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Jamy D Ard

Publications and source records attributed to Jamy D Ard.

10 recordsLinked to original sources
PubMed2006

The impact of cost on the availability of fruits and vegetables in the homes of schoolchildren in Birmingham, Alabama.

OBJECTIVES: Fruit and vegetable cost is a presumed barrier to intake. We sought to determine whether fruit and vegetable cost and consumers' race and income would predict availability of fruits and vegetables in homes of schoolchildren in the Birmingham, Ala, area. METHODS: Data on availability of 27 fruit and vegetable items were obtained from homes of 1355 children (32% African American) in the Birmingham area. Fruit and vegetable costs were obtained from the US Department of Agriculture. We used discrete choice analysis with the dependent variable represented as presence or absence of the fruit or vegetable item. Explanatory variables included fruit and vegetable price per serving; child's gender, race, and age; and parent's body mass index and income. RESULTS: Higher cost was inversely related to fruit and vegetable availability. Higher income, African American race, and female gender were positively related to availability. Cost per serving was stratified into 3 categories-low, medium, and high. Relative to low-cost items, only high-cost items decreased the odds of availability significantly. CONCLUSIONS: Fruit and vegetable cost does impact availability and has the greatest impact for high-cost items. Although cost was inversely related to availability, African Americans reported higher fruit and vegetable availability than Whites. Additional studies are needed to determine whether food items of lower nutritive value and comparable cost impact availability.

Black or African American↗
PubMed2006

Dietary restraint and disinhibition do not affect accuracy of 24-hour recall in a multiethnic population.

Some psychological predictors of eating behaviors have been shown to affect usefulness of methods for dietary assessment. Therefore, this study was conducted to determine the association of dietary restraint and disinhibition with dietary recall accuracy for total energy, fat, carbohydrate, and protein. In a cross-sectional study, data were obtained from 79 male and 71 female non-Hispanic whites and African-American volunteers. Participants selected and consumed all foods for a 1-day period under observation and actual intake was determined. The following day, each participant completed a telephone 24-hour recall using the US Department of Agriculture Multiple-Pass method to obtain recalled intake. The Eating Inventory, which measures dietary restraint and disinhibition, was administered prior to eating any food in the study. Repeated measures analyses of variance were used to determine if dietary restraint or disinhibition were independent predictors of recall accuracy. The mean (+/-standard deviation) age and body mass index of the participants was 43+/-12 years and 29+/-5.5 (calculated as kg/m2), respectively. On average, men overreported intake of energy by 265 kcal and women by 250 kcal; both groups also overreported intake of protein, carbohydrate, and fat. When controlling for body mass index, sex, and race, restraint was a significant independent predictor of energy intake (P=0.004) and negatively correlated with energy intake (r=-0.23, P<0.001). Unlike intake of carbohydrate or protein, fat intake was significantly and negatively associated with dietary restraint (P<0.001; r=-0.3). Dietary restraint did not affect accuracy of recall of intake of energy, fat, carbohydrate, or protein, but was significantly associated with intake of energy and fat. Disinhibition was not related to intake or accuracy. Dietetics professionals should consider dietary restraint a possible reason for a lower than expected estimate of energy intake when using 24-hour recalls.

Adult↗
PubMed2006

Weight maintenance 2 years after participation in a weight loss program promoting low-energy density foods.

OBJECTIVE: Observational study designed to determine weight outcomes and associated dietary intake patterns for a sample of participants > or =1 year after completing the University of Alabama at Birmingham EatRight Weight Management Program. RESEARCH METHODS AND PROCEDURES: Seventy-four former participants (64% women) completed follow-up visits > or =1 year after participating in EatRight, which promotes low-energy density, high-complex carbohydrate foods. Weight maintenance was defined as gaining <5% of body weight since completion of the EatRight program and staying below their program entry weight. Those who gained > or =5% of their body weight since completion were classified as gainers. RESULTS: During EatRight, participants of the follow-up study lost an average of 4.0 kg. After a mean follow-up time of 2.2 years, the average weight change was +0.59 kg (mean BMI, 32.5 kg/m(2)). Seventy-eight percent of participants gained <5% of their body weight; 46% had no weight regain or continued weight loss. Unadjusted mean intake for maintainers was 1608 kcal, whereas calorie intake for gainers was 1989 kcal. Despite eating slightly fewer calories (adjusted difference, 244; p = 0.058), maintainers ate a similar amount of food, resulting in a lower energy-density pattern (p = 0.016) compared with those who regained > or =5% of body weight. Gainers also reported consuming larger portions of several food groups. DISCUSSION: Our results indicate that low-energy-density eating habits are associated with long-term weight maintenance. Those who maintain weight after the EatRight program consume a low-energy-density dietary pattern and smaller portions of food groups potentially high in energy density than those who regain weight.

Adult↗
PubMed2005

Informing cancer prevention strategies for African Americans: the relationship of African American acculturation to fruit, vegetable, and fat intake.

Acculturation has been associated with health-related behaviors in African Americans. We sought to determine if there is a relationship between acculturation and dietary intake in African Americans. African Americans in the PREMIER trial completed the African American Acculturation Scale (AAAS) and 2 nonconsecutive 24-h dietary recalls (n = 238). Analysis of variance (ANOVA) and canonical correlation were used to assess relationships between acculturation and dietary intakes. Canonical correlation (p = 0.05) showed that traditional African Americans had lower intakes of fruits/vegetables and milk/dairy with higher intakes of fats, meat, and nuts. This pattern was supported by differences in the ANOVA. African American acculturation is related to dietary intake. These findings have implications for the design of cancer-related public health messages targeted to African Americans.

Acculturation↗
PubMed2005

Perceptions of African-American culture and implications for clinical trial design.

OBJECTIVE: To identify unique cultural variables for African Americans that might limit the effectiveness of behavioral interventions in clinical trials. DESIGN: Focus group discussions lasting 90 minutes. SETTING: Outpatient, clinical research center. PATIENTS: Twenty-six African-American men and women, who completed the screening process but were ineligible for the PREMIER study, participated in six focus group sessions. PREMIER is a multicenter, randomized clinical trial that studies the effects of three different lifestyle interventions designed to reduce blood pressure without medication. MEASUREMENTS AND MAIN RESULTS: Participants used a value sort of cultural characteristics to select items that make them unique as African Americans. The following seven themes were consistently identified: 1) extensive use of nontraditional support systems; 2) general mistrust of European Americans; 3) African Americans' being undervalued as human beings and members of American society; 4) effective use of improvisation; 5) uneven playing field as a result of persistent discrimination; 6) preservation of a unique ethnic identity; 7) socioeconomic status as a major influence and predictor of behaviors. CONCLUSIONS: Cultural variables can affect African-American perceptions of the feasibility of certain behavior modifications as health interventions and their perceptions of clinical research. Using these themes, investigators can design trials and interventions that capitalize on certain cultural variables and avoid strategies that conflict with others. The identification of such cultural characteristics unique to African Americans may help to enhance the outcomes achieved by African Americans in clinical trials, improving the generalizability of results from behavior modification research.

Adult↗
PubMed2004

One-year follow-up study of blood pressure and dietary patterns in dietary approaches to stop hypertension (DASH)-sodium participants.

BACKGROUND: We conducted a 12-month follow-up study on participants in the Dietary Approaches to Stop Hypertension (DASH)-Sodium trial to determine the impact of the DASH diet and 150, 100, or 50 mmol/day of sodium after discontinuation of the feeding intervention. METHODS: Upon completion of the trial, 56 of the 113 participants at the clinical center at Duke University entered a longitudinal observational study. Measurements including 24-h ambulatory systolic and diastolic blood pressure (BP), weight, and 24-h urinary electrolytes were obtained at 1, 6, and 12 months after completion of the DASH-Sodium trial. Block food frequency questionnaires were completed at the 12-month visit. Linear mixed-effects regression models were used to analyze the effect of the diet and sodium intake on longitudinal changes in BP during the final feeding period. RESULTS: The DASH participants significantly increased their intakes of fruits or juices and vegetables at 12 months. Control participants had no change in DASH food group intake. Both groups increased sodium intake. Among control participants, systolic and diastolic BP increased 5.33 (95% confidence interval [CI] 0.28, 10.37) and 3.20 mm Hg (95% CI 0.25, 6.16), respectively. Among DASH participants, systolic and diastolic BP increased 3.12 (95% CI -0.44, 6.68) and 0.79 mm Hg (95% CI -1.15, 2.72), respectively. There was a significant effect of the final sodium level by diet on the change in SBP over time (P = .04 for three-way interaction among diet, time of visit, and sodium). CONCLUSIONS: After the feeding intervention, DASH diet participants ate more fruits/vegetables and had sustained reductions in BP despite increased sodium intake.

Adult↗
PubMed2004

Comprehensive lifestyle modification and blood pressure control: a review of the PREMIER trial.

The PREMIER trial assessed the aggregate effect on blood pressure (BP) of nationally recommended lifestyle modifications in free-living adults with high-normal (stage 1) hypertension. Participants (N=810) were randomized to the advice-only group; the established group (consisting of weight loss, increased physical activity, and reduced sodium and alcohol intake); or the established plus Dietary Approaches to Stop Hypertension (DASH) diet group (consisting of the established interventions in addition to the DASH dietary pattern). The primary outcome was change in systolic BP at 6 months. Net of advice only, mean systolic BP declined by 3.7 mm Hg for members of the established group (p<0.001) and 4.3 mm Hg for the established plus DASH group (p<0.001). The prevalence of hypertension decreased from a baseline of 38% to 17% in the established group (p=0.01) and to 12% in the established plus DASH group (p<0.001) compared with a decrease to 26% in the advice-only group. The PREMIER trial demonstrated that persons with above-optimal BP and stage 1 hypertension can make multiple lifestyle changes leading to better control of BP.

Behavior↗
PubMed2004

The effect of the PREMIER interventions on insulin sensitivity.

OBJECTIVE: This ancillary study of PREMIER sought to determine the effects on insulin sensitivity of a comprehensive behavioral intervention for hypertension with and without the Dietary Approaches to Stop Hypertension (DASH) dietary pattern. RESEARCH DESIGN AND METHODS: Participants were assigned to one of three nonpharmacologic interventions for blood pressure (group A, advice only; group B, established; and group C, established plus DASH). The established intervention included weight loss, reduced sodium intake, increased physical activity, and moderate alcohol intake; the DASH dietary pattern was added to the established intervention for those in group C. The DASH dietary pattern is high in fruits, vegetables, and low-fat dairy products while being lower in total fat, saturated fat, and cholesterol. It is abundant in nutrients such as magnesium, calcium, and protein, which have been associated with improved insulin sensitivity. Insulin sensitivity was measured at baseline and at 6 months using the frequently sampled intravenous glucose tolerance test with minimal model analysis. RESULTS: Both intervention groups decreased total calories, percentage of calories from fat, and sodium intake to similar levels, with similar amounts of energy expenditure and weight loss. Covariate differences seen only in group C included increased intake of protein, potassium, calcium, and magnesium. Compared with control subjects, insulin sensitivity improved significantly only in group C, from 1.96 to 2.95 (P = 0.047). Group B did have a significant decrease in fasting insulin and glucose, but the changes in insulin sensitivity did not reach statistical significance when compared with control subjects. CONCLUSIONS: These results suggest that including the DASH dietary pattern as part of a comprehensive intervention for blood pressure control enhances insulin action beyond the effects of a comprehensive intervention that does not include DASH.

Adult↗
PubMed2003

A new model for developing and executing culturally appropriate behavior modification clinical trials for African Americans.

Past clinical trials addressing behavior modification for cardiovascular disease (CVD) prevention have not been culturally appropriate for African Americans. This supposition is borne out by the continued challenges researchers face not only in recruiting and retaining African Americans in clinical trials, but also in achieving the desired outcomes among this population. Investigators have limited resources to develop culturally appropriate CVD prevention trials. The scientific literature reveals 2 models for implementing culturally appropriate interventions applicable to CVD prevention among African Americans; however, these models are not easily applied to the clinical trial setting. We propose a new model for developing a culturally appropriate clinical trial. The clinical trial is a function of the investigator's cultural framework, meaning that an investigator will have more difficulty designing clinical trials appropriate for use with cultures other than his or her own, a definite limitation when attempting to effectively reach diverse populations. Differences between the cultural frameworks of most clinical trials and African Americans' cultural frameworks lead to intrinsic biases, limiting the ability of African Americans to achieve the desired outcomes for any particular trial. An African-American participant's degree of immersion in traditional African-American culture, or acculturation, influences the magnitude of these biases. Investigators must be aware of, and attempt to mitigate, such biases so that the trial's potential for success is equitable across ethnic groups. In addition, investigators must understand how to effectively address relevant biases of African Americans without challenging their ethnic identity. Steps to decrease biases are described.

Black or African American↗