Nutritional Concerns among Female International Volunteers Based on the Income and Development Status of Their Country of Service
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Collection
2.2. Triad Factors
2.3. Country Classifications
2.4. Statistical Analysis
3. Results
3.1. Participant Characteristics
3.2. Odds of Triad Risk Factors Based on Country of Service’s Income and Development Status
3.3. Secondary Amenorrhea
3.4. Food Insecurity
3.5. Physical Activity
3.6. Changes and Satisfaction with Weight
3.7. Weight Satisfaction
3.8. Dietary History Questionnaire
3.9. Healthy Eating Index
3.10. DXA Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Missionary Program. ChurchofJesusChrist.org. Available online: https://newsroom.churchofjesuschrist.org/topic/missionary-program. (accessed on 14 April 2022).
- New Wave of Missionaries is Young, Energetic and Female. ABCNews.com. Available online: https://abcnews.go.com/US/wave-mormon-missionaries-young-energetic-female/story?id=27924269 (accessed on 14 April 2022).
- Freire, A.N.; Brown, K.N.; Fleischer, S.H.; Eggett, D.L.; Creer, A.R.; Graf, M.I.; Dyckman, J.; Turley, J.M.; Fullmer, S. Prevalence of Female Athlete Triad Risk Factors among Female International Volunteers and College Age-Matched Controls. Int. J. Environ. Res. Public Health 2022, 19, 1223. [Google Scholar] [CrossRef] [PubMed]
- Vescovi, J.D.; Scheid, J.L.; Hontscharuk, R.; De Souza, M.J. Cognitive dietary restraint: Impact on bone, menstrual, and metabolic status in young women. Physiol. Behav. 2008, 95, 48–55. [Google Scholar] [CrossRef] [PubMed]
- Nattiv, A.; Loucks, A.B.; Manore, M.M.; Sanborn, C.F.; Sundgot-Borgen, J.; Warren, M.P. American College of Sports Medicine. American College of Sports Medicine position stand. The female athlete triad. Med. Sci. Sports Exerc. 2007, 39, 1867–1882. [Google Scholar] [PubMed]
- Mountjoy, M.; Sundgot-Borgen, J.K.; Burke, L.M.; Ackerman, K.E.; Blauwet, C.; Constantini, N.; Lebrun, C.; Lundy, B.; Melin, K.A.; Meyer, N.L.; et al. IOC consensus statement on relative energy deficiency in sport (RED-S): 2018 update. Br. J. Sports Med. 2018, 52, 687–697. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Huhmann, K. Menses requires energy: A review of how disordered eating, excessive exercise, and high stress lead to menstrual irregularities. Clin. Ther. 2020, 42, 401–406. [Google Scholar] [CrossRef] [PubMed]
- De Souza, M.J.; Toombs, R.J.; Scheid, J.L.; O’Donnell, E.; West, S.L.; Williams, N.I. High prevalence of subtle and severe menstrual disturbances in exercising women: Confirmation using daily hormone levels. Hum. Reprod. 2010, 25, 491–503. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Leutscher, P.D.C.; Bagley, S.W. Health-related challenged in United States Peace Corps volunteers serving for two years in Madagascar. J. Travel Med. 2003, 10, 263–267. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Martini, D.; Godos, J.; Bonaccio, M.; Vitaglione, P.; Grosso, G. Ultra-Processed Foods and Nutritional Dietary Profile: A meta-analysis of nationally representative samples. Nutrients 2021, 13, 3390. [Google Scholar] [CrossRef] [PubMed]
- Imamura, F.; Micha, R.; Khatibzadeh, S.; Fahimi, S.; Shi, P.; Powles, J.; Mozaffarian, D. Dietary quality among men and women in 187 countries in 1990 and 2010: A systematic assessment. Lancet Glob. Health. 2015, 3, e132–e142. [Google Scholar] [CrossRef] [Green Version]
- National Cancer Institute: Division of Cancer Control and Population Science. Available online: https://epi.grants.cancer.gov/dhq3/ (accessed on 31 October 2021).
- United States Department of Agriculture Economic Research Service. Available online: https://www.ers.usda.gov/media/8282/short2012.pdf (accessed on 3 January 2022).
- Food and Nutrition Services Healthy Eating Index. Available online: https://www.fns.usda.gov/healthy-eating-index-hei (accessed on 31 October 2021).
- Dietary Guidelines for Americans. Available online: https://www.dietaryguidelines.gov/sites/default/files/2020-12/Dietary_Guidelines_for_Americans_2020-2025.pdf (accessed on 25 January 2022).
- University of Copenhagen Department of Nutrition, Exercise, and Sports. The LEAF-Q Questionnaire. Available online: http://www.diva-portal.org/smash/get/diva2:1303041/FULLTEXT02.pdf (accessed on 8 January 2022).
- United Nation’s World Economic Situation and Prospects. Available online: https://www.un.org/development/desa/dpad/document_gem/global-economic-monitoring-unit/world-economic-situation-and-prospects-wesp-report/ (accessed on 31 October 2021).
- Meczekalski, B.; Katulski, K.; Czyzyk, A.; Podfigurna-Stopa, A.; Maciejewska-Jeske, M. Functional hypothalamic amenorrhea and its influence on women’s health. J. Endocrinol. Investig. 2014, 37, 1049–1056. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Aladashvili-Chikvaidze, N.; Kristesashvili, J.; Gegechkori, M. Types of reproductive disorders in underweight and overweight young females and correlations of respective hormonal changes with BMI. Iran J. Reprod. Med. 2015, 13, 135–140. [Google Scholar] [PubMed]
- Gibson, M.E.S.; Fleming, N.; Zuijdwijk, C.; Dumont, T. Where have the periods gone? The evaluation and management of functional hypothalamic amenorrhea. J. Clin. Res. Pediatr. Endocrinol. 2020, 12, 18–27. [Google Scholar] [CrossRef] [PubMed]
- Nikolaus, C.J.; Ellison, B.; Nickols-Richardson, S.M. College students’ interpretations of food security questions: Results from cognitive interviews. BMC Public Health 2019, 19, 1282. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Our World in Data Per Capita Milk Consumption. Available online: https://ourworldindata.org/grapher/per-capita-milk-consumption (accessed on 30 October 2021).
- National Institutes of Health Definition & Facts for Lactose Intolerance. Available online: https://www.niddk.nih.gov/health-information/digestive-diseases/lactose-intolerance/definition-facts. (accessed on 30 October 2021).
- Whole Grains Council Whole Grain Statistics. Available online: https://wholegrainscouncil.org/newsroom/whole-grain-statistics (accessed on 30 October 2021).
- Micha, R.; Khatibzadek, S.; Shi, P.; Fahimi, S.; Lim, S.; Andrews, K.; Engell, R.; Powles, J.; Ezzati, M.; Mozaffarian, D. Global, regional, and national consumption levels of dietary fats and oil in 1990 and 2010: A systematic analysis including 266 country-specific nutrition surveys. BMJ 2014, 348, 2272. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Peace Corps FAQs. Available online: https://www.peacecorps.gov/faqs/about-service/ (accessed on 12 April 2022).
- Peace Corps Stories: Corps to Career: Turning a nutritious West African treat into a business. Available online: https://www.peacecorps.gov/stories/corps-to-career-turning-a-nutritious-west-african-treat-into-a-business/ (accessed on 12 April 2022).
Dissatisfied (n = 1187) | Satisfied (n = 563) | Neutral (n = 307) | p-Value | |
---|---|---|---|---|
n (%) | n (%) | n (%) | <0.001 | |
Gained Weight | 652 (54.9) | 81 (14.40) | 86 (28.01) | |
Gained/Lost Weight | 417 (35.13) | 182 (32.32) | 129 (42.02) | |
Lost Weight | 69 (5.81) | 155 (27.53) | 51 (16.6) | |
Maintained Weight | 48 (4.04) | 144 (25.60) | 39 (12.70) |
Developed (n = 134) | Nondeveloped (n = 73) | p-Value | |
---|---|---|---|
Mean ± SD | Mean ± SD | ||
HEI Total Score | 62.36 ± 9.27 | 63.96 ± 8.31 | 0.22 |
HEI Adequacy Component Scores | |||
Total Fruits | 3.52 ± 1.45 | 4.02 ± 1.23 | 0.01 |
Whole Fruits | 4.29 ± 1.26 | 4.51 ± 0.91 | 0.15 |
Total Vegetables | 3.68 ± 1.04 | 3.79 ± 1.08 | 0.47 |
Greens and Beans | 3.85 ± 1.49 | 3.42 ± 1.85 | 0.09 |
Whole Grains | 4.10 ± 2.06 | 3.32 ± 2.01 | 0.01 |
Dairy | 6.60 ± 2.41 | 5.53 ± 2.51 | 0.003 |
Total Protein Foods | 4.71 ± 0.60 | 4.74 ± 0.58 | 0.79 |
Seafood and Plant Proteins | 3.98 ± 1.34 | 3.82 ± 1.48 | 0.44 |
Fatty Acids | 4.49 ± 2.75 | 5.50 ± 2.78 | 0.12 |
Moderation HEI Component Scores | |||
Refined Grains | 6.93 ± 2.80 | 7.38 ± 2.63 | 0.26 |
Sodium | 3.98 ± 2.14 | 4.56 ± 2.27 | 0.07 |
Added Sugars | 6.32 ± 2.21 | 6.02 ± 2.74 | 0.43 |
Saturated Fats | 5.92 ± 2.55 | 7.34 ± 2.23 | <0.001 |
High-Income (n = 152) | Non-High-Income (n = 51) | p-Value | |
---|---|---|---|
Mean ± SD | Mean ± SD | ||
HEI Total Score | 62.85 ± 9.08 | 63.37 ± 8.77 | 0.726 |
HEI Adequacy Component Scores | |||
Total Fruits | 3.63 ± 1.43 | 3.88 ± 1.33 | 0.280 |
Whole Fruits | 4.35 ± 1.22 | 4.40 ± 0.97 | 0.799 |
Total Vegetables | 3.74 ± 1.03 | 3.67 ± 1.13 | 0.704 |
Greens and Beans | 3.79 ±1.51 | 3.61 ± 1.85 | 0.526 |
Whole Grains | 4.08 ± 2.06 | 3.17 ± 2.03 | 0.007 |
Dairy | 6.42 ± 2.49 | 5.58 ± 2.38 | 0.036 |
Total Protein Foods | 4.70 ± 0.63 | 4.77 ± 0.48 | 0.472 |
Seafood and Plant Proteins | 3.94 ± 1.36 | 3.93 ± 1.44 | 0.967 |
Fatty Acids | 4.64 ± 2.77 | 5.51 ± 2.77 | 0.053 |
Moderation HEI Component Scores | |||
Refined Grains | 7.05 ± 2.72 | 7.24 ± 2.82 | 0.658 |
Sodium | 4.10 ± 2.21 | 4.38 ± 2.20 | 0.427 |
Added Sugars | 6.23 ± 2.33 | 6.05 ± 2.67 | 0.664 |
Saturated Fats | 6.18 ± 2.56 | 7.15 ± 2.25 | 0.016 |
High-Income (n = 294) | Not High-Income (n = 107) | p-Value | |
---|---|---|---|
Mean ± SD | Mean ± SD | ||
Neck Mean Z-Score | 0.18 ± 0.94 | 0.216 ± 0.95 | 0.79 |
Neck Low BMD (g/cm2) | 0.00 ± 0.06 | 0.00 ± 0.00 | 0.55 |
Troch Low BMD(g/cm2) | 0.04 ± 0.19 | 0.04 ± 0.19 | 0.99 |
Troch Mean Z-Score | −0.23 ± 1.034 | −0.219 ± 1.03 | 0.95 |
Total Mean Z-Score | 0.48 ± 0.99 | 0.464 ± 0.98 | 0.89 |
Total Low BMD (g/cm2) | 0.00 ± 0.59 | 0.00 ± 0.00 | 0.55 |
L1-L4 Z-Score | 0.28 ± 0.92 | 0.377 ± 0.97 | 0.36 |
L1-L4 Low BMD (g/cm2) | 0.00 ± 0.06 | 0.00 ± 0.00 | 0.55 |
Developed (n = 264) | Nondeveloped (n = 146) | p-Value | |
Neck Mean Z Score | 0.16 ± 0.91 | 0.32 ± 1.01 | 0.09 |
Neck Low BMD (g/cm2) | 0.00 ± 0.62 | 0.00 ± 0.00 | 0.46 |
Troch Low BMD(g/cm2) | 0.04 ± 0.20 | 0.03 ± 0.17 | 0.47 |
Troch Mean Z Score | −0.26 ± 1.01 | −0.16 ± 1.08 | 0.31 |
Total Mean Z Score | 0.45 ± 0.97 | 0.57 ± 1.04 | 0.24 |
Total Low BMD (g/cm2) | 0.00 ± 0.06 | 0.00 ± 0.00 | 0.46 |
L1-L4 Z Score | 0.27 ± 0.92 | 0.41 ± 0.96 | 0.16 |
L1-L4 Low BMD (g/cm2) | 0.00 ± 0.06 | 0.00 ± 0.00 | 0.46 |
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Jensen, M.J.; Brown, K.N.; Turley, J.M.; Graf, M.I.; Dyckman, J.; Creer, A.R.; Fullmer, S. Nutritional Concerns among Female International Volunteers Based on the Income and Development Status of Their Country of Service. Int. J. Environ. Res. Public Health 2022, 19, 4846. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19084846
Jensen MJ, Brown KN, Turley JM, Graf MI, Dyckman J, Creer AR, Fullmer S. Nutritional Concerns among Female International Volunteers Based on the Income and Development Status of Their Country of Service. International Journal of Environmental Research and Public Health. 2022; 19(8):4846. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19084846
Chicago/Turabian StyleJensen, Megan J., Katie N. Brown, Jennifer M. Turley, Marlene I. Graf, Jenna Dyckman, Andrew R. Creer, and Susan Fullmer. 2022. "Nutritional Concerns among Female International Volunteers Based on the Income and Development Status of Their Country of Service" International Journal of Environmental Research and Public Health 19, no. 8: 4846. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19084846