ISRN Nutrition http://www.hindawi.com The latest articles from Hindawi Publishing Corporation © 2013 , Hindawi Publishing Corporation . All rights reserved. Branched-Chain Amino Acid Plus Glucose Supplement Reduces Exercise-Induced Delayed Onset Muscle Soreness in College-Age Females Sun, 17 Mar 2013 09:34:57 +0000 http://www.hindawi.com/isrn/nutrition/2013/921972/ Supplementation with branched-chain amino acids (BCAAs) has been used to stimulate muscle protein synthesis following exercise. The purpose of this study was to determine if supplementation with BCAAs in combination with glucose would reduce exercise-induced delayed onset muscle soreness (DOMS). Using a double-blind crossover design, 20 subjects (11 females, 9 males) were randomly assigned to either BCAA () or placebo () groups. Subjects performed a squatting exercise to elicit DOMS and rated their muscle soreness every 24 hours for four days following exercise while continuing to consume the BCAA or placebo. Following a three-week recovery period, subjects returned and received the alternate BCAA or placebo treatment, repeating the same exercise and DOMS rating protocol for the next four days. BCAA supplementation in female subjects resulted in a significant decrease in DOMS versus placebo at 24 hours following exercise (). No significant effect of BCAA supplementation versus placebo was noted in male subjects nor when male and female results were analyzed together. This gender difference may be related to dose per body weight differences between male and female subjects. Danielle T. Leahy and Stephen J. Pintauro Copyright © 2013 Danielle T. Leahy and Stephen J. Pintauro. All rights reserved. B Vitamins and Cognitive Performance in Older Adults: Review Mon, 11 Mar 2013 15:29:49 +0000 http://www.hindawi.com/isrn/nutrition/2013/650983/ A copious amount of scientific scrutiny has been dedicated to documenting typical and atypical human ageing, with a substantial body of work focusing upon the impact of lifestyle choices. One such lifestyle choice is that of diet and, in particular, micronutrient ingestion. Epidemiological studies have reported positive associations between B vitamin status and cognitive function, including negative associations between biological markers (i.e., homocysteine) of dysregulated one-carbon metabolism and cognitive function. This has led to a surge of randomised control trials (RCTs) investigations into B vitamin therapy. However, results have continuingly failed to show beneficial behavioural effects. Despite this, results reliably show treatment-related increases in B vitamin level and decreases in homocysteine level—both of which have been identified as risk factors for atypical ageing. In this paper we argue that it would be premature to conclude that B vitamin therapy has no potential and that more research is needed to systematically investigate the optimal dose, the therapeutic “window,” and individual differences in therapy responders and nonresponders. We start with a brief look at one-carbon metabolism and then consider the evidence from epidemiological studies and RCTs in relation to three specific B vitamins: folic acid (B9), pyridoxine (B6), and cobamides (B12). J. L. Reay, M. A. Smith, and L. M. Riby Copyright © 2013 J. L. Reay et al. All rights reserved. Impact of Daily versus Weekly Supply of Locally Produced Ready-to-Use Food on Growth of Moderately Wasted Children on Nias Island, Indonesia Wed, 27 Feb 2013 12:06:21 +0000 http://www.hindawi.com/isrn/nutrition/2013/412145/ This study reports the outcomes of daily (semi-urban areas) and weekly (remote rural regions) programs for moderately wasted children supplemented with locally produced ready-to-use foods in the form of fortified cereal/nut/legume-based biscuits on Nias Island, Indonesia (RUF-Nias biscuit). Thirty-four children in daily and twenty children in weekly programs aged ≥6 to <60 months with weight-for-height -score (WHZ) ≥ −3 to < −2 SD were recruited (October 2007–June 2008) on Nias and admitted into existing nutrition centers in the Church World Service project area. Individual discharge criterion was WHZ ≥ −1.5 SD. Weight gain of the children in daily and weekly programs was and  g/kg/day, respectively. A higher proportion of children in daily than weekly programs reached target WHZ (76% vs. 35%, ). Weight gain at program discharge/closure was highly predicted (, ) by compliance to RUF biscuits: high vs. low compliance resulted in a 1.33 (95% CI 0.16 to 1.53) g/kg/day higher weight gain. Compliance and admission in daily programs were significant factors in reducing the risk of not reaching the discharge criterion. However, mothers complained more frequently about time constraints in the daily relative to weekly programs. Ratna Chrismiari Purwestri, Veronika Scherbaum, Dyah Ayu Inayati, Nia Novita Wirawan, Julia Suryantan, Maurice Alexander Bloem, Rosnani Verba Pangaribuan, Wolfgang Stuetz, Volker Hoffmann, Matin Qaim, Hans Konrad Biesalski, and Anne Camilla Bellows Copyright © 2013 Ratna Chrismiari Purwestri et al. All rights reserved. Bioavailability of Oil-Based and β-Lactoglobulin-Complexed Vitamin A in a Rat Model Tue, 19 Feb 2013 16:07:35 +0000 http://www.hindawi.com/isrn/nutrition/2013/270580/ β-Lactoglobulin is capable of binding fat-soluble compounds including vitamin A palmitate and is suggested to specifically enhance intestinal uptake of retinol. In this study, bioavailability of a vitamin-A-retinyl palmitate complex in skim milk and in water-based liquids was investigated in vitamin-A-depleted rats. First, rats were fed a vitamin-A-free pellet diet for 6 wk and were thereafter gavage-fed with vitamin A in oil, vitamin-A-β-lactoglobulin complex, vitamin A in oil + skim milk, and vitamin-A-β-lactoglobulin + skim milk for 2 wk and 42 wk. Vitamin A repletion, as judged by vitamin A accumulation in serum and liver, occurred in all the treatments. Vitamin-A-β-lactoglobulin complex treatments had statistical equivalence with oil-based vitamin A treatments. In a second experiment, vitamin-A-depleted rats were fed UHT-processed skim milk fortified with either oil-based or freeze-dried β-lactoglobulin-complexed retinyl palmitate. Liver and serum vitamin A were analyzed by HPLC to indicate vitamin A status in the rats. Results showed no significant difference in bioavailability of retinyl palmitate from milk made with either regular oil-based or β-lactoglobulin-complexed fortifiers. The vitamin-A-β-lactoglobulin complex, being water soluble, may be useful for fortification of nonfat products. Ying Liu, Ju-Jean Shaw, Harold E. Swaisgood, and Jonathan C. Allen Copyright © 2013 Ying Liu et al. All rights reserved. Intake of n-3 Polyunsaturated Fatty Acids Increases Omega-3 Index in Aged Male and Female Spontaneously Hypertensive Rats Tue, 19 Feb 2013 14:26:23 +0000 http://www.hindawi.com/isrn/nutrition/2013/209360/ The purpose of this study was to examine whether n-3 PUFA intake affects n-3 and n-6 FA levels in plasma and red blood cells as well as omega-3 index in old male and female spontaneously hypertensive (SHR) and healthy rats. Plasma linoleic acid and eicosapentaenoic acid increased due to n-3 PUFA intake in SHR and healthy rats. Comparing to healthy rats the levels of PUFA in red blood cells of SHR were lower in males and higher in females with exception of arachidonic acid, which was high in males and low in females. Feeding of rats with n-3 PUFA resulted in increase of red blood cells levels of eicosapentaenoic acid and/or docosahexaenoic acid in a sex- and strain-dependent manner. Moreover, n-3 PUFA intake decreased arachidonic acid in healthy female rats but increased it in SHR and did not affect it in males. Omega-3 index was lower in SHR comparing to healthy rats and it increased due to the consumption of n-3 PUFA. Results point out sex- and strain-related differences in red blood cells levels of n-3 and n-6 PUFA in basal conditions as well as in response to n-3 PUFA intake. Barbara Bačová, Peter Seč, Milan Čertik, and Narcis Tribulova Copyright © 2013 Barbara Bačová et al. All rights reserved. Children’s Food and Drink Purchasing Behaviour “Beyond the School Gate”: The Development of a Survey Module Thu, 14 Feb 2013 10:14:01 +0000 http://www.hindawi.com/isrn/nutrition/2013/501450/ Many children eat a diet which supplies a higher than recommended amount of nonmilk extrinsic sugars and saturated fatty acids. The school setting is often targeted for nutrition intervention as many children consume food at school. In Scotland, attempts have been made to improve the nutritional content of food in schools and attention has now turned to food and drink available “beyond the school gate.” This paper describes the development of a module on food and drink purchasing behaviour. The Food Purchasing Module was designed to collect data, for the first time, from a representative sample of children aged 8–16 years about food and drinks purchased on the way to/from school, during break time/free periods, and at lunchtime, from outlets around schools. Cognitive testing of the module highlighted that younger children find self-completion questionnaires problematic. Older children have fewer problems with self-completion questionnaires but many do not follow question routing, which has implications for the delivery of future surveys. Development of this survey module adds much needed evidence about effectively involving children in surveys. Further research exploring food and drinks purchased beyond the school gate is needed to continue to improve the nutritional quality of children’s diets. Wendy J. Wills, Jennie I. Macdiarmid, Lindsey F. Masson, Catherine Bromley, Leone Craig, and Geraldine McNeill Copyright © 2013 Wendy J. Wills et al. All rights reserved. Dietary Supplementation of Calendula officinalis Counteracts the Oxidative Stress and Liver Damage Resulted from Aflatoxin Tue, 12 Feb 2013 12:40:59 +0000 http://www.hindawi.com/isrn/nutrition/2013/538427/ This study was conducted to evaluate the total phenolic compounds, the antioxidant properties, and the hepatorenoprotective potential of Calendula officinalis extract against aflatoxins (AFs-) induced liver damage. Six groups of male Sprague-Dawley rats were treated for 6 weeks included the control; the group fed AFs-contaminated diet (2.5 mg/kg diet); the groups treated orally with Calendula extract at low (CA1) and high (CA2) doses (500 and 1000 mg/kg b.w); the groups treated orally with CA1 and CA2 one week before and during AFs treatment for other five weeks. The results showed that the ethanol extract contained higher phenolic compounds and posses higher 1,1-diphenyl 1-2-picryl hydrazyl (DPPH) radical scavenging activity than the aqueous extract. Animals fed AFs-contaminated diet showed significant disturbances in serum biochemical parameters, inflammatory cytokines, and the histological and histochemical pictures of the liver accompanied by a significant increase in malondialdehyde (MDA) and a significant decrease in superoxide dismutase (SOD) and glutathione peroxidase (GPx) in liver. Calendula extract succeeded to improve the biochemical parameters, inflammatory cytokines, decreased the oxidative stress, and improved the histological pictures in the liver of rats fed AFs-contaminated diet in a dose-dependent manner. It could be concluded that Calendula extract has potential hepatoprotective effects against AFs due to its antioxidant properties and radical scavenging activity. Mohamed A. Hamzawy, Ezzeldein S. M. El-Denshary, Nabila S. Hassan, Fathia A. Mannaa, and Mosaad A. Abdel-Wahhab Copyright © 2013 Mohamed A. Hamzawy et al. All rights reserved. A Nutrition Education Intervention to Combat Undernutrition: Experience from a Developing Country Tue, 05 Feb 2013 07:33:55 +0000 http://www.hindawi.com/isrn/nutrition/2013/210287/ Introduction. Undernutrition in children is a major public health concern in Pakistan. A number of interventions which focused only on providing nutrient supplementation have failed to change child undernutrition status during the last 2 decades. The present study aimed to assess the impact of nutrition education on the nutritional status of children living in resource-limited environments. Methods. Subjects were 586 children from Tando Jam and Quetta, Pakistan, aged from 6 months to 8 years. Children were characterized as mild, moderate, or severely wasted on Z-scores. Anthropometry and 24-hour dietary recall were used for nutritional assessment. Intervention strategy was nutrition counselling targeting mothers. Primary outcome was decrease in the severity of wasting and changes in the feeding practices. Results. Nearly 36% children in Tando Jam and 32% children in Quetta progressed to a normal nutritional status. There was a significant increase in the number of meals taken per day (Tando Jam—/Quetta—). In Tando Jam, significant increase was reported in the intake of high starch food items, vegetables, and fruits (). In Quetta, significant increase was noted in the intake of plant protein (), dairy foods (), and vegetables (). Conclusion. Nutrition education was successful in reducing undernutrition in food insecure households. Ayesha Zahid Khan, Ghazala Rafique, Haneen Qureshi, and Salma Halai Badruddin Copyright © 2013 Ayesha Zahid Khan et al. All rights reserved. Food Value of Two Varieties of Ginger (Zingiber officinale) Commonly Consumed in Nigeria Thu, 17 Jan 2013 15:47:21 +0000 http://www.hindawi.com/isrn/nutrition/2013/359727/ Ginger (Zingiber officinale) is a well-known and widely used herb, which contains several interesting bioactive constituents and possesses health-promoting properties. The proximate, mineral, antinutrient, amino acid, and phytochemical components of two varieties of ginger (Zingiber officinale) were investigated. Amino acid composition was determined using standard analytical techniques. The results obtained in percentages in the two varieties of ginger (white and yellow types) were crude fibre (21.90, 8.30), fat (17.11, 9.89), carbohydrate (39.70, 58.21), crude protein (12.05, 11.65), ash (4.95, 7.45) and moisture (3.95, 4.63) contents respectively. Elemental analysis revealed that potassium (0.98 ppm and 1.38 ppm) is the most abundant, while copper (0.01 ppm) is the least. Phytochemical screening indicated that they are both rich in saponins, anthraquinones, phlobatannin and glycosides. Also, the antinutrient constituents of white ginger were lower than yellow ginger, although the levels of the antinutrient constituents in the two varieties are saved for consumption. The essential amino acids in the two varieties were almost the same, with Leu being the most abundant in both. The two ginger varieties were adequate only in Leu, Phe + Try, and valine based on FAO/WHO provisional pattern. Overall, the findings indicate that the two varieties of ginger are good sources of nutrients, mineral elements, amino acid, and phytochemicals which could be exploited as great potentials for drugs and/or nutritional supplements. Olubunmi B. Ajayi, Seun F. Akomolafe, and Funmilayo T. Akinyemi Copyright © 2013 Olubunmi B. Ajayi et al. All rights reserved. Health Benefits of Probiotics: A Review Wed, 02 Jan 2013 13:21:56 +0000 http://www.hindawi.com/isrn/nutrition/2013/481651/ Probiotic bacteria have become increasingly popular during the last two decades as a result of the continuously expanding scientific evidence pointing to their beneficial effects on human health. As a result they have been applied as various products with the food industry having been very active in studying and promoting them. Within this market the probiotics have been incorporated in various products, mainly fermented dairy foods. In light of this ongoing trend and despite the strong scientific evidence associating these microorganisms to various health benefits, further research is needed in order to establish them and evaluate their safety as well as their nutritional aspects. The purpose of this paper is to review the current documentation on the concept and the possible beneficial properties of probiotic bacteria in the literature, focusing on those available in food. Maria Kechagia, Dimitrios Basoulis, Stavroula Konstantopoulou, Dimitra Dimitriadi, Konstantina Gyftopoulou, Nikoletta Skarmoutsou, and Eleni Maria Fakiri Copyright © 2013 Maria Kechagia et al. All rights reserved. Irregular Meal Timing Is Associated with Helicobacter pylori Infection and Gastritis Sun, 30 Dec 2012 14:12:50 +0000 http://www.hindawi.com/isrn/nutrition/2013/714970/ Helicobacter pylori (HP) is associated with chronic gastritis and gastric cancer, and more than half of the world’s population is chronically infected. The aim of this retrospective study was to investigate whether an irregular meal pattern is associated with increased risk of gastritis and HP infection. The study involved 323 subjects, divided into three groups as follows: subjects with HP infection and gastritis, subjects with gastritis, and a control group. Subjects were interviewed on eating habits and meal timing. Multivariate logistic regression was used to compare groups. Adjusted odds ratios (OR) were derived controlling for gender, age, stress, and probiotic consumption. Subjects who deviated from their regular meals by 2 hours or more had a significantly higher incidence of HP infection with gastritis (adjusted OR = 13.3; 95% CI 5.3–33.3; ) and gastritis (adjusted OR = 6.1; 95% CI 2.5–15.0; ). Subjects who deviated their meals by 2 hours or more, twice or more per week, had an adjusted OR of 6.3 and 3.5 of acquiring HP infection with gastritis (95% CI 2.6–15.2; ) and gastritis (95% CI 1.5–8.5; ), respectively. Frequent deviation in meal timing over a prolonged period appears associated with increased risk of developing HP infection and gastritis. Su-Lin Lim, Claudia Canavarro, Min-Htet Zaw, Feng Zhu, Wai-Chiong Loke, Yiong-Huak Chan, and Khay-Guan Yeoh Copyright © 2013 Su-Lin Lim et al. All rights reserved. Markers of Cardiovascular Risk in Postmenopausal Women with Type 2 Diabetes Are Improved by the Daily Consumption of Almonds or Sunflower Kernels: A Feeding Study Wed, 19 Dec 2012 18:16:03 +0000 http://www.hindawi.com/isrn/nutrition/2013/626414/ Dietary guidelines for the treatment of type 2 diabetes advocate the regular consumption of nuts and seeds. Key lipid abnormalities associated with diabetes include raised LDL-C, VLDL-C, and TAG concentrations and decreased concentrations of HDL-C. The fatty acid profiles of nuts and seeds differ and may potentially influence lipid outcomes in people with diabetes differently. To examine the effects of nut or seed consumption on lipid and lipoprotein markers of cardiovascular disease (CVD), we added almonds (AD) or sunflower kernels (SKD) to a recommended diet in a randomised crossover feeding study. Twenty-two postmenopausal women with type 2 diabetes consumed personalised diets, with the addition of 30 g/d of either almonds or sunflower kernels. All food was supplied for two periods of three weeks, separated by a four-week washout. There was a significant reduction in high-density lipoprotein cholesterol (HDL-C), triacylglycerol (TAG), and apolipoprotein (apo) A1 and B100 on the SKD compared to the AD. Total (TC) and low density lipoprotein cholesterol (LDL-C) decreased significantly on both diets from baseline, with no difference between diets. A diet with the addition of either almonds or sunflower kernels has clinically beneficial effects on lipid- and lipoprotein-mediated CVD risk. Korina Richmond, Sheila Williams, Jim Mann, Rachel Brown, and Alexandra Chisholm Copyright © 2013 Korina Richmond et al. All rights reserved. Comparative Studies of the Effects of Egg Yolk, Oats, Apple, and Wheat Bran on Serum Lipid Profile of Wistar Rats Wed, 12 Dec 2012 11:12:04 +0000 http://www.hindawi.com/isrn/nutrition/2013/730479/ Excess consumption of egg especially its yolk has been implicated in hyperlipidaemia (high level of cholesterol and triglyceride in the blood). Conversely, soluble dietary fibers, probably due to their ability to bind free lipid molecules, appear to play an important role in protecting against hyperlipidaemia. This study sought to evaluate the comparative effects of selected sources of fibers: apple, oats, and wheat bran, on serum lipid profile in physiologically normal Wistar rats. Twenty rats were used for the study and were randomized into four groups, with each containing five animals (). A group which serves as control was fed with egg yolk while the other three groups were fed with apple, oats, and wheat bran, respectively. After two weeks of feeding, the animals were fasted overnight and blood samples from the retro-orbital sinus of the eye were collected for analyses of lipid profile. The results obtained showed that the group fed with oats had the lowest level of total cholesterol ( mg), low density lipoprotein (LDL) cholesterol ( mg), and triglycerides (TG) ( mg), as well as the highest level of HDL cholesterol ( mg). On the contrary, the group fed with egg yolk showed the highest level of total cholesterol ( mg), LDL cholesterol ( mg), and triacylglyceride ( mg), as well as the lowest level of HDL cholesterol ( mg). There was no significant difference () between oats and apple in their effects on blood lipid profile of Wistar rats. Wheat bran, being an insoluble dietary fibre, had less significant () effect on the blood lipid profile when compared to oats and apple. Findings from this study may assist physicians and dieticians in recommending appropriate diet for individuals desiring to normalize their blood lipids levels. J. O. Omole and O. M. Ighodaro Copyright © 2013 J. O. Omole and O. M. Ighodaro. All rights reserved. Association between Taste Sensitivity and Self-Reported and Objective Measures of Salt Intake among Hypertensive and Normotensive Individuals Wed, 24 Oct 2012 08:46:21 +0000 http://www.hindawi.com/isrn/nutrition/2013/301213/ This study investigated the gustatory threshold for salt and its relationship with dietary salt intake among hypertensive () and normotensive () subjects. Salt intake was evaluated through 24-hour urinary sodium excretion and self-reported measures (discretionary salt, Sodium- Food Frequence Questionnaire (Na-FFQ), and 24-hour recall). Detection and recognition thresholds were higher among hypertensive subjects, as well as the total sodium intake. Detection and recognition thresholds were positively related to discretionary salt and total intake of the group as whole. Hypertensive and normotensive subjects presented positive correlations between taste sensitivity and the different measures of salt intake. To conclude, a positive correlation exists between taste threshold and salt intake and both seem to be higher among hypertensive subjects. The combined use of methods of self-report and assessment of taste thresholds can be useful in health promotion and rehabilitation programs, by screening subjects at higher risk of elevated salt intake and the critical dietary behaviors to be targeted as well to evaluate the result of targeted interventions. Paula de Moura Piovesana, Karina de Lemos Sampaio, and Maria Cecília B. J. Gallani Copyright © 2013 Paula de Moura Piovesana et al. All rights reserved. Nutritional Intervention Incorporating Expedited 10 g Protein Counter (EP-10) to Improve the Albumin and Transferrin of Chronic Hemodialysis Patients Mon, 22 Oct 2012 11:39:03 +0000 http://www.hindawi.com/isrn/nutrition/2013/396570/ Objective. The expedited 10 g protein counter (EP-10) is a quick and valid clinical tool for dietary protein quantification. This study aims to assess the clinical effectiveness of the EP-10 in improving serum albumin and transferrin in chronic hemodialysis patients. Methods. Forty-five patients with low serum albumin (<38 g/L) were enrolled in this study. Parameters measured included dry weight, height, dietary intake, and levels of serum albumin, transferrin, potassium, phosphate, and kinetic modeling (Kt/V). The nutritional intervention incorporated the EP-10 in two ways (1) to quantify protein intake of patients and (2) to educate patients to meet their protein requirements. Mean values of the nutritional parameters before and after intervention were compared using paired t-test. Results. Three months after nutritional intervention, mean albumin levels increased significantly from 32.2 ± 4.8 g/L to 37.0 ± 3.2 g/L . Thirty-eight (84%) patients showed an increase in albumin levels, while two (4%) maintained their levels. Of the thirty-six (80%) patients with low transferrin levels (<200 mg/dL), 28 (78%) had an increase and two maintained their levels after intervention. Mean transferrin levels increased significantly from 169.4 ± 39.9 mg/dL to 180.9 ± 38.1 mg/dL . Conclusion. Nutritional intervention incorporating the EP-10 method is able to make significant improvements to albumin and transferrin levels of chronic hemodialysis patients. Su-Lin Lim and Jamie Lye Copyright © 2013 Su-Lin Lim and Jamie Lye. All rights reserved. Serum Retinol and Carotenoids in Association with Biomarkers of Insulin Resistance among Premenopausal Women Wed, 12 Sep 2012 15:48:55 +0000 http://www.hindawi.com/isrn/nutrition/2013/619516/ Objective. The aim of this study was to investigate how serum retinol and carotenoids (β-carotene, β-cryptoxanthin, lutein/zeaxanthin, lycopene) are associated with biomarkers of insulin resistance. Research Methods and Procedures. The BioCycle Study (2005–2007) is a prospective cohort of 259 healthy premenopausal women. Fasting serum samples were collected at up to sixteen clinic visits, from which retinol, carotenoids, insulin, glucose, and sex hormone-binding globulin (SHBG) were measured. Insulin resistance was estimated by the homeostasis model assessment (HOMA-IR). Linear mixed models were used to determine associations adjusting for age, race, body mass index (BMI), education, smoking, physical activity, triglycerides, and energy intake. Results. Retinol was positively associated with HOMA-IR (𝛽=0.19 (95% CI: 0.07, 0.32)) units per ug/mL increase in retinol; the relationship was driven by insulin (𝛽=0.20 (95% CI: 0.08, 0.31)). Retinol was inversely associated with SHBG (𝛽=−0.22 (95% CI: −0.28, −0.16)). Although no significant associations were found between serum carotenoids and HOMA-IR, β-carotene was positively associated with SHBG and β-cryptoxanthin inversely with fasting plasma glucose. Conclusion. Results indicate a possible role for serum retinol in the pathogenesis of type 2 diabetes. However, they do not support a strong association between individual or total serum carotenoids and insulin resistance. Stacy A. Blondin, Edwina H. Yeung, Sunni L. Mumford, Cuilin Zhang, Richard W. Browne, Jean Wactawski-Wende, and Enrique F. Schisterman Copyright © 2013 Stacy A. Blondin et al. All rights reserved.