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Overweight and obesity are a growing national concern, particularly among women and selected minority populations (Ayala, Elder, Campbell, Slymen, Roy, Engelberg, et al., 2004; NHANES, 2003). Pregnant women bear a disproportionate risk of becoming overweight or obese (Greene, Smickikias-Wright, Scholl, & Karp, 1988; Gunderson et al., 2000; Rossner, 1999). Although exercise is a key factor in preventing overweight and obesity, women often decrease their exercise levels during pregnancy (McTigue, Garrett, & Popkin, 2002; Viau, Padula, & Eddy, 2002; Zhang & Savitz, 1996). Reported percentages of regular exercise during pregnancy have been documented as low as 5% in a predominately White population (Steele, 2002). Although there is ample evidence demonstrating that Hispanic women exercise less than White women during every other stage of life, little is known about how pregnant Hispanic and White women compare in exercise behaviors (Crespo, Smit, Andersen, Carter-Pokras, & Ainsworth, 2000). The purpose of this research was to study low-income White and Hispanic pregnant women to (1) determine the nature and the extent of exercise behaviors both before pregnancy and during pregnancy (2) identify factors that influence exercise behaviors (3) determine if there are differences in factors that influence exercise between ethnicities. Data were collected via a questionnaire developed by the author. A sample of 301 White and Hispanic pregnant women were recruited through the Women, Infants, and Children [WIC] agencies in four selected counties in Oregon. Although ACOG guidelines provide clear information on the benefits of exercise, over 90% of the women surveyed did not exercise at ACOG guidelines. A majority of the women, 57.8%, actually decreased exercise during pregnancy. Although ethnic differences did not exist in the prevalence of exercise during pregnancy, differences between ethnicities were found in the variety of exercise activities performed and behavioral factors that predicted exercise behavior. Analysis of these differences and the factors contributing to the overall low levels of exercise may provide critical information for future intervention program planning. Well targeted programs will ultimately decrease the excessive weight gain and subsequent increased risk for overweight or obesity that pregnant women face. / Graduation date: 2006

The health of pregnant women is a major concern to health care providers. This grounded theory study of 40 women examined the health of pregnant women and the special threat that poverty and violence posed to their capacity for health. Pregnant women experienced their health as an integrated part of their daily lives; that is, they reported that their health was affected by 'everybody and everything." Women's main concern during pregnancy was to have a healthy newborn and, to this end, they engaged in the process of creating a healthy pregnancy by engaging in health-enhancing behaviours. In this process, the woman focused primarily on ensuring the birth of a healthy baby. Three conditions were essential to a woman's capacity to create a healthy pregnancy: (1) the acceptance of the pregnancy, (2) adequate financial resources, and (3) supportive relationships (especially having a supportive partner). Pregnancies invariably carried with them some uncertainty, and this caused the 40 women in this study to experience a state of vulnerability which, in turn, triggered attempts to create healthy pregnancies. This led to a cycle of improving health: the more energy women had to carry out health-enhancing behaviours the better they felt physically and mentally; the more able they were to conduct their daily activities; and, consequently, the better their health. However, living within a context of poverty and/or violence increased pregnant women's vulnerability and decreased their capacity for creating a healthy pregnancy, leading to extreme stress and the experience of threat. Male violence threatened the women's ability to be connected to those who were important sources of emotional, financial, task-oriented, and knowledge-oriented support, and, thus jeopardized their ability to meet their fundamental needs. Furthermore, the lack of sufficient financial resources limited women's abilities to leave their abusive partners. In order to survive, women in these circumstances sometimes reverted to previous, often harmful, ways of coping in an attempt to reduce their high levels of stress. These coping strategies usually took the form of behaviours that required little energy, such as smoking, not eating properly, and consuming alcohol. Having financial support and a safe place to go were crucial with regard to enabling women to decide to leave abusive partners. Regaining control of their lives in this way allowed women to refocus their energy on health-enhancing behaviours. The women in this study showed incredible strength as they met the challenges imposed by poverty and abuse. They did not remain victims but took hold of their lives with courage and conviction. In order to promote the adoption of health-enhancing behaviours by childbearing women, health care providers must recognize poverty and violence as factors that significantly threaten women's capacity for health. Further to this, special efforts must be made to render culturally sensitive care to First Nations women (i.e., recognizing their cultural identity and heritage, their connection to nature, and the importance of the elders of their community). To this end, we must recognize the connections between racism, colonization, poverty, and violence. For until we have eradicated poverty, and the cycle of violence and degradation that is its legacy, we will not have succeeded in doing all we can to ensure the health and well being of our citizens.

The health of pregnant women is a major concern to health care providers. This grounded theory study of 40 women examined the health of pregnant women and the special threat that poverty and violence posed to their capacity for health. Pregnant women experienced their health as an integrated part of their daily lives; that is, they reported that their health was affected by 'everybody and everything." Women's main concern during pregnancy was to have a healthy newborn and, to this end, they engaged in the process of creating a healthy pregnancy by engaging in health-enhancing behaviours. In this process, the woman focused primarily on ensuring the birth of a healthy baby. Three conditions were essential to a woman's capacity to create a healthy pregnancy: (1) the acceptance of the pregnancy, (2) adequate financial resources, and (3) supportive relationships (especially having a supportive partner). Pregnancies invariably carried with them some uncertainty, and this caused the 40 women in this study to experience a state of vulnerability which, in turn, triggered attempts to create healthy pregnancies. This led to a cycle of improving health: the more energy women had to carry out health-enhancing behaviours the better they felt physically and mentally; the more able they were to conduct their daily activities; and, consequently, the better their health. However, living within a context of poverty and/or violence increased pregnant women's vulnerability and decreased their capacity for creating a healthy pregnancy, leading to extreme stress and the experience of threat. Male violence threatened the women's ability to be connected to those who were important sources of emotional, financial, task-oriented, and knowledge-oriented support, and, thus jeopardized their ability to meet their fundamental needs. Furthermore, the lack of sufficient financial resources limited women's abilities to leave their abusive partners. In order to survive, women in these circumstances sometimes reverted to previous, often harmful, ways of coping in an attempt to reduce their high levels of stress. These coping strategies usually took the form of behaviours that required little energy, such as smoking, not eating properly, and consuming alcohol. Having financial support and a safe place to go were crucial with regard to enabling women to decide to leave abusive partners. Regaining control of their lives in this way allowed women to refocus their energy on health-enhancing behaviours. The women in this study showed incredible strength as they met the challenges imposed by poverty and abuse. They did not remain victims but took hold of their lives with courage and conviction. In order to promote the adoption of health-enhancing behaviours by childbearing women, health care providers must recognize poverty and violence as factors that significantly threaten women's capacity for health. Further to this, special efforts must be made to render culturally sensitive care to First Nations women (i.e., recognizing their cultural identity and heritage, their connection to nature, and the importance of the elders of their community). To this end, we must recognize the connections between racism, colonization, poverty, and violence. For until we have eradicated poverty, and the cycle of violence and degradation that is its legacy, we will not have succeeded in doing all we can to ensure the health and well being of our citizens. / Applied Science, Faculty of / Nursing, School of / Graduate

Over the past decade, the "problem" of Fetal Alcohol Syndrome and Fetal Alcohol Effects among Aboriginal peoples has received increasing attention from the Canadian nation-state. However, few feminist, anti-racist, anti-ableist, and anti-colonial scholars have offered a critique of FAS/E "prevention" policies aimed at Aboriginal women. In this dissertation, I present my analysis of the "official knowledge" and "public pedagogies" articulated in one such policy, The First Nations and Inuit Fetal Alcohol Syndrome/ Fetal Alcohol Effects Initiative (herein "the Initiative"). This analysis unravels the complex and contradictory tensions in contemporary state policy formation. My findings show how the Initiative paradoxically supports the development of inclusive, grassroots approaches to FAS/E prevention in Aboriginal communities while at the same time eclipsing the voices and concerns of Aboriginal women. Though neglected in the official policy texts and talk of the Initiative, young Aboriginal mothers' agency and insights are central in the dialectic of ideology, discourse, and lived experience that this study documents. To facilitate this shift, I engage a productive methodological synthesis of textual analysis, institutional ethnography, and participatory research, by grounding my analysis of the texts in indepth group interviews with six Aboriginal mothers whose lives include substance use and FAS/E. This study offers significant implications for the development of future policy, research, and "culturally appropriate" pedagogy for and about FAS/E "prevention". My findings do not support the outright rejection of medical models of disability, as has been favoured by many critical theorists and activists on the grounds that such models are universally oppressive and disenfranchising. Rather, the women's insights into their own lived experiences emphasize the simultaneously enabling and disabling consequences of medicalization. Accordingly, my findings underscore the urgent need to reconsider the roles of "race", gender, class, nation and dis/ability in contemporary theories and practices of substantive citizenship and nation-building in and outside of education. / Education, Faculty of / Educational Studies (EDST), Department of / Graduate

Conclusion. We observed a small but independent effect of soy intake and lipid lowering effect, even after taking into account the other important predicting factors - initial cholesterol, body composition, physical activity, dietary intake and age. The beneficial effect between soy protein intake and lipid profile were observed even with this relatively low level of soy protein consumption suggests that the effect of soy protein supplement use on lipid profile may be much greater than those observed here. The results of our study add to the existing evidence that soy protein may be beneficial in human lipid profile. Our data will be useful for planning effective education programs as well as providing background information for further interventional studies to prevent coronary heart disease. / Coronary Heart Disease (CHD) is the major cause of death in most developed countries and is rapidly increasing in developing countries. Recent studies showed that natural menopause confers a threefold increase in CHD risk. While many risk factors, such as hypertension, diabetes mellitus, obesity and physical inactivity contribute to the risk for CHD, lipid abnormalities are the major factor. Hyperlipidemia plays a central role in the atherosclerotic process. Recent studies showed that consuming soy, a food containing large amounts of soy protein, improves the plasma lipoprotein profile by decreasing total cholesterol, LDL cholesterol, triglycerides as well as increasing HDL level. Although soy is a main component of traditional Asian food, many of the studies on soy consumption have been conducted in Caucasian populations (table 1.2), among whom soy intake is rather low or almost nil, it was difficult to explore the association of soy protein intake and lipid profile in those populations. Soy products such as tofu and soymilk are traditional Chinese foods. With the changing dietary pattern, it gives rise to a range of intake from traditional to modern and increasing incidence of cardiovascular disease Hong Kong poses a unique opportunity for the investigation of the relation between soy protein intake and lipid profile. / For baseline age stratified subgroup analysis, our study results showed no association between soy protein intake and lipid pro file in women whose baseline age younger than 55.3 years old, but we did observe a positive association in women belonging to older subgroup. In the 12-month follow up analysis, for women whose baseline age was older than 55.3 years (mean age=58.4+/-2.1), after controlling for the potential confounders, soy protein intake was significantly associated with HDL cholesterol concentration (Linear Regression p=0.033, ANCOVA=0.011, P value for trend p=0.014), total cholesterol/HDL ratio (Linear Regression p=0.045) and LDL/HDL ratio (Linear Regression p=0.037). Similar observation was observed in the yearly change rate of HDL in 24-month follow up (Linear Regression p=0.047, P value for trend p=0.043). / For women whose initial cholesterol level was higher or equal to 200mg/dL, in our 2-year longitudinal analysis, after controlling for the potential confounders, soy protein intake was significantly associated with HDL (Linear Regression p=0.041) and cholesterol/HDL ratio (ANCOVA=0.022). We also observed a statistically significant trend for higher HDL cholesterol (p=0.038), with an increase of 11.4g in soy protein intake between the 1st and 3rd tertiles, our data showed a 3.8% increase in HDL. / In the 12-month longitudinal analyses, after controlling for the potential confounders, soy protein intake was significantly associated with HDL concentration (Linear Regression p=0.036). We also observed a statistically significant trend for higher HDL cholesterol (p=0.036), with an increase of 10.9g in soy protein intake between the 1st and 3rd tertiles, our data showed a 7.9% increase in HDL. / Methods. 307 women aged between 48 to 62 years were recruited from community subjects residing in housing estates in Shatin. Women within the first 12 years of menopause, with no history of malabsorption syndromes, chronic liver kidney diseases, parathyroid diseases, gastric operation or cancer and without currently taking lipid lowering therapy were included in the study. We estimated the dietary intake of soy foods and other key nutrients by using quantitative food frequency method. We recorded serum values of fasting cholesterol, LDL cholesterol, HDL cholesterol and triglycerides as well as other covariance measurement. Soy protein consumption was categorized as tertiles of intake and related to lipid profile. / Objectives. In order to study the relation between soy protein intake and lipid profile in the early postmenopausal Chinese women in Hong Kong, we conducted the study from February 2000 to February 2002, as a part of the population-based soy consumption and bone mineral density study. The hypothesis to be tested is that high intake of dietary soy protein has a beneficial effect on lipid profile in the early postmenopausal Chinese women in Hong Kong. / Results. In our cross-sectional analysis, our findings showed that habitual dietary soy protein intake had a weak but statistically significant correlation with triglyceride concentration (Linear Regression p=0.045, ANCOVA p=0.045 P value for trend p=0.023), and the soy protein beneficial effects were more pronounced in women whose % of total body fat were higher than 33.4%. After controlling for the potential confounders, soy protein intake was significantly associated with triglyceride concentration (Linear Regression p=0.048, P value for trend =0.021), the average decrease in triglycerides were 24.6% and 29.1 % in the 2nd and 3rd tertile compared with the 1st tertile respectively. / Lam Siu Hung. / "February 2006." / Adviser: Ho Suzanne Sutying. / Source: Dissertation Abstracts International, Volume: 67-11, Section: B, page: 6300. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2006. / Includes bibliographical references (p. 181-191). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.

Background and objective. Ultrasonic evaluation of carotid intima media thickness (IMT) has been widely used as a surrogate of atherosclerosis. Few studies have specifically examined risk factors related to subclinical atherosclerosis (SA) among early postmenopausal women, in particular in the Chinese population. There is also little information on the distribution of IMT in Asian midlife women. We described the prevalence of SA, as determined by IMT and carotid plaque, and the associated risk factors in early postmenopausal Chinese women in Hong Kong. / Conclusions. Our findings showed that age, SBP, HDL-C, and LDL-C were independent predictors of IMT, while age, LDL-C, and abdominal obesity were independent predictors of the presence of plaque. The optimal IMT cutoff of 0.783 mm was defined and that a prevalence of SA (IMT ≥ 0.783 mm) of 38.6% was found among 'healthy' early postmenopausal Chinese women in Hong Kong. / Methods. 518 women aged 50 to 64 years, and within 10 years since menopause were recruited from random telephone dialing. Women with surgical menopause, established cardiovascular diseases (CVD), and severe disease conditions such as cancer and renal failure were excluded. Sociodemographic, anthropometric and lifestyle factors were obtained based on standardized questionnaires. Fasting blood sample was also obtained. B-mode ultrasound was used for measuring IMT at 12 sites of the carotid arteries and plague index, which is the sum of the grades (ranged from 0 to 3) at the 6 segments. The relations between traditional risk factors, and other potential risk factors such as inflammatory markers, as well as lifestyle factors including physical activity, dietary intake, and psychological factors with SA were also assessed. / Results. The mean IMT +/- SD was 0.76 +/- 0.12 mm, with a range from 0.53 to 1.00 mm. IMT was higher on the far wall than on the near wall (P<0.01), and differ among segments (greatest at the bulb and least at the ICA) (P<0.01). One-fifth of women had at least 1 plaque in the carotid artery with most of the plaque occurred in the bulb area. IMT increased with age, and was positively associated with carotid plaque. With the use of receiver operating characteristic curve (ROC) analysis, the optimal cutoff IMT for diagnostic plaque was 0.783 mm, at which sensitivity and specificity was 80.5% and 75.1%, respectively. The prevalence of SA was 38.6%. Among the traditional risk factors, systolic blood pressure (SBP), high density lipoprotein cholesterol (HDL-C), and low density lipoprotein cholesterol (LDL-C) were associated with high IMT. Abdominal obesity assessed by waist circumference (WC) and waist hip ratio (WHR) was also found to be positively associated with IMT. Stepwise multiple regression showed that age, SBP, HDL-C, and LDL-C were independent predictors of IMT. Multiple logistic regression showed that women with LDL-C ≥ 130 mg/dL were associated with a 2.4-fold (95% CI 1.5-3.7) higher risk of having plaque compared to those with LDL-C < 130 mg/dL. In addition, women with abdominal obesity (WHR ≥ 0.85) had a 1.7-fold (95% CI 1.08-2.67) higher risk of having plaque than women with WHR < 0.85 after adjustment for age, and potential confounders including physical activity, dietary intakes etc. Significant inverse associations were observed between physical activity and indices of obesity, as well as fasting blood glucose, while psychological perceived stress and trait anxiety were independent risk factors for both total cholesterol and LDL-C. / Yu Ho-yan. / "February 2006." / Adviser: Suzanne C. Ho. / Source: Dissertation Abstracts International, Volume: 67-11, Section: B, page: 6350. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2006. / Includes bibliographical references (p. 220-256). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.

Abstract not available

Ecuador, a country of multi-ethnic culture, has very acute health problems, especially in rural areas where two out of every three poverty-stricken Ecuadorians live. 77% of the population under 18 years of age is under the poverty level. The greater part of the indigenous population inhabits the rural areas of the Andes and the Amazon. 76% of children in the rural Andes are poor. Little Afro-Ecuadorian boys and girls also face severe disadvantages where, in the rural areas, poverty climbs above 70% of the population under 18 years of age. Academic desertion is another factor that affects especially the young women, who have to assume agricultural and communitary jobs due to the adult men's migration to the cities. In areas of indigenous population, chronic malnutrition in those who are under five years of age ascends to 65.3% while the national average reaches 49.4%. Another at-risk group is expecting mothers. Of every 1,000 births, 70 will die before living one year, and for every 100,000 births, 198 mothers die. The Province of Imbabura is rich in alimentary production and has hot, cold, and temperate climates which in turn contribute to a diversity of cultivated products. Nevertheless, the polarization of wealth and the existence of classes with low income levels lessen the possibility of acquiring good nutrition. To this is added the individual nutritional customs and beliefs of each culture that do not allow adequate nourishment in communities which are principally indigenous, Mestizo, and Black. Indigenous, Mestizo, and Black communities have very small parcels of land (minifundios or "small farms") which they cultivate with few resources and tools. This destines the majority for living conditions of extreme poverty. The majority of Mestizos are unemployed or semi-employed, have limited health services, and lack a basic sanitary infrastructure. Another minority group is the Blacks, the majority of whom cultivate fruit and legumes, who also have limited health services and a barely acceptable sanitary infrastructure. In addition, all of these people are victims of racism and federal neglect, and claim the highest rates in general, infant, and maternal mortality in the country. This reality makes difficult the development of adequate training activities which bring about the improvement of the nutritional state of the designated at-risk groups: nursing babies, children under five years of age, and pregnant women. Facing this lacerative situation, and thanks to the support of the EZRA TAFT BENSON Institute (Agriculture and Food Institute. Brigham Young University), we designed this study to determine the understanding, attitudes, and practices in nutritional traditions and beliefs of mothers of nursing babies, children under five years old, and expecting mothers. These three groups were analyzed within the three ethnic groups in the communities of Chota, La Gangotena, and Chilcapamba-communities selected randomly and because of their ethnic populations. In the mothers of the three ethnic groups, we found similar beliefs regarding certain foods. But, there are also discrepancies regarding other recommended and prohibited foods. Diets have a lack of indispensable foods such as vitamins and minerals. Even though these goods are produced in the communities, they are not administered due to stronger ancestral traditions and beliefs. This study provides profound knowledge of their nutritional traditions and beliefs, and with the results, an appropriate intervening proposition may be formulated. The proposition will permit the bettering of alimentary and nutritional conditions in nursing babies, children under five years, and pregnant women by ethnic groups. The Universidad Ténica del Norte has complied in this manner with the social commitment assigned by the State for improving the quality of life of Ecuadorians in general and of the groups studied in particular.

Bone loss among the elderly is of increasing concern to the medical community. In a study combining retrospective data on 438 women from southern Arizona and current bone mineral values determined at the one-third distal radius, the effects of premenopausal reproductive events on postmenopausal bone mineral are investigated. Among those women who reach menarche at an early age are some whose growth is not accompanied by normal height and long bone growth. These women tend to exhibit lower bone mineral density postmenopausally. In addition, the early accumulation of weight in excess of height and a later age at menarche appears to result in wider bones still observed postmenopausally. Pregnancy normally is accompanied by an acceleration of calcium accumulation in excess of the fetal demand. However, parity appears to have little significant impact on postmenopausal bone mineral status. However, women pregnant during their teens tend to accumulate a greater amount of bone than women who first become pregnant later. These benefits to the teenage mother can be lost during lactation, an impairment of the skeleton which may continue into the postmenopausal years. The skeleton appears to require a recovery period between pregnancy and lactation cycles. Inadequate recovery time, particularly when accompanied by advanced maternal age, may have adverse effects on postmenopausal bone mineral status.