The association of dietary patterns and obesity, particularly in Hispanics, is relatively poorly understood. This large U.S. population subgroup has a high prevalence of obesity and associated chronic conditions, and Hispanics are changing their dietary practices as they acculturate. Our objectives were 1) to identify dietary patterns among elderly Hispanics in Massachusetts, compared with those of non-Hispanic whites; 2) to associate dietary patterns with acculturation; and 3) to associate dietary patterns with total and central obesity. We used a representative sample of 449 Puerto Rican and 133 Dominican elders and a neighborhood-based sample of 243 non-Hispanic white elders, aged 60 to 92 y, from the cross-sectional Massachusetts Hispanic Elders Study. Obesity and central obesity were assessed with BMI (kg/m2) and waist circumference measurement, respectively. Acculturation was assessed by evaluating language use. Usual diet was assessed with a food frequency questionnaire specifically designed for use with this population. Dietary patterns were defined by cluster analysis of food group variables. We identified five clusters of individuals by dietary pattern, with proportionately greater energy intake from 1) fruit and breakfast cereal, 2) starchy vegetables, 3) rice, 4) whole milk and 5) sweets, respectively. Hispanics were less likely to follow the fruit and cereal or sweets patterns, and more likely to follow the starchy vegetables or milk patterns, than were non-Hispanic whites. Only Hispanics followed the rice pattern. Among Hispanics, acculturation was positively associated with the fruit and cereal pattern, and negatively with the rice pattern. Total and central obesity were positively associated with the rice pattern. Longitudinal studies are needed to clarify the causal nature of these associations.

The negative effects of prenatal substance exposure on neurobiological and psychological development and of early adversity are clear, but little is known about their combined effects. In this study, multilevel analyses of the effects of prenatal substance exposure and early adversity on the emergence of neurobehavioral disinhibition in adolescence were conducted. Neurobehavioral disinhibition has previously been observed to occur frequently in multiproblem youth from high-risk backgrounds. In the present study, neurobehavioral disinhibition was assessed via behavioral dysregulation and poor executive function composite measures. Data were drawn from a prospective longitudinal investigation of prenatal substance exposure that included 1073 participants followed from birth through adolescence. The results from latent growth modeling analyses showed mean stability but significant individual differences in behavioral dysregulation and mean decline with individual differences in executive function difficulties. Prior behavioral dysregulation predicted increased executive function difficulties. Prenatal drug use predicted the emergence and growth in neurobehavioral disinhibition across adolescence (directly for behavioral dysregulation and indirectly for executive function difficulties via early adversity and behavioral dysregulation). Prenatal drug use and early adversity exhibited unique effects on growth in behavioral dysregulation; early adversity uniquely predicted executive function difficulties. These results are discussed in terms of implications for theory development, social policy, and prevention science.

This first report of behavior problems in patients as young as 3 years associated with MA exposure identifies an important public health problem. Continued follow-up can inform the development of preventive intervention programs.

Patients with mental illness merit special attention in national diabetes quality improvement efforts.