South Asians (SAs) are among the fastest-growing ethnic groups in the U.S. Metabolic syndrome (MetS) is a condition that is characterized by multiple health factors that increase the risk for chronic diseases, such as cardiovascular disease (CVD) and diabetes. MetS prevalence among SA immigrants ranges from 27–47% in multiple cross-sectional studies using different diagnostic criteria, which is generally higher compared to other populations in the receiving country. Both genetic and environmental factors are attributed to this increased prevalence. Limited intervention studies have shown effective management of MetS conditions within the SA population. This review reports MetS prevalence in SAs residing in non-native countries, identifies contributing factors, and discusses ways to develop effective community-based strategies for health promotion targeting MetS among SA immigrants. There is a need for more consistently evaluated longitudinal studies to facilitate the development of directed public health policy and education to address chronic diseases in the SA immigrant community.

Zellweger spectrum disorders (ZSDs) are rare, debilitating genetic diseases of peroxisome biogenesis that require constant management and lifelong care. Nevertheless, the experience of family caregivers for children diagnosed with ZSD is not well understood. In this study, we sought to characterize the emotional experience of ZSD family caregivers. Three 90-min focus groups were conducted with thirty-seven parents (25 mothers and 12 fathers) of children with ZSD during a family advocacy conference. Focus groups were arranged by age of proband (Group 1: 0-4 years, Group 2: 5-10 years, Group 3:> 11 years). Audio recordings of focus groups were transcribed and analyzed using software for coding purposes. Analyzed content was validated using peer debriefing, member checking, and method triangulation. Focus group results showed that nearly a third of ZSD caregivers described their overall emotional experience as a "rollercoaster." Additionally, three interconnected themes were identified: 1) range of emotions, 2) stressors, and 3) coping. Feeling overwhelmed and devastated were the most frequently described emotional responses. Corresponding stressors to these emotions included the burden of caregiver tasks associated with ZSD, and negative interactions with healthcare professionals. The most common coping strategies were acceptance of limitations of the diseases, redefining "normal" in the parenting experience, and advocating on behalf of the child and the patient community. This study underscores the profound emotional impact on parents who are caregivers for children with ZSDs, highlighting the utility of patient community feedback and qualitative approaches to fully characterize the overall family experience. Simple, targeted approaches focusing on improved communication between healthcare professionals and families, as well as offering resources for emotional support may greatly improve the lives of families living with ZSD and other rare pediatric diseases.

Purpose: – Public health policy has long called for significant reductions in salt intake. To date most research has been confined to processed foods. This approach fails to include the foodservice industry and its impact on population health. The purpose of this paper is to understand perceptions of what responsibility, if any, these professionals felt they had within the public health agenda. International comparisons were made to assess whether previous reductions of salt intake among UK adults was attributable to groundswell attitudinal changes at the chef/manager level, which US counterparts may not have embraced. Design/methodology/approach: – This study took the qualitative approach of phenomenology as the research strategy to explore prevailing perceptions of the role and responsibility of food service regarding salt intake. Chefs and managers who deal directly with consumers were given in-depth semi-structured interviews designed to reveal the underlying themes that inform the participant’s perceptions of added salt. Findings: – Major findings from both the USA and UK indicate that ground-level chef/managers do not feel a social responsibility to limit public salt consumption. Chef/managers of both countries exhibited little nutritional understanding of the health impacts of salt intake and strong reluctance to make any reductions in salt use in their daily operations. The participants cite a lack of consumer interest and the fear that any salt adjustment would change the food’s sensory acceptability putting them at a competitive disadvantage. Originality/value: – To the authors’ knowledge this is the first study to examine professional foodservice personnel’s perceptions and knowledge of salt intake and the public health perspective.

The toll of HIV/AIDS and drug abuse on economically disadvantaged women of color in the United States is a public health problem of epidemic proportions. Malnutrition, believed to be pervasive in this population, exacerbates the devastating health effects of addiction and HIV. This study documented dietary deficiencies in this population and examined factors influencing the food choices and eating patterns of marginally housed and homeless African American HIV-positive substance abusing women. Data were collected from 28 women ages 19–55 using two 24-hour dietary recalls and a semi-structured interview guide. Data revealed multiple nutritional intake hazards including skipped meals, substitution of carbohydrate-laden foods for dairy foods rich in animal fat and proteins, and an absence of raw fruits and vegetables indicative of deficiencies in key macro- and micronutrients. Food risks were increased for homeless women who were more likely to lack public assistance, have difficulty accessing free food service, and frequently eating food from dumpsters. Qualitative data analysis of interviews generated three major themes describing the context in which nutritional deficiencies emerged: (1) diet-disease and food-safety misconceptions; (2) socio-cultural and lifestyle barriers; and (3) lack of personal resources and neighborhood food availability and affordability. The relevance of these findings to nutrition intervention programs for this population is discussed.