Educational inequalities in smoking among men and women aged 16 years and older in 11 European countries

Objective: To determine those groups who are at increased risk of smoking related diseases, we assessed in which male and female generations smoking was more prevalent among lower educated groups than among the higher educated, in 11 European countries.

Design: Cross sectional analysis of data on smoking, covering the year 1998, from a social survey designed for all member states of the European Union.

Subjects: Higher and lower educated men and women aged 16 years and older from 11 member states of the European Union.

Outcome measures: Age standardised prevalence rates by education and prevalence odds ratios of current and ever daily smoking comparing lower educated groups with higher educated groups.

Results: A north–south gradient in educational inequalities in current and ever daily smoking was observed for women older than 24 years, showing larger inequalities in the northern countries. Such a gradient was not observed for men. A disadvantage for the lower educated in terms of smoking generally occurred later among women than among men. Indications of inequalities in smoking in the age group 16–24 years were observed for all countries, with the exception of women from Greece and Portugal.

Conclusions: Preventing and reducing smoking among lower educated subgroups should be a priority of policies aiming to reduce inequalities in health in Europe. If steps are not taken to control tobacco use among the lower educated groups specifically, inequalities in lung cancer and other smoking related diseases should be anticipated in all populations of the European Union, and both sexes.

     

Short communication: Dairy consumption among middle-aged and elderly adults in Switzerland

Different studies have shown that people are aware of the benefits of dairy products, but a sizeable part of the world's population still does not consume the recommended amount of dairy produce. The aims of the present research were to determine which dairy products are consumed by the middle-aged and elderly (50–81 yr old) living in Switzerland and to explore why some of this population segment are actually reducing their consumption of dairy products. On average, older Swiss adults consumed 2.6 portions of dairy products per day, which is slightly less than the recommended 3 to 4 portions a day. Additionally, about one-quarter of the respondents indicated that they have reduced their milk or dairy consumption. The main reasons given for this decision were to reduce fat or cholesterol. A reported difficulty in digesting some dairy products may be a further reason for limiting dairy intake, particularly cheese. It follows that a need for the propagation of appropriate nutritional information about dairy products to the middle-aged and elderly exists.     

Outcomes of screening and nutritional intervention among older adults in healthcare facilities.

A nutritional screening and early intervention program was administered to older adults in a subacute care facility. The study group was recruited among patients aged 65 or older, who were admitted to the geriatric and rehabilitation units of two hospitals. Two simple, reliable, and valid tools were used to screen subjects for the risk or presence of malnutrition. Those determined to be at high nutritional risk (n=62) were included in the study. Dietitians then conducted a full nutritional assessment and implemented a nutritional care plan for these subjects. Weekly follow-up was completed to measure oral intake, weight, and biochemical indices. A Short-Form 36 Health Survey was administered upon admission and discharge. Results showed significant increases in energy (p=0.0001) and protein (p=0.01) intakes, and in serum albumin (p=0.001), prealbumin (p=0.003), transferrin (p=0.024), and hematocrit (p=0.026) levels. There was also a significant increase in seven of the eight dimensions of the health-related quality of life questionnaire (p<0.05). Outcomes improve when older adults are screened for the risk or presence of malnutrition and receive an early nutritional care program.     

复合大豆功能因子对中年以上妇女血清雌二醇及SOD活性的影响

实验了工业化条件下生产的大豆复合功能因子能够提高中年以上妇女血清雌二醇含量,与对照组比较存在显著性差异(p<0.01);而且能增强人体血清SOD活性,与对照组比较有明显性差异(P<0.05)。因此证明日服用大豆复合功能因子具有推迟妇女更年期、抗氧化、抗衰老的作用。     

Determinants of anemia among pregnant women in Mali

BACKGROUND: Anemia in pregnancy remains a major problem in nearly all developing and many industrialized countries. In Mali, the subpopulation prevalence and etiology of anemia during pregnancy are largely unknown. OBJECTIVE: To examine the prevalence and likely etiologies of anemia in pregnancy in a poor urban population in Bamako, Mali. METHODS: Pregnant women (n = 190) were selected randomly. Hemoglobin, serum iron, and total iron-binding capacity were measured; blood smears were examined for Plasmodium falciparum malaria; and single stool and urine samples were examined for Schistosoma haematobium and hookworm. Gynecologic examinations were performed and interviews conducted to qualitatively assess food consumption and other socioeconomic characteristics. Associations among mild, moderate, and severe anemia; iron and parasite status; erythrocyte sedimentation rates; and the presence of abnormal vaginal discharge were evaluated. Differences in hemoglobin and serum iron concentrations, total iron-binding capacity, and anemia were compared according to trimester of pregnancy and between infected and noninfected women. The relative and attributable risks of anemia were calculated, and adjusted odds ratios for anemia and low serum iron were estimated by multivariate logistic regression. RESULTS: Of the 131 women for whom complete data were available, 47% had hemoglobin concentrations below 110 g/L; 13% had serum iron concentrations below 12 micromol/L; none had transferrin saturation values below 16%; 11%, 23%, and 8% harbored P. falciparum, S. haematobium, and hookworm, respectively; and 82% had an abnormal vaginal discharge. Food restrictions were reported by 45% of the women. Abnormal vaginal discharge correlated significantly with anemia (Pearson chi2 = 62.4; p < .01). Univariate and multivariate analyses found that infections were strongly associated with and predictive of anemia. CONCLUSIONS: Our data suggest that infections and food accessibility contribute to the high rates of anemia during pregnancy in Mali.     

Prevalence among Tajikistan women of reproductive age obesity

The article presents data on excess body weight and obesity prevalence among Tajikistan women of reproductive age.     

Associations of food insecurity with body mass index among baby boomers and older adults

Increasing obesity levels portend a challenging societal healthcare issue, while the current economic crisis may foster food insecurity, characterized by limited or uncertain access to adequate food. This study examines associations among food insecurity, meeting recommendations for dietary and physical activity patterns, and body mass index (BMI) among baby boomers and older adults completing the 2010 Brazos Valley Health Survey. Subjects included 2,985 respondents (1,589 baby boomers and 1,396 older adults). Thirty-six percent of participants were obese while 15 % of participants were food insecure. Approximately 8 % of baby boomers and older adults were both food insecure and obese. Among all study participants, an increased BMI was more common among those who were ethnic minorities and had depression. An increased BMI was less common among those who met fruit/vegetable intake and physical activity recommendations. There was a positive association between food insecurity and BMI only among baby boomer and older adult females. A combined emphasis on availability of healthy foods and increased opportunities for meeting physical activity guidelines can help to counter the food insecurity-obesity connection among both baby boomer and older adult females.     

Cigarette smoking and smoking cessation among older adults: United States, 1965-94

OBJECTIVE: To characterise patterns of cigarette smoking and smoking cessation among older adults in the United States. DESIGN: Data from the National Health Interview Surveys (NHIS) 1965-94 were analysed. The NHIS is a cross-sectional survey using a representative national sample. SETTING: In most cases interviews were conducted in the home; telephone interviews were conducted when respondents could not be interviewed in person. PARTICIPANTS: Participants were from a representative sample of the American civilian, non-institutionalised population aged 18 and older. Sample sizes for the years analysed ranged from n = 19,738 to n = 138,988 overall, and n = 3806 to n = 12,491 for those aged 65 years and older. MAIN OUTCOME MEASURES: Using the NHIS data from 1965-94, trends in current smoking and the prevalence of smoking cessation by demographic characteristics among older adults (65 years and older) were assessed and compared with trends among younger adults. A logistic regression analysis was conducted to determine the demographic characteristics of former smokers compared with current smokers among those aged 65 and older. RESULTS: The prevalence of current smoking among 65 year olds and older declined from 1965 to 1994 (17.9% to 12.0%). Although smoking prevalence was lower among older adults than younger adults (aged 18- 64), the rate of decline in smoking was slower among older adults. Among older adults, the prevalence of cessation rose with increasing educational attainment, and was consistently higher for men than for women and for whites compared with blacks. After adjustment for demographic factors among older adults who had ever smoked, increasing age and educational attainment were strongly related to the likelihood of being a former smoker. Although there were no racial differences among women, older white (OR = 2.6) and Hispanic (OR = 3.67) men were significantly more likely to be former smokers than older black men. Also, the gender difference in smoking cessation was noted only for whites. CONCLUSIONS: Given the projected increase in the elderly population, the medical and economic consequences of smoking will become a greater burden in the next decades. Therefore, focusing attention on cessation among the elderly is an immediate and urgent priority for public health professionals and clinicians.


     

中年人保健与营养

介绍了人体的健康标准及中年人的代谢和生理功能变化特点,分析了中年人的营养需要、合理膳食方法及需要达到的健康目标等,以强化中年人的营养保健意识。     

Food safety practices among pregnant women and mothers in the women, infants, and children program, Miami, Florida

Pregnant women and infants are two groups at the highest risk of severe outcomes from foodborne illnesses. We surveyed adult clients of a Women, Infants, and Children (WIC) clinic serving predominately African Americans in inner-city Miami, Florida, to assess food safety practices. Eligible and consenting women completed a 23-item self-administered survey with questions concerning food handling practices around the Partnership for Food Safety Education's Fight BAC! campaign constructs of "clean", "separate" (not cross-contaminated), "cook", and "chill". Of 342 eligible clients, 299 (87.4%) consented to participate. In general, the clients' food safety practices were most problematic in the cook and chill constructs. Using a cooking thermometer, refrigerating foods within 2 h, and thawing them safely were the least commonly reported safe practices. Women who were pregnant with their first child had the lowest food safety practice scores. Of the 62 pregnant participants, 32 (51.6%) reported eating hot dogs or deli meats without first reheating them some of the time or more often, and 22 (35.5%) reported eating soft cheeses and blue-veined cheeses some of the time or more often, putting the women at risk of listeriosis. Although all women in the WIC program could benefit from food safety education, these findings indicate that women during their first pregnancy should especially be targeted for food safety education.     

Use of flavored cigarettes among older adolescent and adult smokers: United States, 2004--2005

Cigarettes with candy, fruit and alcohol flavors have been introduced in recent years as extensions to popular cigarette brands, raising concerns in the public health community that the enticing names, creative packaging, and intense flavorings of these products may be especially appealing to youth. This study used two national surveys to examine the prevalence of use of Camel Exotic Blends, Kool Smooth Fusion, and Salem Silver Label brands during 2004--2005 among older adolescents and young adult smokers aged 17-26 years and adult smokers aged > or =25 years. Overall use of any of these flavored brands in the past 30 days was 11.9% among smokers aged 17-26 years and 6.7% among smokers aged > or =25 years. A significant gradient in use was seen across age, with the highest rates of utilization among 17-year-old (22.8%) and 18-19-year-old smokers (21.7%) (p<.001). Uniquely flavored cigarette brands seem to be most attractive to the youngest smokers and should be prohibited.     

Prevalence of anemia among pregnant women and adolescent girls in 16 districts of India

BACKGROUND: Nutritional anemia is one of India's major public health problems. The prevalence of anemia ranges from 33% to 89% among pregnant women and is more than 60% among adolescent girls. Under the anemia prevention and control program of the Government of India, iron and folic acid tablets are distributed to pregnant women, but no such program exists for adolescent girls. OBJECTIVE: To assess the status of anemia among pregnant women and adolescent girls from 16 districts of 11 states of India. METHODS: A two-stage random sampling method was used to select 30 clusters on the basis of probability proportional to size. Anemia was diagnosed by estimating the hemoglobin concentration in the blood with the use of the indirect cyanmethemoglobin method. RESULTS: The survey data showed that 84.9% of pregnant women (n = 6,923) were anemic (hemoglobin < 110 g/L); 13.1% had severe anemia (hemoglobin < 70 g/L), and 60.1% had moderate anemia (hemoglobin > or = 70 to 100 g/L). Among adolescent girls (n = 4,337)from 16 districts, the overall prevalence of anemia (defined as hemoglobin < 120 g/L) was 90.1%, with 7.1% having severe anemia (hemoglobin < 70 g/L). CONCLUSIONS: Any intervention strategy for this population must address not only the problem of iron deficiency, but also deficiencies of other micronutrients, such as B12 and folic acid and other possible causal factors.