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N M Betts

Publications and source records attributed to N M Betts.

16 recordsLinked to original sources

Assessing stages of change for fruit and vegetable intake in young adults: a combination of traditional staging algorithms and food-frequency questionnaires.

Adequate fruit and vegetable intake is strongly associated with a reduced risk for various chronic diseases. US national surveys show that 18- to-24-year-olds are not consuming enough of these foods. Theory-based nutrition interventions, e.g. stage-tailored education programs, are needed for promoting fruit and vegetable consumption in this age group. Accurate stage assignment is the basis for developing effective stage-tailored interventions. In the current study, three different methods were compared for assigning stages of change in fruit and vegetable intakes by young adults. Significant differences in food intake, decisional balance and self-efficacy were found between respondents with concordant responses to the traditional stage algorithm and the food-frequency questionnaire (FFQ) and those with discordant responses. The stage assignment method that combined the staging algorithm and FFQ identified a distinct stage, labeled 'non-reflective action', in addition to the traditional five stages of change. This stage lay between the preparation and action stages with regard to food intake and psychosocial variables. Implications of the findings were discussed for future intervention programs that attempt to promote fruit and vegetable intake.

Adult↗

Antioxidant intakes and smoking status: data from the continuing survey of food intakes by individuals 1994-1996.

BACKGROUND: Cigarette smoking is a major risk factor for several chronic oxidative diseases that can be ameliorated by antioxidants. OBJECTIVES: This study identified the typical dietary intakes and the major food group contributors of the antioxidants beta-carotene, vitamin C, and vitamin E by smoking status. DESIGN: The 1994-1996 Continuing Survey of Food Intakes by Individuals (CSFII) provided the current sample (n = 6749), who were categorized as non- (n = 3231), former (n = 1684), and current (n = 1834) smokers. In the CSFII, individuals' food intakes were estimated with two 24-h dietary recalls. Data were analyzed by using a chi-square test with a simultaneous Fisher's z test, analysis of variance with Scheffe's test, multivariate analysis of covariance, and analysis of covariance with Bonferroni adjustment for multiple comparisons. RESULTS: The sample consisted of 3707 men and 3042 women. Current smokers tended to be younger with less education and lower incomes than nonsmokers and former smokers. The average body mass index (in kg/m(2)) of current smokers was 25.8, the lowest of the 3 groups. Current smokers had the lowest dietary antioxidant intake. Fatty foods such as luncheon meats, condiments and salad dressings, and ground beef contributed more to the antioxidant intakes of current smokers than to those of the other 2 groups, whereas fruit and vegetables contributed less. Current smokers consumed the fewest numbers of servings of all nutrient-bearing groups in the food guide pyramid, except the meat group. CONCLUSION: Future interventions should target the clustering of cigarette smoking and other unhealthy lifestyle habits, eg, an imprudent diet.

Adult↗

Zinc and copper intakes and their major food sources for older adults in the 1994-96 continuing survey of food intakes by individuals (CSFII).

Zinc and copper are two trace minerals essential for important biochemical functions and necessary for maintaining health throughout life. Several national food surveys revealed marginally to moderately low contents of both nutrients in the typical American diet. Using data from the respondents >/= 60 y old in the 1994-96 Continuing Survey of Food Intakes by Individuals (CSFII), we examined average dietary intakes of zinc, copper and relevant dietary factors; primary dietary contributors of zinc and copper; and Zn:Cu ratios of the primary dietary contributors. Data were analyzed with the use of a chi(2) test, Student's t test and multivariate analysis of covariance with Bonferroni correction. The daily zinc intake was 12 +/- 6.4 mg for men and 8.0 +/- 4.0 mg for women (P < 0.05); the daily copper intake was 1.3 +/- 0.7 mg for men and 1.0 +/- 0.5 mg for women (P < 0.05). Foods such as beef, ground beef, legumes, poultry, ready-to-eat and hot cereals, and pork constituted the major sources of zinc. Copper consumption was contributed mainly by legumes, potato and potato products, nuts and seeds, and beef. The less-than-recommended intakes of zinc and copper by the elderly were likely associated with age, low income and less education. The intakes of zinc and copper could be improved by more frequent consumption of food sources rich in these minerals. An inherent limitation of this study was the use of the 24-h dietary recall method, which may underestimate usual dietary intakes. Nonetheless, this study affirms the need for assessment of zinc and copper nutriture in the elderly.

Aged↗

Cigarette use during adolescence: effects on nutritional status.

Despite numerous anti-tobacco campaigns, smoking among adolescents continues to be a predominant public health issue. This report details the interrelationships between adolescence, smoking, and nutrition and health. Current data indicate that most smokers become nicotine-dependent as adolescents, which places them at risk for chronic diseases associated with continuous oxidative damage. Additionally, nicotine has antidepressant and hypermetabolic effects, which may be of particular importance during adolescence because nicotine use leads to increased dependence on tobacco, contributes to difficulty in smoking cessation, and promotes weight gain following smoking cessation.

Adolescent↗

The 'age+5' rule: comparisons of dietary fiber intake among 4- to 10-year-old children.

OBJECTIVE: To determine children's sources of dietary fiber and to identify the food group choices made by those who met the "age+5" rule, which recommends that children daily consume an amount of fiber that is equal to their age plus an additional 5 g fiber. DESIGN: This study used 24-hour dietary recalls and 1-day food records to assess the nutrient intake and food group choices of children who did and did not meet the recommendations of the age+5 rule. SUBJECTS: The 1989-1991 US Department of Agriculture Continuing Survey of Food Intakes by Individuals provided the study sample of 603 children between the ages of 4 and 6 years and 782 children between the ages of 7 and 10 years. STATISTICAL ANALYSES: Differences in nutrient and food group intakes between age categories were determined by t tests. RESULTS: Only 45% of 4- to 6-year-olds and 32% of 7- to 10-year-olds consumed adequate fiber to meet the age+5 rule. Those who met the age+5 rule did so by consuming significantly more high- and low-fiber breads and cereals, fruits, vegetables, legumes, nuts, and seeds. Children with low fiber intakes had significantly higher energy-adjusted intakes of fat and cholesterol, whereas those who met the age+5 rule had significantly higher energy-adjusted intakes of dietary fiber, vitamins A and E, folate, magnesium, and iron. APPLICATIONS: The majority of the children had low intakes of dietary fiber, suggesting that they are at risk for future chronic disease. Parents and school foodservice personnel should strive to offer fiber-rich foods to children so their acceptance and consumption of them will be increased.

Child↗

Among young adults, college students and graduates practiced more healthful habits and made more healthful food choices than did nonstudents.

OBJECTIVES: Health-related characteristics and habits and food choices of young adults were compared for three groups: college students, college graduates, and nonstudents. DESIGN: Subjects completed a mailed survey that included questions about demographics, attitudes, and behaviors and a food frequency questionnaire. Main outcome measures were health-related characteristics and habits and food choices. SUBJECTS: Female (n = 758) and male (n = 580) 18- to 24-year-olds in nine states who were selected randomly by zip code in each state. The response rate averaged 43% for all states. STATISTICAL ANALYSES PERFORMED: Analysis of variance of chi 2 tests were applied to health-related personal characteristic variables and the Kruskal-Wallis analysis of variance was applied to food consumption variables for women and men separately. RESULTS: According to self-reported heights and weights, female nonstudents were more often overweight than female students or graduates. Nonstudents of both genders reported smoking more often than students or graduates. College students and graduates ate more grain foods high in dietary fiber, more fruits and dark-green vegetables, and more lower-fat milk and meats than nonstudents. CONCLUSIONS/APPLICATIONS: Nonstudents were at greater health risk for some chronic illnesses, because of poorer health habits and food choices, than were college students and graduates. The behavior of nonstudents implies weaker response to messages promoting weight control, smoking cessation, and observance of the Dietary Guidelines for Americans than behavior exhibited by students or college graduates. Health promotion efforts could be enhanced by identifying demographic, educational, situational, and formative influences on positive health and dietary behaviors of young adults.

Adolescent↗

Comparisons of dietary intake and sources of fat in low- and high-fat diets of 18- to 24-year-olds.

OBJECTIVE: To determine the sources of fat in the diets of 18- to 24-year-olds and to identify the food group choices of those consuming 30% of energy or less from fat. DESIGN: This study compared the fat intake, nutrient intake, and food group choices of young men and women consuming 30% or less or more than 30% of energy from fat. SUBJECTS: The 1989-1991 Continuing Survey of Food Intakes by individuals (CSFII) provided the study sample of 1,062 (436 men and 626 women) 18- to 24-year-olds residing in the 48 coterminous states who completed one 24-hour food recall and two 1-day food records. MAIN OUTCOME MEASURES: Dietary fat, vitamin, mineral, and food group intakes were determined by analysis of the 24-hour food recalls and the 1-day food records. STATISTICAL ANALYSIS PERFORMED: Tests were used to detect differences in nutrient and food group intakes between the two groups for both men and women. RESULTS: More than 75% of the sample consumed more than 30% of energy from fat. The men and women who consumed low-fat diets did so by choosing more low-fat dairy products, fruits, and grains. Men who consumed low-fat diets consumed significantly more alcohol than other men; women who consumed low-fat diets showed a similar trend although the difference was not statistically significant. Although men and women who consumed a high-fat diet did consume significantly greater amounts of fat and cholesterol, they also fared better in vitamin and mineral intake. CONCLUSIONS: A minority of young adults consumed 30% or less of energy from fat. Compared with those who consumed more than 30% of energy from fat, men consumed significantly greater mean amounts of vitamin C and folate, and women consumed significantly greater mean amounts of vitamin A and folate. Young adults who consumed more than 30% of energy from fat exceeded current recommendations for dietary fat intake; however, the men were less likely to be at risk for calcium deficiency and the women were less likely to be at risk for vitamin E and zinc deficiencies. Because excess dietary fat and alcohol can lead to chronic disease, dietitians should continue to educate people about the relationship between nutrition and health.

Adolescent↗

Validity of percent body fat estimations in males.

The present investigation examined the validity of selected skinfold (Sum3), near-infrared interactance (F5000 and F1000), and bioelectrical impedance (BIA) equations for estimating percent body fat (% fat) in young adult males (mean age +/- SD = 22 +/- 3 yr) by comparing the estimates with values obtained from underwater weighing. Fifty-seven Caucasian male (mean % fat +/- SD = 15.1 +/- 6.2) volunteers served as subjects. The statistical analyses included examination of constant error (CE), standard error of estimate (SEE), r, and total error (TE). The results indicated that the Sum3 equation had the lowest SEE (2.7% fat) and TE (3.6% fat) as well as the highest validity coefficient (r = 0.90). The F5000, however, had the lowest CE (-1.0% fat). Based on these findings, the Sum3 equation is recommended over the F5000 (TE = 4.2% fat), F1000 (TE = 6.1% fat), and BIA (TE = 5.0% fat) equations for estimating % fat in young adult males.

Adipose Tissue↗

Physicians' perspectives on cholesterol and heart disease.

In early spring of 1988, questionnaires were mailed to 4,000 Midwestern physicians to survey their attitudes and practices regarding elevated serum cholesterol and their use of referrals for nutrition counseling; 633 physicians responded. Sixty-eight percent of the physicians thought that reducing high serum cholesterol levels would substantially affect heart disease; however, physicians attributed considerably less preventive value to reducing the cholesterol level than to reducing blood pressure (80.3%) or ceasing smoking (90.0%). The range of serum cholesterol for which diet therapy was most frequently initiated was 5.70 to 6.20 mmol/L. The most frequent range for initiation of drug therapy was 7.80 to 8.25 mmol/L. The physicians reported that although their medical school training did not prepare them adequately for providing diet counseling, they did feel prepared to provide, and were successful in, counseling on diet modifications for reducing serum cholesterol. Few (10%) of the total sample reported having registered dietitians available for dietary counseling, and most (88.8%) believed that it is the physician's responsibility to provide such counseling. Although the low response rate limits the conclusions of the survey, it is likely that those physicians most interested in the topic responded. We conclude that registered dietitians should explore the need for their special services further. More aggressive marketing of dietetic services could benefit both physicians and patients in the campaign to reduce serum cholesterol.

Cholesterol↗

Attitudes of rural and urban elderly concerning supplement use.

To examine supplement purchase practices and attitudes toward supplements of rural and urban elderly, two questionnaires were designed. One questionnaire included demographic questions, an attitude scale, and questions concerning supplements purchases and sources of information about nutrition. The second questionnaire contained an advertisement about calcium supplements followed by questions regarding means to "improve calcium" and health concerns. The rural elderly had a significantly lower mean education level and a significantly higher number of misconceptions. The average expenditures on supplements were $52.00 per month for the total group and sources of information were media, physicians, family and friends. In response to the advertisement, nearly one-third of the respondents reported that they would be unlikely to take calcium supplements to improve calcium even though 86.7% stated they would take calcium supplements to prevent health problems and 51.7% believed there could be dangers in taking calcium supplements. The most commonly reported means to improve calcium were to increase milk and to eat cheese (86.7% each). Contradictions in the responses may indicate that these elderly are susceptible to advertising implying supplements are needed to prevent health problems.

Aged↗

Developing a strategy for understanding adolescent nutrition concerns.

Disseminating nutrition information that adolescents will incorporate into their lives has been a difficult challenge for nutrition educators. The communication of such information has often been a "one-way street"; adolescents are given information that educators feel they need to have. Researchers contend that a more effective way to communicate is for adolescents to describe what they need to know in order to relate nutrition messages to their own worlds. A research model based on Brenda Dervin's work with the "sense-making" theory of communication was used to better determine adolescents' perceived nutrition concerns. Adolescents aged 14 to 16 across six states were interviewed to record personal situations they experienced concerning food, nutrition, and/or eating. Situation "movement states" were identified to determine the qualitative ways in which the adolescents perceived themselves as dealing with the situations they described. Data indicate that this theoretical base may be used by nutrition educators to identify adolescents' nutrition needs and to design appropriate education materials.

Adolescent↗

The sense-making approach for audience assessment of adolescents.

The purpose of the research was to test the methodology used to identify how adolescents approach their nutrition concerns and questions. The methodology was based on Dervin's sense-making theory. Using a time-line interview technique, 305 adolescents 14 to 16 years of age detailed a situation involving their most important nutrition concerns. Other pertinent information was obtained. Cluster analysis was chosen as the appropriate analysis to identify groups of adolescents who responded similarly to the technique. Discriminant analysis was then used to determine which variables maximally separated the groups. Four groups were identified, two of which described action-oriented approaches to dealing with nutrition situations and differed in terms of how much outside help they wanted. The remaining two groups perceived barriers to dealing with situations and also differed in how much help they wanted. A fifth group indicated no nutrition concerns or questions. The results will be used to develop and test the effectiveness of nutrition education when it is focused on the different approaches.

Adolescent↗

Clustering of lifestyle behaviors: the relationship between cigarette smoking, alcohol consumption, and dietary intake.

PURPOSE: To examine relationships between cigarette smoking, alcohol use, and dietary intake. DESIGN: Respondents to the U.S. Department of Agriculture's Continuing Survey of Food Intakes by Individuals, a nationwide probability sample conducted from January 1994 through January 1997 (n = 23,602; response rate = 80%), were selected. Adults ages 19 years and older were grouped according to their smoking and drinking habits. Selected demographic variables, food group servings, food energy, and densities of selected nutrients were compared. SETTING: In-home interviews were conducted in the 50 states and the District of Columbia. SUBJECTS: The selected sample (n = 6745) included 3229 nonsmokers, 1701 former smokers, and 1808 current smokers, and 2284 abstainers, 2713 occasional drinkers, 1000 moderate drinkers, and 748 liberal drinkers. MEASURES: Responses to standard questionnaires were examined by Student's t-test, chi 2, one-way analysis of variance, and univariate and multivariate analyses of covariance. RESULTS: Men were more likely than women to be current smokers and liberal drinkers (64% vs. 40% and 62% vs. 38%). For both, the use of cigarettes and alcohol was closely related. An additive relationship was observed between smoking/drinking classification and lower food group servings and nutrient intakes. Although cigarette and alcohol use may have been underreported, these findings support previous ones showing poor food choices along with lower nutrient intakes as smoking and drinking increase. CONCLUSIONS: Smoking and drinking habits may alter individuals' food selections and nutrient intakes. Future interventions for health promotion may achieve greater success by targeting multiple risk factors simultaneously or sequentially.

Adult↗

Measuring stage of change for assessing readiness to increase fruit and vegetable intake among 18- to 24-year-olds.

PURPOSE: To examine the appropriateness of the five-stage schema developed for addictive behaviors when applied to nonaddictive behaviors such as fruit and vegetable consumption. DESIGN: A cross-sectional mail survey was conducted. SETTING: Self-administered questionnaires were mailed to the home addresses of respondents recruited in 10 states and returned upon completion. SUBJECTS: In all, 116 male and 185 female young adults (response rate = 70%) completed the questionnaires. Most respondents were Caucasian (74.4%) and college students (62.2%). MEASURES: Statistical analyses included analysis of variance with Scheffe's test, Pearson correlation and Cronbach's alpha coefficients, factor analysis, and cluster analysis. RESULTS: Staging algorithms for fruits and vegetables were developed according to the five-stage schema, and their construct validity was verified by the incremental trend of food intakes. The algorithms identified more than 80% of the subjects as precontemplators, preparers, or maintainers for both food groups. This distribution pattern agreed well with the three-factor solution generated from the stages of change questionnaire, for which internal reliability and validity were confirmed. Seven cluster profiles of the respondents were derived based on the three generated factors and appeared to represent stage subgroupings of those factors. The two food groups shared marked similarities regarding the profiling of the clusters, which was validated by comparing food intake. The results, however, cannot be generalized because of limitations involved in the current sample. CONCLUSIONS: The original five stages of change and traditional staging measures may need to be adapted and/or extended for dietary change.

Adolescent↗