Nutrition & Food Science
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Item IS THE CURRENT DEFINITION OF THE METABOLIC SYNDROME A USEFUL TOOL FOR THE DETECTION OF CARDIOVASCULAR DISEASE IN NON-HISPANIC BLACKS?(2010) Rodriguez, Omayra Isabel; Song, Jiuzhou; Nutrition; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Blacks in the country suffer from higher prevalences of obesity, diabetes, hypertension and cardiovascular disease compared to whites. Paradoxically, they have the lowest prevalence of the Metabolic Syndrome (MS) compared to whites and Mexican Americans. This is likely due to the fact that blacks tend to have lower triglycerides (TG) and higher high density cholesterol (HDL) levels. We challenged the current lipid criteria established by the Adult Treatment Panel III for the detection of the MS and set out to find more appropriate TG and HDL cutoffs to detect the MS in blacks. Using data from the National Health and Nutrition Examination Survey from 1999-2006, we identified that a more appropriate TG cutoff for blacks to detect the MS is 110 mg/dL but were not able to identify more suitable HDL cutoffs. Our results confirm that race/ethnic-specific criteria should be established for the detection of the MS across racial/ethnic groups.Item Appropriate Waist Circumference Cutoff Values for the Diagnosis of Metabolic Syndrome in Mexican American Adults(2009) Sarafrazi, Neda; Jackson, Robert T; Nutrition; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Metabolic syndrome increases the risk of cardiovascular disease and diabetes. The International Diabetes Federation (IDF) recently proposed new criteria for the diagnosis of metabolic syndrome, which requires the presence of central obesity as measured by ethnic specific waist circumference (WC) cutoff values. Currently, no specific WC thresholds for diagnosis of central obesity in Hispanics are available. The objectives were to determine the appropriate gender specific WC thresholds for diagnosis of central obesity in Mexican American adults and to estimate the prevalence of metabolic syndrome using IDF definition with and without the modified WC in this population. Data from 3265 Mexican American adults aged 20-80 years who participated in the National Health and Nutrition Examination Survey 1999-2006 were used. The prevalence of metabolic syndrome was compared using IDF criteria with and without the modified waist circumference. Receiver operating characteristic curve analysis suggested that yielding at least 80% sensitivity, the WC value of 90 cm in both genders was more appropriate in predicting the presence of two or more metabolic syndrome risk factors in this population. Based on this cutoff, there was 34% reduction in the prevalence of central obesity in women (82.5% to 54.2%). The age adjusted prevalence of metabolic syndrome decreased from 58.4 to 48.2%. The metabolic syndrome was more common among Mexican American men than women (55.8% in men versus 37.8% in women, P =0.0003). Our findings provided a practical guidance in the assessment and screening of central obesity and metabolic syndrome in Mexican Americans.Item Supplementation strategy and its impact on hematological status in the control of anemia of pregnancy in Senegal(2007-07-31) Seck, Binetou Cheikh; Jackson, Robert T; Nutrition; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Anemia of pregnancy remains highly prevalent in Senegal despite the national iron/folic acid (IFA) supplementation program, which consists of providing prescriptions to purchase IFA to women during prenatal visits. The purpose of this study was to provide a framework for recommendations to improve the effectiveness of the program. We determined the prevalence and risk factors of anemia in a cohort of 480 pregnant women at 6 prenatal health centers in Dakar; we compared compliance after 20 weeks of supplementation between women who received prescriptions at 3 control centers and those who received free IFA at 3 intervention centers; and we assessed the factors that influenced high and low compliance in both groups. Overall, 39% of women were anemic and 71% were iron deficient (ID). Twelve percent were infected with P. falciparum; 21% had intestinal helminthes, and 6.5% had Hb AS. Women consumed foods containing iron absorption inhibitors at high frequency. ID > quadrupled the risk of anemia; malaria and Hb AS also significantly increased the risk for anemia. Compliance was 48% and 86% in the control and intervention groups, respectively (P<.001). Anemia prevalence was 62% among controls versus 31% among interventions (P<.01); ID prevalence was 84% and 57% in the control and intervention groups, respectively (P<.01). Women with high compliance were motivated by 1) the perception of improved health upon taking the tablets, 2) the insistence by midwives that they take them, and 3) the mention that the tablets would improve health. Women with low compliance indicated 1) experiencing side effects that they associated with the tablets, 2) misunderstanding that they needed to continue taking the tablets throughout pregnancy, and 3) forgetfulness. Our findings indicate that for effective control of anemia in Senegal, iron supplementation is needed in addition to educating women about better food choices. Antimalarial chemoprophylaxis and helminthes screening should be made available to all women. In addition, increasing access to IFA and educating women about the health benefits of the tablets can dramatically increase compliance and therefore improve iron status and decrease the incidence of anemia.