Background: Fatty acids (FA) have a role on energy storage and membrane formation. FA consists of an aliphatic chain with varying number of carbon and a carboxylic functional group. Perfluorooctanoic acid (PFOA) exhibits a similar structure to that of the FA. Given their structural resemblance, we hypothesized that alterations in FA metabolism could arise from competition with PFOA for endogenous FA binding sites in transport and with FA binding proteins. Objectives: Explore associations of serum concentrations of perfluorooctanoic acid (PFOA) with serum concentrations of linoleic (LA), eicosapentanoic (EPA), and docosapentanoic (DHA) acid in adults. Methods: We analyzed data from 1,829, 20-80 years old participants in the 2003–2004 National Health and Nutrition Examination Survey (NHANES). Linear regression models were used to estimate adjusted predicted means of the FA (in µmol/L) for quartiles of PFOA (in ng/mL) and explore linear trends. Results: Increasing concentrations of PFOA were not associated with adjusted predicted means of serum LA (Q1 3534, Q2 3445, Q3 3778, Q4 3399) (p trends=0.6460). Increasing concentrations of PFOA, however, were associated with increasing trends in adjusted predicted means of serum EPA (Q1 49.8, Q2 51.5, Q3 60.9, Q4 55.7).

The 2004 Canadian Community Health Survey (CCHS) revealed many indicators of poor diet quality in Canada which, together with the high rates of obesity and diet-related chronic disease, suggest that shifts in dietary patterns are urgently needed. Given the widespread promotion of foods on the basis of nutrition and health, the aim of this work was to explore the population health implications of voluntary food fortification and nutrition-related marketing in Canada. Using the CCHS, the potential impact of a proposed discretionary food fortification policy on nutrient inadequacies and excesses was examined, in addition to the relationship between consumption of foods eligible to be fortified under this policy and indicators of dietary quality. To better understand the potential risk associated with liberal fortification practices, the National Health and Nutrition Examination Survey (2007-08) was used to examine potential for risk of excess associated with voluntarily fortified food consumption in the US, where these practices have long been permitted. The results suggest that proposed changes to voluntary fortification may reduce inadequacy and increase excess, and may reinforce poor diet patterns. Excessive nutrient intakes were also found to be associated with consumption of voluntarily fortified foods in the US, particularly among children. Therefore, there appears to be real potential for risk associated with voluntary fortification practices in Canada. The extent, nature, and population health implications of nutrition marketing in Canada was examined, using a survey of front-of-package nutrition-related marketing on foods within three large grocery stores in Toronto. Nutrition-related marketing was found on 41% of all foods surveyed, and was widely found on highly processed, often fortified foods. References to nutrients of public health concern (e.g. sodium, vitamin D) were infrequently found. Overall, this practice provides limited nutritional guidance. Current directions in nutrition policy in Canada should be re-evaluated, to ensure that they support healthy diet patterns.

Abstract Objectives: To establish the prevalence of lower serum selenium status (<106 ng/ml) among the adult white American male population, to determine whether certain social, economic, geographic, physical, and dietary characteristics are risk factors for lower selenium status, and to identify a selenium augmentation strategy for white adult men deficient in this trace element. Design: An exploratory cross-sectional study using nationally representative data from the National Health and Nutrition Examination Survey III, 1988-1994 (NHANES III). Methods: 2989 white men, aged 20 or greater in the NHANES III dataset had recorded serum selenium values. These men were divided in two groups based on selenium status, those with values of less than 106 ng/ml (n=288) and those with a status greater than or equal to 106 ng/ml (n=2701). Various demographic, physical, and dietary variables were then compared between the two selenium status groups in a bivariate analysis. Multiple logistic regression was then performed to assess possible risk factors for lower selenium status. Results: This study estimated that 7.7% of white American adult men aged 20 years and older, a total of 4,751,618 individuals, had a selenium status less than 106 ng/ml. Several, of the more than forty, social, economic, geographic, physical and dietary characteristics examined were shown to be significantly associated with a lower selenium status. Risk factors for lower selenium status (<106 ng/ml) were, smoking, living in the Southern census region, being in either the 20-39 or the 60 years or older age groups, exercising less than their peers, having a lower income, and not consuming dark bread. Conclusion: It would appear that certain physical, geographic, dietary and demographic characteristics are significantly associated with lower selenium status. While, this work was unable to identify a suitable selenium fortification vehicle to reduce the prevalence of lower selenium status, it did identify risk factors that may contribute to this condition.

The 2004 Canadian Community Health Survey (CCHS) revealed many indicators of poor diet quality in Canada which, together with the high rates of obesity and diet-related chronic disease, suggest that shifts in dietary patterns are urgently needed. Given the widespread promotion of foods on the basis of nutrition and health, the aim of this work was to explore the population health implications of voluntary food fortification and nutrition-related marketing in Canada. Using the CCHS, the potential impact of a proposed discretionary food fortification policy on nutrient inadequacies and excesses was examined, in addition to the relationship between consumption of foods eligible to be fortified under this policy and indicators of dietary quality. To better understand the potential risk associated with liberal fortification practices, the National Health and Nutrition Examination Survey (2007-08) was used to examine potential for risk of excess associated with voluntarily fortified food consumption in the US, where these practices have long been permitted. The results suggest that proposed changes to voluntary fortification may reduce inadequacy and increase excess, and may reinforce poor diet patterns. Excessive nutrient intakes were also found to be associated with consumption of voluntarily fortified foods in the US, particularly among children. Therefore, there appears to be real potential for risk associated with voluntary fortification practices in Canada. The extent, nature, and population health implications of nutrition marketing in Canada was examined, using a survey of front-of-package nutrition-related marketing on foods within three large grocery stores in Toronto. Nutrition-related marketing was found on 41% of all foods surveyed, and was widely found on highly processed, often fortified foods. References to nutrients of public health concern (e.g. sodium, vitamin D) were infrequently found. Overall, this practice provides limited nutritional guidance. Current directions in nutrition policy in Canada should be re-evaluated, to ensure that they support healthy diet patterns.

Thesis (Masters) -- The College of Saint Elizabeth, 2009. / Typescript. Available at The College of Saint Elizabeth - Office of Graduate Programs. "October 2009"

Of the 3.5 million persons infected with chronic HCV in the United States, the African American population is the largest racial group with chronic HCV. Disparities in access to care and treatment involve a complex set of individual, interpersonal, socioeconomic, and environmental factors that influence the course of HCV infection in the African American population, resulting in poorer outcomes and survival. Drawing upon both the theory of reasoned action and the theory of planned behavior, this study was conducted to determine whether the seeking of health care by HCV-positive African Americans and the responses of health care providers to HCV-positive African Americans had improved since 2008 following the introduction of new treatment options, as compared to other HCV-positive racial/ethnic groups, using secondary data analyses with survey datasets from the National Health and Nutrition Examination Survey, 2005-2012. Using chi-square test of difference and logistic regression analyses, the study did not identify a statistically significant relationship between health care seeking behavior and responses from health care providers for HCV-positive African Americans before (2005-2008) and after (2009-2012) the introduction of new treatment options as compared to other HCV-positive racial/ethnic groups. Given the ongoing development of new and improved drugs to treat HCV infection, further research might focus on the HCV-infected population as a whole to ascertain whether differences exist as compared to earlier therapies before 2013. This study may drive social change within the health care community by raising awareness of the risks of HCV infection resulting in less provider bias and the introduction of resources into the African American and underserved communities that will improve outcomes and reduce barriers to care.

Disparities exist in the recognition and treatment of depression among Hispanics in the United States, creating a social, ethical, economic, and public health burden. This study was designed to generate an improved understanding of the causes of and/or contributors to depression within this population. It was specifically designed to 1) assess the prevalence and severity of depression among Hispanic adults in the United States relative to adults of other race/ethnicities in the United States; 2) clarify the inconsistent results in the literature concerning the relationship between acculturation and depression among Hispanic adults in the United States; and 3) fill a gap in the literature by evaluating the potential for inflammation to mediate the relationship between acculturation and depression among Hispanic adults in the United States. The biopsychosocial model was used as a theoretical foundation for this study. Data from the 2009-2010 National Health and Nutrition Examination Survey were analyzed descriptively and via logistic regression. Findings confirmed higher prevalence of depression among Hispanic adults compared with non-Hispanic White adults, and that a lower degree of acculturation was consistently associated with a decreased likelihood of depression among Hispanics. No mediating effect of inflammation on the relationship between acculturation and depression was observed. The findings from this study are intended for use by health care providers, health educators, and public health practitioners to improve depression prevention, diagnosis, and treatment opportunities within this population and to accordingly to affect positive social change.

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