also involve families and communities to help improve diet quality and reduce risk factors for chronic diseases.
Continuing Education Article:
Wang Y, Jahns L, Tussing-Humphreys L, Xie B, Rockett H, LIANG H, Johnson L. Dietary Intake Patterns of Low-Income Urban African-American Adolescents. J Am Diet Assoc. 2010;110:1340-1345.
Link: http://download.journals.elsevierhealth.com/pdfs/journals/0002-8223/PIIS0002822310006413.pdf
Supplemental Articles:
Details about this study’s design and data collection:
Wang Y, Tussing L, Odoms-Young A, Braunschweig C, Flay B, Hedeker D, Hellison D. Obesity prevention in low socioeconomic status urban African-American adolescents: Study design and preliminary findings of the
HEALTH-KIDS Study. Eur J Clin Nutr. 2006;60:92-103.
More information about the 1995 USDA Healthy Eating Index (HEI):
Kennedy ET, Ohls J, Carlson S, Fleming K. The Healthy Eating Index: Design and applications. J Am Diet Assoc. 1995;95:1103-1108.
More information about the reproducibility and validity among adolescents of the Harvard Youth/Adolescent Questionnaire:
Rockett HR, Breitenbach M, Frazier AL, Witschi J, Wolf AM, Field AE, Colditz GA. Validation of a youth/adolescent food frequency questionnaire. Prev Med. 1997;26:808-816.
posted by Anna Taylor @ 6:13 PM
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1 Comments:
The summary of this month's discussion:
September Journal Club Summary
Throughout September, the ISU DI Journal Club discussed the JADA article, "Dietary Intake Patterns of Low-Income Urban African-American Adolescents."
The first question concerned identifying components of the population’s demographics believed to have had the greatest effect on the differences in HEI scores. Most replied that SES and geographical location were the major reasons for differences, but several believed race may be a contributing factor as well due to the types of foods common in African American culture. Several people identified the three demographics as interrelated in the ways that they affected eating habits. For example, Sarah G. and Bethany noted that limited transportation due to a low SES may mean no options besides public transport or walking, which can be a real barrier if there are no grocery stores nearby due to urban geographical location. Bethany suggested this could lead to less fresh fruits and vegetables being purchased, and more processed foods laden with preservatives and lacking in nutrients. Amy and Sarah U. pointed out that it is difficult to answer this question using the studies provided, since one study looked at sample populations across the U.S., while the newer study only looked at sample populations in Chicago, IL.
The second question asked for suggestions to improve the dietary intake of urban, low-income, African American adolescents. Melanie and Amy agreed that instilling healthy eating habits at an early age is easier than trying to intervene and change habits of older populations. However, Rose identified parent involvement as a necessary component, since adults are the ones making the majority of food purchases; similarly, Bethany pointed out that children’s eating habits may be influenced by those of their parents, and so reaching out to families as a whole may be particularly worthwhile. Many respondents agreed that community organizations, such as schools (healthier choices being made available, implementing nutrition classes, creating more opportunities for physical activity), local businesses (grocery store tours, wellness fairs), and the government (creating programs that enforce nutrition and wellness curriculums, free/reduced lunch programs, assistance/educational programs like WIC), could all make meaningful impacts upon the nutrition of the next generation, as well as the present ones.
The final question concerned the appropriateness of adjusting funding for nutrition education in schools according to demographics such as race, geographic location, and income of students. There was less agreement among respondents here; bloggers were divided between having equal funding for all schools regardless of demographics and varying funding according to these demographics. Additionally, those in favor of varying funding based on need were divided on which demographics should be considered. Rose and Amy both posited that the results from this study were not different enough to validate unequal distribution of funding; Amy suggested that HEI scores alone were not sufficient indicators of need for funding for nutrition education programs. However, there were a few threads of agreement throughout the discussion. For example, many respondents agreed that all kids could benefit from additional funding, implementation of nutrition education classes in schools, and healthier choices in school cafeterias. The ways in which the funding is used is inarguably of great importance as well. Perhaps the best conclusion is that more research must be done, more attention must be drawn, and more funding must be found before leaders of the nutrition revolution are able to even begin the question of who gets how much and why.
Great work this month, bloggers!
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