Perceived Health Benefits Research Articles

Influence of green infrastructure on residents' self-perceived health benefits in Lagos metropolis, Nigeria

There is a growing body of knowledge on the health benefits of green infrastructure (GI) in the built environment. However, the aspects of GI with the most significant positive influence on human health, especially in densely populated cities in sub-Saharan Africa have not been adequately investigated. This study relied on household survey involving 1560 residents to explore the influence of GI on residents' self-perceived health benefits in Lagos Metropolis, Nigeria. The data were analysed using descriptive and multiple regression analyses. The findings revealed that around 42% of the respondents had visited green spaces more than any other type of GI, and that this had positive influence on their perceived physical, mental and psychological health and wellbeing. Access to parks; availability of well-equipped green spaces; condition, adequacy and proximity of green areas to residents' emerged as the key aspects with the most significant influence on their perceived health benefits of GI in the neighbourhoods. This study concludes that for urban population to derive maximum health benefits from GI, more attention should be given to issues of accessibility, quantity, quality and location in the provision and management of GI in urban neighbourhoods in Nigeria and beyond.

On the association between risk attitude and fruit and vegetable consumption: insights from university students in Italy

As a novel contribution, this paper explores the possible association between individual risk attitudes and consumer fruit and vegetable (FV) intake. Inspired by the literature, the study also investigates the relationship between FV consumption frequency and health consciousness, perceived health benefits, trust, and attitude towards eating the recommended five-a-day FV portions. An ordered logit model is estimated on data collected through direct interviews among university students. The results show that risk aversion has a positive effect on consumer choice to eat the recommended number of FV servings, similar to the individual health consciousness and the perception of health benefits. The results pave the way for new research that aims to provide useful evidence for the implementation of new strategies to foster people’s FV intake in compliance with the five-a-day recommendation.

Evaluating the clinical experience of a regional in-center nocturnal hemodialysis program: The patient and staff perspective.

End-stage kidney disease causes significant morbidity, mortality, and reduced quality of life. Despite improvements in conventional hemodialysis, these problems persist. In-center nocturnal hemodialysis (INHD) has been shown to be beneficial in observational studies. This report outlines a 4-year renal network experience of INHD from the patient and frontline staff perspective. Staff and patients' experiences of INHD were evaluated through two work streams. Work stream one: 12 patients who chose to stop INHD and 24 patients who chose to continue with INHD completed an anonymous survey. Work stream two: one-to-one interviews with 20 patients receiving INHD and seven staff working INHD shifts were conducted. Clinical incident reporting for conventional hemodialysis and INHD from April 2014 to December 2018 was reviewed. Work stream one: Five themes were identified; facilities, time, health and well-being, sleep, and transport. A patient "starter pack" was developed and improvements to the dialysis unit were completed. Work stream two: Patient interviews demonstrated starter packs to aid sleep were well received; sleep itself was not a single reason to discontinue INHD. Staff indicated that their greatest concern was staffing levels; although staff-to-patient ratio remains unchanged, total numbers on INHD shifts were fewer, causing concern around less colleague availability for support during an emergency. 363 clinical incidents were reported across all dialysis shifts; for conventional hemodialysis, a larger proportion were due to medical interventions, infection control, and transport; for INHD, most incidents centered around communication with patients and relatives, delays in patient transfer, and issues with medical equipment or facilities. Patients continue with INHD due to increased social time and perceived health benefits. Patient starter packs and adjustments to the dialysis unit may enhance sleep. This experience has optimized the design of the NightLife study; a randomized controlled trial evaluated the effect of INHD on quality of life.

Organic Food: Nutritional and Environmental Considerations.

1. Sumathyuthee Kamalakannan, MD* 2. Irene P. Mathieu, MD* 1. *Department of Pediatrics, University of Virginia, Charlottesville, VA The demand for organic foods has grown substantially during the past several decades. Due to the widespread perception that organic food is healthier, parents may feel compelled to buy organic instead of conventional products to provide the most nutritious option available despite the cost of organic foods being on average 10% to 40% more expensive than conventionally produced foods. Furthermore, families may be concerned about the environmental impact of conventionally produced foods. Currently there is limited evidence for the nutritional superiority of organic foods. In this article we summarize the available evidence on the differences between organic and conventional food products and describe the limitations of the evidence currently available. In general, organic foods are defined as those that are grown or produced without the use of synthetic chemicals, hormones, antibiotic agents, genetic engineering, and irradiation. In the United States consumers may find product labeling at the grocery store misleading. For instance, processed products that contain mostly but not exclusively organic ingredients can use the phrase “made with organic ingredients.” Products can also be marked “natural” if no artificial ingredient or color has been added. These labels can lead consumers to incorrectly believe that such products meet the definition of organic. This heterogeneity, and the fact that few people eat an exclusively organic diet, complicate studies to assess the health impact of organic foods. For many people, the decision to buy organic produce is rooted in its perceived health benefits. Compared with conventionally grown produce, organic fruits and vegetables have been noted to contain more minerals such as iron, magnesium, phosphorus, vitamin C, and plant metabolites such as phenols and flavonoids. These metabolites function as defense agents for plants and may also have a role in preventing human disease. However, there is wide variation in the nutrient content of produce …

Acceptance of oat-based beverages tailored for patients with cancer.

Oat-based beverages are a nutritious product with the potential to support increased nutrient intake of patients with cancer. The aim of this research was to evaluate the sensory acceptance of oat-based beverages and perceptions of oats among patients with cancer as future vehicles for nutrient delivery. In study 1, three flavors of oat-beverages were well accepted without significant difference in liking among flavors or serving temperature, or between patients with cancer and healthy participants. Patients with cancer more frequently rated the beverages as too sweet compared to healthy participants; flavor intensity was just about right for all participants. In the second study, one of two formulations fortified with protein and fish oil was not different in liking compared to the unfortified chocolate product. Patients associated oat food products with specific oat-based food products and oat health benefits in a free-word association task in the third study. Together, sensory acceptance and the perceived health benefits of oats indicate the potential for oats to be incorporated in fortified and unfortified products tailored for patients with cancer. PRACTICAL APPLICATION: The three studies presented here to assess the sensory acceptance of oat-based beverages and perceptions of oats among patients with cancer demonstrate that oats can be incorporated in fortified and unfortified products tailored for patients with cancer. Inadequate nutrition is highly prevalent among oncology patients and there is a lack of available products targeted to improve their nutritional intake. These findings can support product developers and sensory scientists in the development and evaluation of food products acceptable to this population.

Views on Exercise Among Black Women During Pregnancy

ObjectiveTo describe and understand exercise practices, beliefs about exercise, support for exercise, barriers to exercise, and preferences for a group exercise program in the context of individual and environmental factors among Black women during pregnancy. DesignMixed-methods design. SettingLarge university-affiliated urban midwifery practice. ParticipantsFourteen Black women who were pregnant. MethodsWe conducted semistructured interviews to determine participants’ exercise practices, beliefs about exercise while pregnant, exercise support and barriers, and preferences for a group pregnancy exercise program. Participants also completed self-report measures for exercise, neighborhood environment, symptoms of depression, and sociodemographic characteristics. We used matrices to facilitate integrated analysis of the interview and self-report data to determine areas of concordance and discordance among the data sources and to note patterns in the data. ResultsWe identified and described themes that represented concepts in our data: Exercise Misinformation and Folklore, Supportfor Exercise While Pregnant, Barriers to Exercise While Pregnant, Perceived Health Benefits, and Exercise Program Preferences. Data diverged for some participants on neighborhood as a barrier to exercise. Except for the two participants with high levels of symptoms of depression, data converged regarding symptoms of depression as a barrier to exercise. ConclusionHealth care providers can successfully promote exercise if they provide education about exercise during pregnancy, help pregnant women overcome barriers to exercise, prompt women to exercise with partners for tangible and social support while pregnant, and refer women to exercise programs for pregnant women if available.

LC-ESI-QTOF-MS/MS Profiling and Antioxidant Activity of Phenolics from Custard Apple Fruit and By-Products

Custard apple is an edible fruit grown in tropical and subtropical regions. Due to its abundant nutrient content and perceived health benefits, it is a popular food for consumption and is utilized as a medicinal aid. Although some published research had provided the phenolic compound of custard apple, the comprehensive phenolic profiling of Australian grown custard apple is limited. Hence, this research aimed to evaluate the phenolic content and antioxidant potential by various phenolic content and antioxidant assays, followed by characterization and quantification of the phenolic profile using LC-ESI-QTOF-MS/MS and HPLC-PDA. African Pride peel had the highest value in TPC (61.69 ± 1.48 mg GAE/g), TFC (0.42 ± 0.01 mg QE/g) and TTC (43.25 ± 6.70 mg CE/g), followed by Pink’s Mammoth peel (19.37 ± 1.48 mg GAE/g for TPC, 0.27 ± 0.03 mg QE/g for TFC and 10.25 ± 1.13 mg CE/g for TTC). African Pride peel also exhibited the highest antioxidant potential for TAC (43.41 ± 1.66 mg AAE/g), FRAP (3.60 ± 0.14 mg AAE/g) and ABTS (127.67 ± 4.60 mg AAE/g), whereas Pink’s Mammoth peel had the highest DPPH (16.09 ± 0.34 mg AAE/g), RPA (5.32 ± 0.14 mg AAE/g), •OH-RSA (1.23 ± 0.25 mg AAE/g) and FICA (3.17 ± 0.18 mg EDTA/g). LC-ESI-QTOF-MS/MS experiment successfully characterized 85 phenolic compounds in total, encompassing phenolic acids (20), flavonoids (42), stilbenes (4), lignans (6) and other polyphenols (13) in all three parts (pulp, peel and seeds) of custard apple. The phenolic compounds in different portions of custard apples were quantified by HPLC-PDA, and it was shown that African Pride peel had higher concentrations of the most abundant phenolics. This is the first study to provide the comprehensive phenolic profile of Australian grown custard apples, and the results highlight that each part of custard apple can be a rich source of phenolics for the utilization of custard apple fruit and waste in the food, animal feeding and nutraceutical industries.

Consumers' perception and purchase behaviour of meat in China

China has experienced significant economic growth in recent decades, and this has accounted for an increase in meat consumption. Therefore, it is important to understand the underlying factors of consumers' perception and purchasing behaviour of lamb meat in China. This study adopts a conceptual framework, which includes expectations, perception, and purchase behaviour of red meat among Chinese consumers. A total of 31 questions were included in a self-administered questionnaire through an online platform, with 601 meat consumers who participated in this study. Results showed that Australian and New Zealand meat were perceived as having positive quality characteristics (e.g. natural, reliable) followed by Chinese local meat. Partial Least Squares Path Modelling (PLS-PM) further identified that the key drivers that influenced meat purchase were seasonality, purchase location, and consumer experience particularly in cooking methods used. Purchase point for Chinese consumers were equally weighed with butchers, supermarket, and traditional market as being the most common purchase locations. Unexpectedly, Chinese consumers were found to consume less meat in summer and more during winter. Purchase drivers included meat safety certification and the perceived health benefits of meat.

Severe Hypercholesterolemia in Very-Low-Carbohydrate Diet

There is growing popularity and interest in very-low-carbohydrate (VLC) diets for a variety of established and perceived health benefits. While some impacts have been seen in cardiometabolic diseases such as diabetes, hypertension and short-term weight loss (particularly when paired with caloric restriction), other effects such as in energy levels, mood and sense of well-being are variable. In the extreme, these diets suggest restriction of dietary carbohydrates (CHO) to less than 20 grams daily and often encourage a compensatory increase in dietary fat to promote ketogenesis. There has been concern about the long-term effects of these changes, as well as unintended consequences of increased saturated fat intake. A minority of patients, such as in the case below, may experience exaggerated lipid changes, thought to be influenced by underlying metabolic and genetic factors. Meta-analyses have shown conflicting results of the effects of VLC diets on low density lipoprotein cholesterol (LDL-C) levels.A 63-year-old woman presented for outpatient consultation for markedly elevated LDL-C 524 mg/dL. The rest of her lipid panel was as follows: total cholesterol 637 mg/dL, triglycerides 152 mg/dL, HDL-C 83 mg/dL. She was asymptomatic. Record review of annual laboratory testing from her primary care physician revealed baseline LDL-C 114–134 mg/dL between 2012 and 2017. Her lipid panel in 2017 was as follows: total cholesterol 216 mg/dL, triglycerides 82 mg/dL, HDL-C 68 mg/dL, LDL-C 132 mg/dL. She described that in late 2017 she began a VLC diet for perceived metabolic benefits, and in the past year intensified CHO restriction to less than 15 grams daily. In 2018–2019, her LDL-C level increased to 303–316 mg/dL, and in 2020 to 524 mg/dL.She had no history of diabetes, liver or kidney disease, nephrotic syndrome, hypothyroidism or alcohol use. She took no prescribed medications. She reported over-the-counter use of magnesium and potassium. She denied use of any other supplements or herbal remedies. Her past medical history included osteoarthritis. Her family history included hyperlipidemia in her mother, and coronary artery disease in both parents with age of onset in their 70s. She was a lifelong non-smoker and did not drink alcohol. Her BMI was 21.5. On examination, she was normotensive, euthyroid-appearing, and had no stigmata of familial hypercholesterolemia. Other labs were grossly normal, including blood counts, comprehensive metabolic panel, thyroid function tests, hemoglobin A1c and urinalysis. She was counseled extensively regarding her laboratory results and concerns about her cardiovascular safety.This case demonstrates an exaggerated lipid response to a VLC diet, and supports the National Lipid Association scientific statement Class IIa recommendation to obtain baseline and follow-up lipid profiles in patients who follow such diets due to variation in lipid response.

Does a Supplement Cocktail a Day Keep the Doctor Away? An Unusual Case of Alcohol Induced Diabetes Mellitus: A Case Report and Review of Literature

Background: Currently there are no evidence-based medical recommendations to support the use of supplements in type 1 diabetes mellitus (DM), although there is some data that supports glucose lowering in type 2 DM with supplements such as cinnamon. Additionally, there is no evidence regarding the use of supplements in insulin-dependent DM secondary to pancreatic dysfunction from alcohol use disorder. Despite lack of clear evidence, it is estimated that more than 65% of Americans with DM use at least one dietary supplement for perceived health benefits. (1)Clinical Case: A 58-year old male presented with insulin-dependent DM secondary to pancreatic dysfunction from alcohol use disorder. Initial labs were significant for a low C-peptide of 0.13 ng/mL (0.80–3.85 ng/mL), A1c -9.4%, and blood glucoses ranging from 160–300 mg/dL. Patient’s DM regimen consisted of glargine 40 units nightly and aspart 12 units three times a day with meals. On a subsequent visit two months later, the patient stated that he had begun taking numerous supplements in hopes that these would improve his overall medical status. Supplements included Blood Boost Formula, Ultra K2 with MK-7, Chromium Picolinate, Male Enhancement, Super C Immune Complex, Nugenix Total-T, Niacinamide, Omega Q Plus Max, Cortisol Hormone Balancer, and Vitamin D3. Simultaneously, the patient self-discontinued all his maintenance medications except for his aforementioned insulin regimen due to the fear of negatively impacting his pancreas. Unexpectedly, his blood glucoses improved to a range of 90–150 mg/dL after being on these supplements without increasing his insulin dose. Upon literature review, three ingredients showed the most evidence for the possible explanation for his improvement in glucose control: L-arginine, nettle extract, and biotin with chromium. Conclusion: Literature review of in vivo and randomized, placebo-controlled studies demonstrated mechanisms of action for L-arginine, nettle extract, and biotin with chromium that indicate their potential role in lowering blood glucoses and increasing C-peptide levels in insulin-dependent DM secondary to pancreatic dysfunction from alcohol use disorder. Further investigations include exploring long-term impact on pancreatic function, glucose control, and insulin resistance. Reference: (1) Garrow, D., Egede, L. Association Between Complementary and Alternative Medicine Use, Preventive Care Practices, and Use of Conventional Medical Services Among Adults with Diabetes. Diabetes Care 2006 Jan; 29(1): 15–19.

Perceived Social Norms as Determinants of Adherence to Public Health Measures Related to COVID-19 in Bali, Indonesia.

Introduction: Before the widespread availability of an effective COVID-19 vaccine, it is crucial to control the rate of transmission by ensuring adherence to behavioral modifications, such as wearing masks, physical distancing, and washing hands, all of which can be implemented as public health measures. Focusing on the conditions in Bali, this study explored the level of compliance to public health measures targeted at COVID-19 and identified the determinants of compliance via the values, rules, and knowledge approach.Materials and Methods: This cross-sectional study conducted an online survey using the Google Form application from June 29 to July 5, 2020. The minimum required sample size was 664. Inclusion criteria were set as follows: 18 years of age or older and residing in Bali during the data collection period. Adherence was measured based on nine protocol indicators that were rated using a four-point Likert scale. A multiple linear regression analysis was then conducted to determine the associated factors of adherence to public health measures.Results: Of the 954 survey respondents, data from 743 were included for analysis. The average level of adherence to public health measures was 32.59 (range of 20–36). The linear regression analysis showed that perceived health benefits from public health measures, being female, and having COVID-19 test histories were significantly associated with adherence to public health measures.Conclusions: For public health measures targeted at COVID-19, adherence was strongly associated with perceived social norms, in which individuals played social community roles by adapting to standardized public health measures. It is thus imperative for governments to support and monitor public health measures during the COVID-19 pandemic.

Functional and Bioactive Properties of Protein Extracts Generated from Spirulina platensis and Isochrysis galbana T-Iso

There is growing consumer demand for food products derived from microalgae, driven largely by the perceived health benefits associated with them. The functional and bioactive potential of proteins isolated from two microalgae—Spirulina sp. and Isochrysis galbana T-Iso—were determined. The results obtained show the potential of microalgal protein extracts for use in the beverage industry, based on solubility values and other functional characteristics, including water and oil holding capacities, foaming, emulsifying activities and stabilities, water activities, solubility and pH. The solubility of algal proteins was pH-dependent, and they were largely insoluble at pH values between 2 and 11. However, the proteins were increasingly soluble at a pH of 12, and they have potential use in formulating foods with higher viscosities or gels, where they could act as fillers to strengthen networks. Compared with whey and flaxseed proteins, the Spirulina sp. protein extract had a superior oil-holding capacity (OHC). The OHC is important in developing texture in food products such as meats. Overall, better foam stability was observed for both Spirulina sp. and Isochrysis sp. soluble protein extracts, compared with flaxseed protein at pH values from 2 to 10 over a period of 120 min. The foam capacity and stability increase the physical properties of foods. However, the emulsion activity and stability values for soluble algal protein extracts were less than the values observed for flaxseed and whey proteins. Algal proteins would not be suitable for use in creaming and food processing involving flocculation. In addition, algal protein extracts inhibited Angiotensin-converting enzyme-I (ACE-I) and renin, and they have potential for use in functional food ingredient applications to maintain heart health and also to act as meat substitutes.

Perceptions of e-cigarettes among smokers and non-smokers in households with children in rural China: A cross-sectional study.

INTRODUCTIONThe perceived health benefits and effectiveness of electronic cigarettes (e-cigarettes) in quitting smoking may affect e-cigarette usage, however, research on the use of e-cigarettes among the Chinese, especially among the rural Chinse, is scarce. This study examined factors associated with perceptions of e-cigarette related harms, benefits, and addictiveness, among smoker and non-smoker households with children in rural China, to support the design of population-based interventions targeting rural Chinese households.METHODSIn a cross-sectional study design, using a structured questionnaire, we collected data from the household members of children in two selected rural communities in China. Descriptive analyses were used to characterize respondents; χ2 test and Fisher’s exact probability test were used to compare the perceptions of e-cigarettes between different sociodemographic groups. Logistic regression was used to determine predictors for e-cigarette harms, benefits, and addictiveness, adjusting for demographic and other characteristics.RESULTSThe overall participation rate was 81% (1211/1498). Of the participants, 668 (55%) were smokers and 543 (45%) were non-smokers; 53% knew about e-cigarettes. Participants from rural Dali (77% vs 59%), those who were ethnic minority (76% vs 59%), those who perceived increased COPD risks from smoking (mean score 4.37 vs 4.18) and concerned about harmful effects of secondhand smoke (SHS) exposure to children (mean score 4.48 vs 4.30) and adults (mean score 4.06 vs 3.87) were more likely to believe that e-cigarettes were less harmful (p<0.05). Participants with more knowledge about the harm of smoking were more likely to believe that e-cigarettes were helpful in quitting smoking (p<0.05). Of those participants who knew about e-cigarettes, females (19%) were significantly more likely to believe that e-cigarettes are addictive than males (10%). In the logistic regression analyses, believing e-cigarettes are helpful to quit smoking was the only variable associated with holding a higher knowledge about smoking and SHS exposure (OR=0.608; 95% CI: 0.450–0.820).CONCLUSIONSOur results showed that more than half of the rural household members who have a child at home were aware of e-cigarettes. Knowledge about health impacts of SHS exposure and perceptions about the benefits, harms and addictiveness of e-cigarette use varied among the participants, with a significant proportion of participants having wrong information. Public health campaigns to disseminate evidence-based information of e-cigarette benefits and harms are warranted. As knowledge about the harmfulness of smoking and SHS exposure was associated with perceived e-cigarette benefits, particular focus should be given to increasing knowledge about the health hazards related to smoking and SHS exposure.

Capturing sustainable fashion purchase behavior of Hispanic consumers in the US

ABSTRACT Despite the vital role Hispanic consumers play in the U.S. apparel market, research on their sustainable apparel consumption behavior is limited. This study investigated the influence of normative expectations on young Hispanic consumers’ organic apparel purchasing behavior. A self-administered online survey was used to collect data from a population of Hispanic college students. The proposed conceptual model was tested using structural equation modeling (SEM). The study results revealed that social norms did not directly influence organic apparel purchase behavior of Hispanic consumers. Instead, social norms determined personal norms and organic apparel knowledge, which then affected the purchase behavior. Perceived health benefits also significantly affected young Hispanic consumers’ purchase behavior of organic apparel. We also found that organic apparel knowledge significantly affected the perceived quality and health benefits of organic apparel. This study contributed to the literature by 1) understanding the complex relationships of social norms with personal norms, organic apparel knowledge, and organic apparel purchase behavior of Hispanic consumers, and 2) incorporating perceived product value into the conceptual model. Findings of this study can help sustainable apparel manufacturers and retailers to develop effective marketing strategies for targeting Hispanic consumers in the US apparel markets.

Exploring the competing influences of privacy concerns and positive beliefs on citizen acceptance of contact tracing mobile applications

The continued proliferation of information technology in all aspects of our lives fosters benefits but also generates risks to individuals' privacy. In emerging contexts, such as government surveillance technologies, there is a dearth of research investigating the positive and negative drivers of citizens' acceptance. This is an important gap given the importance of citizen acceptance to the success of these technologies and the need to balance potentially wide-reaching benefits with any dilution of citizen privacy. We conduct a longitudinal examination of the competing influences of positive beliefs and privacy concerns on citizens' acceptance of a COVID-19 national contact tracing mobile application among 405 Irish citizens. Combining privacy calculus theory with social exchange theory, we find that citizens’ initial acceptance is shaped by their perceptions of health benefits and social influence, with reciprocity exhibiting a sustained influence on acceptance over time and privacy concerns demonstrating a negative, albeit weak influence on willingness to rely on the application. The study offers important empirical and theoretical implications for the privacy literature in the government surveillance, location-based services, and mobile health application contexts, as well as practical implications for governments and developers introducing applications that rely on mass acceptance and reciprocal information disclosure.

Identification of factors influencing motivation to undertake time-restricted feeding in humans

The interaction between time of day and energy intake, termed chrono-nutrition, has received considerable recent interest. One aspect of chrono-nutrition with potential to benefit long-term cardio-metabolic health is time-restricted feeding (TRF). Current support for TRF primarily derives from animal research, although recent small-scale human studies indicate possible translational benefit. Whether free-living humans, however, can incorporate TRF into their daily lives is poorly understood. This study reports data from participants (n = 608) who completed an online questionnaire to investigate daily routine, likelihood of TRF incorporation within work vs free-days, and key considerations influencing TRF uptake. The majority of participants reported a typical daily feeding window (time between first and last energy intake) of between 10 and 14 h on workdays and free days, 62.7 and 65.5% respectively. Likelihood of adherence to TRF declined with an increase in the proposed restriction of the feeding window by 0.5 to 4-h per day. We then examined data from participants with a typical daily feeding window of 12+ h on workdays (n = 221) and free-days (n = 223) to investigate the likelihood of using TRF, and the most important considerations in making this decision. Of these participants, (n = 132) on workdays and (n = 125) on free days would likely reduce their feeding window by 3-h. Multiple regression analysis revealed that key considerations determining the likelihood of adopting TRF were: cost, time availability, and perceived health benefits (on workdays); wake time, bed time, time availability, motivation to change and perceived health benefits (on free-days). These data provide novel information regarding public attitudes towards TRF and highlight important aspects to be considered when translating controlled laboratory studies to public dietary advice.

Herbal products containing aristolochic acids: A call to revisit the context of safety

Herbal products are used globally for their perceived health benefits, and as a complement to alternative therapy to Western medicines. Herbal products can be beneficial, although they can also be harmful in several circumstances. Aristolochic acids (AA) are a compound that is abundant in Aristolochia plants. Previous studies have reported that AAs exert several therapeutic effects and have been commonly used to treat a variety of illnesses, such as eczema, pneumonia, stroke, hepatitis, snakebites, arthritis, gout and coronary artery diseases. AAs, thus, are widely used in traditional and local medicines and herbal products. Unfortunately, the intake of AAs has been linked to kidney failure, as well as cancers of the urinary tract. A direct association between use of AAs and hepatocellular carcinomas has been established. According to the International Agency for Research on Cancer (IARC), AAs are classified into Group 1, which indicates there is sufficient evidence that they cause cancer in humans. Given uncontrolled adulteration of herbal products, along with a decreasing trend in clinical investigations into products containing AAs, adverse events due to exposure to Aristolochia herbs should be given much more attention. Even though the latest evidence has concretely proven that exposure to AAs is widespread throughout countries and regions such as China, South Korea, Japan, Southeast Asia, Europe and North America, the public awareness and attention given by physicians and native healers is not very encouraging. The toxicity and adverse drug events associated with AAs should be investigated thoroughly. Further law enforcement to restrict the sale and use of products containing AAs is warranted.

Nutrition counseling and monitoring via tele-nutrition for healthy diet for people with spinal cord injury: A case series analyses

Objective To evaluate the effect of a tele-nutrition counseling program on diet quality, weight, waist circumference, and quality of life in people with spinal cord injury (SCI). Design Prospective observational study. Participants Fifteen participants with SCI were enrolled from an acute inpatient rehabilitation unit and outpatient SCI clinic; ten participants completed the intervention. Interventions Six tele-nutrition counseling sessions over 3 months, utilizing videoconferencing and a photographic food diary. Outcome measures Weight, waist circumference, Life Satisfaction Index A (LSIA), Knowledge and Nutrition Evaluation with Supplement on Eating Behavior, and Program Satisfaction Survey (PSS). Results Ten participants completed both baseline and 3-month follow-up evaluations and were used in this analysis. There were no statistically significant changes from baseline to 3-month follow up in weight, waist circumference, Knowledge and Nutrition Evaluation, and LSIA (P > .48). Using the Supplement on Eating Behavior total score to measure overall changes in healthy food choices, 9 out of 10 participants rated their healthy food choices as improving (P = .008). A post-hoc exploratory itemized analysis on the Supplement on Eating Behavior revealed significant improvements from baseline to 3-month follow-up in participant’s self-reported choice of balanced meals (P = .008), reading food labels (P = .031), logging meals (P = .007), and monitoring portions of eating favorite foods (P = .031). Participants endorsed a 97-100% satisfaction rating in relation to perceived health benefits, equipment, and program satisfaction. Conclusion This study provides preliminary data suggesting that tele-nutrition is an efficacious intervention that may improve diet quality for individuals with SCI.

Changes in cannabis use, exposure, and health perceptions following legalization of adult recreational cannabis use in California: a prospective observational study

BackgroundMost U.S. states have legalized cannabis for medical and/or recreational use. In a 6-month prospective observational study, we examined changes in adult cannabis use patterns and health perceptions following broadened legalization of cannabis use from medical to recreational purposes in California.MethodsRespondents were part of Stanford University’s WELL for Life registry, an online adult cohort concentrated in Northern California. Surveys were administered online in the 10 days prior to state legalization of recreational use (1/1/18) and 1-month (2/1/18–2/15/18) and 6-months (7/1/2018–7/15/18) following the change in state policy. Online surveys assessed self-reported past 30-day cannabis use, exposure to others’ cannabis use, and health perceptions of cannabis use. Logistic regression models and generalized estimating equations (GEE) examined associations between participant characteristics and cannabis use pre- to 1-month and 6-months post-legalization.ResultsThe sample (N = 429, 51% female, 55% non-Hispanic White, age mean = 56 ± 14.6) voted 58% in favor of state legalization of recreational cannabis use, with 26% opposed, and 16% abstained. Cannabis use in the past 30-days significantly increased from pre-legalization (17%) to 1-month post-legalization (21%; odds ratio (OR) = 1.28, p-value (p) = .01) and stayed elevated over pre-legalization levels at 6-months post-legalization (20%; OR = 1.28, p = .01). Exposure to others’ cannabis use in the past 30 days did not change significantly over time: 41% pre-legalization, 44% 1-month post-legalization (OR = 1.18, p = .11), and 42% 6-months post-legalization (OR = 1.08, p = .61). Perceptions of health benefits of cannabis use increased from pre-legalization to 6-months post-legalization (OR = 1.19, p = .02). Younger adults, those with fewer years of education, and those reporting histories of depression were more likely to report recent cannabis use pre- and post-legalization. Other mental illness was associated with cannabis use at post-legalization only. In a multivariate GEE adjusted for sociodemographic characteristics and diagnoses, favoring legalization and the interaction of time and positive health perceptions were associated with a greater likelihood of using cannabis.ConclusionsLegalized recreational cannabis use was associated with greater self-reported past 30-day use post-legalization, and with more-positive health perceptions of cannabis use. Future research is needed to examine longer-term perceptions and behavioral patterns following legalization of recreational cannabis use, especially among those with mental illness.

Why garden? – Attitudes and the perceived health benefits of home gardening

Domestic (home) gardens provide opportunities for psychological and physical health benefits, yet these environments have received less attention in terms of their therapeutic value compared to other urban green spaces. This is despite their ubiquity and the popularity of gardening as a pastime. This research explored why residents engaged with gardening and the extent to which they recognised any health benefits from the activity. A questionnaire was distributed electronically within the UK, with 5766 gardeners and 249 non-gardeners responding. Data were collated on factors including garden typology, frequency of gardening and individual perceptions of health and well-being. Significant associations were found between improvements in well-being, perceived stress and physical activity and more frequent gardening. Gardening on a frequent basis i.e. at least 2–3 times a week, corresponded with greatest perceived health benefits. Improving health, however, was not the prime motivator to garden, but rather the direct pleasure gardening brought to the participants. There was evidence that satisfaction with one's front garden and the time spent in it increased as the proportion of vegetation was enhanced. The data supports the notion that domestic gardens should be given greater prominence in urban planning debates, due to the role they play in providing health benefits.