OREGON STATE UNIVERSITY

college of public health and human sciences

Nutrient offers hope to stop deadly march toward cirrhosis, liver cancer

CORVALLIS, Ore. – A new study suggests that one type of omega 3 fatty acid offers people who are obese or have a poor diet a chance to avoid serious liver damage.

This is something that no available drug can accomplish, and can otherwise only be obtained by significant weight loss based on a very healthy diet.

The findings, published by researchers from Oregon State University today in PLOS ONE, were based on a study done with laboratory animals. They could be significant, researchers say, since millions of people in the developed world try, and fail, to sustain weight loss or eat an optimal diet.

Supplements of DHA, one of the most critically important of the omega 3 fatty acids, were shown to stop the progression of nonalcoholic steatohepatitis, or NASH, into more serious and life-threatening health problems such as cirrhosis or liver cancer. This took place even with the continued consumption in lab animals of what scientists call a “western” diet – one that’s high in fat, sugar and cholesterol.

NASH, which is characterized by liver inflammation, oxidative stress and fibrosis, is a substantial risk factor for cirrhosis and liver cancer. It’s predicted to be the leading cause of liver transplants by 2020, and the FDA currently has no approved medical treatments for it.

Based in large part on consuming the “western diet,” nearly 80 million adults and 13 million children in the United States are obese, and about 30 percent of the nation’s population is estimated to have some form of chronic fatty liver disease.

“Considering there are no FDA-approved ways to stop NASH progression, other than weight loss therapy, this supplement may be of significant help,” said Donald Jump, a professor in the OSU College of Public Health and Human Sciences, and principal investigator with the Linus Pauling Institute.

“In the time frame that we studied, DHA supplementation was not able to achieve full remission of NASH, but it did stop it from getting worse. NASH is a serious disease, an enormous health care cost and we need to put the brakes on it. There’s clear evidence this might help.”

Over one 10-year study period, cirrhosis and liver-related deaths occurred in 20 percent and 12 percent of NASH patients, respectively.

Research has also shown that when humans with NASH are examined, they have very low levels of omega 3 fatty acids. When those levels are raised, the disease progression stops.

Omega 3 fatty acids regulate important biological pathways, including fatty acid synthesis, oxidation, and breakdown of triglycerides, or fats in the blood. A natural nutrient, DHA appears to be one of the most significant of the omega 3 fatty acids, and plays a role in repairing liver damage.

The highest levels of DHA are found in oily fish such as salmon, mackerel, tuna and sardines, and to a much lesser extent in some foods such as poultry, liver, egg yolks, and some types of algae. DHA is also increasingly being included in some prenatal vitamin and mineral formulas because of studies showing its critical importance to a developing fetus.

The current medical approach to NASH is based on lifestyle management, including diet and exercise. If successful and sustained, research indicates such approaches can completely reverse liver damage. However, in this study researchers noted that “this treatment, while ideal for clinical use, is likely not sustainable in NASH patients due to poor compliance.”

EPA, another valuable omega 3 fatty acid, has not been found to lower liver fat and fibrosis in humans, Jump said, probably due to the poor conversion in humans of EPA to DHA.

DHA is a readily available supplement and safe to use, researchers say. Referring to the use of DHA supplementation to address problems with NASH, the researchers said in their report that, “This scenario will likely be used clinically since patient compliance to low-fat, low-sucrose dietary recommendations has historically been poor.”

This research was supported by the U.S. Department of Agriculture and the National Institutes of Health. 

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Steve Lundeberg, 541-737-4039

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Healthy recipes and effective social marketing campaign improve eating habits

CORVALLIS, Ore. – The Food Hero social marketing campaign is an effective way to help low-income families eat more nutritious meals through fast, tasty, affordable and healthy recipes, two new research studies from Oregon State University have found.

Food Hero was launched by the OSU Extension Service in 2009 in an effort to encourage healthy eating among low-income Oregonians. The initiative includes several components, such as a website, www.foodhero.org, with information in both English and Spanish; Food Hero recipe taste-tasting events in schools and communities across Oregon; and a library of healthy recipes that have all been taste-tested and many approved by children.

“The success of the program is by far exceeding the scope of what we envisioned when we started,” said Melinda Manore, a professor of nutrition in the College of Public Health and Human Sciences at OSU and co-author of the studies. “Getting people to change their diet and eating behavior, especially when they do not have much money, is very difficult, and this program is helping to do that.”

The social marketing program is led by Lauren Tobey of Extension Family and Community Health at OSU, and Tobey is lead author of the studies. Food Hero is funded by the U.S. Department of Agriculture Food and Nutrition Service’s Supplemental Nutrition Assistance Program – Education, or SNAP-Ed. SNAP-Ed focuses on obesity prevention within low-income households.

One of the new studies, published in the journal Nutrients, explores how Food Hero was developed and tested. The goal of the program is to increase fruit and vegetable consumption among those eligible for SNAP benefits in Oregon, with a particular focus on low-income mothers.

The campaign’s strategy includes providing clearly focused messages, writing in plain language, being positive and realistic with the messaging, and offering simple tools for action that include an explanation of what to do and how to do it. The campaign has been effective in part because educators stayed focused on their target audience, the researchers said.

The other study, published in the Journal of Nutrition Education and Behavior, examines Food Hero’s recipe project in more depth. The recipes used in the Food Hero campaign are formulated to be healthy, tasty and kid-friendly. To date, the Food Hero recipes have been accessed millions of times via the website and social media sites such as Pinterest.

“All of the recipes are simple to make and cost-effective for families on tight budgets,” Tobey said. “Many families can’t afford to have a recipe fail or try an untested recipe the family may not end up liking.”

The recipes also are being tested with children who complete surveys or participate in a vote. If at least 70 percent of participating children say they “like the taste” of a recipe, it is considered “kid-approved.” The program has collected more than 20,000 assessments from kids who have tried Food Hero recipes at school or at community events. About 36 percent of the tested recipes have received the “kid-approved” rating to date.

“When our nutrition educators say to the children, ‘Would you like to try this for us and tell us what you think?’ it empowers them,” Manore said. “It also is a way to expose kids to foods they may not have tried before.”

Parents and caregivers are also surveyed after their children participate in tasting exercises. Of those who completed surveys, 79 percent said their child talked about what they had learned in school about healthy eating; 69 percent reported that their child asked for specific recipes; and 72 percent reported making at least one Food Hero recipe, the research showed.

As Food Hero’s tips, tools and recipes get shared in person, online, through the media and via social media, the program’s reach also expands beyond the initial audience, the researchers said. Recipes from the program are now being used around the world, and in 2015, the recipes on the Food Hero website received more than 290,000 page views.

Anyone interested can also subscribe to Food Hero Monthly, an electronic magazine that includes recipes and tips. To sign up, visit https://foodhero.org/monthly-magazine.

In addition to their collaborations with Oregon partners such as the Department of Human Services, Department of Education and Oregon Health Authority, Food Hero program leaders are sharing materials and ideas with public health and SNAP-Ed programs in other states.

“Since 95 percent of the Food Hero recipes contain fruits and/or vegetables, people who try the recipes are helping us meet the primary goal of the campaign, which is to encourage more fruit and vegetable consumption, especially among low-income families,” Tobey said.

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Melinda Manore, 541-737-8701, Melinda.manore@oregonstate.edu; Lauren Tobey, 541-737-1017, lauren.tobey@oregonstate.edu

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Cowboy salad

Cowboy Salad

Magical fruit salad

Magical Fruit Salad

Southwestern stuffed potatoes

Southwestern Stuffed Potatoes

Preschoolers’ motor skill development connected to school readiness

CORVALLIS, Ore. – Preschoolers’ fine and gross motor skill development is indicative of later performance on two key measures of kindergarten readiness, according to a study published today by researchers from Oregon State University.

Preschoolers who performed better on fine and gross motor skill assessments early in the school year were more likely to have better social behavior and “executive function,” or ability to pay attention, follow directions and stay on task later in the school year, scientists said.

“Physical activity and motor skills are important for preparing for school and for life,” said Megan MacDonald, an assistant professor in OSU’s College of Public Health and Human Sciences and lead author of the study.

“Now that we know these things are linked to school readiness, we have more tools to share with parents and educators so they can help young children be ready for school.”

The findings were published in Research Quarterly for Exercise and Sport, and supported by the Environmental Health Sciences Center and the Hallie E. Ford Center for Healthy Children and Families at OSU and OSU-Cascades. The work included an interdisciplinary team of researchers.

Past research has proven that good social behavior, including cooperation, is key to a healthy transition to school. Other research has shown that children with strong executive function skills are more likely to be successful in kindergarten and beyond. Executive function, also known as self-regulation, includes ability to pay attention, follow directions and persist through difficulty.

For the study, researchers used a range of assessments to measure the fine and gross motor skills, as well as the executive function and social behavior, of 92 children, ages 3-5. The assessments were conducted in fall and again in spring.

Results showed that fall measures of visual motor integration skills – a type of fine motor skills – predicted children’s scores on executive function tasks in the spring. Children’s object manipulation skills, a type of gross motor skill, predicted their scores on spring social behavior assessments.

The researchers found that children with strong fine motor skills also showed better executive function skills, and stronger gross motor skills predicted better social behavior.

 “The findings speak to the potential role, early on, of fine and gross motor skill development,” MacDonald said. “In kindergarten, children are playing games, socializing, lining up on the playground and more, which children learn through exposure and experience. For a variety of reasons, some children come into school not prepared for those things.”

Additional research is needed to better understand how or why motor skills are linked to these key school readiness skills, but the findings underscore the importance of exposing young children to play and physical activity, which are essential to developing their fine and gross motor skills, MacDonald said.

“If we know this, then that gives us some things we can advise parents to focus on if they want to help prepare their child for school,” she said.

Fine motor skill development could include stacking blocks or other items, copying circles on a page or playing with creative toys such as Legos or crayons. Gross motor skill development could include things like playing catch, playing on toys at the park or drawing a line on the sidewalk and having the child jump back and forth over it.

“Kids need to move. It’s part of who they are at that age,” MacDonald said. “It’s important to remember to give them time to do it.”

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Megan MacDonald, 541-737-3273, Megan.MacDonald@oregonstate.edu

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Researcher Megan MacDonald plays with a child

Megan MacDonald

Entrants sought for healthy tailgate recipe contest; 5k fun run at OSU

CORVALLIS, Ore. – Recipes are now being sought for the 2016 GridIron Chef healthy tailgate recipe contest sponsored by the Moore Family Center for Whole Grain Foods, Nutrition and Preventive Health and the College of Public Health and Human Sciences at Oregon State University.

Contestants are encouraged to enter a favorite original recipe for a healthy snack, appetizer or other tailgate food in the annual contest. Entrants do not need to submit a prepared dish, only the recipe. The contest is open to anyone interested in participating, including alumni, students, staff, faculty and community members. The deadline is Oct. 24.

The top five recipes will be chosen by food experts and showcased at the College Tailgate and 5K GridIron Challenge fun run held Saturday, Nov. 19, at the Women’s Building, 160 S.W. 26th St., Corvallis. For additional information and recipe contest submission guidelines, visit http://bit.ly/2dTkszg.

The finalists’ recipes also will have a nutrition analysis performed by the Moore Family Center and will be included on the Moore Family Center and College of Public Health and Human Sciences websites. Prizes will include Bob’s Red Mill prize packages, Beavers football tickets and gift cards.

The tailgate event will include food, drinks, adult beverages and samples of the finalists’ recipes. The winning recipe also will be available to taste outside Reser Stadium before that day’s football game.

Registration also is underway for the 5k GridIron Challenge fun run. The run, which starts at 9:45 a.m., includes football skills challenge stations. A 1k fun run for children will also be held at 9:30 a.m.

Entry is $35, or $30 for OSU faculty, staff, students and alumni, or $15 for children under 18, and includes admission to the GridIron Chef tailgate event, which begins at 10:15 a.m. For more information or to register, visit http://bit.ly/2dLmHEl. Proceeds from the run benefit OSU’s KidSpirit and Faculty Staff Fitness programs.

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Relationship factors affect young adult use of condoms

CORVALLIS, Ore. ­­­– The characteristics of a person’s relationship, including commitment and partner-specific risk factors, affect the choice of whether or not to use condoms, according to new research from Oregon State University.

Understanding the reasons that sexual partners use condoms - for pregnancy prevention, disease prevention, or both - is critical to increasing their use, especially among young adults who are considered most at risk, researchers say. 

A recent study, led by S. Marie Harvey, associate dean and professor in the College of Public Health and Human Sciences, was published in The Journal of Sex Research. It found that the use of condoms by young adults is often dependent on their specific sexual partner and characteristics of the partnership.

Condoms are unique in their ability to both protect against unintended pregnancy and sexually transmitted infections, or STIs. Although their use is important for every demographic, it is especially important for young adults, who have the highest rates of unintended pregnancy and HIV infection of any age group. Other STIs, like chlamydia and gonorrhea, also appear to be increasing for this age group. 

The study, supported by the National Institute for Child Health and Human Development, explored the reasons for using condoms, including partner-specific factors such as commitment to the relationship, the perceived risk of getting an STI from a partner, and comfort in discussing and using condoms. Researchers examined the influence of these relationship characteristics and others on condom use among about 450 young adults, aged 18-30, for one year.

Study participants were questioned about their sexual behaviors, relationship characteristics, and reasons for condom use. All were condom users and if they had more than one sexual partner, the same series of questions were repeated for each partnership. 

“The partner-specific questions provided unique and critical insight into the role relationships play in decisions about why condoms were used,” said co-author Lisa Oakley, a post-doctoral researcher at OSU.

Researchers found that a number of relationship characteristics specific to a partner influenced reasons for condom use, including perceived risk of contracting a STI and confidence in discussing and using condoms with each partner. Although it seems intuitive that reasons for condom use, risk assessment and decision-making would be specific to a particular sexual partner, this is the first study to actually examine and demonstrate that point. 

The study also found that 51 percent of the participants used condoms primarily to prevent pregnancy; only 17 percent primarily to prevent the spread of disease; and 33 percent for both birth control and disease prevention. This was of particular interest because condoms are the only widely available way to prevent the spread of sexually-transmitted diseases.

“Overall, people are much more aware of the risk of getting pregnant and often don’t perceive themselves as at risk of contracting a sexually-transmitted infection,” Harvey said. 

“The goal of public health professionals is to help people lead healthier lives. When it comes to understanding why people use condoms, there is a need to understand the complexity of the partnership and the role relationship factors may play in influencing behavior.”

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S. Marie Harvey, 541-737-3824, Marie.harvey@oregonstate.edu

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Condoms

Condoms

Nutrition education and simple cafeteria changes leads to healthier eating

CORVALLIS, Ore. –  A combination of nutrition education and simple and inexpensive changes in elementary school cafeterias can lead children to make healthier eating choices, new research from Oregon State University shows.

The findings indicate that an integrated approach to child nutrition in schools could help address a nationwide child obesity epidemic. It also supports the “smarter lunchroom” movement that is gaining steam in school cafeterias around the country, said Stephanie Grutzmacher, an assistant professor of nutrition in the College of Public Health and Human Sciences at OSU.

The goal of the smarter lunchroom concept is to encourage kids to make better food choices through subtle changes in the cafeteria.

“They are all low-cost behavioral nudges, such as placing healthy food items at the front of the cafeteria line, using verbal prompts to encourage children to try something new, or posting fun facts about the healthy food items,” said Grutzmacher, who led the study while on the faculty at the University of Maryland.

The researchers’ goal was to test the effectiveness of those kinds of changes as well as the effectiveness of a companion classroom-based nutrition education program. The program, called Project ReFresh, was tested in public and private Maryland schools.

The findings were published recently in the Journal of School Health. Co-authors of the study are Hee-Jung Song of the University of Maryland and Ashley L. Munger of California State University, Los Angeles. The project was supported by grants from the U.S. Department of Agriculture’s Supplemental Nutrition Assistance Program, the USDA’s Team Nutrition program and the Maryland State Department of Education.

One group of students received classroom nutrition education as well as the cafeteria intervention program; another group received only the cafeteria intervention; and the third group did not receive either component of the program.

For the cafeteria intervention, researchers developed a toolkit of tips and ideas for cafeteria workers as well as training food service supervisors and staff to implement suggested changes. The researchers focused on small changes that might encourage students to make healthier food choices and encouraged cafeteria workers to evaluate their environments and pick a few changes that made the most sense in their school.

For example, asking things such as “Which fruit would you like: apples or peaches?” instead of “Would you like a fruit?” might help encourage the children to make a healthier choice, Grutzmacher said.

“We developed about 100 ideas for elementary school cafeterias, knowing that not all of the ideas were going to work in all of the cafeterias,” Grutzmacher said. “Moving the salad bar is not practical at every school, because of locations of plug-ins or other set-up issues.”

The classroom education included visits by trained nutrition educators as well as teacher training and lessons for the classroom teacher to use. The lessons were designed to integrate other school lessons, including math skills, writing prompts and reading.

Students reported their healthy food intake, including fruit and vegetable consumption, on a daily and weekly basis; before they started the program; and again once it was complete.

While researchers noted some improvements in healthy eating among students who received the cafeteria intervention, they found a larger improvement among the children who received both the classroom education program and the cafeteria changes. Students in that group reported eating more fruits and vegetables and enjoying foods such as whole grain pasta, Grutzmacher said.

The findings support the researchers’ belief that programs that address both individual and environmental factors may be most effective in improving children’s diets, she said.

“Vegetable consumption typically declines over time in school cafeterias,” Grutzmacher said. “It is pretty rare to find kids who are still choosing vegetables by the fifth grade. With this program, we saw an increase in vegetable consumption among these kids.

“We need more research but we think that integrating these approaches is a good idea.”

The findings are particularly valuable for low-income schools where children rely on school breakfast and lunch each day. Those children often have less opportunity to try new foods or eat a diet with a wide variety of fruits or vegetables, Grutzmacher said, and the school cafeteria plays a special role in helping to expose them to new fruits, vegetables and whole grain foods.

“If I could get every school to make one change, I would encourage them to offer tasting opportunities, so kids have a chance to try some new healthy food items and new recipes,” Grutzmacher said. “And I would give the kids a chance to vote on them, so they have a say in what ends up on their menus.”

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Stephanie Grutzmacher, 541-737-1610, Stephanie.grutzmacher@oregonstate.edu

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Cafeteria display of healthy food choices

School lunch display

Nutrition education lesson

nutrition education

Working longer may lead to a longer life, new OSU research shows

CORVALLIS, Ore. – Working past age 65 could lead to longer life, while retiring early may be a risk factor for dying earlier, a new study from Oregon State University indicates.

The researchers found that healthy adults who retired one year past age 65 had an 11 percent lower risk of death from all causes, even when taking into account demographic, lifestyle and health issues. Adults who described themselves as unhealthy were also likely to live longer if they kept working, the findings showed, which indicates that factors beyond health may affect post-retirement mortality.

“It may not apply to everybody, but we think work brings people a lot of economic and social benefits that could impact the length of their lives,” said Chenkai Wu, the lead author of the study. He conducted the research as part of his master’s thesis at OSU, where he is now a doctoral student in the College of Public Health and Human Sciences.

The findings were published recently in the Journal of Epidemiology and Community Health. Co-authors include Associate Professor Robert Stawski and Assistant Professor Michelle Odden of OSU and Gwenith Fisher of Colorado State University. The research was supported by a grant from the National Institute on Aging.

The research was the basis for Wu’s master’s thesis in human development and family science; he’s now pursuing a doctorate in epidemiology.

Wu took an interest in the effects of retirement on health in part because of China’s mandatory laws, which are often debated. Retirement age is also an issue for debate elsewhere around the world, including the United States, he said.

“Most research in this area has focused on the economic impacts of delaying retirement. I thought it might be good to look at the health impacts,” Wu said. “People in the U.S. have more flexibility about when they retire compared to other countries, so it made sense to look at data from the U.S.”

Wu examined data collected from 1992 through 2010 through the Healthy Retirement Study, a long-term study of U.S. adults led by the University of Michigan and funded by the National Institute on Aging. Of the more than 12,000 initial participants in the study, Wu narrowed his focus to 2,956 people who began the study in 1992 and had retired by the end of the study period in 2010. 

Poor health is one reason people retire early and also can lead to earlier death, so researchers wanted to find a way to mitigate a potential bias in that regard.

To do so, they divided the group into unhealthy retirees, or those who indicated that health was a factor in their decision to retire – and healthy retirees, who indicated health was not a factor. About two-thirds of the group fell into the healthy category, while a third were in the unhealthy category.

During the study period, about 12 percent of the healthy and 25.6 percent of the unhealthy retirees died. Healthy retirees who worked a year longer had an 11 percent lower risk of mortality, while unhealthy retirees who worked a year longer had a 9 percent lower mortality risk. Working a year longer had a positive impact on the study participants’ mortality rate regardless of their health status.

“The healthy group is generally more advantaged in terms of education, wealth, health behaviors and lifestyle, but taking all of those issues into account, the pattern still remained,” said Stawski, senior author of the paper. “The findings seem to indicate that people who remain active and engaged gain a benefit from that.”

Additional research is needed to better understand the links between work and health, the researchers said. As people get older their physical health and cognitive function are likely to decline, which could affect both their ability to work and their longevity.

“This is just the tip of the iceberg,” Stawski said. “We see the relationship between work and longevity, but we don’t know everything about people’s lives, health and well-being after retirement that could be influencing their longevity.”

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Chenkai Wu, wuche@oregonstate.edu; Robert Stawski, robert.stawski@oregonstate.edu, 541-737-9052

Mobility plays important role in development for toddlers with disabilities

CORVALLIS, Ore. – Typical toddlers simultaneously spend about three hours a day in physical activity, play and engagement with objects such as toys, while their peers with mobility disabilities are less likely to engage in all of those behaviors at the same time, new research from Oregon State University shows.

The study shows the marked differences in play and activity among toddlers with and without disabilities. It also underscores the need for young children with disabilities to have opportunities to play and explore in the same manner as their peers, said the study’s lead author, Sam Logan.

“Whatever typically-developing kids do should be the gold standard for all children, including those with disabilities,” said Logan, an assistant professor of kinesiology in the College of Public Health and Human Sciences. “The ability to move independently is a mechanism for a host of developmental benefits for children.”

Physical activity has important physiological benefits for children, but it also is a vehicle through which children can engage with their peers and interact with their surroundings, Logan said. One way researchers are now encouraging children with mobility disabilities to move more is through the use of modified toy ride-on cars.

Past research has shown that independent mobility is linked to cognitive, social, motor, language and other developmental benefits in young children. Being pushed in a stroller or being carried from one place to another is fundamentally different from having active control over one’s own exploration, which is where the developmental gains are seen, he said.

The latest study, published recently in the journal Pediatric Physical Therapy, compared the activity of typically-developing toddlers to those with disabilities, with a particular focus on the co-occurrence of play, physical activity and engagement with objects such as toys.

The researchers found that typically-developing toddlers spent about an hour per day in direct play interactions with their peers, while toddlers with disabilities affecting mobility spent less than 20 minutes and as few as six minutes per day in similar interactions. 

The toddlers with disabilities also had less variety in the types of physical activity they engaged in and were less likely to interact with objects such as toys, Logan said. One of the goals for physical therapists and other clinicians should be to encourage more simultaneous activity, he said.

“Moving is not the objective, but if you’re not able to move independently, then play with peers or interaction with toys is even more difficult,” Logan said. “So how can we help these kids move more for play?”

One challenge is the lack of commercially-available devices to help toddlers with mobility issues to get around on their own, Logan said. Power wheelchairs can be costly and typically aren’t available for children until they are older, and may not always be an option at all for children who are expected to eventually be able to walk.

Some low-cost interventions are emerging to help address this issue. Logan is a leader of the Go Baby Go program, which provides children with movement disabilities modified ride-on toy cars.

The cars give children independence at a much younger age, allowing them the mobility needed to increase their interaction with peers and other objects, Logan said. The modified cars have proven effective even among children with complex medical issues, he said.

A case study on the cars’ use among children with complex medical issues, including use of tracheotomy tubes and ventilators for aid in breathing, was also published recently in the journal Pediatric Physical Therapy.

The three children featured in the study, ranging in age from 6 months to 5 years of age, learned to drive modified ride-on cars independently. The children used the cars to explore their environment and some of the children also participated in play-based activities using the cars.

“The car becomes a tool,” Logan said. “It’s not just about getting from point A to point B. “It’s about how the child is using the car to play and interact with peers and objects.”

Together, the two studies provide further evidence of the benefits of mobility for children with disabilities and the effectiveness the modified cars in helping children gain that mobility, Logan said.

His latest research is focused on modified cars that require children to stand to operate them, which helps build muscle strength and prepare children for walking, and further reduces barriers for play and socialization with peers.

“The expectation should be that they have the same opportunities for mobility and play as any other kids,” Logan said. “Even the most complicated medical cases should not be barriers for play.”

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Sam Logan, 541-737-3437, sam.logan@oregonstate.edu

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Toddler using a modified toy car
GoBabyGo at Oregon State


Researcher Sam Logan

Sam Logan

No evidence that water birth poses harm to newborns, new OSU study finds

CORVALLIS, Ore. – There is no evidence that water births, where a baby is intentionally born under water in a tub or pool, poses any increased harm to the child, Oregon State University researchers have found.

Researchers examined outcome data for more than 6,500 midwife-attended water births in the United States and found that newborns born in water were no more likely to experience low Apgar scores, require transfer to the hospital after birth or be hospitalized in their first six weeks of life, than newborns who were not born in water.

The results were published this week in the Journal of Midwifery and Women's Health. The study is believed to be the largest study of water births to date and the first to examine the practice in the United States, said lead author, Marit Bovbjerg, an epidemiology instructor in the College of Public Health and Human Sciences at OSU. 

“The findings suggest that water birth is a reasonably safe, low-intervention option for women who face a low risk of complications during the birthing process,” Bovbjerg said. “These are decisions that should be made in concert with a medical professional.”

Co-authors of the study are Melissa Cheyney, a medical anthropologist and associate professor in OSU’s College of Liberal Arts, and Courtney Everson, a former OSU graduate student who recently completed her doctorate.

For the study, researchers analyzed birthing outcome data collected from 2004 through 2009 by the Midwives Alliance of North America Statistics Project, commonly referred to as MANA Stats. Most of the nearly 17,000 women in the study were attended by Certified Professional Midwives, who provided detailed reports on their cases from their medical records.

More than 6,500 women in the database gave birth in water, either at home or in a free-standing birthing center. The outcomes in those births were compared to the outcomes for non-water births. The study compared only births at home or in a birthing center and not those in hospitals. 

The researchers found that babies born in water were no more likely to require transfer or admission to a hospital, nor were the mothers who gave birth in water. However, the researchers found an 11 percent increase in perineal tearing among mothers who gave birth in water.

“For some women, that potential risk of tearing might be worth taking if they feel they will benefit from other aspects of a water birth, such as improved pain management,” Bovbjerg said. “There is no one correct choice. The risks and benefits of different birthing options should be weighed carefully by each individual.” 

The researchers’ findings are congruent with outcomes reported in other water birth studies, Cheyney said, but are contrary to the American College of Obstetricians and Gynecologists’ and the American Academy of Pediatrics’ Committee Opinion.

“Those groups support laboring in water, but caution against giving birth while immersed,” Cheyney said. “Our findings suggest that water birth is a reasonably safe option for low-risk women, especially when the risks associated with pharmacologic pain management, like epidural anesthesia, are considered.”

The researchers have shared their findings with a group that is developing a clinical bulletin designed to inform health care providers about the practice of water birth in both hospital and out-of-hospital settings.

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Melissa Cheyney, 541-737-4515, melissa.cheyney@oregonstate.edu; Marit Bovbjerg, 541-737-5313, Marit.Bovbjerg@oregonstate.edu

Exercise DVDs could be psychologically harmful for users

CORVALLIS, Ore. – Using fitness DVDs to work out at home may seem like a good way to get started on new exercise goals this year, but those DVDs may also include negative imagery and demotivating language.

A study of 10 popular commercial exercise DVDs showed that the imagery in the fitness videos may be perpetuating and reinforcing hyper-sexualized and unrealistic body images, said Brad Cardinal, a kinesiology professor in the College of Public Health and Human Sciences at Oregon State University. 

In addition, researchers found that one in every seven motivational statements on the DVDs was actually a demotivating statement that could reduce the effectiveness of the workout, diminish the user’s hope and potentially cause psychological harm, said Cardinal, the lead author of the study.

“These findings raise concerns about the value of exercise DVDs in helping people develop and commit to a workout program,” said Cardinal, who is a national expert on the benefits of physical activity. “There are a lot of exaggerated claims through the imagery and language of ‘do this and you’ll look like me.’ ” 

The findings are being published in the latest issue of the Sociology of Sport Journal. Co-authors of the study are: OSU graduate students Kim A. Rogers, Brian Kuo, Rosalee L. Locklear and Katelyn E. Comfort; and Professor Marita K. Cardinal of Western Oregon University.

Fitness DVDs are a $250 million a year industry but there is no scientific evidence about their safety and effectiveness or the accuracy of the information contained in them, and the industry is largely unregulated, Cardinal said. 

For the study, the researchers reviewed 10 popular, instructor-led fitness DVDs, evaluating both the imagery used in the videos as well as the motivational language used by the instructors. The goal was to better understand the visual and auditory messaging and how it might affect users.

Researchers found that most of the instructors and models were slim, female and white, and they typically wore revealing attire. That sends a subtle message about what people who are fit should look like, Cardinal said. This perpetuates objectification of the female body in particular and emphasizes physical appearance as opposed to improved health, he said.

The researchers also found that a quarter of the language used by instructors was motivational, but one of every seven motivational statements was considered negative. Negative statements included phrases such as “say hello to your sexy six-pack,” “you better be sweating,” and “you should be dying right now.” 

 

Those kinds of phrases focus on outcomes, encourage social comparison, and don’t take into account individual differences in health or fitness, Cardinal said. “Tough love” phrases and strategies can also have a harmful effect because they can lead to injuries or other adverse health outcomes, he said.

Such messages could be particularly harmful to users who are turning to exercise DVDs to start a new fitness routine or who are uncomfortable in a gym or fitness class setting, Cardinal said. The exercise videos were marketed to novice exercisers while the movement skills tended to be designed for intermediate or advanced levels of fitness, and the instructors’ verbal messages sometimes taunted observers to keep up. 

“You’re inviting into your home these images and messages that could make you feel bad about yourself, and ultimately hinder your efforts to improve your health,” he said. “If the experience is not positive, the likelihood the person is going to continue with an exercise program diminishes.”

Cardinal urged potential fitness DVD consumers to be mindful of the potential pitfalls of the product when selecting and using exercise videos. 

“Buyers should beware when making these purchases,” he said. “Remember that we all have different body shapes and styles, and our bodies may respond differently to the exercises being shown. Don’t expect to get the same results as what you see on the screen or compare yourself to others.”

The findings indicate that there is a need to further study commercial fitness DVDs, Cardinal said. Along with the language and imagery used in the videos, researchers should consider studying the effectiveness and safety of the types of exercises and techniques used, he said. In addition, many of the instructors appear to have little or no credentials in fitness instruction, he said. 

“We don’t think the videos are very psychologically safe,” Cardinal said. “There are also questions about some of the exercises, which could lead to injuries and pose a real danger to the user.”

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Source: 

Brad Cardinal, 541-737-2506, brad.cardinal@oregonstate.edu

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