Aliment Pharmacol Ther 2012; 35: 76–82Summary: Background  Non‐alcoholic fatty liver disease (NAFLD), the hepatic manifestation of metabolic syndrome, is the most common cause of primary liver disease. Although recent studies have found that coffee drinking is protective against end stage chronic liver disease, there are scarce caffeine intake data in NAFLD specifically.Aim  To investigate the effects of dietary behaviour in NAFLD patients, using four continuous cycles of the National Health and Nutrition Examination Surveys (NHANES 2001–2008).Methods  Using data from four continuous cycles of NHANES, dietary intake questionnaires that list 62 nutrition components. Logistic regression was used to identify independent predictors of NAFLD among nutrition components after adjustment for potential clinical confounders. All analyses were run using sas 9.1 and sudaan 10.0 (SAS Institute Inc., Cary, NC, USA).Results  Of the 62 nutrient components used for the univariate analysis, 38% were significant (P‐value <0.05) in NAFLD with caffeine consumption being higher in the control group (P‐value <0.001). The multivariate analysis using demographics, clinical parameters and nutritional components found five factors independently associated with NAFLD [African American Race P‐value <0.001); Male gender P‐value <0.001); Obesity (BMI ≥ 30) P‐value <0.001); Caffeine intake (mg) P‐value <0.001) and total plain water consumption (g) P‐value ≤0.02)].Conclusions  Our analysis shows that caffeine intake is independently associated with a lower risk for NAFLD suggesting a potential protective effect. These data necessitate further research to elucidate the mechanism by which caffeine can protect against NAFLD.

The purpose of this study was to determine whether maternal prepregnancy overweight/obesity has independent effects on breastfeeding initiation and duration and whether these effects are different for women who experience medical problems during pregnancy or labor/delivery complications in comparison with those who have no medical or labor/delivery complications. We used the early childhood longitudinal study-birth cohort data. Kaplan-Meier survival functions, logistic, and Cox regression modeling were used in the analyses. Findings indicate that overweight/obese women with medical or labor/delivery complications were less likely to initiate breastfeeding in comparison with their counterparts of normal weight. We did not find an independent effect of prepregnancy overweight/obesity on breastfeeding initiation among women with no medical problems. This group of women, however, had an 11% increased risk of stopping breastfeeding with each additional month of breastfeeding duration in comparison to those of normal weight. It is important to evaluate the health history and pregnancy complications among overweight/obese mothers in developing interventions for successful initiation and duration of breastfeeding.

Obesity, a complex disease determined both by genetic and environmental factors, is strongly associated with NAFLD, and has been demonstrated to have a negative impact on HCV and other chronic liver diseases (CLD). This study assessed the association between type and location of food sources and chronic liver disease (CLD) using Geographic Information Systems (GIS). CLD patients completed surveys [267 subjects, 56.5% female, age 55.8 ± 12.0, type of CLD: 36.5% hepatitis C (HCV), 19.9% hepatitis B (HBV), 19.9% non-alcoholic fatty liver disease (NAFLD); primary food source (PFS): 80.8% grocery store, secondary: 26.2% bulk food store, tertiary: 20.5% restaurants; fresh food (FF): 83%, pre-packaged (PP) 8.7%, already prepared (AP) 8.3%]. FF consumers had significantly fewer UEH servings/month (p = 0.030) and lived further away from convenience stores (1.69 vs. 0.95 km, p = 0.0001). Stepwise regression reveals the lowest FF consumers were NAFLD patients, subjects with UEH or restaurants and ethnic food stores as their PFS (R = 0.557, p = 0.0001). Eating already-packaged foods and utilizing restaurants or ethnic food stores as the PFS positively correlated with NAFLD (R = 0.546, p = 0.0001). Environmental food source measures, including type and density, should be included when examining areas hyper-saturated with a variety of food options. In hyper-saturated food environments, NAFLD patients consume more prepared food and less FF. CLD patients with UEH also eat significantly more prepared food and frequent restaurants and ethnic food stores as their PFS.

Objective: Mali is one of the poorest countries in Africa, with 72 % of its population surviving on less than $US 1·00 per day. Health and demographic indicators are bleak. With few exceptions, studies related to the health of women in Mali have largely been under-represented. In addition, in recent years a new type of malnutrition stemming from weight gain and obesity has been observed throughout Africa. The present study aimed to (i) describe geographic and health variations of women of reproductive age, (ii) describe geographic variations of household salt iodine levels and (iii) investigate potential factors associated with women's anthropometric status and use of adequately iodized salt among households in Mali.Design: Demographic and Health Survey data, multistage-stratified cluster sampling methodology.Setting: Rural and urban areas of Mali.Subjects: Non-pregnant women (n6015) between the ages of 19 and 44 years.Results: Nineteen per cent of the women were overweight or obese while 11 % were underweight. Seventy-eight per cent of the households utilized adequately iodized salt. Underweight women were more prevalent in southern Mali, while obesity was more frequent in the north-east and within the major urban areas. Households located within the southern parts of Mali were more likely to utilize adequately iodized salt. Education, age, modern contraceptive use, breast-feeding status at time of the survey and household wealth index were significantly associated with the women's BMI or households’ use of adequately iodized salt.Conclusions: The combined use of statistical and geographic system analysis contributes to improve targeting of interventions among vulnerable populations.

The need for successful nutrition interventions is critical as the prevalence of childhood obesity increases. Thus, this pilot project examines the effect of a nutrition education program, Color My Pyramid, on children’s nutrition knowledge, self-care practices, activity levels, and nutrition status. Using a pretest–posttest, quasiexperimental design, 126 fourth- and fifth-grade students from experimental and control schools are compared. The intervention program incorporates an online component www.MyPyramid.gov, Orem’s Self-Care Deficit Nursing Theory, and consists of six classes taught over a 3-month period. Results indicated that the program increased nutrition knowledge in the control group. Furthermore, it increased activity time from pretest to posttest and decreased systolic blood pressure for children in both groups; however, there were no significant differences in BMI percentiles. The findings indicate that Color My Pyramid can be successfully employed in school settings and thus support school nursing practice.