Sara Quandt | Wake Forest University School of Medicine (original) (raw)

Papers by Sara Quandt

Encyclopedia of Social Problems, Oct 5, 2012

141st APHA Annual Meeting and Exposition (November 2 - November 6, 2013), Nov 4, 2013

ABSTRACT Farmworkers are at risk for health consequences of pesticide exposure. While acute expos... more ABSTRACT Farmworkers are at risk for health consequences of pesticide exposure. While acute exposure causes immediate symptoms, most exposure is likely low level and chronic, with possible health effects manifest years later as neurodegenerative diseases. We hypothesized that subclinical effects might be detected in current farmworkers to provide evidence of early stage neurodegeneration. From animal studies, olfactory function, an early sign of Parkinson's disease, is known to be sensitive to pesticide exposure. The study objective was to compare olfactory function in comparable samples of exposed and non-exposed workers. Migrant farmworkers (n=304) and a comparison sample of non-farmworkers (n=247) 18+ years and self-identified Latino/Hispanic were recruited in North Carolina with the help of community partners. Non-farmworkers were restricted to those with no occupational pesticide exposure in the previous 3 years. Odor identification and odor threshold tests were administered in a clinic setting and analyzed using logistic and linear regressions, adjusting for age, gender, and smoking. Lifetime pesticide exposure was obtained using the NINDS common data elements questionnaire to confirm group pesticide exposure differences. The total sample was 84% male, 23% current smokers, and 97% born in Latin America. Farmworkers and non-farmworkers did not differ in odor identification performance (p=0.6726). However, non-farmworkers detected a standard odor at significantly lower concentrations than did farmworkers (p<.0001). Farmworkers display significant non-selective impairment in olfactory function, compared to non-farmworkers. These results suggest that subclinical markers signal neurological effects before neurodegenerative diseases can be detected. Such data could be important in demonstrating health consequences of occupational pesticide exposure.

Anthropology News, Sep 1, 1987

American Anthropological Association eBooks, 1986

... Availability number, 9001632. Serial Title, A Special publication of the AmericanAnthropologi... more ... Availability number, 9001632. Serial Title, A Special publication of the AmericanAnthropological Association (USA). Serial number, no. 20. ... Email: access@nal.usda.gov. URL: http://www.nal.usda.gov. AGRIS 2010 - FAO of the United Nations.

Social Science & Medicine, 1986

This paper describes the range and patterning of variation in specific breast-feeding behaviors a... more This paper describes the range and patterning of variation in specific breast-feeding behaviors among a sample of 62 American mothers, as well as the relationship of the patterns to duration of exclusive breast feeding. Infant feeding data were collected using 24-hr records completed by mothers every 8 days through the first 6 months post purtum. Behaviors examined were: number of daily feedings, minimum and maximum intervals between feedings, length of feedings and total daily nursing duration. Variation in magnitude of these behaviors ranged from three-to eight-fold. Principal components analysis found this variation patterned in two dimensions, relating to feeding frequency and length of time spent breast feeding. These dimensions accounted for approximately equal proportions of variance in the breastfeeding behaviors, totaling about 80% of all variance at 4 and 8 weeks. There was significant continuity of breast-feeding styles practiced by any one woman from 4 to 8 weeks. The feeding frequency dimension was strongly associated with duration of exclusive breast feeding. Three explanations-cultural, biological and biocultural-are proposed to account for this association. It is argued that the intracultural variation in breast-feeding styles in this sample may be sufficient to cause corresponding variation in breast milk production, in part accounting for variation in duration of exclusive breast feeding. Predictions of exclusive breast-feeding duration will be most accurate for women with a breast-feeding style of infrequent feedings, while predictions for women with a style of frequent feeding will be confounded by cultural factors which have an independent effect on breast-feeding supplementation.

American Journal of Physical Anthropology, Apr 1, 1983

The relationship between maternal fatness and infant feeding practices was studied in 46 healthy ... more The relationship between maternal fatness and infant feeding practices was studied in 46 healthy Caucasian women from parturition to 6 months postpartum. Mothers reported infant feeding practices in diary form throughout the study. Weight, triceps and subscapular skinfolds, and midarm circumference were measured on seven occasions. Upper arm fat area was computed. All women breast fed their infants for at least 5 months, with no nonbreast milk food introduced for at least 2 months. All women had declining or stable postpartum weights. Linear regressions of upper arm fat area on days since parturition were used to ascertain overall direction of change in adiposity for each woman. Declining fat area occurred in 17 cases and was associated with a breast-feeding pattern of short frequent feeds. In the remaining 29 cases, increasing fat area was associated with significantly longer and less frequent feeds. It is hypothesized that these different fat change patterns result from differential activity of adipose tissue lipoprotein lipase, which is itself mediated by serum prolactin concentration. Relevance of these findings for resolution of the controversy surrounding the critical body composition hypothesis and lactation amenorrhea is discussed.

Osteoporosis International, Sep 21, 2004

This review assessed alendronate for preventing hip fractures in postmenopausal women. The author... more This review assessed alendronate for preventing hip fractures in postmenopausal women. The authors concluded that alendronate was associated with reductions in hip fracture rates in women with postmenopausal osteoporosis. The evidence presented in the review appears to support the authors' conclusions, but poor reporting of the review methods means that the reliability of the conclusions is unclear. Searching MEDLINE, EMBASE and the Cochrane CENTRAL Register were searched using the reported keywords. In addition, the Merck database was searched for unpublished studies. Study selection Study designs of evaluations included in the review Randomised controlled trials (RCTs) were eligible for inclusion. The duration of the included studies ranged from 1 to 4.5 years. Specific interventions included in the review Studies of alendronate were eligible for inclusion. Most of the included studies compared between 5 and 20 mg/day alendronate with placebo; one of the included studies compared alendronate plus calcium with calcium alone. Participants included in the review Studies of postmenopausal women with a T-score of-2.0 or less, or with a vertebral fracture, were eligible for inclusion. The majority of the included studies were in women with a T-score of-2.0 or less at the femoral neck or lumbar spine, with and without prevalent vertebral fracture. One study included women with a prevalent vertebral fracture and a T-score of-1.6 or less at the femoral neck. One of the included studies was in women in a long-term care facility. Most of the participants were Caucasian and ages ranged between 39 and 91 years. Outcomes assessed in the review Studies that presented sufficient data to permit calculation of the relative risk (RR) of hip fracture were eligible for inclusion. How were decisions on the relevance of primary studies made? Data extraction The authors did not state how the data were extracted for the review, or how many reviewers performed the data

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014), Nov 17, 2014

ABSTRACT Dental impairments in older adults are frequently accompanied by reduced dietary quality... more ABSTRACT Dental impairments in older adults are frequently accompanied by reduced dietary quality and nutritional status. Even with dental repair, dietary quality usually remains low. This study aims to: (1) evaluate the impact on dietary quality of an intervention among African American and White older adults with self-reported oral health problems and related eating constraints; and (2) identify characteristics of participants for whom the intervention produced positive change in dietary quality. Community-dwelling adults (n=38) experiencing oral health problems and eating constraints were enrolled in a 6-month individualized dietary intervention; evaluation used a pre-post design. The intervention used tailoring and goal setting to promote dietary intake consistent with the Dietary Guidelines for Americans. The primary outcome, dietary quality, was measured by the Health Eating Index 2010 (HEI) calculated from the NCI Diet History Questionnaire. HEI includes a total score (range 0 to 100) and 12 subscales. 35 participants completed the intervention (median age=69). Mean total HEI scores improved from 67.1 (±10.1) to 72.7 (±7.4) (p=0.0037). Significant improvements were seen in 6 subscales: total fruit (p=0.0106), whole grains (p=0.0135), dairy (p=0.0332), total protein foods (0.0107), seafood/plant proteins (0.0104), and empty calories (0.0133). 25 participants had positive change scores for total HEI. Positive HEI change was greater among those with low baseline HEI and poorer oral health status. Change in HEI was unrelated to age, sex, or ethnicity. Significant dietary improvement is possible among older adults with oral health deficits. Randomized trials are needed to confirm these findings and extend evaluation to clinical populations.

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014), Nov 17, 2014

ABSTRACT Reports of food insecurity for farmworker households have found 50-80% food insecure. Ho... more ABSTRACT Reports of food insecurity for farmworker households have found 50-80% food insecure. However, most measure difficulty obtaining enough food over a 12-month period. For workers whose income may fluctuate seasonally, this long recall period makes it difficult to know whether reported food insecurity is episodic or chronic. The goals of this study were to (1) describe within-household variation in food security over four quarters, and (2) identify predictors of episodes of food insecurity. The USDA Food Security Module was administered quarterly over one year to 231 Latino farmworker families with children 2-3 years at baseline. Families were recruited in North Carolina (28% migrant; 72% seasonal). In total, families contributed data for 834 quarters in 2011-13. Low or very low food security (“food insecurity”) was reported for 24.6% of quarters. Food insecurity was concentrated in about half of the families, with less than 10% reporting food insecurity during all quarters. In logistic regression predicting food insecurity, being migrant (vs. seasonal) and reporting a move during the quarter increased the odds of being food insecure in any quarter, while using diverse food sources (e.g., gardening, fishing), having more children, and the child obtaining meals at childcare (e.g., Migrant Head Start) or school decreased the odds of being food insecure. Season of the year, parental employment, and household size were not associated with food insecurity. These findings suggest that food insecurity in farmworker families is largely episodic, not chronic. These findings help identify farmworker families most likely to need food or income assistance.

141st APHA Annual Meeting and Exposition (November 2 - November 6, 2013), Nov 4, 2013

ABSTRACT Preschool age children of Latino farmworkers are at risk for early childhood caries and ... more ABSTRACT Preschool age children of Latino farmworkers are at risk for early childhood caries and subsequent oral health (OH) problems; many face significant barriers in accessing dental care. We compare OH and hygiene between migrant and seasonal farmworker children and note disparities between maternal knowledge and practices. The Nios Sanos Study is a cohort (N=248) of mothers and preschool age children from migrant and seasonal farmworker families recruited in North Carolina. Mothers reported the child's OH condition, hygiene behaviors, and professional care, as well as their beliefs about child OH in response to the Behavioral Risk Factor Questionnaire of the NIDCR Centers for Research to Reduce Disparities in Oral Health. At interview, children averaged 44.3 7.4 months. Migrant mothers rated their child's OH condition and OH-related quality-of-life significantly worse than did seasonal mothers. 87% of children had ever had teeth examined by a healthcare provider, and 83% had had fluoride varnish applied in the previous year; rates did not differ between migrant and seasonal families. Children enrolled in Head Start were more likely to have had examinations and varnish applied than those not in Head Start. Mothers exhibited high levels of knowledge of proper child oral hygiene, but rates of recommended practices were substantially lower. Farmworker families, particularly migrants, frequently live in crowded, substandard housing and share facilities with other families. Steps to help families achieve appropriate OH practices should prioritize behaviors and problem-solve with mothers ways to best meet child OH needs in the context of farmworker living conditions.

Springer eBooks, 2020

Migrant and seasonal farmworkers experience substantial stress resulting from their difficult wor... more Migrant and seasonal farmworkers experience substantial stress resulting from their difficult work, low income, separation from family, experiences of discrimination, and poor housing. This chapter is centered on a stress/distress model. This model posits that stressors are both structural and situational. Stress levels can be countered by positive or negative coping behaviors. Distress results from chronic, unmitigated stress and may contribute to mental health conditions such as depression, anxiety, and alcohol use disorders. The chapter summarizes the current sparse literature on mental health research among farmworkers in the eastern United States. Symptom levels for anxiety and depression are highly variable, with studies reporting 0–23% prevalence for anxiety and 7–52% for depression. Alcohol use disorders are common, particularly among men, with most studies reporting more than 30% prevalence. Although variable, the evidence suggests that farmworkers in the eastern US have a substantial burden of mental distress that is untreated. Future directions for research, practice, and policy are suggested.

Cambridge University Press eBooks, Dec 7, 2000

Social Science & Medicine, 1984

The 'critical body composition hypothesis' (CBCH) is frequently used to explain variations in the... more The 'critical body composition hypothesis' (CBCH) is frequently used to explain variations in the duration of postpartum amenorrhea. The hypothesis predicts that ovulation will not occur if fat reserves fall below a critical threshold. This paper attempts to analytically separate the CBCH from the broader concept of nutritional thriftiness on which it is based. A review of previous research on fat cell metabolism and ovulation finds no direct link between fatness and fecundity. Rather they are each regulated by lactation and mother-infant interactions associated with breast feeding. As a system which delivers available fat into breast milk and prevents ovulation only during the time when the infant is dependent on the mother, the pathways outlined here represent a nutritionally thrifty method of fertility regulation, one which maximizes reproductive success while minimizing energy investment. The cultural patterning both of infant feeding behaviors and the wider range of maternal activities which affect breast feeding suggest specific testable hypotheses to explain interpopulation variations in fertility and infant nutritional status.

Springer eBooks, 2009

... At the community level, farmworker communities in the eastern US are often located in rural a... more ... At the community level, farmworker communities in the eastern US are often located in rural areas isolated spatially and ... Or, if the entire family migrates, the child will migrate as well, a practice that can have negative ... Among newly arrived farmworkers, only 10% are women. ...

Journal of Applied Gerontology, Jun 1, 2000

Older adults are vulnerable to nutrition-related health problems due to health and psychosocial c... more Older adults are vulnerable to nutrition-related health problems due to health and psychosocial changes that accompany aging. Those in rural communities face additional problems. This study characterizes the nutritional risk of rural older adults using the Nutritional Risk Index (NRI), paying particular attention to gender differences in risk. Data come from face-to-face interviews with a random sample of 638 White rural adults aged 55 and older. Women scored significantly higher on the NRI, indicating greater nutritional risk. Women were more likely to report NRI items related to oral health, special diets, disease interference with eating, gastrointestinal problems, and anemia, whereas men were more likely to report smoking regularly. A comparison with the application of the NRI in other populations indicates that it is sensitive to nutrition-related health conditions that may be more prevalent in rural populations, making it a useful tool for measuring nutritional risk. Achieving adequate nutrition in older adults is important for both health and quality of life. Nutritional status has been linked to immune function and infectious disease risk (Bell & High, 1997; Roebothan & Chandra, 1994) as well as to morbidity and mortality (Casper, 1995; Mowé & Bøhmer, 1996; Sullivan & Walls, 1994). Eating regular meals and familiar foods enhances feelings of well-being for older persons (Quandt, Vitolins, DeWalt, & Roos, 1997). However, both the biological and social aspects of nutrition are frequently harder to achieve in older adults than in younger adults. Chronic diseases characteristic of aging alter nutrient and food requirements (Casper, 1995; Cohen, 1994). Oral health problems and prescription drug use can result in changes in taste and appetite (Mowé & Bøhmer, 1996; Roe, 1994). Changes in social contact, mobility, and income can lead to problems in obtaining appropriate food (Miller et al.

Mayo Clinic Proceedings, Mar 1, 2005

JAMA, Dec 27, 2006

STEOPOROSIS IS COMMON among postmenopausal women, and the disease process is characterized by inc... more STEOPOROSIS IS COMMON among postmenopausal women, and the disease process is characterized by increased bone turnover, progressive loss of bone mass, microarchitectural deterioration, and increased fracture risk. Bisphosphonates, which are antiresorptive drugs, are the most commonly used pharmacologic treatments for postmenopausal osteoporosis. Alendronate, a potent bisphosphonate, decreases bone turnover, increases bone mineral density (BMD), and decreases vertebral, nonspine, and hip fracture risk in women with osteoporosis. 1-4 For editorial comment see p 2968. Author Affiliations and Members of the FLEX Research Group are listed at the end of this article.

Journal of Applied Gerontology, Dec 1, 1996

This is the 15th volume in a series designed to synthesize perspectives on aging, from medicine t... more This is the 15th volume in a series designed to synthesize perspectives on aging, from medicine to the social and behavioral sciences to policy. The inclusion of a volume on nutrition is timely, because nutrition is increasingly recognized as both a predictor of outcomes in the aging process and a point of intervention for health promotion of older persons. The volume includes eight topical chapters and an introduction. There is considerable variation in the depth with which topics are reviewed and in the extent to which reviews evaluate the state of research. Several of the chapters are quite strong. Mary-Margaret Wilson and John Morley review the diagnosis and management of protein-energy malnutrition (PEM). The chapter includes a discussion of the tech-

Reviews in Anthropology, Aug 1, 1995

... of the authors in Diet and Disease take as given that variation in the presence of nutrient-l... more ... of the authors in Diet and Disease take as given that variation in the presence of nutrient-linked diseases reflects variation in diet, Richard Burghart draws ... Hendrickse, RG 1984 The Influence of Aflotoxins on Child Health in the Tropics with Particular Reference to Kwashi-orkor. ...

Encyclopedia of Social Problems, Oct 5, 2012

141st APHA Annual Meeting and Exposition (November 2 - November 6, 2013), Nov 4, 2013

ABSTRACT Farmworkers are at risk for health consequences of pesticide exposure. While acute expos... more ABSTRACT Farmworkers are at risk for health consequences of pesticide exposure. While acute exposure causes immediate symptoms, most exposure is likely low level and chronic, with possible health effects manifest years later as neurodegenerative diseases. We hypothesized that subclinical effects might be detected in current farmworkers to provide evidence of early stage neurodegeneration. From animal studies, olfactory function, an early sign of Parkinson's disease, is known to be sensitive to pesticide exposure. The study objective was to compare olfactory function in comparable samples of exposed and non-exposed workers. Migrant farmworkers (n=304) and a comparison sample of non-farmworkers (n=247) 18+ years and self-identified Latino/Hispanic were recruited in North Carolina with the help of community partners. Non-farmworkers were restricted to those with no occupational pesticide exposure in the previous 3 years. Odor identification and odor threshold tests were administered in a clinic setting and analyzed using logistic and linear regressions, adjusting for age, gender, and smoking. Lifetime pesticide exposure was obtained using the NINDS common data elements questionnaire to confirm group pesticide exposure differences. The total sample was 84% male, 23% current smokers, and 97% born in Latin America. Farmworkers and non-farmworkers did not differ in odor identification performance (p=0.6726). However, non-farmworkers detected a standard odor at significantly lower concentrations than did farmworkers (p<.0001). Farmworkers display significant non-selective impairment in olfactory function, compared to non-farmworkers. These results suggest that subclinical markers signal neurological effects before neurodegenerative diseases can be detected. Such data could be important in demonstrating health consequences of occupational pesticide exposure.

Anthropology News, Sep 1, 1987

American Anthropological Association eBooks, 1986

... Availability number, 9001632. Serial Title, A Special publication of the AmericanAnthropologi... more ... Availability number, 9001632. Serial Title, A Special publication of the AmericanAnthropological Association (USA). Serial number, no. 20. ... Email: access@nal.usda.gov. URL: http://www.nal.usda.gov. AGRIS 2010 - FAO of the United Nations.

Social Science & Medicine, 1986

This paper describes the range and patterning of variation in specific breast-feeding behaviors a... more This paper describes the range and patterning of variation in specific breast-feeding behaviors among a sample of 62 American mothers, as well as the relationship of the patterns to duration of exclusive breast feeding. Infant feeding data were collected using 24-hr records completed by mothers every 8 days through the first 6 months post purtum. Behaviors examined were: number of daily feedings, minimum and maximum intervals between feedings, length of feedings and total daily nursing duration. Variation in magnitude of these behaviors ranged from three-to eight-fold. Principal components analysis found this variation patterned in two dimensions, relating to feeding frequency and length of time spent breast feeding. These dimensions accounted for approximately equal proportions of variance in the breastfeeding behaviors, totaling about 80% of all variance at 4 and 8 weeks. There was significant continuity of breast-feeding styles practiced by any one woman from 4 to 8 weeks. The feeding frequency dimension was strongly associated with duration of exclusive breast feeding. Three explanations-cultural, biological and biocultural-are proposed to account for this association. It is argued that the intracultural variation in breast-feeding styles in this sample may be sufficient to cause corresponding variation in breast milk production, in part accounting for variation in duration of exclusive breast feeding. Predictions of exclusive breast-feeding duration will be most accurate for women with a breast-feeding style of infrequent feedings, while predictions for women with a style of frequent feeding will be confounded by cultural factors which have an independent effect on breast-feeding supplementation.

American Journal of Physical Anthropology, Apr 1, 1983

The relationship between maternal fatness and infant feeding practices was studied in 46 healthy ... more The relationship between maternal fatness and infant feeding practices was studied in 46 healthy Caucasian women from parturition to 6 months postpartum. Mothers reported infant feeding practices in diary form throughout the study. Weight, triceps and subscapular skinfolds, and midarm circumference were measured on seven occasions. Upper arm fat area was computed. All women breast fed their infants for at least 5 months, with no nonbreast milk food introduced for at least 2 months. All women had declining or stable postpartum weights. Linear regressions of upper arm fat area on days since parturition were used to ascertain overall direction of change in adiposity for each woman. Declining fat area occurred in 17 cases and was associated with a breast-feeding pattern of short frequent feeds. In the remaining 29 cases, increasing fat area was associated with significantly longer and less frequent feeds. It is hypothesized that these different fat change patterns result from differential activity of adipose tissue lipoprotein lipase, which is itself mediated by serum prolactin concentration. Relevance of these findings for resolution of the controversy surrounding the critical body composition hypothesis and lactation amenorrhea is discussed.

Osteoporosis International, Sep 21, 2004

This review assessed alendronate for preventing hip fractures in postmenopausal women. The author... more This review assessed alendronate for preventing hip fractures in postmenopausal women. The authors concluded that alendronate was associated with reductions in hip fracture rates in women with postmenopausal osteoporosis. The evidence presented in the review appears to support the authors' conclusions, but poor reporting of the review methods means that the reliability of the conclusions is unclear. Searching MEDLINE, EMBASE and the Cochrane CENTRAL Register were searched using the reported keywords. In addition, the Merck database was searched for unpublished studies. Study selection Study designs of evaluations included in the review Randomised controlled trials (RCTs) were eligible for inclusion. The duration of the included studies ranged from 1 to 4.5 years. Specific interventions included in the review Studies of alendronate were eligible for inclusion. Most of the included studies compared between 5 and 20 mg/day alendronate with placebo; one of the included studies compared alendronate plus calcium with calcium alone. Participants included in the review Studies of postmenopausal women with a T-score of-2.0 or less, or with a vertebral fracture, were eligible for inclusion. The majority of the included studies were in women with a T-score of-2.0 or less at the femoral neck or lumbar spine, with and without prevalent vertebral fracture. One study included women with a prevalent vertebral fracture and a T-score of-1.6 or less at the femoral neck. One of the included studies was in women in a long-term care facility. Most of the participants were Caucasian and ages ranged between 39 and 91 years. Outcomes assessed in the review Studies that presented sufficient data to permit calculation of the relative risk (RR) of hip fracture were eligible for inclusion. How were decisions on the relevance of primary studies made? Data extraction The authors did not state how the data were extracted for the review, or how many reviewers performed the data

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014), Nov 17, 2014

ABSTRACT Dental impairments in older adults are frequently accompanied by reduced dietary quality... more ABSTRACT Dental impairments in older adults are frequently accompanied by reduced dietary quality and nutritional status. Even with dental repair, dietary quality usually remains low. This study aims to: (1) evaluate the impact on dietary quality of an intervention among African American and White older adults with self-reported oral health problems and related eating constraints; and (2) identify characteristics of participants for whom the intervention produced positive change in dietary quality. Community-dwelling adults (n=38) experiencing oral health problems and eating constraints were enrolled in a 6-month individualized dietary intervention; evaluation used a pre-post design. The intervention used tailoring and goal setting to promote dietary intake consistent with the Dietary Guidelines for Americans. The primary outcome, dietary quality, was measured by the Health Eating Index 2010 (HEI) calculated from the NCI Diet History Questionnaire. HEI includes a total score (range 0 to 100) and 12 subscales. 35 participants completed the intervention (median age=69). Mean total HEI scores improved from 67.1 (±10.1) to 72.7 (±7.4) (p=0.0037). Significant improvements were seen in 6 subscales: total fruit (p=0.0106), whole grains (p=0.0135), dairy (p=0.0332), total protein foods (0.0107), seafood/plant proteins (0.0104), and empty calories (0.0133). 25 participants had positive change scores for total HEI. Positive HEI change was greater among those with low baseline HEI and poorer oral health status. Change in HEI was unrelated to age, sex, or ethnicity. Significant dietary improvement is possible among older adults with oral health deficits. Randomized trials are needed to confirm these findings and extend evaluation to clinical populations.

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014), Nov 17, 2014

ABSTRACT Reports of food insecurity for farmworker households have found 50-80% food insecure. Ho... more ABSTRACT Reports of food insecurity for farmworker households have found 50-80% food insecure. However, most measure difficulty obtaining enough food over a 12-month period. For workers whose income may fluctuate seasonally, this long recall period makes it difficult to know whether reported food insecurity is episodic or chronic. The goals of this study were to (1) describe within-household variation in food security over four quarters, and (2) identify predictors of episodes of food insecurity. The USDA Food Security Module was administered quarterly over one year to 231 Latino farmworker families with children 2-3 years at baseline. Families were recruited in North Carolina (28% migrant; 72% seasonal). In total, families contributed data for 834 quarters in 2011-13. Low or very low food security (“food insecurity”) was reported for 24.6% of quarters. Food insecurity was concentrated in about half of the families, with less than 10% reporting food insecurity during all quarters. In logistic regression predicting food insecurity, being migrant (vs. seasonal) and reporting a move during the quarter increased the odds of being food insecure in any quarter, while using diverse food sources (e.g., gardening, fishing), having more children, and the child obtaining meals at childcare (e.g., Migrant Head Start) or school decreased the odds of being food insecure. Season of the year, parental employment, and household size were not associated with food insecurity. These findings suggest that food insecurity in farmworker families is largely episodic, not chronic. These findings help identify farmworker families most likely to need food or income assistance.

141st APHA Annual Meeting and Exposition (November 2 - November 6, 2013), Nov 4, 2013

ABSTRACT Preschool age children of Latino farmworkers are at risk for early childhood caries and ... more ABSTRACT Preschool age children of Latino farmworkers are at risk for early childhood caries and subsequent oral health (OH) problems; many face significant barriers in accessing dental care. We compare OH and hygiene between migrant and seasonal farmworker children and note disparities between maternal knowledge and practices. The Nios Sanos Study is a cohort (N=248) of mothers and preschool age children from migrant and seasonal farmworker families recruited in North Carolina. Mothers reported the child's OH condition, hygiene behaviors, and professional care, as well as their beliefs about child OH in response to the Behavioral Risk Factor Questionnaire of the NIDCR Centers for Research to Reduce Disparities in Oral Health. At interview, children averaged 44.3 7.4 months. Migrant mothers rated their child's OH condition and OH-related quality-of-life significantly worse than did seasonal mothers. 87% of children had ever had teeth examined by a healthcare provider, and 83% had had fluoride varnish applied in the previous year; rates did not differ between migrant and seasonal families. Children enrolled in Head Start were more likely to have had examinations and varnish applied than those not in Head Start. Mothers exhibited high levels of knowledge of proper child oral hygiene, but rates of recommended practices were substantially lower. Farmworker families, particularly migrants, frequently live in crowded, substandard housing and share facilities with other families. Steps to help families achieve appropriate OH practices should prioritize behaviors and problem-solve with mothers ways to best meet child OH needs in the context of farmworker living conditions.

Springer eBooks, 2020

Migrant and seasonal farmworkers experience substantial stress resulting from their difficult wor... more Migrant and seasonal farmworkers experience substantial stress resulting from their difficult work, low income, separation from family, experiences of discrimination, and poor housing. This chapter is centered on a stress/distress model. This model posits that stressors are both structural and situational. Stress levels can be countered by positive or negative coping behaviors. Distress results from chronic, unmitigated stress and may contribute to mental health conditions such as depression, anxiety, and alcohol use disorders. The chapter summarizes the current sparse literature on mental health research among farmworkers in the eastern United States. Symptom levels for anxiety and depression are highly variable, with studies reporting 0–23% prevalence for anxiety and 7–52% for depression. Alcohol use disorders are common, particularly among men, with most studies reporting more than 30% prevalence. Although variable, the evidence suggests that farmworkers in the eastern US have a substantial burden of mental distress that is untreated. Future directions for research, practice, and policy are suggested.

Cambridge University Press eBooks, Dec 7, 2000

Social Science & Medicine, 1984

The 'critical body composition hypothesis' (CBCH) is frequently used to explain variations in the... more The 'critical body composition hypothesis' (CBCH) is frequently used to explain variations in the duration of postpartum amenorrhea. The hypothesis predicts that ovulation will not occur if fat reserves fall below a critical threshold. This paper attempts to analytically separate the CBCH from the broader concept of nutritional thriftiness on which it is based. A review of previous research on fat cell metabolism and ovulation finds no direct link between fatness and fecundity. Rather they are each regulated by lactation and mother-infant interactions associated with breast feeding. As a system which delivers available fat into breast milk and prevents ovulation only during the time when the infant is dependent on the mother, the pathways outlined here represent a nutritionally thrifty method of fertility regulation, one which maximizes reproductive success while minimizing energy investment. The cultural patterning both of infant feeding behaviors and the wider range of maternal activities which affect breast feeding suggest specific testable hypotheses to explain interpopulation variations in fertility and infant nutritional status.

Springer eBooks, 2009

... At the community level, farmworker communities in the eastern US are often located in rural a... more ... At the community level, farmworker communities in the eastern US are often located in rural areas isolated spatially and ... Or, if the entire family migrates, the child will migrate as well, a practice that can have negative ... Among newly arrived farmworkers, only 10% are women. ...

Journal of Applied Gerontology, Jun 1, 2000

Older adults are vulnerable to nutrition-related health problems due to health and psychosocial c... more Older adults are vulnerable to nutrition-related health problems due to health and psychosocial changes that accompany aging. Those in rural communities face additional problems. This study characterizes the nutritional risk of rural older adults using the Nutritional Risk Index (NRI), paying particular attention to gender differences in risk. Data come from face-to-face interviews with a random sample of 638 White rural adults aged 55 and older. Women scored significantly higher on the NRI, indicating greater nutritional risk. Women were more likely to report NRI items related to oral health, special diets, disease interference with eating, gastrointestinal problems, and anemia, whereas men were more likely to report smoking regularly. A comparison with the application of the NRI in other populations indicates that it is sensitive to nutrition-related health conditions that may be more prevalent in rural populations, making it a useful tool for measuring nutritional risk. Achieving adequate nutrition in older adults is important for both health and quality of life. Nutritional status has been linked to immune function and infectious disease risk (Bell & High, 1997; Roebothan & Chandra, 1994) as well as to morbidity and mortality (Casper, 1995; Mowé & Bøhmer, 1996; Sullivan & Walls, 1994). Eating regular meals and familiar foods enhances feelings of well-being for older persons (Quandt, Vitolins, DeWalt, & Roos, 1997). However, both the biological and social aspects of nutrition are frequently harder to achieve in older adults than in younger adults. Chronic diseases characteristic of aging alter nutrient and food requirements (Casper, 1995; Cohen, 1994). Oral health problems and prescription drug use can result in changes in taste and appetite (Mowé & Bøhmer, 1996; Roe, 1994). Changes in social contact, mobility, and income can lead to problems in obtaining appropriate food (Miller et al.

Mayo Clinic Proceedings, Mar 1, 2005

JAMA, Dec 27, 2006

STEOPOROSIS IS COMMON among postmenopausal women, and the disease process is characterized by inc... more STEOPOROSIS IS COMMON among postmenopausal women, and the disease process is characterized by increased bone turnover, progressive loss of bone mass, microarchitectural deterioration, and increased fracture risk. Bisphosphonates, which are antiresorptive drugs, are the most commonly used pharmacologic treatments for postmenopausal osteoporosis. Alendronate, a potent bisphosphonate, decreases bone turnover, increases bone mineral density (BMD), and decreases vertebral, nonspine, and hip fracture risk in women with osteoporosis. 1-4 For editorial comment see p 2968. Author Affiliations and Members of the FLEX Research Group are listed at the end of this article.

Journal of Applied Gerontology, Dec 1, 1996

This is the 15th volume in a series designed to synthesize perspectives on aging, from medicine t... more This is the 15th volume in a series designed to synthesize perspectives on aging, from medicine to the social and behavioral sciences to policy. The inclusion of a volume on nutrition is timely, because nutrition is increasingly recognized as both a predictor of outcomes in the aging process and a point of intervention for health promotion of older persons. The volume includes eight topical chapters and an introduction. There is considerable variation in the depth with which topics are reviewed and in the extent to which reviews evaluate the state of research. Several of the chapters are quite strong. Mary-Margaret Wilson and John Morley review the diagnosis and management of protein-energy malnutrition (PEM). The chapter includes a discussion of the tech-

Reviews in Anthropology, Aug 1, 1995

... of the authors in Diet and Disease take as given that variation in the presence of nutrient-l... more ... of the authors in Diet and Disease take as given that variation in the presence of nutrient-linked diseases reflects variation in diet, Richard Burghart draws ... Hendrickse, RG 1984 The Influence of Aflotoxins on Child Health in the Tropics with Particular Reference to Kwashi-orkor. ...