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- OPEN ACCESSIntroduction: Food insecurity at the individual level has been shown to be associated with the adoption of risky behavior and poor healthcare-seeking behavior. However, the impact of household food insecurity (HFI) on the utilization of maternal healthcare services (MHS) remains unexplored. In this study, we aimed to investigate whether or not household food insecurity was associated with non/inadequate utilization of MHS. Methods: Participants consisted of 3562 mothers aged between 15 and 49 years and with at least one child. The outcome variable was the utilization of MHS, e.g., institutional delivery, attendance ante-, and pre-natal visits. The explanatory variables included various sociodemographic factors (e.g., age, residence, education, wealth) apart from HFI. HFI was measured using the Household Food Insecurity Access Scale (HFIAS). Result: The prevalence of non- and under-utilization of MHS was 5.3 and 36.5, respectively. In the multivariate analysis, HFI, wealth index, and educational level were independently associated with MHS status. The odds of non- and under-utilization of MHS were 3.467 (CI = 1.058–11.354) and 4.104 (CI = 1.794–9.388) times higher, respectively, among women from households reporting severe food insecurity. Conclusion: Severe HFI was significantly associated with both under- and non-utilization of MHS. Interventions programs that address HFI and the empowerment of women can potentially contribute to an increased utilization of MHS.
- OPEN ACCESS
- Lesya Marushka,
- Malek Batal,
- Donald Sharp,
- Harold Schwartz,
- Amy Ing,
- Karen Fediuk,
- Andrew Black,
- Constantine Tikhonov, and
- Hing Man Chan
Consumption of fish and n-3 fatty acids (n-3 FAs) has been postulated to prevent type 2 diabetes (T2D). Objective: To explore the association between self-reported T2D and fish consumption, dietary n-3 FAs, and persistent organic pollutants (POP) intake in a regionally representative sample of First Nations (FNs) in Manitoba. Design: Data from the cross-sectional First Nations Food, Nutrition and Environment Study (FNFNES) collected from 706 members of 8 Manitoba FNs in 2010 were used. Household interviews were used to collect social and lifestyle data. The consumption of fish was estimated using a traditional food frequency questionnaire. Fish samples were analyzed for the presence of POP. Multiple logistic regression models adjusted for potential risk factors for T2D were developed. Results: A negative, dose–response relationship was found between fish intake and self-reported T2D. Fish consumptions of 2–3 portions per month and ≥1/week were inversely associated with T2D with odds ratio (OR) values of 0.51 (95% CI: 0.28–0.91) and 0.40 (95% CI: 0.19–0.82), respectively, compared with no fish intake. Similarly, intake of n-3 FAs was negatively associated with T2D (OR = 0.48 (95% CI: 0.30–0.77). Dietary POP intake was not associated with T2D. Conclusion: These findings suggest that the consumption of traditionally harvested fish may have a beneficial effect on T2D in Manitoba FNs. - OPEN ACCESS
- Brett Emo,
- Li-Wen Hu,
- Bo-Yi Yang,
- Kahee A. Mohammed,
- Christian Geneus,
- Michael Vaughn,
- Zhengmin (Min) Qian, and
- Guang-Hui Dong
To assess the effects of housing characteristics and home environmental factors on lung function of Chinese children, 6740 children (aged 6–16 years) were recruited from seven cities in Northeast China in 2012. Performance of lung function was determined by comparison of forced vital capacity (FVC), forced expiratory volume (FEV1), peak expiratory flow (PEF), and maximal mid-expiratory flow (MMEF). Multivariate regression models were used to evaluate the associations with lung function deficit. The results showed that housing conditions were associated with lung function deficit in children. The adjusted odds ratios were 0.47 (95% CI: 0.26–0.83) for FVC for “ping-fang” housing compared with “dan-yuan-lou-fang” housing and 2.90 (95% CI: 2.43–3.47) for FEV1 with home renovations completed within two years compared with counterparts. The linear regression models consistently showed a significant association of housing conditions and home environmental factors with lung function measurements across subjects. A residence taller than seven stories was negatively associated with FEV1 (β = −55; 95% CI: −97 to −13). In conclusion, housing conditions and home environmental factors are particularly important to the development of lung function and respiratory health in children. These factors are concerning and action should be taken to improve them. - OPEN ACCESSInnovative, highly processed foods are often designed to “substitute” for traditional, less-processed items in the diet. Yet, concerns about the unhealthfulness of diets high in highly processed foods are growing. Their dominance in the diet has been hypothesized to relate, in part, to the strategic use of on-package nutrition promotion. Our goal was to compare front-of-package (FOP) labelling on highly processed products that appear to have been explicitly designed as substitutes for traditional foods with the FOP labelling on their traditional counterparts. FOP references were recorded from packaged foods in three major Toronto grocery stores (N = 20520). Foods were categorized as substitute or traditional counterparts if these had (1) immediate interchangeability within the diet, (2) inherently different formulation, and (3) the substitute was more heavily processed than its traditional counterpart. Eight substitute–traditional pairs were identified, comprising 18% of products in the data set. Substitute foods were more likely than traditional products to bear FOP nutrition, “organic”, and “natural” references. Substitute foods bore 1.21 times more FOP references, the majority of which highlighted nutrients inherent to the traditional counterpart. Our findings support the contention that highly processed foods may be displacing less-processed foods at least in part through the use of strategic on-package marketing.
- OPEN ACCESSThe objective is to support development of a nutritional intervention for Chinese immigrants with diabetes by defining current deficiencies and identifying modifiable factors and mechanisms of change. Semi-structured interviews conducted with 13 ethnic Chinese with type 2 diabetes identified modifiable problems related to culturally relevant diabetes resources and low cultural acceptability of recommended diets. These factors could be addressed through creation of resources developed in partnership with Chinese-speaking health care professionals and persons with diabetes.
- OPEN ACCESS
- Eric Kai-Chung Wong,
- Jennifer Watt,
- Hanyan Zou,
- Arthana Chandraraj,
- Alissa Wenyue Zhang,
- Jahnel Brookes,
- Ashley Verduyn,
- Anna Berall,
- Richard Norman,
- Katrina Lynn Piggott,
- Terumi Izukawa,
- Sharon E. Straus, and
- Barbara Arlena Liu
Atypical disease presentations are common in older adults with COVID-19. The objective of this study was to determine the prevalence of atypical and typical symptoms in older adults with COVID-19 through progressive pandemic waves and the association of these symptoms with in-hospital mortality. This retrospective cohort study included consecutive adults aged over 65 years with confirmed COVID-19 infection who were admitted to seven hospitals in Toronto, Canada, from 1 March 2020 to 30 June 2021. The median age for the 1786 patients was 78.0 years and 847 (47.5%) were female. Atypical symptoms (as defined by geriatric syndromes) occurred in 1187 patients (66.5%), but rarely occurred in the absence of other symptoms (n = 106; 6.2%). The most common atypical symptoms were anorexia (n = 598; 33.5%), weakness (n = 519; 23.9%), and delirium (n = 449; 25.1%). Dyspnea (adjusted odds ratio [aOR] 2.05; 95% confidence interval [CI] 1.62–2.62), tachycardia (aOR 1.87; 95% CI 1.14–3.04), and delirium (aOR 1.52; 95% CI 1.18–1.96) were independently associated with in-hospital mortality. In a cohort of older adults hospitalized with COVID-19 infection, atypical presentations frequently overlapped with typical symptoms. Further research should be directed at understanding the cause and clinical significance of atypical presentations in older adults.