Biomedical subjects

S B Leonard

Publications and source records attributed to S B Leonard.

10 recordsLinked to original sources

PubMed1996

A measure of stages of change in fruit and vegetable consumption among fourth- and fifth-grade school children: reliability and validity.

OBJECTIVE: We developed, pilot-tested, and field-applied a stages of change questionnaire regarding fruit and vegetable (F&V) consumption among fourth- and fifth-grade students. METHODS: The design included cross-sectional assessment of internal consistency and construct validity, and 2-week and 7-week longitudinal assessment of test-retest reliability. Subjects included 134 students from one school for pilot-testing and 252 from two schools for field application. Thirty-two questions from McConnaughy et al's stages of change questionnaire were adapted and pilot-tested; minor revisions were made for field application. Statistical analyses included principal components analysis to identify subscales; cluster analysis to identify subgroups within students; Cronbach's alpha coefficient to assess internal consistencies; Pearson product-moment correlations to assess test-retest reliabilities; and oneway ANOVA's by F&V stages of change clusters with actual F&V consumption, F&V self-efficacy subscales, F&V preferences, and F&V outcome expectations subscales to determine construct validity. RESULTS: Principal components analysis from the field application indicated two subscales (precontemplation and beyond precontemplation) accounting for 39.5% of variance. Cluster analysis indicated 6 interpretable clusters; 2 (n = 63) provided responses inconsistent with the stages of change theory and 4 (n = 189) provided responses consistent with the theory. Internal consistencies and test-retest reliabilities were acceptable. Students in the "beyond precontemplation" clusters had higher levels of self-efficacy and outcome expectations regarding eating F&V. CONCLUSIONS: Measuring stages of change other than the precontemplation stage in F&V consumption among elementary school children is problematic. Perhaps the theoretical concept does not apply to children, or elementary school children lack the ability to comprehend the questions measuring the concept, or the approach used was not entirely appropriate.

Attitude to Health↗

PubMed1995

A brief, telephone-administered food frequency questionnaire can be useful for surveillance of dietary fat intakes.

A 13-item questionnaire designed for quick telephone administration was evaluated for use in surveillance of fat intake in the United States. Study populations included 560 middle-aged and older adults from Beaver Dam, WI, 252 middle-aged and older women from Wisconsin, 73 young, low income Hispanic women from Chicago, IL, 52 older adults from Arizona and 135 younger adults from Augusta, GA. Correlations between fat scores and fat intakes measured by multiple food records or recalls or by more extensive food frequency questionnaires ranged from 0.33 to 0.60, similar to results from other published questionnaire validation studies. Correlations with percentage of energy from fat were lower (0.26 to 0.42), except for the Chicago population, for which there was no correlation (-0.02). There was no systematic variation in correlations among other subgroups defined by demographic and health-related characteristics, including race (black vs. white). Most, but not all, of the substantial differences in fat intakes among subgroups were identified by the questionnaire. The questionnaire will not capture small differences in intakes among groups and is inappropriate when the sample size is limited or for populations with diets substantially different from the typical U.S. diets, such as the Chicago population. However, with attention to its limitations, the questionnaire is useful for surveillance.

Adolescent↗

PubMed1994

Fruit and vegetable food frequencies by fourth and fifth grade students: validity and reliability.

OBJECTIVE: Due to the increased emphasis on fruit and vegetable (F+V) consumption and a desire to use the simplest dietary assessment method appropriate to determine F+V intake, we assessed the reliability and validity of weekly and monthly fruit and vegetable food frequency questionnaires (F+V FFQ) among fourth and fifth grade students by comparing them to food records previously validated through school lunch observations. METHODS: The multiethnic sample (primarily African-American and Caucasian) included predominantly lower-middle socioeconomic students from 10 classes at one elementary school. F+V FFQ were printed on optical scanning forms and classroom administered on two occasions. Students completed preprinted food record forms at school and received new forms weekly. To allow comparison between the F+V FFQ and food records, a dietitian abstracted information from the records according to a written protocol and transferred it to F+V FFQ forms covering respective time periods. F+V FFQ were converted to estimated daily servings and aggregated to create five F+V indices plus three summary indices. Statistical analyses included Spearman correlations and paired t-tests. RESULTS: Students demonstrated acceptable reliability in completing food records as well as weekly and monthly F+V FFQ; however, validity was unacceptable for both F+V FFQ versions due to significant overreporting. CONCLUSION: Of the two methods studied, the food record procedure is preferred over the FFQ procedure for collecting self-reported F+V consumption data among fourth and fifth grade students.

Child↗

PubMed1994

Accuracy of fourth- and fifth-grade students' food records compared with school-lunch observations.

Fourth- and fifth-grade students' food records completed by using a labor-intensive approach (with daily monitoring) or a less labor-intensive approach (with weekly monitoring) were compared with school-lunch observations. Records were completed at three elementary schools for 14-23 d by students in 26 classes. Record pages were printed forms with areas for recording items consumed, number of servings, and locations of meals. Students were randomly selected for lunch observation. Kappa coefficients and percent of agreement for interobserver reliability for both approaches combined ranged from 0.43 to 0.91 and 72.6% to 95.5%, respectively, on 24 observations. Pearson correlations for 117 record/observation matches were significant for eight and three of nine meal items for the daily and weekly monitoring approaches, respectively. Thus, students were reasonably accurate in keeping records and more accurate with the more labor-intensive approach. Researchers need to select an approach based on the degree of accuracy desired and available finances.

Child↗

PubMed1993

Measuring fruit and vegetable preferences among 4th- and 5th-grade students.

BACKGROUND: Achievement of the nation's Year 2000 fruit and vegetable goal of five or more daily servings may relate to children's preferences for fruits and vegetables. There are, however, no easily administered instruments for measuring preferences for fruits and vegetables among children. METHODS: An initial questionnaire systematically varied preparation methods after focus group discussions had indicated that this had an impact on fruit and vegetable preferences. The three-part questionnaire (fruits, vegetables, fruit and/or vegetable snacks) was classroom administered. Internal consistencies and test-retest reliabilities were acceptable. Principal components analyses, however, revealed food-specific rather than preparation factors; thus, preparation was eliminated from a revised questionnaire. RESULTS: Repeat classroom administration of the revised questionnaire yielded acceptable internal consistencies and test-retest reliabilities. Preferences were higher for fruits than vegetables. Principal components analyses indicated single fruit and vegetable factors and a two-factor solution for snacks (vegetables, fruits). Pearson correlations between preferences and consumption were significant, but accounted for only a small fraction of the variance. Correlations between fruit exposure and preferences, and between vegetable exposure and preferences were 0.55 and 0.51, respectively. CONCLUSION: The revised questionnaire provides a reliable, valid, and simple tool for assessing fruit and vegetable preferences of 4th- and 5th-grade students. The relationship between these preferences and actual consumption is weak; however, making fruits and vegetables more available may enhance preferences.

Child↗

PubMed1993

Defining the year 2000 fruit and vegetable goal.

Various nutrition guidelines recommend increased consumption of fruits and vegetables (F+V); a Year 2000 goal targets five or more daily servings of F+V. Decisions are needed regarding how to define F+V to facilitate measurement of goal achievement. Four alternative definitions (narrow and broad, each with and without legumes) were developed and applied to food frequencies from 133 children and 211 parents. Results varied by definition. Mean intake met the goal of five or more daily servings regardless of definition and exceeded it for both broad definitions by children and both broad definitions and the narrow definition with legumes for adults. Median intakes met the goal for all definitions except for children with the narrow definition without legumes, and exceeded it for children with both broad definitions and for adults with the broad definition with legumes. These differences by definition indicate that a clear definition of F+V is needed.

Adult↗

PubMed1992

Vitamin A in hypercholesterolemia.

This study evaluated the relationship between plasma vitamin A and cholesterol in 48 patients with hypercholesterolemia studied before and after treatment with a cholesterol-lowering diet, with or without lipid-lowering medication. Plasma vitamin A levels were higher in hypercholesterolemic subjects than in healthy controls (2.58 +/- 0.15 vs. 1.82 +/- 0.14 mmol/L, p = 0.025) despite similar values for retinol binding protein (RBP). Successful cholesterol lowering, defined as greater than 25% reduction in low density lipoprotein cholesterol, was achieved in 16 patients. In this subset, plasma vitamin A declined from 3.00 +/- 0.32 (pretreatment) to 2.34 +/- 0.15 mmol/L (post treatment; p = 0.018). A nonsignificant increase in RBP was observed, resulting in a significant decrease in the molar ratio of vitamin A to RBP (1.05 +/- 0.06 vs. 0.80 +/- 0.05, p = 0.013). These data suggest an interaction between vitamin A and cholesterol that is independent of the transport mechanisms for vitamin A in association with chylomicrons (post absorptive) and with RBP. Further examinations of the form or forms of vitamin A (retinol, retinyl ester), its distribution within the plasma lipoproteins, and the mechanisms of origin and removal are warranted to explain these findings.

Anticholesteremic Agents↗

PubMed1992

Physician's and dietitian's role in obese care.

In the Surgeon General's Report on Nutrition and Health, of the ten leading causes of death in the United States, five are nutrition related. Instead of nutritional deficiencies as seen in the 1940s, the national diet has shifted to dietary excesses and imbalances. Dietary excesses and imbalances are reflected in obesity, a major health problem affecting approximately 30% of the United States' population. Unfortunately, the diet industry is not regulated and, hence, patients have many avenues from which to choose. Many of these leave patients lost and confused as to why they have failed in maintaining their weight loss. It is well documented that the recidivism rate in the obese is high with only 5% maintaining their weight loss after one year. The following is a review of the physician's and dietitian's roles in long-term weight maintenance.

Dietetics↗

PubMed1990

Dietary assessment instruments for preschool children: reliability of parental responses to the 24-hour recall and a food frequency questionnaire.

Nutrient intakes of preschool-age children were assessed with a 24-hour dietary recall and a 3-month food frequency questionnaire (FFQ). Parents of 55 preschoolers (mean age = 4.25 +/- 0.59 years) completed the recall and FFQ on two occasions 1 week apart. The recalls and FFQs were analyzed for energy, cholesterol, protein, total carbohydrate, calcium, sodium, potassium, and saturated, polyunsaturated, and monounsaturated fats; each nutrient was expressed as raw value, value per kg body weight, and value per 1,000 kcal. Test-retest reliability estimates for the 24-hour recall indicated significant variability in reported total energy intake, but stable reports of intake were observed for one or all units of expression for polyunsaturated fats, cholesterol, protein, total carbohydrate, calcium, and potassium. The FFQ showed significant positive test-retest reliability estimates for all nutrients for all units of expression. Comparison of the recall and FFQ data showed similar percentages of intakes of energy from fat, carbohydrate, and protein and significant correlations for reported intakes of cholesterol, protein, calcium, and potassium. Comparison of the recall and FFQ data with recall data from a comparable cohort showed lower reported intakes for our sample, with the exception of protein, carbohydrate, calcium, and potassium. If validation studies are successful, the FFQ may be useful in epidemiological studies of preschoolers' intakes over extended periods. The recall may prove to be a useful tool in the assessment of day-to-day variations in macronutrient intakes.

Calcium, Dietary↗

PubMed1989

Creation of a regional medical-nutrition education network.

The Southeastern Regional Medical-Nutrition Education Network (SER-MEN) was developed to coordinate and improve nutrition education in a consortium of the medical schools in Alabama, Florida, Georgia, and South Carolina. SERMEN's central office is at the Medical College of Georgia with the testing office at the University of Alabama at Birmingham. Students, faculty, and consultants in nutrition, education, and computer networking work together on projects on each campus that are coordinated and planned through semiannual meetings. A standardized examination was developed with the Nutrition Test-Item Bank to assess nutrition knowledge at various years of medical students from network schools. Each SERMEN school is connected to a microcomputer system at the central office that provides access to a data base of nutrition education and resources on each campus for developing curricula and syllabi. Funding has been provided by societies, foundations, and government agencies.

Computer Communication Networks↗