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ABSTRACT
NUTRITIONAL STATUS OF PRESCHOOL CHILDREN
IN RELATION TO SELECTED FACTORS
CHARACTERIZING THE FAMILY ENVIRONMENT-
AN ECOLOGICAL APPROACH
BY
Laura Smail Sims
Nutrient intake is recognized as but one of many
environmental factors which act upon the genetic potential
of the young child to influence his physical develogment.
The syndrome of malnutrition occurs not in isolation, but
within the context of an entire constellation of environ-
mental factors which together contribute to the final
manifestation of the problem. Often differences which may
be observed in children's dietary intake may be traced to
contributory factors in the home setting. Thus, because
nutrient intake may be associated with various environmen-
tal characteristics, the‘approach taken in the present
study is ecological, i.e., the nutritional status of
preschool children is examined in relation to factors which
characterize his near environment, particularly his family.
A total of 163 children served as the sample for the
present study. These children were attending either a
nursery school program or a public health clinic. Although
Laura Smail Sims
the sample was drawn from a relatively small_geographical
area, the families of the children represented a variety
of ethnic, socioeconomic, and resource characteristics.
Data collected on the children which would serve to
evaluate their nutritional status included: dietary
records which were used for the calculation of nutrient
intakes; blood tests analyzed for hemoglobin, hematocrit,
serum albumin, and total serum proteins; urinalysis for
the determination of urinary hydroxyproline and
creatinine; and a series of anthrOpometric measurements.
Because the objectives of the research entailed studying
nutritional status in an environmental context, mothers
of the children in the sample were asked to provide the
researcher with data which would serve to characterize
the family environment. Data collected included: a
home interview to determine demographic characteristics
and certain resource and management patterns, an
evaluation of the home and immediate neighborhood, and
a series of attitude-measuring instruments used to assess
certain psychosocial attributes of the mothers.
Analysis of the three-day food records indicated
that children in the sample were, for the most part, well
nourished. 0n the average, all nutrients, except iron,
either met or exceeded the Recommended Dietary Allowances.
For those few children who had nutrient intakes less than
two-thirds of the RDA for any one nutrient, those
nutrients which were most limiting were iron, ascorbic
Laura Smail Sims
acid, calcium, and Vitamin A. Evaluation of the blood
components and anthropometric measurements failed to
reveal evidences of gross malnutrition. Evaluation of
weight and height measurements in reference to accepted
standards revealed that more children were overweight for
height than were underweight.
.Using correlational and multiplefgroup cluster analysis
procedures, a typology of family characteristics and
maternal attributes was elucidated which, in turn, had a
direct bearing on the dietary intake and resultant physical
status of the children. The â€Type I" family had a higher
socioeconomic status and this mother exhibited more
equalitarian attitudes toward child-rearing. In contrast,
the Type II family was from the lower socioeconomic groups,
and the mother diSplayed more authoritarian attitudes and
powerlessness. The typology of family environment
characteristics was directly associated with certain
patterns of nutrient intake. Children of the more affluent,
non-authoritarian mothers tended to have higher intakes of
calcium and ascorbic acid, while children of the Type II
mothers ate more calories, carbohydrate, iron, and thiamin.
Children of the latter type of mothers tended to have
higher hemoglobin and hematocrit values and were somewhat
more overweight for their height.
The primary contribution of the present research is
the demonstration that an ecological approach is a viable
Laura Smail Sims
means of studying the nutritional status of individuals
in the context of their environmental setting. In
addition, multivariate analysis procedures were effec—
tively used to establish a typology of family environment
characteristics which exerted a direct influence on the
dietary intake and the consequent nutritional status of
children within particular family environments.
NUTRITIONAL STATUS OF PRESCHOOL CHILDREN
IN RELATION TO SELECTED FACTORS
CHARACTERIZING THE FAMILY ENVIRONMENT-
AN ECOLOGICAL APPROACH
BY
Laura Smail Sims
A THESIS
Submitted to
Michigan State University
in partial fulfillment of the requirements
for the degree of
DOCTOR OF PHILOSOPHY
Department of Food Science and Human Nutrition
1971
62 Copyright by
LAlHUA SMAJIJ.SIMS
1972
DEDICATION
In honor of my mother, and
in memory of my grandmother,
whose inSpiration instilled
a love for learning.
ii
n 4.!
t r
ACKNOWLE DGMEN TS
Any successful research results not from the efforts
of a single individual, but as a cooperative venture among
many. It is virtually impossible to conduct a study of
this nature without accumulating numerous debts to many
pe0ple.
Sincere appreciation is extended to members of my
guidance committee:
To Dr. Portia M. Morris, Department of Food Science
and Human Nutrition, who served as my major professor,
for her continuous support, encouragement, and guidance
throughout this research.
To Dr. Dena C. Cederquist, Department of Food Science
and Human Nutrition, for her interest and support through—
out my course of study.
To Dr. Beatrice Paolucci, Department of Family
Ecology, for her incisive direction and encouragement
throughout the study.
To Dr. Everett M. Rogers, Department of Communication,
for his interest and advice, particularly in the area of
multivariate analysis.
.Dr. Dr. William B. Weil, Department of Human Develop-
ment, for his support and advice regarding assessment of
physical development and nutritional status.
iii
Thanks are extended to Dr. Robert P. Boger, the
teachers and staff of the M. S. U. Laboratory Preschool
Program, to Miss Mariella Aikman and the staff of the
Spartan Nursery School, and to the staff of the Cristo
Rey clinic for their invaluable assistance in helping me
to obtain data from the children and their mothers.
Sincere appreciation is expressed as well to others
who helped me with various phases of the study.
To Dr. Olaf Mickelsen and Dr. Modesto Yang, of the
Department of Food Science and Human Nutrition, for
technical guidance and advice regarding determination of
nutritional status.
To Mrs. Margaret Shick and Mrs. Nadine Fisher of the
Olin Health Center who were reSponsible for the collection
and analysis of blood samples.
To TOm Nicol, Steve Huyser, and Dr. John Hunter of
the Department of Psychology, who were extremely helpful
in assisting me with the computer analyses and interpre-
tation of data.
I also wish to express my heartfelt appreciation to
all the families who welcomed me and my interviewers into
their homes. Without their c00peration and interest,
this study could never have been conducted.
Finally, a personal note of thanks is due to my
husband, Henry P. Sims, jr., without whose understanding,
encouragement, and insightful advice, this project would
never have reached fruition.
iv
TABLE OF CONTENTS
Chapter
I INTRODUCTION
Objectives
Assumptions
II DEVELOPMENT OF THE CONCEPTUAL FRAMEWORK
An Ecological Systems Approach
Characteristics of Ecosystems
The Flow of Matter-Energy in the
Ecosystem '
The Flow of Information in the
Ecosystem
The Ecosystem Approach to the Study
of Nutritional Status
Implications of the Model
Description of the Model
III SELECTION AND MEASUREMENT OF VARIABLES
The Family as Environment
Demographic Characteristics
Family Resources
Psychosocial Attributes of the Mother
1. Parent Attitude Research
Instrument
2. Homemaker Values
3 . Anomie
4. Powerlessness
5. Semantic Differential Instrument
Dietary Evaluation
Assessment of Nutritional Status
Clinical Methods: Nutritional
Anthropometry
Biochemical Parameters
IV DATA COLLECTION AND ANALYSES
Selection and Description of Sample
Data Collection
Data Analyses
Factor Analysis
Scale Develogment
Moderator Effects
Page
Chapter
Classification and Codification of
Data for Analysis
Dietary Data
Biochemical Data
V FINDINGS
'Characteristics of Families in the
Sample
Results from Home Interview
Psychosocial Attributes of Mothers
Interrelationships Among Family
Characteristics '
Evaluation of Dietary Data
Nutrient Intake of Children
Relationship of Nutrient Intake to
Other Variables
Relationship of Biochemical Data to
Other variables
Results of AnthrOpometric Measurements
. VI DISCUSSION, CONCLUSIONS, AND IMPLICATIONS
Discussion of Results
Limitations of the Present Research
Summary and Conclusions
Suggestions for Future Research
Implications
BIBLIOGRAPHY
APPENDICES
Vi
Page
96
96
100
100
100
128
137
139
139
150
161
171
187
187
191
192
198
199
200
216
Table
3.1
4.1
5.8
5.9
LIST OF TABLES
Items in PARI according to scale
designation
E.C.H.O. neighborhood profile, Lansing,
Michigan
Sex distribution
Race distribution
Age distribution
Timing schedule for data collection
Methods used in analysis of data
Education of parents
Employment status of parents
. Hours per week child is cared for by
someone other than parents
Income distribution of families in sample
Classification of families by source of
family income
Household size
Characteristics of families in relation
to number, age and spacing of children
Description of families by stage in
family life cycle ‘
Religion of children in sample
£5.10 Number of years in present home
vii
Page
41
82
84
84
84
86
89
101
101
102
102
103
103
104
104
105
105
Table
5.11
5.12
5.13'
5.15
5.16
5.17
5.18
5.19
5.20
5.21
5.22
5.23
5.24,
5.25
5.26
5.29
5.30
Appliances present in the home
Meals eaten together as a family
Mothers' reSponses as to how important
it is for child to finish everything on
his plate
Mothers' usual action when the child
dawdles with food or refuses food served
to him
Frequency of snacking
Food preferences of children
Extent of feeding problems in the preschool
period
Reasons for shOpping in particular markets
Weekly food expenditure
Frequency of use of certain convenience
food items
Number of "Basic 4" named
Scores on nutrition knowledge test
Scales developed from items in interview
schedule
Intercorrelations among demographic-
resource characteristics of families
Deve10pment of new PARI scales
Percentage of samples by value rating
responses
Intercorrelations among socipsychological
attributes
Correlations among soci0psychological
attributes of mothers and selected
demographic/resource characteristics of
families
Average nutrient intake for total sample
Percentage of Recommended Dietary Allowances
‘ met by mean intake of nutrients from food
viii
Page
107
109
110
111
113
114
116
117
117
119
120
120
126
127
128
136
140
141
142
143
Table
5.31
5.34
5.35
5.36
5.37
5.38
5.39
5.40
5.41
5.42
5.43
5.44
5.45
5.46
Percentage of sample meeting Specified
proportions of Recommended Dietary
Allowances
Percentage of calories supplies by
carbohydrate, fat, and protein
Pattern of consumption of calories and
protein
Consumption of calories and protein
expressed by kilogram of body weight
Food intakes of preschool children as
exPressed by servings of food groups
Nutrient intake data (by percentiles)in
.comparison with Beal data
Intercorrelations among nutrients
Correlations among nutrient intake selected
.demographic and resource characteristics
Nutrient intake (as % RDA) in relation to
family income
Comparison between "low-income" children
and "high-income" children in relation to
nutrient intake
Calories and protein/kg body weight basis
in relation to family income
Correlations among nutrient intake.and
sociopsychological attributes of mothers
Results of blood tests of preschool
children expressed in relation to ICNND
categories
Correlation Matrix: Biochemical data vs
nutrient intake
Correlation matrix: Biochemical data vs
anthrOpometric measurements
Correlations among biochemical data and
selected demographic characteristics of
families
Relationship of family income to blood data
ix
Page
144
144
146
147
148
149
151
152
143
154
157
158
160
162
164
166
167
Table
5.48
5.49
5.50.
5.54
5.55
5.56
5.57~
5.58
Correlations among biochemical data vs
sociOpsychological attributes of mothers
Effects of selected moderator variables on
the relationship between nutrients and
blood components
Distributions of heights and weights of
preschool children compared with Stuart
percentiles
Distribution of heights and weights of
preschool children compared with Fels
percentiles
Comparison of height and weight data in
reference to Fels and Stuart standards
Distribution of height and weight
measurements by height-weight-age
Intercorrelations among anthrOpometric
measurements
Correlations between anthr0pometric measure-
ments and nutrient intake
Correlations among anthropometric measure-
ments and socipsychological attributes of
mothers
Correlations among anthrOpometric measure-
ments and demographic characteristics of
families
Effects of selected moderator variables on
the relationship between nutrient intake
and anthropometric measurements
Page
168
170
173
174
175
176
179
180
181
183
185
Figure
1
LIST OF FIGURES
A conceptual model using an ecological
approach for the study of nutritional
status of children
Description of variables in the study
Techniques for evaluation of nutritional
status
Geographical distributions of children
in the sample
Nutrient intakes of children,expressed
as percentage of the RDA, in relation to
family income
xi
Page
23
26
60
83
156
LIST OF APPENDICES
Appendix Page
A Corre3pondence
1. Letter to mothers, December 1969 216
2. Letter to mothers, February 1970 217
3. Letter to mothers, May 1970 218
4. Permission request for blood tests 219
5. Letter to teachers scheduling
measurements ' 220
6. Letter of thanks and appreciation 221
B Guidelines for Interviewers 222
C Instruments
1. Food record recording form 224
2. Home interview schedule 228
3. Attitudesmeasuring questionnaires
a. Parent attitudes 247
b. Homemaker values 252
c. Parent Opinions scale (anomie) 254
d. Powerlessness 255
e. Nutrition knowledge and
attitudes test ‘ 258
f. Semantic differential instrument 263
D Guidelines for data coding
1. Coding form for food records 266
2. Coding guide for all variables 267
3..Identification codes for derived
scales 297
E Correlation matrices
1. Multiple group analysis for PARI scales 300
2. Final inter-scale matrix 305
xii
CHAPTER I
INTRODUCTION
Nutrient intake is but one of a myriad of environ-
mental factors that affects the growth and development
of young children. Malnutrition does not occur in
isolation; many of the non-nutritional factors which
contribute to its occurrence may independently Operate
to influence develOpment. Often differences in the level
of dietary intake are associated with other profound
differences in familial characteristics and environmental
circumstances. Because preschool children are, by
necessity, dependent on others (primarily other family
members) for the provision of food as well as environmental
Stimulation (both factors which operate to influence
.9r0Wth and development), it is proposed that data on the
PhYSical growth and nutritional status of the preschool
Child is most meaningful when examined in the context of
rï¬s home and family environment. It has been emphasized
that, "...much more research is needed on the effect of
interrelationships between socio-psychological and physical
factors in the environment on the...physical status of the
child (Wakefield and Merrow, 1967) ."
The relationships which exist between malnutrition,
certain disease states, and physical development have been
well documented, although the underlying mechanisms are
not yet well elucidated. It is commonly recognized that
per capita income, infant mortality, sanitation, and
malnutrition are interrelated. But, why then, are
children from families of similarly low levels of income
and deprived environmental circumstances not equally
impaired in terms of nutritional status? Is it possible
that the end result (in this case, malnutrition) may be
a result of more than the linear sum of the individual
contributing factors? It is not sufficient to identify
only evidences of the clinical nutritional deficiency;
the entire constellation of ecologic factors contributing
to the problem must be examined (Read, 1970). Thus,
there is a need for the development of a theoretical
model for the study of the syndrome of malnutrition which
identifies underlying causes as well as showing interre-
lationships among contributory factors.
The model presented by this research focuses on the
nutritional status of the preschool-aged child. The
Conference,("Malnutrition Is A Problem of Ecology",
called attention to the fact that the preschool child was
at the most vulnerable age class in human deve10pment
“florgy and Kline, 1970). Bloom (1964:200) suggested
that, "the environment will have its greatest effects in
the period of most rapid development." This statement
lends additional support to the contention that the young
child is most vulnerable to changes in his environmental
circumstances.
It has been established from the results of animal
experimentation that undernutrition at an early age may
exert an adverse effect on subsequent physical development
(McCance, 1962). There is considerable evidence both
direct and indirect, that the increased growth rate seen
in some children is attributable to improved nutrition
(Greulich, 1958). Growth of underprivileged children,
both in deve10ping countries and in the so-called developed
countries, is accelerated when they receive improved
environmental care (especially better food and more
protection from infectious diseases), a factor which is
eSpecially evident in the critical preschool age period
(Jackson, 1966:18). In addition to the effect of nutri-
tional intake on physical development of children, food
Practices and attitudes developed during the formative
Years of childhood tend to persist into adulthood. Eating
Practices thus established during the early years are
believed to affect food choices and consequently,
nutritional status throughout life.
Thus, because food intake varies with environmental
cï¬rcmmstances, the approach taken in the present study is
ecological, i.e., a nutritional status of preschool
children is examined in relation to factors which charac-
terize the near environment of the child, particularly
his family.
Objectives
The primary objective of the present research is to
study the relationship between a child's physical growth
and nutritional status with selected factors which may be
used to characterize the family environment. A second
objective is to determine which variables (of those
selected as representative of the family environment) are
the most predictive of the level of nutritional status of
the preschool child. In addition, the study also seeks
to obtain information on the physical growth and nutritional
intake of children from several socioeconomic groups. A
final objective entails the development of a conceptual
framework appropriate to the study of nutritional status
of children from an ecological perSpective.
Assumptions
l. Soci0psychological disturbances in the family
enV'ironment exert an adverse effect on the physical growth
and nutritional status of the growing child (Fried and
Mayer, 1948).
2. Nutritional status and family environment
cmaracteristics can be adequately appraised using the
instruments selected for this study.
3. Mothers of preschool children are familiar with
the family characteristics and eating practices of their
children and can accurately report on such practices.
CHAPTER II
DEVELOPMENT OF THE CONCEPTUAL FRAMEWORK
It is important in any research study to assimilate
data from the literature in order to condense findings
into a unified and valid theory. Conceptual frameworks
have been used increasingly in recent years because Of
their contribution to theory building, i.e., they intro-
duce orderliness into the research process and provide
Opportunities for replication and application of the
findings. Hill and Hansen (1960) use the term conceptual
framework to refer to "clusters of inter-related but not
necessarily inter-defined concepts." Nye and Berardo
(1966:5) have suggested that conceptualIframeworks have
three functions: 1) identification of factors that enter
into behavioral processes; 2) tracing the sequence of
Various stages of behavioral processes; and 3) description
0f Structural relationships between and among factors
susPected to, be associated with observed behaviors. The
PIBSent study is primarily concerned with the latter
f\lmztion, i.e., the development Of a framework by which
the nutritional status of children may be studied.
An Ecological Systems Approach
In the development of a conceptual model for the
study of the nutritional status of population groups, it
is proposed that the most meaningful approach is one which
deals with the subject pOpulation as an "ecosystem." An
ecosystem framework is appropriate for the study of
nutritional status because it integrates the science of
ecology with the systems approach.
A system may be conceptualized as "a set of components
which act with and upon one another to bring about a state
of balance, inter-dependence, or 'wholeness'" (Havelock,
1971). On the other hand, the enviromnent may be thought
of as "all other factors [outside the system] which impinge
upon that system“ (Chin, 1969).
Systems may be characterized as either "Open" or
"closed." Closed systems are isolated from their environ-
ment in that there is no exchange Of information across
System boundaries. In contrast, Open systems may exchange
information, energy, and materials with their environments.
Living entities most certainly demonstrate the complexity
0'15 Open systems, i.e., they have inputs and outputs.
Systems may be further described as "static" or
"dynamic." In static systems, components exist in a more
or less fixed relationship with one another. In contrast,
cOmponents of dynamic systems act upon one another; they
force changes in a pattern of action and reaction that
‘Lmaintains a dynamic equilibrium or balance of forces.
Most systems that can be identified and examined in the
real world are likely to be open systems which contain
both dynamic and static components (Havelock, 1971).
In classical terms, ecology may be defined as the
science of relationships between organisms and their
environment. An ecological perspective in the study of
living systems enables one to consider the "whole" being
rather than isolated component parts in the analysis of
any system. Jackson (1966) has stated,
The study of nutrition is a study of
ecology, and for a valid assessment the
whole of the environment must be
examined.
The term "ecosystem" is used to describe the basic
functional unit for the study of living entities (Evans,
1956) . This term, first proposed by Tansley in 1935,
refers to the interaction system comprised both of
lixrixlg things together with their non-living habitat,
hTtiJnately linked by a variety of biological, chemical
and physical processes.
An ecosystem, can be visualized as a
grouping of components linked by...
flows of energy and connected to the
surrounding biosphere by its system
of inputs and outputs (Bormann and
Likens, 1970).
All ecosystems are Open systems in that matter-energy
continually escape from them in the course of life pro-
cesses and must be replaced if the system is to continue
mafunction (Evans, 1956).
The environment of the ecosystem is seen as providing
resources potentially useful for the maintenance of life.
Two types of environmental factors may be distinguished:
1) those independent of man, i.e., the physical and
biological components; and 2) those related to the
association of man with his fellow man, i.e., the social,
cultural, and economic features of human existence
(Rafalski and Mackiewicz, 1968). Within this total
environment can be superimposed three human systems:
1) the biOphysical, or metabolic and physiological pro-
cesses; 2) the psychosocial, or the interpersonal
rtelationships expressed by individual and collective
patterns of behavior; and 3) the technological, which
includes materials, tools, and techniques (McHale, 1968).
In order to utilize the systems approach effectively,
it. is imperative that the environmental factors which
.ï¬npxinge upon the system be identified. Obviously, this
task is far easier in describing physical systems than
ï¬lr' systems in the life, behavioral, or social sciences.
Many of the models which have addressed themselves to the
multiple etiology of malnutrition focused upon a particular
environment which exists in the develOping countries.
The ecosystem approach allows one to develop a model which
is appropriate for describing the environment for a complex,
affluent society, as well as for more primitive societies.
10
According to Kartman (1967), the term, "human ecolOgy"
implies,
The broadest possible view of human beings,
both as individuals and as populations, in
terms of the ecosystem, that is, the
biologic, socioeconomic, political, cul-
tural, and emotional complexes in their
dynamic action and reaction.
Hanlon (1969) emphasized that the convergent complexity
of the relationship of total man to his total environment
must be recognized. He suggested that human ecology attempts
to develop a conceptual framework whereby,
...needs of mankind--as individuals, in
groups, and as communities--may be
approached, not merely in a reductionist
fashion...but rather in a holistic manner
wherein the integrated reSponses of man
to environmental forces find expression.
The human ecologic approach must, by necessity, draw
upon an interdisciplinary effort. Auerswald (1968)
indLicated that an ecological systems approach focuses on
the: interfaces between various disciplines and the
processes taking place there, rather than on the concep-
uRal. framework of each contributing discipline in the
research. He suggested that this type of analysis
coupled with the holistic nonexclusive nature of the
ecol-<>gical approach, minimizes the dangers of excessive
SElectivity in the collection of data and allows for much
more clarity in the contextual contributions to the
analysis of the problem.
11
Characteristics of Ecosystems
Miller (1971) has stated that living systems are
composed of matter and energy, organized by information.
Thus, two cycles, or flows, may characterize an ecosystem:
l) the matter—energy flow, and 2) the flow of information.
The movement of matter-energy over space, action, is one
form of process which describes the first type of flow.
Another form of process is information processing or
communication, which is the change of information from one
state to another, or its movement from one point to
another over Space (Miller, 1971a) . The exchange of
unatter-energy contributes to the information a system
processes, and communication of any type requires the
input or out-take of matter-energy. Information signifies
input of matter-energy or perceptual data from outside
the system. Matter-energy and information always flow
together (Miller, 1971a).
Hanlon (1969) has applied the notion of the flows
0f matter-energy and information in the ecosystem to the
stuuiyvof human ecology:
...We can think of the biosocial organism
that we call man as an open-ended system
through which the energy, resources, and
influences of the environment are trans—
formed for good or ill, and which
transforms man in the process... From
the sociocultural component comes the
never-ending stream of informational
stimuli which require correct decisions
or adaptive strategies that too often
pose a threat to psychological and social
integrity, and trigger emotional and
12
behavioral patterns inimical to self and
others.
The Flow of Matter-Energy in the Ecosystem
Katz and Kahn (1966:16—17) indicate that open systems
are characterized by,
...input of energies and the conversion
of output into further energic input
[which] consist of transactions bet-
ween the [system] and its environment.
...The stability or recurrence of
activities, in the system can be
examined in relation to the energic
input into the system, the transforma-
tion of energies within the system, and
the resulting product or energic output.
.Fom'all living things it is essential that a source of
enaergy, in the form of calories, be provided from the
errvironment in order to carry out growth and maintenance
of life.
The matter-energy flow through a system consists of
three processes: 1) the input from the environment;
2) ‘the.transformation or utilization of energy by the
Organism; and 3) the output of energy from the system,
Which may or may not be recycled back into the system
(Katz and Kahn, 1966) .
The energy flow model may be applied to the study of
nutJiitional status for energy which is essential for the
maintenance of life and the promotion of growth is fur-
nished from the larger environment. Although an
individual functions as an ecosystem himself, he is also
anmmber of a larger system--a family--which in turn exists
13
as but one subsystem in a much larger supersystem, or
macrosystem. The input of energy (in the form of food)
to the individual comes, usually, as a result of the
transactional process between the family and the total
environment .
The Flow of Information in an Ecosystem
Ecosystems, as any human organization, are informa-
tional as well as energic systems in that both the exchange
of matter-energy and information with the environment must
be considered in order to understand the overall functioning
of the system. Information exchange is itself energic,
but its energic aSpects are negligible compared with its
symbolic aspects, i.e., information flows are significant
for what they imply, trigger, or control (Katz and Kahn,
1966:257) .
Communication circuits, or information flows, within
systems, may be characterized by the type of communication
network which they represent. Several types of networks
(named the “circle", "all-channel", and "wheel") have been
Proposed (Katz and Kahn, 1966:237). The "wheel" network
13 most apprOpriate for consideration in the evaluation
0f nutritional status. This type of communication network
may be represented by the following diagram:
0 I
I
0
14
where each circle represents one individual in the system
(such as the family).
Using the "wheel“ network as a model for information
flows, the mother in a nuclear family may be represented
as the central figure. She acts as the major link between
the outside environment and the other family members in
that it is usually she who is responsible for the prepara-
tion and distribution of energy, i.e., food, to the family
members.
Cultural patterns and folkways exert a powerful
influence on the physical distribution of food to individual
family members. In some African cultures, heads of house-
holds receive food first and consume the larger portion of
what is made available, Often thus depriving the small
children of sufficient calories or protein to meet their
nutritive requirements for growth. In the "typical"
American family today, it seems (upon observation) that
even when the amount of food available to the family is
limited, small children are usually adequately fed, and
their food likes and dislikes are a strong influence upon
decisions regarding meal planning for the family.)
The use of the "wheel" communications network to
analyze the flow of energy and information within the family
SYstem has relevance to Lewin's "channel theory" (1943) in
‘theh he described his theory why people eat what they
Qatn Lewin (1943) suggests that food comes to the table
15
via channels that are controlled by a Fgatekeeper" figure,
usually represented as the mother. The mother's
psychology exerts an influence on food habits of the
family. In turn, her choice of food may be influenced
by: 1) her cognitive structure, i.e., what she considers
"food for us†and what "fits into our idea of meals",
and.2) the values behind her choice of foods, e.g., her
motives and ideologies such as health, taste, status,
cost.
The Ecosystem Approach to the Study of Nutritional Status
Two types of systems may be considered in the study
of the nutritional status of preschool children, namely
the family and the individual child. Hook and Paolucci
(1970) suggest that the family may be viewed as an ecosystem
on the basis that interdependent relations between man and
his near environment basically focus on the family which
acts as a life support system in providing both physical
and social nurturance. The family as a life support system
links both the natural environment with the social environ-
?ment because of its mutual dependency upon both the natural
environment for physical sustenance and upon the social
organizations which are related to man's humanness and
.give quality and.meaning to life. Because the interactions
of man as a total being and his near. environment may be
Inanaged and controlled by the family, an ecological approach
is implied.
16
Literature from the field of home management suggests
that family resources, both tangible and intangible, may
be managed in such a way as to direct family behaviors
toward predetermined group goals, the major one being
.growth and develOpment of individual family members.
Home management helps the group create
an environment in which members can
perform, grow, and develOp as individuals
and at the same time, cooperate in
attaining group goals (Paolucci, 1966).
The family may be seen as a system in that it acts
as a processor or convertor Of input goods and services
from the environment, by means of services (managed in
such a way as to meet the needs of individual family
members), and produce an output flow of converted products,
waste, or surplus. Thus, when families manage resources
appropriately and establish relevant goals, requirements
of children will be met for a supply of required nutrients
(as food) and for emotional support and stimulation, all
required for Optimum growth and nutritional status. The
individual family may be viewed as but one of a number of
Subsystems (such as the political system, the educational
System,_the religious system, etc.) within the total social
Inacrosystem. .
A second type of system which may be defined is that
<3f the individual child as an ecosystemt The individual
Inay be viewed as a type of open system in that he, too,
(is a processor of information, materials, and energy from
17
his environment which he utilizes to provide sustenance
to meet physical, mental, emotional, or social needs.
Nutritional status.and physical development of the child
are but facets of a larger, more complex, system which
contributes to the total ecosystem concept of the child,
thus:
Mental Physical
Psycho-
SOClal emotional
This approach views both the individual as a system
and the family (as a unit of interacting personalities)
(Hook and Paolucci, 1970) as a subsystem within the larger
social macrosystem. The family is regarded as a system;
however, in addition, this model also assumes that the
family acts as environment for the develOping child.
The family is seen as both an environ-
ment for the individual and as existing
in a larger physical and biological and
social environment; the family exists
within only part of the total environ-
ment (Hook and Paolucci, 1970)._v
\
In essence,_the family functions as an interface
'between the develOping child and his larger environment.
(Am.interface is the boundary across which matter—energy
oI'information is transmitted from the external systems
ibnto the system at issue.) Breckenridge.and Murphy
(1969) state,
18
...how a child's needs will be met will
depend upon the family and the circum-
stances in which it lives.
Certain fundamental needs, both physical and psychological,
which are considered basic to a child's sense of well-being
and optimum development include: 1) warmth, both physical
and close personal warmth or love (Conceived of as an
information flow component in the present model);
2) physical and psychologic security; 3) dependence and
independence; 4) nutrition; 5) activity, which includes
movement itself and as it provides a means for exploration
of.the larger environment; 6) rest and sleep; 7) social
contact. The child, although independent in being able
to satisfy his tissue needs for nutrients and energy, to
excrete waste products of metabolism, and to make
involuntary movements, is dependent on others (primarily
the family) to provide him with food, warmth, and security
(Breckenridge.and Murphy, 1969).
ImplicationS'of'the Model
Nutrition is recognized as an important environmental
factor affecting the growth and development of young
Children. Moreover, the food practices and attitudes
develOped during the early years are eStablished primarily
:bY'the family in which the child is raised. Such food
habitsare belieVed to affect food choices, and
‘Consequently, nutritional status throughout life. The
development of food habits in children as a result of
19
family mealtime practices reflects an inter-meshing of the
flows of energy and information. We may consider that
food habits are a result of the transactional patterns
between resources which may enter.the family from the
environment, and the family's use of such resources which,
in turn, may vary as a result of the decisionsmaking and
valuing processes.
Flows of matter-energy and of information in the
ecosystem act together to influence the nutrient intake,
and physical development of the child. .The matter-energy
flow relates to the provision of food to the child to
meet his physical, or survival, needs, while the informa-
tion flow relates more Specifically to the affective or
behavioral components of the system- Man directs his
available resources to meet his needs, both for the
survival and affective components of his environment.
The energy flow concept may be related to Maslow's
"Hierarchy of Needs" theory. In this concept, Maslow
Classified all human needs into either physiological
(survival) and social (e.g., the belongingness and love
needs, the esteem needs, and the self-actualization needs).
Hetmaintains that a minimum satisfaction of a need at one
(level is essential before the person can move on to seek
Satisfaction of the next need in the hierarchy. From
'Ehis theory, one can postulate that only when a person
ihas.enough'food to satisfy hunger, i.e., to meet the
20
survival need, can he be interested in any other meaning
for food (Lawenberg et al., 1968:105-106).
. The flow of information in the system (the
"communication circuit") reflects, to a largedegree, the
affective or socio-emotional components of the child's
environment. Many studies have been conducted to deter-
mine the influence of the emotional climate on the child's
physical growth and development. Widdowson (1951) suggests
that an unfavorable psychological environment may Operate
independently of caloric intake to retard linear growth.
Fried and Mayer (1948) emphasize that emotional adjustment
and physical growth of children are inseparably related.
Patton and Gardner (1962) indicate that there are several
means by which disturbances in the soci0psychological
quality of the environment could interfere with growth,
including: 1) inadequate intake of calories to meet
physiological needs; 2) reduction in appetite resulting
from the child's lethargy and depression; 3) altered
intestinal motility and rates of absorption resulting from
emotional disturbances; and 4) emotional effects on the
endocrine system resulting in an interference with inter-
lIlediary metabolic processes. A review of studies both on
Children reared in an institutional setting and on those
‘flho.experienced maternal deprivation in their own homes,
inevealed that neglected, or emotionally deprived, children
maynotgrow as well as happy, emotionally secure youngsters.
21
Kallen (1971) has suggested that the slower mental
develOpment Observed in some children from disadvantaged
environment may Simply be a reflection that these
children had insufficient energy to benefit from social
stimulation provided by the environment. Likewise,
Dubos (1968:86) Observed:
...a child may be listless, dull, and
immobile because he hasn't enough
energy to act otherwise.
Such examples provide support for the contention that the
flows of matter-energy and information within the eco-
system are inseparably linked; both must be functioning
well in order to meet the needs of the system.
Whitten et a2. (1969) undertook a study to test.the
validity of the assumption that the growth failure in the
maternal deprivation syndrome is due solely to psycho-
logical factors. Their data suggest that maternally
deprived infants are underweight not because of some
psychologically induced defect in absorption of metabolites,
but.because of undereating, secondary to not being
offered adequate food, or not accepting what is Offered.
Studies such as this demonstrate.the interelatedness of
the matter-energy flow with the information flow, i.e.,
the amount of matter—energy available to.the system
influences communication patterns, and in turn, information
flows influence the utilization of matter—energy components,
Such as food.
22
'Description‘of " the "" Model
The concept of the "child as ecosystem" implies a
dynamic, changing system. Moreover, it is acknowledged
that the present model is somewhat limited in its capacity
to.deccribe.the ecosystem concept in its entirety because
of its static nature, and because it views the subjects
at one~point in time rather than over their entire life
Span. .The overall conceptual model develOped to study
nutritional status of preschool children is shown by
Figure 1.
In the context of this model, nutrient intake of the
child is seen as the most significant linkage.between the
systems of the family and the individual child. (Linkage
is a term which may be used to indicate.that two systems
are connected so as to.form a greater system; it Suggests
a regularized pattern of interaction between the two
systems which in~a sense forms a bond between them
(Havelock, 1971:2-10).) Nutrient supply to the child is
an output of the family system in that it is a result of
theprocessing features or the interplay between the
matter-energy and information flows within the family
system. The child (functioning as an ecosystem), in
turn, processes the nutrient supply in such a way as to
produce (as outputs Of the system) his physical develOp-
ment.and nutritional status. The model as develOped has
been used to study physical develOpment of preschool
23
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24
children; however, it is suggested that it may be also
appropriate for the study of mental develOpment and
behavioral patterns as well.
CHAPTER III
SELECTION AND MEASUREMENT OF VARIABLES
This chapter presents a brief discussion Of the
rationale behind the selection of each category of
variables included in the model. In addition, the Specific
measurement techniques and procedures used to assess each
variable in the present research are discussed.
Figure 2 is a more detailed version of the model
which describes categories of variables which are
applicable to the study of nutritional status from an
ecological perspective. These variables have been chOsen
for study in the present research because of evidence
in the literature that such factors are influential in
characterizing the family, or because they represent an
appropriate way of measuring physical_growth and nutritional
status of children.
'The’FamilyfaS‘Environment
The premise that the family acts as the immediate
environment for the develOping child is the basic
assumption of the ecological approach to the assessment
of nutritional status in this study. The family plays a
key linking role in providing the conditions for inter-
change between the developing organism and the larger
25
26
Figure 2. Description of Variables in Study
THE FAMILY AS ENVIRONMENT
. Meo u e
Variables S r s
I. Current Family 7 A. Socioeconomic Status
Setting 1. Income
(Demographic Octal-«b 2. Education
3. Occupation
. Ethnicity lRacel
. Family Composition
. Family Stability
Mobility
{“0057
l—
11. Resource 7 Physical description of
Availability the "near" environment,
and Use ------- -> including: nutrition
knowledge, attitudes re
feeding children, tood
buying practices, use at
__ space, housing conditions.
111. Social-psychological FA. Semantic differential:
Attributes ol Mot'..er -p "How I See Mysell As
Mother" instrument.
Anomie
. Powerlessness
. Parental Attitudes on C..ild—
rearing lPARI Instrument)
E. Homemaker Values Scale
capo
.
Nutrient Intake of Child
Variables Measures
Dietary __________ _. A. 3, Zd-hour Food Records
Evaluation 8. Dietary History of child
THE CHILD AS ECOSYSTEM
-
Physical DeveIOpment; Nutritional Status
Variables Measures
1. Biochemical (A. Blood.
Indices ————————— -p l. Hemoglobin
2. Hematocrit
3. lotal serum proteins
4. Serum albumin
8. Urine: hydroxyproline:
_ creotlnine ratio.
11. Anthropo- EA. Height: shndlng,
metrlc sitting.
Measures --------- D Weight
Sklnlold thickness:
triceps, subsoapular
D. Circumferences:
head, upper arm, chest
E. Diameters: biacromial,
blcrishl.
5"?"
27
environment. A family may be viewed as, "a corporate
unit of interacting and interdependent personalities who
have a common theme and goals, have a commitment over
time, and share resources and living space (Hook and
Paolucci, 1970)."
For the child, the family might be considered as an
environment which represents a primary set of powerful
pervading forces which affect human characteristics, such
as physical develOpment and nutritional status. Within
the home setting, as well as in the neighborhood and
community, in which the young child is living and carrying
out his daily activities, would be found those environ-
mental resources or means for enabling him to meet his
_growth potential. Operationally, the environment would
be bounded by the child's direct and indirect involvement
with these resources, whether they be persons, activities,
or objects (Baker, 1970:50-51).
Children are not isolated beings; they exist not only
as individuals, but as members of families, as members
of peer groups, and as members of general social systems.
Any study of the nutritional status of children which
fails to consider the impact of the family and other
environmental influences can be expected to provide only
limited insight regarding the nature of the situation. It
is duly recognized that the influences upon a child's
well—being act as a complex of interacting factors.
28
Identification and analysis of the interrelationships
among such variables is essential for a complete under-
standing of nutritional status of children.
It is acknowledged that a wide range of environ-
mental forces may act concurrently to influence human
development. Burgess et al. (1942:29) suggest:
...any [factor]...may legitimately become
the focus of interest: the biological
influences,..., the highly specific
features of the immediate environment,
or, finally, those more general in-
fluences which are characteristic of a
particular culture... . A one-sided
emphasis on any of these factors
necessarily leads to false conclusions.
Stott (1967:405-407) suggests that family environ-
mental factors which act to influence the develOpment
of children may be divided into two classes: 1) those
that relate to family functions, such as providing the
common essentials for health, growth, and personal
develOpment; and 2) family structural differences, such
as the composition, physical and social nature, as well
as the cultural backgrounds of the family itself. It is
apparent that families differ structurally, for instance
in the number of family members, in the sex and age
distributions of children in the home. In addition,
differences are to be found in the physical facilities of
the home, thegeneral educational level of family members,
and the adequacy of intellectual and cultural stimulation
within the home setting.
29
An outstanding example of the interchange between
the developing child and his larger environment via his
family is related to the food intake and dietary practices
of the family. The adequacy or inadequacy of the food
intake of the growing child depends directly, and in most
cases completely, upon the family, most specifically the
mother. The role of family members in influencing the
develOpment of dietary practices of the young child may
be viewed from two aspects: 1) the family directly
influences dietary practices in terms of its obligation
to provide the child with the necessary foods in sufficient
quantities and in forms suitable to his needs and his
ability to manage them, and 2) indirectly, dietary practices
are influenced by the family's transmission of food
attitudes, preferences, and other factors which affect
lifetime eating patterns.
In summary, two aSpects by which the family serves
as an environment to influence the nutritional status and
physical development of the young child are:
1. The family controls the food intake of the child,
and in general, is reSponsible for directly providing the
appropriate nutrients of sufficient quantity and quality
which act to influence the child's develOpment.
2. The emotional climate of the home setting
influences the child's physical growth. Studies, both on
children in an institutional setting and on those in their
30
own homes who experienced "maternal deprivation", have
shown that neglected, or emotionally deprived, children
may not grow as well as happy, emotionally secure
children (Widdowson, 1951; Fried and Mayer, 1948; Patton
and Gardner, 1962).
Demographic Characteristics
Jessor and Richardson (1968) indicate that demo-
~graphic characteristics of the family (including race,
amount and source of family income, occupation and education
of parents, family composition [age and sex of family
members] marital status of parents, mobility, and the like)
may be considered components of the distal environment.
They suggest that such distal environment characteristics
can serve as indicators for the kinds of behaviors which
can be expected of peOple located within a specified
strata within the larger society. Comparable factors,
such as family income, education and occupation of parents,
family size and composition, employment status of the
parents, and arrangements for child care when the mother
is employed, have been included in other nutrition studies,
such as the North Central Regional Study of Diets of
Preschool Children (Fox et al., 1970) because it was felt
that such variables influenced food habits and the nutri—
tional well-being of the children. In the present research
suCh.variables were included for study in order to more
completely assess those environmental characteristics
31
which are most influential in affecting the nutritional
quality of preschool children's diets. In addition,
comparisons can thus be made with other studies which
used the same variables.
The concept of "socioeconomic status" has received
considerable attention in recent literature. It is
.generally accepted that socioeconomic status (SES) is not
defined solely by the level of income, but is also
related to education and occupation. One index of
socioeconomic status used in the present study was that
develOped for the Washington Heights Mental Health Survey
and published in the Milbank Memorial Fund Quarterly
(1969). This Index was formed as a summative score on the
basis of the education and occupation of the head of
household and the total family income. Students who were
also heads of households were evaluated on the basis of
potential occupations, i.e., they were rated in the
"professional and managerial“ classification. There was
a preponderance of scores in the nine to thirteen range
in this sample of preschool children's families.
Education of the parents was coded independently as
the number of school years completed. Parental occupation
was coded according to the system develOped by the Bureau
of the Census as "scores for categories of occupation
component" (Bureau of the Census, 1967).
The family may be viewed as a developing entity in
that as circumstances change, the family as a unit also
32
changes in order to c0pe with them. One approach used to
study the family's sequence is in terms of its life cycle.
Duvall (1967) has developed the concept of the "family
life cycle" whose stages are determined according to the
ages of the children and adults in the family, as follows:
Stage I Beginning families (married couple
without children)
Stage II Childbearing families (oldest child,
birth to 30 months)
Stage III Families with preschool children
(oldest child 2 1/2 to 6 years)
Stage IV Families with school children
(oldest child 6 to 13 years)
Stage V Families with teenagers (oldest
child 13 to 20 years)
Stage VI Families as launching centers (first
child gone to last child's leaving
home)
Stage VII Families in the middle years (empty
nest to retirement)
Stage VIII Aging families (retirement to death
of both spouses)
This scheme was used in the present study as one means of
classifying individual families in the sample.
Family Resources
Literature in the field of home management emphasizes
that through the use of resources families are able to
achieve their goals. Thus, in order to achieve the goal
of Optimum develOpment for its members, the family must
have sufficient resources and be able to manage them well.
Obviously, in terms of the study of nutritional status of
children, the family must have resources so that sufficient
nutrients may in turn be channeled to the child. Deacon
and Maloch (1966) define family resources as, "...any-
33
thing-~knowledge, abilities, and skills, objects--which
can be used or which has direct application in the
meeting of demands."
Gross and Crandall (1963:124) have suggested that
family resources may be classified as hgman, which include
thme,energY. Skills, knowledge, attitudes, and nonhuman
which would apply to tangiblegoods and facilities. They
stress that there may be potential human resources (such
as increased capabilities in a particular skill) which
may not presently be available for family use.
In addition to studying tangible resources such as
family income, the amount of money spent for food and
other food buying practices, it is equally important to
assess the human resources in the family which relate to
the child's nutrient intake. For this reason, variables
such.as the mother's knowledge of nutrition, her attitudes
about feeding children, and factors which were influential
in helping her choose what foods to feed her family are
considered for study.
Important among the human resources which may act to
influence the child's nutrient intake and, consequently,
his physical status are the mother's knowledge of
nutrition and her attitudes about the.feeding of children.
Mbrse et al. (1967) after assessing mothers' levels of
nutrition knowledge using a standardized test,_determined
that the higher the level of education, the better was the
34
Imother's knowledge of nutrition facts. In addition, a
course in nutrition (irregardless of the level of higher
education) was directly beneficial to the score attained.
The investigators found positive linear correlations of
mothers' scores of the nutrition knowledge test with the
blood levels for plasma ascorbic acid, and, in male
children, with plasma carotene and cholesterol levels.
Eppright et a1. (1970) reported associations among
the scores of mothers on nutrition knowledge and attitude
tests, nutritional quality of the children's diets, and
selected socioeconomic factors. They reported that the
mothers of the children with the lowest and highest
calorie intakes had the lowest nutrition knowledge test
scores. Of the attitudes investigated, that of permis-
siveness was negatively correlated with all nutrients,
except fat. Favorable attitudes toward nutrition did not
seem to influence.the nutritional quality of the children's
diets. Of the socioeconomic variables studied, that of
education of the mother was more highly related than was
income to dietary components, but was less highly related
than were money spent for food‘and the number of persons
in the household.
In the present study, several means were used to
assess the amount of family resources and the manner in
which they were used. The amount of family income was
recorded independently as a variable. In addition, in
35
their study of the assessment of socioeconomic status,
Warner et a1. (1949) concluded that source of family
income was as significant a variable as was the absolute
amount of income. Their classification scheme for deter-
mining source of income was used in the present research.
The.mother's level of nutrition knowledge and her
attitudes about feeding children were measured using
tests previously validated by empirical research1
(Appendix c-3e).
The test designed to measure the knowledge of nutri-
tion was composed of twenty-three true-false items
dealing with factual information about nutrition. The
total number of correct responses was used in subsequent
statistical analyses.
Attitude-measuring scales1 (Appendix C-3e) were employ-
ed to measure the mother's attitudes regarding the importance
of nutrition for the child and her feelings about permissive—
ness in feeding children. Responses were scored on a
Likert scale so that a "strongly agree" Opinion was
assigned a score of one while responses of "strongly
disagree" were given a value of four. Thus, a lower score
on these instruments indicated that the mother felt that
1The tests were developed at Iowa State University,
Ames, Iowa, under the direction of Dr. Ercel S. Eppright,
Professor of Foods and Nutrition, and were used in the
North.Central Regional Study on Diets of Preschool
Children (Eppright et al., 1970).
36
jprOper nutrition was most important for her child or that
she was highly permissive regarding the feeding of her
children.
Space, as evidenced by family housing conditions, is
an important resource to be considered when defining
environmental characteristics which influence a child's
physical growth. Havighurst.and Neugarten (1942:206-207)
indicate that the "life-space" in which a child lives and
'grows involves at least three different elements, including
â€the physical Space, the objects contained within that
space, and the peOple who inhabit that space.“ Crowded
living conditions have been identified as characteristic
of persons in the "lower" class (Bell, 1965). Rice (1969),
in a study with preschool children to determine the effects
of different housing environments and participation in a
Head Start program on the achievement level of the child-
ren, concluded that:
...rather than acting as a direct
controlling influence in a child's
_growth and develOpment, the housing
environment may simply provide the
setting or the conditioning variable
which encourages or inhibits the
influence of other variables within
the total social environment.
Housing and neighborhood quality were assessed by the
interviewer according toguidelines developed by the U. 8.
Bureau of the Census (1963). Each dwelling unit was
Visually inepected immediately before or after the inter-
view with the child's mother. The dwelling inspection
37
items were tallied to place the dwelling structure in one
of four housing quality classifications: poor,fair, good
or excellent (Rice, 1969). An attempt was made to obtain
at least a cursory appraisal of a sample of the immediate
neighborhood around each dwelling. Land use was noted
and structural condition was recorded simply as dilapidated,
deteriorating, or sound. Because literature has revealed
that crowding may be appraised using the "one person per
room†standard, this procedure was also included in the
present study.
Psychosocial Attributes of the Mother
Bloom (1964:222) has indicated that a distinction
should be made between:
...environmental measures which are based
on relevant...features of the environment
and a set of procedures which more
searchingly summarize the interactional
processes between the individual and
various features of the environment... .
The second approach should be especially
useful for the further development of
theories of human development and for
attempts to alter environmental conditions.
Thus, in addition to demographic characteristics of the
family and a description of available family resources,
it is important to assess some aspects of the qualitative
facets of the family system as environment for the
develOping child, i.e., characteristics which would be
‘indicative of the affective components, or communicative
and symbolic aspects, within that family system. The
38
following sections describe variables which.were chosen
for study because they characterize these psychosocial
attributes of the child's mother, the key link between him
and his near environment. Included also is a description
of the manner in which these variables were measured in
the present research.
Parent Attitude Research Instrument
Mothers' attitudes about childrearing have been
assessed in the present study by use of the "Parent
Attitude Research Instrument" (PARI) develOped by Schaefer
and Bell (1958). The authors' aim was to develOp an
instrument which would indicate how mothers felt about
family life and their role as parents. Theoretically,
such attitudes would extend to the mother's behavior
toward the child and would, in turn, have a bearing on
the child's physical development and nutritional status.
The original instrument contained 115 items, desig-
nated as beonging to thirty-two attitude scales (Schaefer
and Bell, 1958). Cross and Kawash (1968) developed a
shortened form of the PARI, which according to them, could
be used to measure authoritarian attitudes about child-
rearing. This revised instrument contained the following
scales: Encouraging Verbalization, Equalitarianism,
Deification, Excluding Outside Influences, Irritability,
'and Deception (used as a filler in this shortened
39
instrument because it was not associated with authoritarian
attitudes.)
Schaefer and Bell (1958) indicated that selection of
concepts for measurement in the attitude instrument was
based upon a literature search for areas which could pro-
vide information relevant to parent-child relationships.
Several of the "rapport" scales contained in the instrument
included Equalitarianism and Encouraging Verbalization.
The latter scale was written, according to the authors,
to determine whether the parent would permit or encourage
the child to talk about his anxieties, conflicts,
hostilities, and disagreements with parental policies.
Several of the scales were designed to measure concepts
of marital adjustment and tensions in the home environment.
Rejection of the Homemaking Role measured the mother's
discontent over the confinement found in homemaking and
dissatisfaction with the duties and responsibilities
required of the homemaker and parent. Irritability scale
was developed around items which indicate that children
ï¬get on a woman's nerves" and that any woman would "blow
her t0p" frequently in the difficult job of managing a
home. .The authors felt that this scale may be related
to several sources of tension, including tensions in the
marital relationship.
Schaefer and Bell (1958) cite evidence of content
validity for their instrument. Reliability was established
40
by the test-retest method. Pearson product-moment
correlation coefficients reported for the scales used in
the present study were:
’E.
Equalitarianism ---
Deification .79
Encouraging Verbalization .61
Irritability .73
Excluding Outside Influences .67
RejectiOn of the Homemaking Role .72
In the present research, the shortened form of the
PARI develOped by Cross and Kawash (1968) was administered
to mothers participating in the study. Originally, the
scale, Rejection of the Homemaking Role, had been omitted
from the short form in order to make the instrument
suitable for use with fathers as well as mothers. For
purposes of the present study, however, this scale was
reinserted into the instrument because only mothers'
responses were being evaluated. The final instrument used
contained fifty-three items belonging to seven scales,
according to the following distribution: (Copy of the
instrument is in Appendix C-3a.)
41
Table 3.1. Items in PARI According to Scale Designation.
Scale 'Number of Items
Rejection of the homemaking role (8)
Excluding outside influences (5)
Irritability (5)
Deification (5)
Deception (5)
Encouraging verbalization (5)
Equalitarianism (5)
Deification (reversed) (5)
Excluding outside influences (reversed) (5)
Irritability (reversed) (5)
Mothers were asked to express their agreement with
the statements on a four-point continuum. Statements were
worded in such a manner that a lower score (after "reflec-
tion" by the computer) represented less authoritarian
attitudes about childrearing.
Several studies using the techniques of factor analysis
have been conducted using the PARI items. Schaefer and
Bell (1958) suggest that the instrument is comprised of
three factors: 1) democratic acceptance vs. rejection
factor; composed of the "encouraging verbalization" and
"equalitarianism" scales; 2) irritability vs. warmth
factor, composed of the "irritability" and "rejection of
the homemaking role" scales; and 3) parental authoritar-
ianism vs. democratic acceptance factor, composed of the
"excluding outside influences" and "deification" scales.
Zuckerman et a1. (1958) also identified three main factors:
1) authoritarian--control factor; 2) hostility--rejection
factor; and 3) democratic attitudes factor, all composed
42
of scales comparable to those previously indicated. A
third study employing factor analysis was conducted by
Yater et a2. (1968) to determine whether responses of
mothers of Head Start children would be comparable to
those of mothers from higher socioeconomic groups. They
identified three factors, as well: 1) authoritarian--
control; 2) democratic attitudes; and 3) hostility--
rejection. These researchers concluded that since reSponses
were so similar to those found in other studies, there was
a commonality of childrearing attitudes across different
socioeconomic and educational groups. According to the
authors, such findings suggest that the PARI might be
measuring cultural attitudes toward childrearing rather
than attitudes endorsed by Specific groupings of mothers.
Homemaker'Values
Values represent those qualities or entities which
are prized and for which one strives. They are derived
from a number of factors, such as an individual's ideals,
motives, attitudes, and tastes, which are in turn deter-
mined by his cultural background, education, habits, and
experiences. In their classic research, Vernon and
Allport (1931) define values as, "...broad functions of
personality common to all and universal enough for
comparison of one person with another."
.Values influence behavior in the sense that they
provide a basis by which to make decisions, to choose
43
goals for which to work, and to make choices among alter-
native paths to agoal. Kluckholn (1959) suggested that
the concept of a value implies:
...a code or standard...which organizes
a system of action...a conception, explicit
or implicit, distinctive of an individual
or characteristic of a group, of the
desirable which influences the selection
from available modes, means, and ends of
action.
To Operationalize values, Kluckholn (1959) suggested that
"real" values can be discerned by careful analysis of
selections made in situations demanding a choice of
action, many of which occur in the usual run of living.
Several studies have been done to identify those
values related to home and family life. Dyer (1962)
sought to determine homemakers' awareness of values as
they were reflected in family activities. The values
defined in that study were family centrism, health,
aesthetics, friendship, freedom, education, economy,
prestige, and religion. In Dyer's study, homemakers were
asked to identify activities they performed for a given
period of time and to state reasons for performing those
activities. The reasons were sorted into value categories.
Each homemaker then rank-ordered her activities and
reasons. In addition, she also rank ordered the same
values in a forced-choice test situation. Nearly all of
the hOmemakers' activities and accompanying reasons for
them were concerned with the values of health, aesthetics,
and family centrism. The greatest number of activities
44
performed were those related to health. Many of these
‘health activities were those concerned with the daily care
of family members. Religion and education were rated high
on the rank order values test, but did not rate equally
high when the homemakers assigned reasons for activities
into.value categories. Data from this study seemed to
indicate that activities centering around keeping the
family healthy were more important to.homemakers than
,growth in interactional activities among family members.
Kohlmann and Smith (1970) develOped two inventories
of values (one for men, the other for women) which were
designed to measure a functional aspect of personality in
the areas of home and family life. Instead of the eight
values originally included in the inventories, the
researchers found that only two scales for women (Family
Life and Status) and one for men (Family Life) could be
well defined.
Thus, because behavior may be influenced by values,
it was felt that by assessing the mother's values, it
would be possible to determine if such qualities as
health and family well-being were significant in the sense
that.they influenced the nutrient intake of the child.
The forced choice values test, "Homemakers"Values"
(included in Appendix C-3b) which was developed by
Dyer (1962) was used in the present study. Mothers
were asked to select the two value descriptions which
45
described them best (subsequently assigned a score of
two),_and second best (assigned a value of one) and to
choose the one value least likely to describe themselves;
this choice was assigned a score of —2. Dyer indicated
that Spearman rank order correlation coefficients between
first choices on the rank order test and the categorized
reasons for homemaker's activities were of the order 0.51.
Anomie
According to Seeman (1959), the concept of anomie is
a facet of alienation, analogous to the condition of
"normlessness." He indicated that,"in the traditional
usage, anomie denotes a situation in which the social norms
regulating individual conduct have broken down or are no
longer effective as rules for behavior." Anomie has also
been defined as "an anxious awareness that the prevailing
values of society have little or no personal relevance to
one's condition,“ (Funk and Wagnalls, 1968).
A measure of anomie, or "interpersonal alienation"
has been develOped by Srole (1956). In that study, certain
"ideational states" or components were selected because
they theoretically represented internalized counterparts
or reactions in the individual's life situation to con-
ditions of social dysfunction. Srole (1956) included five
such components in his instrument. The first of these
'postulated components was the individual's sense that
community leaders are detached from and are indifferent to
46
his needs, reflecting severance of the inter—dependent bond
within the social system between leaders and those they
represent. The second element of anomie was the
individual's perception of the social order as essentially
fickle and unpredictable, i.e., orderless, inducing the
sense that under such conditions he could accomplish little
toward realizing future life goals. Srole's third element
of anomie related to the respondent's view that he, and
pe0ple like him, were retrogressing from the goals they
had already reached. The fourth component postulated
that the deflation or loss of internalized social norms
and values was reflected in extreme form in the individ-
ual's sense of the meaninglessness of life itself. The
fifth anomie component was conceptualized as the
individual's perception that his framework of immediate
personal relationships, i.e., the "very rock of his social
existence," was no longer predictive or supportive (Srole,
1956). Using procedures of structural analysis, Srole
determined that the five items in the instrument satisfied
the criteria of unidimensionality, i.e., they comprised
a single continuum.
In a recent study, low income mothers participating
in a summer camping experience through the Expanded
Nutrition Program in Kent County, Michigan, were asked to
.respond to the anomie instrument. Anomie scores did not
differ significantly when compared with the number of
47
children in the home, the housekeeping "style", one-day
dietary adequacy, or the education of the homemaker.
Homemakers with.husbands present had higher anomie scores.
The number of children at home made little difference
in itself, but when the husband was present, anomie was
higher when there was more children in the home. When
the husband was absent, anomie was higher for mothers of
fewer children (Evaluation, 1969).
In the present research, Srole's (1956) five-item
anomie instrument was administered to the mothers in the
study (Appendix C-3e). Mothers were asked to express
their agreement with the statements on a five-point
Likert scale. Mothers with lower scores on the instrument
would be considered less alienated and fatalistic than
those with higher scores. It was hypothesized that if
the mother reflected a high degree of anomie, she would
feel as well that there was little she could do to aid in
her child's develOpment and consequently, his dietary
intake and physical status would be less than optimal.
‘Powerlessness
Seeman (1959) identified the sense of powerlessness
as one among five alternative meanings classically
associated with the concept of alienation. He demonstrated
by empirical research that persons with a strong sense of
powerlessness are less likely to feel that they can control
their environmental circumstances.
48
Polansky (1969) defines the concept of felt power-
lessness as, "...the degree to which the individual
believes that he has little control over his fate, but
either is at the mercy of outside forces beyond his
control, or his circumstances are due largely to chance,
or both." Battle and Rotter (1963) suggested that this
attitude relates to the individual's social circumstances,
i.e.,_his class and ethnic group status.
A "Powerlessness Scale", devised by Rotter and
Seeman (1959), measures an individual's feelings that he
is not in control of his own life, that he cannot see any
real pattern or meaning to the things that happen to him
or to peOple in general, and that his life is "other-
administered" rather than "self-administered." Jaffee
(1959:31) demonstrated adequate reliability for the
instrument. In the study by Polansky (1969), a recheck
of odd-even split—half reliability yielded an r of .72.
Evidence of construct validity was cited in the study of
delinquency—proneness by Jaffee and Polansky (1962).
In the present study, it was felt that it would be
productive to assess the level of felt powerlessness among
mothers of preschool children. This attitude would, in
turn, be reflected in the mother's behavior in which she
would decline to take any responsibility for her child's
.dietary intake because she believed that.there was little
she could do to control her life situation and that her
49
efforts would not avail any lasting changes. Mothers were
asked to indicate their agreement with twenty-five
powerlessness items, using a Likert-type format (Appendix
C-3d). After a reflection of scoring, a higher total score
of this instrument indicated that the mother felt less in
control of her own life or the greater were her feelings
of powerlessness.
‘Semantic Differential Instrument
The "semantic differential" is one method of observing
and measuring the connotative meanings of various concepts
as held by a number of individuals. The actual semantic
differential instrument consists of a number of scales,
each of which is a bipolar adjective pair (e.g., good-bad)
together with the concepts to be rated using the various
scales (Kerlinger, 1968:564-580). Osgood et a2. (1964:
37) have found that, when analyzed, adjective pairs fall
into.clusters, which measure one or more of the basic
dimensions or factors, such as evaluative (illustrated by
the adjective paid, "large-—small"), potency (e.g., "strong-
weak") and activity (illustrated by "fast-~slow"),
adjectives which seem to express motion and action. The
semantic differential can be applied to a variety of
research problems. It has been shown to be sufficiently
reliable and valid for many research purposes (Kerlinger,
1968:578).
50
In the present study, the concept, "Myself as
Mother", was measured using a semantic differential
instrument (Appendix C-3f). This instrument was adapted
by Haiman (1970) from a similar semantic used to measure
the “Myself as Teacher" concept (Wright and Tuska, 1966).
This semantic differential instrument has been factored
and the results may be found in Osgood et al. (1964).
DietaryiEvaluation
In the present study, the nutrient intake of the
child is viewed as a key linking variable between the
ecosystems of the family and the child. Assessment of
dietary intake is therefore of prime importance in the
reSearch.
The evaluation of dietary, or nutrient intake, is
integral to any study of nutritional status. The goal is
to determine accurately what foods and how much of each
food a person has eaten. Phases of the dietary intake
survey include: collection of information about foods
consumed and the quantity eaten, the determination of
nutrients in the foods consumed, and an assessment of
nutrient adequacy, using a comparison with a dietary
standard, usually the Recommended Dietary Allowances
(RDA) designed for use in this country. When dietary
surveys form part of a clinica1--biochemical--dietary
-triad, these data may serve as a check on the validity of
the clinical and biochemical observations, and vice versa
(Pearson, 1968:574).
51
In general, four methods may be used to determine
individual food consumption: estimation by recall, dietary
history, the weighed intake, and the food record (Pike
and Brown, 1967:470). Becker et a2. (1960:4) have found
it more useful to consider only two distinctly separate
methods of collecting dietary information, rather than the
above four. These are: 1) food records, where dietary
intake is recorded in weighed, measured, or estimated
amounts, and 2) the dietary history. '
The recall procedure is generally used for a twenty-
four hour period only, where the subject is asked to
recall all food consumed during the previous day and to
esthmate quantities in ordinary household measures or
servings. Information by this method obviously is not
necessarily representative of the usual food intake of the
individual. A very accurate record of food consumption
may be obtained by having the subject weigh all food
consumed during a specific period of time. This proce—
dure for obtaining food intake data is expensive and time
consuming, however’and consequently is rarely used in
nutrition surveys (Pike and Brown, 1967:470). As an
alternative method, the diet history is designed to
discover usual food intake patterns over a relatively long
period of time and is most often obtained by interview.
This method measures frequency of intake of a large number
of foods and thus smooths out seasonal variations in food
intake.
52
. The fourth method, the food record procedure, is
used most often for nutritional status studies. In this
method, the subject is asked to keep a record of the food
he has eaten for a certain period of time, usually three
to seven days. Quantities of food are estimated in
common household measures. Obviously, usefulness of this
method depends largely upon diligent reporting by the
subject and upon his ability to estimate quantities of
food accurately. The method appears to be a fairly
accurate estimate of food intake over a specific period
of time (Pike and Brown, 1967:470). In a comparison of
the results of the various methodologies for obtaining
dietary intake information, Huenemann and Turner (1942)
recommend the use of the food record method when individ-
uals or small groups are being studied or when reliable
quantitative data are being sought.
The literature has focused much attention on the
length of time that a dietary survey should be conducted
in order to furnish a true picture of the nutrient intake.
Becker et al. (1960) indicated that when the mean intake
of a group is desired, one-day records are sufficient,
providing the sample is sufficiently large. But, when a
comparison of intakes on an individual basis is desired,
the suggested number of days was three to seven. Tinsley
(1946) recommended that three days be accepted as the
minimum length of time for a fairly satisfactory picture
53
of individual food intakes. For collecting dietary
information about groups of children, Eppright et a1.
(1952) suggest that data from dietary records should be
interpreted in a variety of ways in order to get a true
picture of the children's food habits. They recommended
inclusion of week—end days and the use of seven-day food
records for use with children.
i: .As in all interview methods, the subject's ability
to accurately recall or record what he has eaten is of
utmost importance for the reliability of the results.
Eppright et a1. (1952) indicated that when records are
kept by.untrained peOple, the results obtained from
recording food items by servings were likely to be some-
what higher than those which were recorded by weighed
amounts. Young et al. (1952) suggested that the errors
in estimation of portion sizes were probably the largest
single source of error in dietary record-keeping.
Becker et a1. (1960) concluded that the recall technique
tended to result in underestimations, while recording in
household measures tended to lead to overestimations, on
the basis of comparison with a weighed diet procedure.
It is well accepted that the pattern of growth
throughout childhood influences a corresponding changing
food intake. -During infancy and adolescence, when
physical growth is most rapid, nutritional requirements
are high, and providing that the child has good physical
S4
and emotional health, his appetite, and consequently, his
food intake increases accordingly. The picture changes
somewhat in regard to the preschool child. During this
period, demands for physical growth are somewhat less,
but at the same time, the child's development and
maturation are rapidly progressing. There are intervals
when appetite is decreased and the intake of some or all
nutrients may be lowered. Other environmental or intrinsic
factors may alter food intake or utilization. For example,
appetite may be increased or decreased by the emotional
changes within the child himself as he reacts to the
progress of his own maturation and to the people and
events in his surroundings. As a result, changes occur
in the level of food intake as the individual progresses
from birth.to maturity.
Some of the classic work in exploring the nature of
the changing food intake of the growing child has been
done by Virginia Beal, working at the Child Research
Council in Denver, Colorado. The objective of this
comprehensive longitudinal study was to investigate the
effects of differing levels of dietary intake on the
physical and physiological findings of the children.
Beal's studies lend much to understanding the nature of
dietary intakes of preschool children; they suggested that
the lowered nutrient intakes noted during the immediate
post-weaning period were increased somewhat after the
55
third year (Beal, 1953, 1954, 1955, 1956). Beal (1961)
also reported that healthy children growing at acceptable
rates vary widely in the amount of food they consume.
The tendency for very high intakes was observed to be
Vgreater than the tendency toward very low intakes.
An important environmental influence on dietary
intake that has received considerable attention in the
literature is that of family income. AS a result of the
nationwide household food consumption survey in the mid-
1950's, it was suggested that the diets of families with
low incomes were not as good as those of families with
higher incomes. But, results of a comparable survey in
1965 revealed that a high family income alone does not
necessarily insure good diets (Adelson, 1968). The more
recent survey revealed that even at the highest income
level, a sizable prOportion of families had poor diets.
Food habits, not the inability to purchase adequate food,
were the dominant causes behind poor diets for this group
(Clark, 1969:270).
Studies conducted with children have been inconclu- /¥’
sive in defining the association between low family
income and inadequate dietary intake. Certain
investigators (Hardy et aZ., 1943; Metheny et aZ., 1962a;
Owen and Kram 1969) have reported an inverse correlation
between the level of family income and dietary adequacy.
Although they did not Specifically evaluate dietary
56
intakes of preschool children from "impoverished†families,
Zee et al. (1970) attributed the growth retardation and
anemia found in the children they studied to a lack of
food; they suggested that this inadequate intake was
primarily due to an inability of the family to obtain a
sufficient quantity and quality of food.
In contrast, other investigators have shown no
association between dietary inadequacy and low family
income. Hootman et a2. (1967) and Kerrey et al. (1968)
indicated that poor diets may not be an inevitable
accompaniment of low levels of family income. These
studies reported that the calculated nutrient intakes of
children from low-income families did not reveal the
prevalence of gross inadequacies in the children's diets.
Certain nutrients have been noted as the ones most often
limiting in children's diets. Implicated in this regard
have been iron, calcium, ascorbic acid, and to a somewhat
lesser extent, Vitamin A, niacin, and calories (Metheny
et al., 1962a; Skidmore, 1965; Cloud, 1967; Kerrey et aZ.,
1968; Owen and Kram, 1969; Brown et aZ., 1970). Lund and
Burk (1969) found a significant association between
dietary intake of certain nutrients, particularly Vitamin
A and ascorbic acid, with various socioeconomic parameters,
most notably family income and educational level of the
mother. Studies by Kerrey et al. (1968) and by Owen and
Kram (1969) indicated that while children from high income
57
families had diets providing more ascorbic acid and
Vitamin A, children from the low income groups received
diets providing the same or additional amounts of iron
and thiamin. Both studies indicated that higher income
children received proportionately more calories from
dairy products, while the greatest single source of
calories for the lower income children was the bread and
cereals.group.
It has been suggested that the younger child may be
more likely than an older, school-age child to consume a
diet which meets the Recommended Dietary Allowances
(Emerson, 1967). This observation may be related to the
fact that the preschool-aged child is far less independent
and is less likely to be eating meals away from home.
In order to obtain information on children's nutrient
intake, mothers participating in the present study were
requested to keep a record of the child's food intake for
a twenty-four hour period on three separate occasions.
These food records were analyzed and the nutrient content
of the diets was used for all subsequent data analyses.
COpies of the.form used for the collection of dietary
information are in Appendix C-l.
Assessment of Nutritional Status
Nutritional status may be defined as, "the state of
health of an individual or group as conditioned by choice
and amounts of foods, or more specifically, nutrients,
58
eaten (Morgan, 1959)." In assessing nutritional status,
an attempt is made to obtain a composite picture of the
many facets of the body's growth, function, and structure,
as related to previous and present food intake; one aims
to measure the extent of a cause-and-effect relationship
between nutrient intake and the level of well-being of
the individual (Leverton, 1960). Several reports have
attempted to review the literature from the numerous
studies conducted to learn the nutritional status of
various population groups. The most comprehensive of
these were probably by Morgan (1959) and by Kelsay (1969).
Investigators have generally agreed that there is a
serious lack of information on the nutritional status of
young children in this country (Krehl and Hodges, 1965;
Lowe, 1967; Select Comm., 1969:586).
The first "comprehensive survey to assess the
nutritional status of the pOpulation of the United States.
of America" was the National Nutrition Survey, undertaken
in 1967. This endeavor received much nationwide support
and attention because the final results were intended to
give a â€reliable picture of the nutritional health status
of the pe0p1e living in the lower income areas of America"
(Schaefer and Johnson, 1969). Only preliminary findings
from the survey in several states have been published to
date (McGanity, 1969; Unglaub, 1969).
59
Classic methods used for the evaluation of nutri-
tional status include: 1) dietary evaluation;
2) biochemical tests; and 3) clinical examinations. In
“general, dietary surveys evaluate current food intake;
biochemical data reflect recent nutritional status, and
clinical examinations evaluate long-term nutritional
history (Pike and Brown, 1967:466). Figure 3 illustrates
the relationships which exist between the three measures
of nutritional status, their positions in the child's
ecosystem framework as well as the sequence of events,
which occur between nutrient inadequacy and the develOp-
ment of a clinical lesion. It must be stressed that the
appraisal of nutritional status involves more than merely
an evaluation of dietary intake. In the present study,
the other means of evaluating nutritional status, namely
the biochemical and clinical measurements, are viewed
as outputs of the child's ecosystem processes.
Clinical Methods: Nutritional Anthropometry
The clinical examination is an important practical
method for assessing the nutritional status of a pOpulation
.group. For the most part, the method is based on
examination for bodily changes believed related to
inadequate nutrition that can be seen or felt in super-
ficial epithelial tissues (Jelliffe, 1966:10). The
clinical assessment of nutritional status may include an
appraisal of the following: 1) growth and develOpment;
60
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61
2) the degree of fatness or leanness; or 3) Specific
physical signs thought to be associated with particular
nutrient deficiencies (Pearson, 1968:565). The evaluation
of growth and developmental status is important in the
nutritional appraisal of infants and young children.
Most commonly, anthropometric measurements, such as height,
weight, or skinfold thicknesses, are employed for this
purpose. Because growth performance is influenced by
'genetic factors, anthr0pometric measurements are more
useful for describing certain population characteristics
than for evaluating the growth of individuals. The assess-
ment of fatness or leanness is most appropriate for
pOpulation groups for whom height- and weight-for-age
standards have been developed. Clinical signs of nutri-
tional deficiency reflect the result of long-term
nutritional impairment. The clinical evaluation is by
far the most subjective area in the determination of
nutritional status. Lesions observed are often non-
specific, i.e., they may be due to trauma, exposure, or
allergies rather than to some distinct nutritional
deficiency. In addition, lesions may be attributable to
some secondary conditioning factor, such as malabsorption
or parasitism, and are rarely diagnostic by themselves.
The Specific lesion noted should always be evaluated in
Ilight of a continuum of severity; this procedure, as well,
lends itself to subjective evaluation (Jelliffe, 1966:12).
62
A child's actual growth and develOpmental progress
exists as an interrelated whole, involving concurrent
progress in psychological and social development, as
well as biological or physical growth- A comprehensive
concept of development implies a growing body, a maturing
ego, and the environment in which those processes are
evolving.
The physical development of children is directly
influenced by environmental factors which act upon the
'genetic potential (Watson and Lowrey, 1967:51-52).
Clinical observation substantiates the fact that genetic
potentialities of the human organism may not become
manifest unless a complex of stimuli act together in a
favorable environment. Genetically determined factors
thus remain used or unused to the extent that the environ-
ment offers Opportunity for their realization.
The final size a person attains is limited largely
by heredity, but whether or not the individual realizes
his full growth potential is determined largely by
nutrition (Mitchell, 1962). It is well known that growth
is stunted in young children receiving diets severely
restricted in proteins and/or calories. The extent to
which such undernutrition influences the size of an
individual depends upon the age at which it occurs (the
(greatest effect being at the period of maximum growth)
and by its duration in relation to the total period of
'growth (Stoch and Smythe, 1963).
63
Jackson (1966:11) has stated, "growth rate of child-
ren is one of the most Simple, inexpensive, reliable, and
important tools available as an index of nutritional
status." He.further suggested that nutritional surveys
should always include observations on the height and
weight of children. Hundley et a1. (1955) indicated that
heighteweight measurements of young children could serve
as a reliable index of nutritional status.
Nutritional anthrOpometry is concerned with the
measurement of the variations of the physical dimensions
and the_gross composition of the human body at different
degrees of nutrition (Jelliffe, 1966:50). Garn (1962)
stated, "anthrOpometry provides the operational measure-
ment of long-term nutritional status, given the assumption
for growing children within a particular gene pool, that
the larger ones have been better nourished." He further
suggested that anthropometry can be a valuable adjunct
to clinical appraisal providing a quantitative indication
of the rapidity of size increase, the relative amount of
different tissues present, and an indication of caloric
excess.
.The two most universally accepted measures of human
physical growth are height (increase in linear size) and
weight (increase in bulk). Weight seems to be the
anthr0pometric measurement most in use. The prevalence
of malnutrition, according to some investigators (Jelliffe,
64
1966), is best indicated by a weight deficiency as evidence
by growth failure in children. On the other hand, height
is considered by others to be a more accurate refleCtion
of nutritional status in children because it is not
influenced by such a variety of extraneous factors as is
weight (Mickelsen et aZ., 1970). Bloom (1964:36) noted
that height represents a highly stable characteristic and
is not reversible in that growth once attained is not lost
except as a result of senility, surgery, or disease. In
contrast, weight may go up as well as down over a period
of time and, to a limited extent, may be controlled by
the individual. Jackson (1966:10) pointed out,
...although weight is used as a standard
reference point, it is a poor index,
whether used for maturity, growth, or
body composition... . Rate of growth in
length is a better criterion of adequacy
of nutrition in infancy and childhood than
are changes in body weight.
A recent study suggested that the ratio, weight to the
squared height, is a measure which can be used in field
studies as a Simple and easy criterion of nutritional
status (Rao and Singh, 1970).
Height and weight measurements of children may be
adversely affected by poor environmental conditions. Data
from several studies supported the contention that height
and weight.measurements tend to be greater for children
from the higher socioeconomic groups (Hundley et al.,
1955; Stine et al., 1967; Crispin et al., 1968). Comparing
65
heights and weights of Head Start children with measure-
ments of children from suburgan areas in Cleveland,
McClelland (1969) concluded that, "growth progress is
related in a negative way with income level." Owen et a1.
(1969) also indicated, "among factors serving to
characterize low income children, undernutrition and
underachievement in growth were evident and may well have
been causally related."
Sex differences in growth rates have been reported.
Douglass (1962) stated that in the more prOSperous
occupational groups in Britain, the girls gained more in
height between two and four and one-half years than the
boys did, whereas in the less prosperous groups they
gained less, thus suggesting to the author that the growth
of girls may be more affected by environmental factors
than is the growth of boys. In contrast to this conclusion,
Stine at al. (1967) indicated that in their sample of
four-year-old children from impoverished families, they
found that male children were significantly heavier than
the females.
Studies of racial differences in appearance and
physiological attributes in which American Negro and
whites have been compared commonly appear in medical
literature. Malina (1969), in reviewing findings about
the differences between American Negroes and whites on the
basis of growth patterns, concluded that the major
differences do not lie in over—all body Size as reflected
66
in stature and weight, but rather exist in the relative
prOportions Of limbs and trunk. From physical measure-
ments obtained from over 2000 healthy North.American
Negro children from low-income families, verghese et a1.
(1969) concluded.that, "height and weight of the Negro
children [appeared] to be similar to those of North
American Caucasian children." The Opposite vieWpoint was
presented by Stine et a1. (1967) who concluded that Negro
males and females were significantly taller than their
white.counterparts.
In the present study, certain physical measurements
were selected for study on the basis that the literature
revealed that differences in physical measurements would
be observed in response to.various environmental circum-
stances, sex, or race. The variables studied included
standing height and weight. Weight was measured on a
balance-beam scale to the nearest 0.25 pound. Standing
height was measured according to the procedures outlined
by Bayer and Bayley (l959:8) to the nearest 0.1 inch.
Both.standing height and weight were measured on children
who were wearing light indoor clothing, but no Shoes.
'Procedures used to classify children either by
height or weight alone may be misleading because of the
range in the heights and weights of children of any given
age. In an attempt to rectify this situation in the
present study, heights and weights Of the children were
compared with several well accepted standards. One of
67
these was the height- and weight-for-age standards which
had been developed at the Fels Research Institute by Garn
and Rohmann; this standard was recommended for use in
the evaluation of nutritional status of preschool children
by.the U. S. Children's Bureau (1967). A second means
used to assess physical measurements was the height- and
weight-for-age.standards develOped by Stuart and his
associates (Nelson, 1968:1007).
From the various height or weight ratios used for
defining body types, one weight-for-height classification
system.used in the present study was that develOped by
Sargent (1961). In this system, a linear regression line
representative Of a normal weight is computed, and per-
centile.deviations from this line are determined and
identified by descriptive body type terms. Six weight-
height classification codes were used.
Children whose weight for height (regardless
of age) fell within plus and minus ten
percent of this average line were classified
in the "normal" weight for height classifi-
cation. Children weighing more in relation
to their height were claSSified as "stocky"
if their weight for height fell between ten
and twenty percent above the average line;
"overweight" for height if between twenty
and forty percent above; or "obese" if
forty percent or more above. Children
weighing less in relation to their height
were classified as "slender" if their
weight for height fell between ten and
twenty percent below the average line, or
"underweight" for height if more than
twenty percent below (Sargent, 1961:27).
68
Noting that no recommendations had been made by the
Children's Bureau (1967) for the combining of weight-for-
age and height-for-age classifications for estimating
overweight or underweight, Smith and Brown (1970)
developed five height-weight-age divisions based on the
Fels Research Institute percentiles for height and weight.
These divisions were also used for classification Of
heights.and weights in the present study.
Drash et a2. (1968:61) suggest that the assessment
Of “developmental age" is a "useful means of comparing a
_given individual to a standard population.“ This concept
is valid for use for any anthropometric characteristic
which varies predictably with chronologic age and for
which there are acceptable standards for children at
various ages. Assessments of "height age" and "weight age"
were performed in the present study. The concept,
â€height ageâ€, expresses an individual's height as the age
at which his height is equivalent to the median height
of a standard, chronologically arranged population.
"Weight age" is calculated in the same manner. The
standard of reference for height and weight measurements
used in the present study was the Boston Growth Chart,
developed by Stuart and his associates (Nelson, 1968:
1007). The height and weight age for each of the subjects
in the study was determined by finding the chronologic age
(in monthS) at which the individual's measurement crossed
69
the fiftieth percentile line of the Stuart Percentile
Grid (Nelson, 1968).
. The "develOpmental index" concept, used by Drash
et a2. (1968) expresses an individual's attainment of a
particular height or weight numerically by eliminating
chronologic age as a variable. Although this concept
has been.more commonly used by psychologists in converting
mental age to an intelligence quotient, it is equally
applicable to variables of physical growth and develOpment.
Its major drawback is the absence Of previous standardi-
zation. As used in the present study, the develOpmental
index was obtained by dividing develOpmental age for
height and weight by chronologic age. In a normal
population, the developmental index would equal 1.0.
Advanced development would be represented by a value
tgreater than 1.0 and retarded development by a value less
than 1.0. According to Drash et al. (1968) a height
index of 0.80 or less would indicate that the individual
was below the third percentile for height, using the
.Stuart standards (Nelson, 1968:1007). Weight index,
which is a more variable factor, is 0.63 for the third
percentile at theage of four years.
,The measurement of head circumference is a standard
procedure widely used in pediatric practice. Head cir-
cumference has been found to be smaller in malnourished
children than in children who were well nourished (Stoch
70
and Smythe, 1963). Stine et a1. (1967) indicated that
twenty-five percent of the children studied in their
sample of preschool children from low-income families
had smaller head circumferences than the lowest ten per-
cent Of the standard pOpulation. These investigators
found significant correlations between height and weight
measurements and head circumferences. ‘Verghese et a1.
(1969) found that the head circumference was consistently
less for Negro children than for white children.
In the present study, in addition to standing height
and weight, other physical measurements.obtained included
sitting height, circumferences Of head, upper arm and
chest, bi-acromial (Shoulder) and bi-cristal (also called
bi-iliac Or pelvic) diameters. Sitting height was measured
according to the procedures specified by Bayer and Bayley
(l959:9). Circumferences were measured to the nearest 0.25
centimeter using a flexible steel tape measure. Diameters
were measured to the nearest millimeter using steel bow
calipers (Bayer and Bayley, 1959:11).
A comprehensive evaluation of the quality of growth
requires not only measurements of overall body size,
length and mass, but also of relative amounts Of muscula-
ture and body fat. Since muscle and fat tissues are most
influenced by the relative amounts of protein and calories,
it is desirable to evaluate body composition in order to
determine the amount and distribution of human subcutaneous
71
fat which represents caloric reserves. While several
means of evaluating body composition are available, only
the use Of skin-fold calipers has been shown to be
practical for field studies (Jelliffe, 1966:72). Garn
(1962) indicated that despite their simplicity (a fact
which had led them to be scorned by some investigators),
fat-fold calipers are of proved value. He concluded,
"...fat-folds are useful measures of relative fatness."
Differences in skinfold thicknesses according to race
or socioeconomic status have been reported in the
literature. Subcutaneous fat, as measured by skin-fold
thickneSses has been reported to be less in Negro children
than white children (Malina, 1971; Stine at al., 1967).
Crispin et al. (1968) found that in contrast to all other
measurements (such as height, weight, body circumferences,
and muscularity measurements), skin—fold thicknesses were
not greater for the higher than the lower socioeconomic
_group.
In the present study, skinfold measurements were
taken at two sites on the body: at the triceps (at the
back of the mid-arm over the triceps muscle), and the
subscapular region (below the tip of the scapula on the
back). All thicknesses were measured by the investigator
using a Lange skinfold caliper and recorded to the nearest
millimeter.
72
Biochemical Parameters
Certain biochemical procedures may be employed tO
test aspects Of nutrition, such as 1) the relative ade-
quacy of dietary intake as reflected by levels in a
particular tissue, e.g., blood; and 2) metabolic changes
due.to tissue malnutrition; and 3) depletion of body
stores of certain nutrients, e.g, protein (Jelliffe,
1966:78-85). Levels of nutrients in the body may be
interpreted in relation to their biochemical Significance
as well as compared with certain standards Of reference
appropriate for the age and sex of the pOpulation under
study. The Interdepartmental Committee for Nutrition for
National Defense (ICNND) has established a set of standard
values which carry descriptive labels, such as "deficient",
"low", "acceptable", and "high" (ICNND, 1963).
Certain biochemical measurements are important for
study in preschool children because they either are
associated with growth or reflect dietary intake Of certain
nutrients noted as being particularly crucial for the
Optimal develOpment of young children. The parameters of
hemoglobin and hematocrit were apprOpriate for investiga-
tion because low values are associated with the incidence
of anemia. Filer (1969) has described iron deficiency
anemia as a "significant public health problem among
young children." In fact, some even regard this syndrome
73
as the most common deficiency disease occurring in infancy
and childhood today (Jacobs, 1960).
Certain investigators support the idea that anemia
occurs more frequently among loweincome groups in the
population (Klipstein, 1968; Hillman and Smith, 1968);
this fact is commonly interpreted to mean that there is
a significant association between low socioeconomic status
and the prevalence Of anemia.
Certain studies have focused on the prevalence of
anemia among children from low-income families. A number
Of surveys have shown that a rather large percentage of
theSe children had hemoglobin or hematocrit values indi-
cative of anemia. Studies which have supported this view
would include Kravitz.(1966), Owen et a1. (1969), and
Goldsmith and Unglaub (1968).
In contrast, other studies, including Kerrey et al.
(1968), Crumrine and Fryer (1970), Mickelsen at al. (1970)
and Haughton (1963), have failed to document that anemia
is widespread among preschool children from low-income
families. Following the mass screening of 7000 preschool
children enrolled in Head Start programs, Pearson et al.
(1967) indicated that they had failed to reveal the ex-
pected high incidence of anemia. Considering levels of
hemoglobin below 11 gm/lOO ml as unacceptable for children
between the ages Of twenty-four and seventy—one months, Owen
et al. (1970) concluded that iron deficiency anemia was not
74
uncommon among preschool children, regardless of socio-
economic.status...0ther researchers (Mickelsen et aZ.,
1970) have suggested that other factors which.may account
for the discrepancy in the prevalence figuresfrom the
various.studies include the ages of the.children, race,
and other regional differences.
Measurement of total serum proteins and serum
albumin levels reflects the protein status of the body.
In addition to knowing the level of total proteins in
the blood, it is also important to assess the albumin
level because this component of the blood is noted to be
reduced in cases of severe protein malnutrition (Jelliffe,
1966:87). Schendel et aZ.(l960) have stated that the
albumin leVels of children can be used as an index of
protein depletion. The recent study of Crumrine and
Fryer (1970) indicated that only one child out of forty
had a serum protein level below the acceptable level and
that albumin levels for all the children studied were
above the acceptable level.
In the present study, blood tests were Obtained on
each child to determine hemoglobin, hematocrit, total
serum proteins, and serum.albumin levels. A finger prick
blood sample was drawn by a registered medical technologist
from the.Olin Health.Center on the Michigan State Univer-
sity.campus where analyses for hemoglobin and hematocrit
were performed. A portion of the whole.blood sample was
75
used for the hemoglobin determination, which was then
analyzed by the cyanmethemoglobin method (ICNND, 1963:
115), as recommended by the Children's.Bureau for the
determination of nutritional status of preschool children
(1967).. This procedure has been widely adopted.because
it is considered simple and accurate (O'Brien et al.,
1968:167). Hematocrit was determined after collection
Of an aliquot Of the whole blood sample in heparinized
micro-capillary tubes by Spinning samples in a Micro
Capillary centrifuge for five minutes.(O'Brien et al.,
1968:187).
Blood samples for the serum protein and serum albumin
detenminations, which were subsequently analyzed by an
independent commercial laboratory, were collected in
unheparinized capillary tubes. The portion of serum used
for the albumin determinations was analyzed colorimetri-
cally using the dye, bromcresol green (BCG) (Rodkey, 1965;
Hernadez et al., 1967; Dow and Pinto, 1969). At pH 4.0,
albumin combines with the dye to yield a blue color, the
intensity of which is prOportional to the albumin concen-
tration in the serum; color intensity of the samples in
the present study was measured on a Coleman Jr. Spectro-
photometer at 600 mp. TOtal serum proteins were measured
using a refractometer, a procedure which.measures only the
dissolved proteins by means of light refraction. This
76
method is unaffected by the presence of chromogens in
the.serum,(Bullen,,1970).
A biochemical index of growth.that recently has been
prOposed is the rate of urinary excretion of hydroxyproline.
This amino acid is present in urine principally in the
form of peptides derived from the metabolism of collagen.
Processes such as growth which accelerate collagen
formation are associated with an increase in hydroxyproline
peptide excretion (Pearson, 1968:577). Whitehead (1965)
indicated that hydroxyproline excretion might be used as
"a Simple and practical test of assessing the rate of
.growth, and consequently, the nutritional status Of
children."
In community studies, the collection Of twenty-four
hour specimens of urine is not practical on a large.sca1e.
For this reason, Whitehead (1965) has develOped a test
called the "hydroxyproline index" which indicates the ratio
between the amount of hydroxyproline and creatinine in
random samples of urine, as corrected for body weight.
The index is calculated as the following ratio:
â€mmoles of hydroxyproline per liter of urine
mmoles of creatinine per liter Of'urine per kg body weight
Allison et a1. (1966) have shown that the simple ratio,
hydroxyproline to.creatinine, falls progressively until
the fifth year,_then levels off and is nearly constant
‘between the ages of five and twelve. Thus, the "hydroxy-
proline index" may be used indepedently of age, but is
77
probably not valid for use after the age of five
(Committee Report, 1970). Mohanram et a1. (1969)
indicated that in the same child, there was considerable
variation in the hydroxyproline index and that daily
(fluctuations in the ratio of hydroxyproline to.creatinine
could have been reSponsible for such variations. If
used as one test Of nutritional status and_growth,
Whitehead (1965) indicated that the hydroxyproline index
may be used to pick up "marginal“ cases of malnutrition.
Because a twenty-four hour urine sample can rarely
be obtained in field studies, random.urine samples may
be collected. Excretion data from such single samples
are.then expressed in relation to creatinine content Of
the sample on the assumption that creatinine excretion is
relatively constant and thus can serve as a basis for
equating excretion data from different individuals (Pike
and Brown, 1967:474-475).
In the present study, random urine samples were
collected at the nursery school and clinic for approxi-
mately one-third of the children in the total sample.
Samples were stored in the refrigerator using toluene as
a preservative. Analyses for urinary creatinine were
performed by the investigator using the alkaline-sodium
picrate method as modified by Bonsnes and Taussky (1945).
_In this procedure, creatinine in solution with.picric acid
and sodium hydroxide forms an intense yellow color
78
.measured on the Beckman DB spectrOphotometer at 525 mu.
Analyses for urinary hydroxyproline.peptides were done
using methods deVeloped by ProckOp and Udenfriend (1960).
In this procedure, hydroxyproline is oxidized to pyrrole
in the presence of alanine. Upon addition of p-
dimethylaminobenzaldehyde (Ehrlich'sreagent), the pyrrole
forms a chromophore. .The intensity Of the bright pink
color thus formed was measured on the Beckman DB spectro-
photometer at 560 mu.
CHAPTER IV
DATA COLLECTION AND ANALYSIS
This chapter discusses the selection and description
Of subjects in the sample; the methods used for data
collection; classification and coding of data for analysis;
and procedures used for data analysis.
Selection and Description of Sample
The particular sampling procedures employed in the
present study may be described as "chunk" sampling (Kish,
1965:320) because typical or representative units Of
preschool children were chosen on an a priori basis to be
included in the final sample. In order that children in
the study would come from a variety of family backgrounds
(in terms Of ethnicity, family income, size and composi-
tion, parental occupation and education), the only
restrictions placed on the children included in the sample
were:
1) That children should be between the ages of
three and five years.
2) That mothers (or caretakers) of the children
would agree to participate in the study by completing an
linterview, questionnaires, and records of the child's
food intake.
79
80
The final sample consisted of 163 children drawn from
the following sources:
1. Michigan State.University Laboratory Preschool PrOgram.
A total of sixty-four children who were enrolled in this
program subsequently participated in the present study.
Approximately one—fourth of these children had been
previously designated as "disadvantaged" for purposes of
inclusion in other concurrent research projects. The
remainder Of children were from middle- and high-income
families living in East Lansing and other surrounding
communities.
2. Spartan'Nursery School. Ninety-one children were
included in the sample from this program. Approximately
20% of these children were enrolled in a "Head Start"
class and met the designated criteria for admission into
that program. The majority Of the other children
attending this nursery school lived in Michigan State
University Married Student Housing; a large percentage
of their parents were enrolled as full-time students at
the University.
3. Public Health Clinic, Cristo Rey Area. Eight children
attending the Clinic, which is staffed by personnel from
the Ingham County Health Department and the Michigan State
University College of Human Medicine, were included in
the sample. All Of these children were from low-income
families.
81
Certain previous studies conducted in the greater
Lansing area documented the fact that the children included
in the final sample had been drawn from a variety Of
neighborhoods possessing different population character—
istics. The Michigan Health Survey (known locally as
"ECHO" for Evidence for Community Health Organization) was
organized as a collaborative effort between the Ingham
County Health Department and the Michigan Department of
Public Health Center for Health Statistics to sample the
Lansing area for the purpose of documenting the prevalence
of health problems in certain areas of the city. Table
4.1 is a profile of the characteristics Of the neighbor-
hood areas identified by ECHO sampling. (Comparable
population characteristics were not available for the
East Lansing and other outlying areas.) Figure 4 is a
map Of the area indicating the number of children included
in the sample from each ECHO neighborhood area. Low-
income children enrolled in the Laboratory Preschool
Program were drawn from ECHO Area NO. 5 and the Turner
Street Housing Project in Area No. 3. Children in the
Head Start class at Spartan Nursery School were drawn
primarily from ECHO Area NO. 8. The Cristo Rey area in
Lansing (included in ECHO Area No. 7) had been identified
by previous public health studies as one in which certain
.problems, including a high infant mortality rate, were
particularly prevalent.
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83
CLINTON CD.
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MICH GAN
84
The sex and racial distribution of the children
included in the sample are shown by Tables 4.2 and 4.3.
Table 4.4 indicates the age distribution of the children
studied. The mean age of the children in the sample at
the beginning of the study in September, 1969 was approxi-
mately four years.
Table 4.2. Sex Distribution
Number Percentage
Male 81 49.7
Female 82 ‘ ' 50.3
Table 4.3. Race Distribution
Number Percentage
White 96 64.4
Negro 37 24.8
Mexican American 5 3.3
Other (including Oriental, 11 7.4
E. Indian, Mid-Eastern)
Table 4.4. Age Distribution
Age in Months,
as of Sept. 1969 Number Percentage
<36 12 7.4
36-42 40 24.5
43-48 43 26.4
49-54 46 28.2
55-60 19 12.9
'>60 1 .6
'Mean Age: 46.2 months
85
Data Collection
Permission was granted by the directors, supervisors,
and teachers of the two nursery school programs and by
administrative personnel at the public health clinic for
the researcher to study the children enrolled therein.
A.multiple-phase program was initiated whereby serial
measurements of anthrOpometric characteristics and food
records for the children and interviews with the
children's mothers could be obtained. Parental permission
for inclusion of the child in the study had been obtained
by the nursery school and clinic personnel prior to data
collection. Refer to Table 4.5 for the scheduling of
data collection.
Measurements obtained on each child included:
certain physical measurements, a blood test and urinalysis,
and food records. Data for the anthrOpometric measure-
ments were collected during the time that the child was
attending the nursery SChOOl or clinic. Standing height
and weight were measured three times throughout the
school year, i.e., in November, February and May. In
addition to these measurements, sitting height, triceps
and subscapular skinfold thicknesses, biacromial and
bicristal diameters, and head, chest and.upper arm cir-
cumferences were collected in the Spring.
A separate parental permission was requested prior
to the blood tests. This letter is included in Appendix
A-4. Blood samples for all participating children
86
Table 4.5. Timing Schedule for Data Collection
Person From
'Data ‘Whom‘COllected
‘ Fall, 1969
Standing height and weight measurements ' Children
One-day food record Mothers*
Winter,'l970-
Standing height and weight measurements Children
Home interview ' Mothers*
Attitude-measuring questionnaires Mothers*
One-day food record Mothers*
Spring,‘1970
All anthrOpometric measurements Children
Blood test Children
Urine collection Children
One-day food record Mothers*
.*COpies of instruments used may be found in Appendix C.
87
obtained by finger prick, was collected by a registered
medical technologist from the Olin Health Center on the
Michigan State.University campus. These tests were
obtained in the Spring during the time that the children
were attending the nursery school or clinic. Random
urine Specimens, collected from approximately one-third
Of the children, were collected by the investigator while
the children were at the nursery school or clinic.
Mothers of the children were requested to OOOperate
in the study for purposes of gaining information about
the child's family and his medical and dietary history.
The mothers were first requested to complete a twenty-four
hour food record (Appendix C-l) for each child. They were
instructed to record all food in terms of household measures
and to complete the record for a day when the child was not
attending the nursery school in order that she might
Observe first-hand her child's food intake. For the first
record obtained in the fall, instructions for completing
the food record forms were given by the researcher to a
_group of approximately twenty mothers. For those not
attending this meeting, the forms with accompanying
instructions and a self-addressed stamped envelOpe were
mailed. Completed food records were then returned by
mail to.the researcher. The second food record form was
“given to the mother at the time Of the home interview in
the.winter; completed forms were again returned by mail.
88
In the spring, the food record forms were mailed to the
mothers participating in the study; completed forms were
returned by mail. An attempt was made to coordinate data
collection so that measurements of height and weight on
the children might be made at approximately the same time
as records were being kept of their food intake.
Interviews with the mothers were performed by persons
Specifically selected and trained for the task by the
investigator. Phone calls were made to arrange the most
suitable time for the interview. At the time the appoint-
ment for the interview was made, the attitude-measuring
questionnaires were mailed to the mother so that she could
independently re5pond to them and have the completed forms
ready for the interviewer to collect at the time of the
home interview. It required approximately one hour for
completion of both the questionnaires and the interview.
Data‘AnalyseS
Data collected from measurements taken on the children
and from the interview with the mother were scored and
transferred to data processing cards. Analysis was
primarily performed on the Control Data Corporation (CDC)
3600 model computer,supplemented by the CDC 6500 model
computer. Table 4.6 summarizes the procedures used for
the complete analysis Of the data including the statistical
'procedures used. The following sections present a more
complete discussion of the classification and coding
89
Table 4.6. Methods Used in Analysis Of Data
INTENT 0? ANALYSIS DATA EMPLOYED STATISTICS AND COMPUTER PROGRAMS
1. Determination of nutrient content of Three, one-day food Transformation program.2
children's food intake and number of records. Punch cards
servings within specified food groups. with nutritive values
per specified food unit.
2. Description Of nutrient intake infor- Data from food record Frequency distribution; mean range,
nation, physical measurements, and transformation program. cell count, and percentages.3v .
biochemical data for children in Results of analysis of
sample. blood and urine.
Physical measurements
of children.
3. Description of family environmental Demographic data. Inter- Frequency distribution, including
characteristics of subjects. view with mother. mean, range, cglg count, and
â€ECHO†Project data. percentages.30 I
4. Determination of children's physical Serial measurements Of Conversion program.6
measurements according to weight- children's standing
and height-for-ags standards. height and weight.
5. Graphical representation of Interview data; Histograms7
children's characteristics and DemOgraphic data.
family environment characteristics. Results from food record
transformation program.
Analysis of blood and
urine. Physical
measurements of children.
6. Determination of degree of As above. Contingency tables.3"'8
association between characteristics Computation of Pearson product- 9 10
of the children with family moment correlation coefficients. '
environment variables.
7. Determination of clusters of As above. Oblique multiple-groups cluster
variables which describe sample. analysis.
8. Determination Of effects of As above. Moderating effects-computer
moderating variables. program.1
1Davenport, E. Calculating the Nutritive Value of Diets. A Manual Of Instructions for the Use
of Punch Cards for Machine Tabulation. U. S. Department of Agriculture, ARS Publication No. 62-10-1,
September 1964.
2Program written by Steven L. Huyser, Michigan State University, 1969.
3Price, L. A. and J. L. Peterson. Control Cards for PrOgrams on the New 6500 CISSR Library
System. Computer Institute for Social Science Research Tech. Report No. 70-4. East Lansing:
Michigan State University, 1970.
‘Price, L. A. and J. L. Peterson. Program DATA. Computer Institute for Social Science Research
Tech. Report No. 70-3. East Lansing: Michigan State University, 1970.
5Thiel, L. and L. Patrick. PERCOUNT. Computer Institute for Social Science Research Tech.
Report NO. 18. East Lansing: Michigan State University, 1968.
6Program written by Thomas Nicol, Michigan State University, 1971.
7Clark, J. and G. Gillmore. Data Plot and Statistics for Variables and Pairs of Variables-~DAPI.
Computer Institute for Social Science Research Tech. Report NO. 15. East Lansing: Michigan State
University, 1968.
8Holdridge, A. R. Four-dimensional contingency tables--NUCROS. Computer Institute for Social
Science Research Tech. Report. No. 12, East Lansing: Michigan State University, 1968.
9Kline, D. IDCORR: Incomplete Data Correlation Program. Computer Institute for Social Science
Research Tech. Report No. 4. East Lansing: Michigan State University, 1968.
10Hunter, J. E. and S. H. Cohen. PACKAGE, Version 1.0, CDC 3600 Extended FORTRAN. Computer
Institute for Social Science Research. East Lansing: Michigan State University, 1969.
11Hunter, J. E. and R. J. Chesser. MODERATOR: A Family Of Computer Programs Designed to Show
Simultaneously the Moderating Effects and Non-linear Relationships Among a Set of Variables.
Unpublished paper written at Michigan State University, East Lansing, 1971.
9 0 "
procedures used in preparing the data for analysis and
the particular types of computer-assisted analyses which
were performed on the data.
Factor Analysis
As a statistical technique for data analysis, factor
analysis has been described as "a method for determining
the number and nature of the underlying variables among
large numbers of measures (Kerlinger, l967:650)." Its
main contribution lies in helping the researcher to
identify unities or fundamental properties underlying a
large set of variables. As Harman (1967:4, 5) states,
The principal concern of factor analysis
is the resolution of a set of variables
linearly in terms of (usually) a small
number of categories or "factors".
This resolutiOn can be accomplished by
the analysis of the correlations among
the variables. A satisfactory solution
will yield factors which convey all the
essential information of the original
set of variables. Thus, the chief aim
is to attain scientific parsimony or
economy of description. ...
This aim should not be construed to
mean that factor analysis necessarily attempts
to discover the 'fundamental' or 'basic'
categories in a given field of investigation...
Since measures for certain important
.variables may not yet have been develOped,
the factors identified from the available
data cannot be considered completely
fundamental...While the goal of complete
description cannot be reached theoretically,
it may be approached practically in a limited
field of investigation where a relatively
small number of variables is considered ex-
haustive. In all cases, however, factor
analysis does give a simple interpretation of
a given body Of data and thus affords a
fundamental description of the particular
set of variables analyzed.
91
Factor analysis is an important technique in multi-
variate research because it is a useful tool for the
explication of constructs.1 Nunnally (1967:289) further
explained:
The first step...is to develOp measures
of particular attributes which are
thought to be related to the construct.
The second step is to correlate scores
on the different measures. The
correlations are analyzed to determine
whether 1) all measures are dominated by
Specific factors, 2) all measures are
dominated by one common factor, or
3) the measures tend to break up into a
number of common factors. ... Factor
analysis is a broad term referring to
methods of analysis used in the second
step above.
Nunnally (1967:289) has also indicated that "factor analysis
can be used either to test hypotheses about the existence
of constructs, or if no credible hypotheses are at issue,
to search for constructs in a group of interesting
variables."
In general, factor analysis consists of extracting
common and unique factors that can be attributed to each
variable from an intercorrelation matrix of a set of
variables. Within the factor analysis system, a variable
can be represented in terms of several underlying factors,
i.e.,
1A â€construct" may be thought of as an effort to
measure relatively abstract variables, i.e., ones thought
- to be evidenced in a variety of behaviors but which do not
exist as an isolated, observable dimension of behavior. In
essence, the construct represents a rather "half-formed"
hypothesis that certain behaviors will correlate with one
another in studies of individual differences (Nunnally,
1967:84-85).
92
A. Common Factors: those pertaining to more than
one variable in the set.
1. General factor: present in all variables.
2. Group factor: present in more than one, but
not all, variables.
B. Unique Factors: those pertaining only to a single
variable in the set.
Common factors account for the observed intercorrelation
among all variables. In contrast, each.unique factor
accounts for that portion of the variance of a variable
that is not associated with that of any other.variable in
the set. The fundamental goal of factor analysis is to
determine the amount of common variance which exists bet-
ween sets of variables.
One method available to the researcher for factor-
analyzing a correlation matrix has been termed cluster
analysis. Tryon and Bailey (1970:1) indicate that cluster
analysis is a procedure by which entities are objectively
,grouped on the basis of their similarities and differ-
ences. Such methods depend upon the identification of
clusters and presumed factors by searching for interrelated
~groups of correlation coefficients or other measures of
relation. This procedure is most apprOpriate when the
inveStigator is able to designate a set of variables as
. belonging to a particular cluster on an a priori basis.
93
In the present study, a system of correlational
analysis programs (named "PACKAGE"), develOped by Hunter
and Cohen (1969), was used. In addition to the computa-
tion of means, standard deviations, and productrmoment
correlation coefficients, these routines also perform
an oblique multipleegroups analysis in which groups may
be Specified by the investigator from those comprising
the correlation matrix stored in core memory. It has
been shown that factor analysis serves the cause of
"scientific parsimony" (Harmon, 1967:4); thus, by using
these programs in the present research, the initially
large set of variables can be reduced to a more manage-
able number. These procedures are useful in indicating
which.measures can be added and studied together rather
than separately.
While a complete description of PACKAGE is beyond
the sc0pe of this report, it must be pointed out that the
analytical strategy used by PACKAGE is to de-emphasize
blind rules for forming large clusters and to facilitate
reordering and presenting correlational matrices for
efficient visual inspection. A hierarchial approach to
synthesis of data is employed in PACKAGE. The operational
procedure entails first the inspection of an inter—item
correlation matrix, followed by the formation of small
. clusters of similar items, possibly two or three item
groups. The procedure of combining items and groups into
94
larger groups is continued until it is felt that additional
combinations would only blur important distinctions.
‘S‘c‘a‘l’e’ Development
In practice, scale development is an iterative pro-
cess of grouping items and evaluating the combinations.
While PACKAGE was capable of generating and arranging
the matrices, the final determination of the manner in
which.items.were to be grouped was left to the discretion
of the researcher. Three techniques were used, to
evaluate item clusters, including internal analysis,
external analysis, and content analysis.
Internal analysis is concerned with internal con—
sistency or how well the items in the scale are related
to one another. If scales consist of parallel items, a
high degree of internal consistency would be expected. A
second means of evaluating the similarity of items in a
group is to analyze the patterns of correlations with items
outside the group; this is called external analysis. If
items in the group "belong" together in the sense that
they are parallel items, they should exhibit a similar
pattern of correlations with other items. Unfortunately,
no single quantitative measure exists to.facilitate an
easy assessment of the external consistency. The
researcher must visually inspect the correlation pattern
' of each item in the scale with other items, noting areas
of inconsistency. A third means used to evaluate a
95
particular item combination was to examine the content of
the items. If items were roughly parallel in their
correlational patterns, one would expect that the content
of the items would be similar. One must be cautious in
interpreting the content of an item because an individual's
perception of the content of that item may or may not be
the same as the original writer's. Given this limitation,
the researcher can subjectively judge the "reasonable"
similarity of the content of the various items.
'Moderator»Effects
To a limited extent, computer-assisted analysis was
performed to determine the interaction (or "moderating")
effects of a group of selected variables. Anastasi (1964:
2861 notes that it is not uncommon to find that a validity
coefficient, whem computed for a total group, may be too
low to be of much practical value; however, when recom-
puted for subsets of individuals differing in some identi-
fiable characteristic, validity may be high in one subset
and negligible in anothers. One means of testing for
this effect is to divide subjects into high and low groups
on some.third variable (identified as the "moderator")
and compute the correlations for both groups. The
significance level of the difference between the correla—
tions obtained for the high and low groups may then be
’teSted.. To test for such effects in the present research,
a family of computer programs, called MODERATOR, was used;
96
this routine was designed to show simultaneously the
moderating effects and the nonlinear relations among a
set of variables. The mathematical derivation and
description of the computer analysis may be found in
Hunter and Chesser (1971).
‘Classification and deification'of Data-for'AnaLysis‘
' Dietary Data
Dietary data were obtained from three separate one-
day food records kept by the children's mothers or persons
responsible for the child's meals. Amounts of food con-
sumed were recorded in terms of common household measures
on forms provided by the researcher for that purpose (Appen—
dix C-l). Transformations of the data from each of the
three original food records were made for analytical pur-
poses. The following is a brief discussion of each of
the transformation procedures employed.
1. conversion of estimated quantities of food consumed
to corresponding nutrient values. Transformation of the
original food record data, reported in terms of estimated
quantities of foods consumed, to nutrient values was made
by using the coding system and conversion factors for
computer usage developed by the Consumer and Food Economics
Research Division, U. S. Department of Agriculture.
Specifics of this method are presented in USDA—ARS
‘ Bulletin No. 62-10—1 (Davenport, 1964).
97
Briefly, this method involved calculation of the
nutritive values of foods by means of:
two sets of data-one with the quantities
of food consumed, the other with nutri-
tive values per Specified unit of food.
The two sets are matched by identifying
food codes. The products of quantity
times nutritive value are derived and
then summed to obtain the nutritive
value of the diet. (Davenport,_l964:l)
. The food composition values used in this method were those
published in the U. S. Department of Agriculture Home and
Garden Bulletin No. 72, 1964. Identification codes for
512 food items, along with a master set of punch cards
carrying the nutritive values for each of the 512 items,
were obtained from the U. S. Department of Agriculture,
Agricultural Research Service. In the present study,
approximately 300 additional identification codes and
matching master cards were develOped for food items not
included in the manual. Food composition data for these
Dadditional items were obtained from food manufacturers,
as well as from Agricultural Handbook No. 8 (Watt and
Merrill, 1963! and from Bowes and Church (Church and
Church,,l970).
.........
2. conversion of nutrient values to proportions of
‘Recommended'Dietary'AllowanceS'CRDA);w These computations
involved comparisons of the individual nutrient intake
values with the 1968 revision of the RDA for three- and
four-year old children (Food and Nutrition Board, 1968).
98
Percentages of the Recommended Dietary Allowances provided
by food intake were calculated for calories, protein,
calcium, iron, vitamin A, thiamin, riboflavin, niacin, and
ascorbic acid.
3.'Comparison'of'quantitieS‘of'calorieS'andgprotein
consumed in relation to how each was eaten. The amount
of food energy and protein ingested, as derived from the
above computer transformations, were analyzed for the
proportion of each eaten at meals or at snacks, with whom
it was eaten (whether alone, with all of the family, with
some of the family, or with others outside the family)
and where.it was eaten (whether at home or elsewhere).
4.'Conversion'of‘estimatediquantitieS'of'foods‘con-
'sume ‘to‘number of servings eaten in certain food groupings.
The manual (Davenport, 1964) used for the coding of food
items for purposes of nutrient analysis provides a six-
digit identification code per food item. The first three
digits refer to the consecutive numbering process for
this listed food items. The next three digits refer to
a food_group code number, designed to group foods by major
sources of nutrients for further study of the composition
of the diets. This code number was used to analyze the
food consumption data in terms of number of servings by
specified food_groups.
99
5. Conversion of nutrient values of foods ingested
according tOithe percentage'of‘calorieS'fUrnished by
‘carbohydrate,ffat, and protein. The number of calories
consumed, as computed by the transformation procedures
just described, were analyzed for the prOportions con-
tributed by carbohydrate, fat, and protein.
Each of the three food records for each child were
analyzed separately. The results indicated no significant
seasonal differences. Therefore, a computer program was
written to average the figures obtained for the three
separate food records and produce one set of data output
for each child in the sample. This average value will be
referred to as the nutritive values of the children's
food intake records.
Biochemical Data
Data obtained from the blood tests for hemoglobin,
hematocrit, total serum proteins, and serum albumin were
transferred to computer cards. In addition, conversion
of these values was made to a category designating the
value as "deficient", "low", "acceptable", or "high",
as Specified in the ICNND Manual for Nutrition Surveys
(1963).
Figures for urinary hydroxyproline and creatinine
were transferred to computer cards as: l) the hydroxy-
proline:creatinine ratio, and 2) the "hydroxyproline
index" (Whitehead, 1965) which calculates urinary
hydroxyproline:creatinine, as corrected for body weight.
CHAPTER V
FINDINGS
The chapter presents a description of the findings
for each category of variables studied and a discussion
of the interrelationships between variables which was
elucidated.
Characteristics of Families in the Sample
Results from Home Interview
Demographic characteristics of families (analogous
to the Jessor and Richardson concept of components of the
"distal environment") were obtained by a home interview
conducted with mothers of the children participating in
the study.
11.4% of the children were from single—parent
families in that their mothers were divorced, widowed,
or had never married. The remaining 88.6% of the mothers
were married and living with their husbands.
Parents in the sample were rather highly educated
in terms of the number of school years completed (Table
5.1). On the average, mothers had completed fourteen
years (or two years past high school), while fathers had
completed an average of seventeen years (or one year past
undergraduate education).
100
101
Table 5.1. Education of Parents (as number
school years completed)
Mother Father
<12 years 14.8% 12.1%
12-16 years 61.7% 25.0%
>16 years 23.5% 62.9%
MEAN YEARS 14 17
Over one-third of the mothers were employed either
part-time or full-time (Table 5.2). Over half of the
children were cared for by someone other than the parents
ten hours or less per week. In contrast, 13.5% were cared
for by others thirty-five hours or more per week (Table
5.3). Over half of the fathers were employed on a full-
time basis. However, 13.8% of the fathers who were working
indicated that they did not have "steady" work. Of the
38.5% of the fathers who were classified as "unemployed",
many were full-time students at the university
(Table 5.2).
Table 5.2. Employment Status of Parents
Mother ’Father
unemployed 63.8% 38.5%
Employed part-time 22.8% 9.6%
Employed full-time 13.4% 51.9%
102
Table 5.3. Hours per Week Child is Cared for
by Someone Other Than Parents
Hours per week Number Percentage
0-6 34 23.0
7-10 46 31.1
11-15 28 18.9
16-34 20 13.5
35-60 20 13.5
Over 13% of the families in the sample were receiving
less than $4000 annually, while nearly 5% had incomes of
over $20,000. The mean annual family income was $9014,
and the median family income was $7047 (Table 5.4). When
classified according to the source of family income
(Warner at al., 1949), the greatest percentage (69.1%)
of families were receiving a salaried wage, while 10.7%
were supported by public welfare (Table 5.5).
Table 5.4. Income Distribution of Families in
Sample
Annual Family Income Number Percentage
<$4000 19 13.3
$ 4000— 6999 46 32.2
7000- 9999 19 15.4
10000-14999 30 20.9
15000-19999 19 13.3
20,000+ 7 4.9
MEAN INCOME: $9014
MEDIAN INCOME: $7047
103
Table 5.5. Classification of Families By Source
of Family Income (Warner et al., 1949)
Source Number Percentage
1. Inherited wealth 0 0
2. Earned wealth 0 0
3. Fees, Services 1 0.7
4. Salary 103 69.1
5. Hourly wages 26 17.5
6. Private relief 3 2.0
7. Public welfare 16 10.7
For the most part, children came from two-parent,
four member families (Table 5.6). Most families had two
children, both of whom were preschool age; therefore
nearly half of the sample children were first-born. On
the average, over half of the families had two years
between births of the children (Table 5.7). According to
Duvall's (1967) stages in the "family life cycle", most
of the families (59.1%) were in Stage III, i.e., their
eldest child was from two and one-half to six years of
age (Table 5.8).
Table 5.6. Household Size
Number of Persons Number Percentage
in Home
2-3 19 12.8
4 61 40.9
5-7 55 36.9
8-11 14 9.4
104
Table 5.7. Characteristics of Families in Relation to
Number, Age and Spacing of Children
(Expressed as Percentage of Families in
Each Category) '
One Two Three Four Five-
Nine
Total number of children
in household
Number of children 5
years & under
12.1 40.9 22.2 10.1 14.8
31.5 47.7 13.4 6.0 1.3
Average years between
births in family
Table 5.8. Description of Families by Stage in Family
Life Cycle
Stage Number Percentage
III. Families with preschool children 88 59 l
(oldest child 2 1/2 to 6 years) °
IV. Families with school children 43 28 9
(oldest child 6 to 13 years) '
V. Families with teenagers 17 11.4
(oldest child 13 to 20 years)
VI. Families as launching centers
(first child gone to last 1 0.7
child’s.1eaving home)
It is thought that food habits are in part influenced
by the family's religious practices. Most children in the
present study were Protestant. Nationality ties did not
exert a discernible influence on the types of foods con-
sumed in the home (Table 5.9).
105
Table 5.9. Religion of Children in Sample
Number Percentage
No religion followed 15 10.7
Protestant 67 47.8
Roman Catholic 30 21.4
Jewish 6 4.3‘
Mixed (affiliated with 2 or more 4 2.8
religious_groups)
.Other (inc. Buddism, Islam, etc.) 18 4 _ 12-9.
In an attempt to ascertain the mobility of the
families in the sample, mothers were asked how many years
they had resided at their present address and how many
times they had moved in the past three years. In general,
families were rather mobile in that 39.9% had lived in
their present home one year or less (Table 5.10).
Approximately one-third of the families had moved two or
more times in the previous three year period.
Table 5.10. Number of Years in Present Home
Years Number Percentage
One or less 58 38.9
Two, three 57 38.3
Four to six 28 8.8
.Seven or more _ 6 I . . 3-4M
106
An index of crowding that has been extensively used
is the ratio of the number of persons living in the home
to the number of rooms in the house. A ratio of less than
1.0 is said to indicate a degree of crowding. In this
sample,_the mean crowding index was 1.16:0.41, with a
range of 0.4 to 2.8 rooms per person in the family.
Using the guidelines set up by the U. S. Census Bureau
(1963) to assess the quality of housing, it was determined
that 85.2% of the homes were in "sound" condition, while
13.3% were "deteriorating" and 1.6% were "dilapidated."
66.2% of the homes were in residential areas. Observation
of the exterior structure of the houses revealed that 42.1%
were of excellent quality, 39.5% were good, 15.8% were
fair and 2.6% were of poor quality. Analysis of the
interviewers' evaluations of the general state of cleanli-
ness and housekeeping conditions showed that nearly half
(49.7%) were rated "very clean and orderly" while 10.5%
were â€dirty and unkept."
Certain appliances are important in the home in order
to assess which items might contribute to the quality of
the child's nutrient intake. Table 5.11 indicates that
more families had a television than an automobile in
working order and that more families had a telephone than
had a properly functioning refrigerator.
107
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108
The interview with the mother in regard to the
child's medical and dietary history revealed that thirteen
children (8.8% of the sample) had had a history of food
allergy at some time in the past. However, only two
children were on some type of Special diet at the time
of the interview. Twenty-three children (15.5%) had
been diagnosed as anemic in the past; of these, ten had
been diagnosed recently, while the others had been
diagnosed at an earlier age. Mothers reported that
thirty-three children (nearly one-fourth of those inter-
viewed) had had a history of feeding problems serious
enough to warrant consultation with a physician. Of
these seven had presented feeding problems recently.
Nearly three-fourths of the mothers indicated that
they gave their child some type of vitamin supplement.
Of these, the most frequently named type was the multiple-
vitamin capsule; 76.4% of the children received this type.
(Mothers frequently reported during the course of the
interview that they gave the child his "choice" of
supplements; thus, the type of flavored, chewable supple-
ment designed especially for consumption by children was
the type most often named.) Thirteen mothers (8.7% of
the sample) indicated that they also gave their child
some other type of supplement or "health food." These
were usually wheat germ and cod liver oil. Approximately
half of the mothers indicated that the recommendation for
109
the child's taking vitamin supplements was of their own
volition, while Slightly fewer indicated that the
physician had recommended their use.
. The vast majority of children had been seen by a
physician within the past year for a routine physical
examination and judged admissable to the nursery school
programs. The other children were being seen by a physician
at the public health clinic. At the time of the study,
45.8% of the children had been seen by a dentist within
the past year, usually for the purpose of a routine dental
examination. Nearly half (46.5%) had never been examined
by a dentist. Twenty-five children (nearly 18%) had
some filled teeth at the time of the interview.
Questions were asked in order to gain information
regarding the family's mealtime practices. In general,
most families ate the evening meal together; lunch and
snacks were consumed on an individual, rather than on a
family, basis (Table 5.12).
Table 5.12. Meals Eaten Together as a Family
Less than
Never 1/2 About 1/2 Almost
the time the time always
Breakfast 25.5% 26.9% 9.4% 38.2%
Lunch 32.0% 32.7% 11.6% 23.8%
Dinner 3.4% 3.4% 5.8% 87.9%
Other, Inc. Snacks 50.8% 22.2% 3.9% 23.0%
110
Mothers were asked about their child's attitude about
eating. Nearly half (45.6%) responded that her pre-
schooler's attitude varied; however, almost as many
mothers (39.6%) felt that their child truly enjoyed
eating. Far fewer mothers felt that the child had to be
coaxed to eat or that he presented an eating problem.
In an attempt to gain information about how important
it was, in the mother's Opinion,_for the child to finish
everything on his plate, reSponses were fairly equally
divided. The largest proportion of mothers (36.2%)
thought.that this was fairly important (Table 5.13).
Table 5.13. Mothers' ReSponses as to How Important It Is
For a Child to Finish.Everything on His Plate
Number Percentage
Not important.at all 25 16.8
Slightly important 24 15,1
Moderately important 54 36.2
Considerably important 31 20.8
. Extremely important .. . , . 15 _ _., .710-l
Table 5.14 presents the results of the mothers'
usual actions when the child dawdles or plays with.his
food. A nearly equal prOportion stated that they insist
that the child eat a certain portion of each food (28.9%)
as did those who threaten some type of punishment for not
eating (26.7%). A somewhat fewer number tell the child
111
there will be nothing to eat until the next meal, then
remove the food (11.1%), and 10.4% say nothing because
they do not think this is important.
Table 5.14. Mothers' Usual Action When the Child Dawdles
With Food or Refuses Food Served to Him
.......................
Number Percentage
l. Insists that child finish meal .
promptly 10 V 7.4
2. Insists that child complete a
certain portion of each food 39 28.9
3. Promises reward e.g.,.dessert,.
for completion of eating 9 6.7
4. Coaxes, but does not force
eating 7 .5.2.
5. Tells child there will be
nothing to eat until the next
meal, then removes food 15 11.1
6. Threatens punishment, e‘.g.,
withholding of dessert, if food
is not eaten 36 26.7
-7. Says nothing to child; talks
to child later about it 0 0
8. Says nothing to child; does
not like arguments at the table 5 3.7
9. Says nothing, does not think
this is important . h 4,. t. _ l4 . ,_ 10.4
It was believed that preschool children consume a
considerable proportion of their calorie intake as snacks.
Mothers were thus asked to estimate the frequency of her
child's snacking at particular times throughout the day.
Table 5.15 indicates that few children snack before the
112
breakfast meal. (Some mothers indicated, however, that
the child may have helped himself to food before She arose
in the morning, and thus she had no way of knowing exactly
if he.ate before breakfast.) Most children did snack
during the day, and nearly two—thirds have something to
eat between the noon and evening meals daily.
Over 30% of the mothers indicated that the child may
miss meals. Reasons cited for the.child's not eating
included lack of time (19.5%), lack of appetite (43.9%),
fatigue (22.0%), and illness (14.6%).
ReSponses regarding the time of day when the child
seemed to be the most hungry were fairly equally divided.
39.9% of the mothers felt her child was the most hungry in
the morning, 27.8% stated that this occurred in the after-
noon, while 33.3% indicated the evening.
Over half (52.7%) of the mothers rated her child's
appetite.in the previous three months as Fgood." 19.9%
felt the appetite could be rated as "excellent", 22.6%
rated it as “fair", and only 4.8% indicated that it had
been "poor."
Nearly all the children in the sample (97.1%) were
able to feed themselves, using a Spoon and fork. Approxi-
mately half of the children (49.0%) were able to use a
knife.
Most peOple have fairly definite ideas about the
kinds of foods that children will or will not eat. Mothers
113
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114
were asked to name their child's "favorite" food and the
food he disliked the most. Responses were categorized
into food groups according to the distribution presented
in Table 5.16. The most pOpular food group was meat
(rated as a favorite by 32.8% of the mothers), followed
by the bread and cereal group (24.4%). Nearly 18%
indicated that sweets were the favorite. The overwhelming
majority of the mothers indicated that vegetables were
the most unpOpular food to the child.
Table 5.16. Food Preferences of Children
............
Favorite Most Disliked
Number Percentage Number Percentage
1. Meat 43 32.8 12. 10.3
2 " â€1:1; (132:? 11 8 . 4 o o
3. Fruits 5 3.8 3' 2.6
4. vegetables 13 9.9 94 81.0
5. Eggs 4 3.1 5 4.3
6. Bread, cereals 32 24.4 2 1.7
4 7. Sweets, . . . 23 ~17.6 _ . 0 _. .0.
Mothers were asked to name the one factor which, she
felt, exerted the most important influence on her meal
planning. 40.4% of the mothers indicated that the nutri-
tional quality of the food was the most important. Fewer
mothers (31.2%) named family preferences. Other reSponses,
in order of decreasing frequency, were: health needs of
115
the family (13.5%), cost of the food (7.8%), time required
for preparation (3.6%), and the mother's own food pre-
ferences (3.6%).
A question was asked to determine how.the families
accepted new foods or new methods of food preparation.
Only 12.8% of the mothers answered that their families
were “enthusiastic†about this, 43.3% said they were
â€willing", 27.0% said they were "cautious", and 13.5%
were "reluctant", but only 3.6% said their families refused
to accept new foods at all.
Only 19.4% of the mothers reported that the child
regularly ate some meals away from home. Over one-fourth
of these children usually ate at the home of a relative;
a similar number ate at a restaurant. Approximately one—
fifth of all children eating away from home ate at the
home of the babysitter, and the rest ate in the homes of
friends or neighbors.
Because the preschool period is notorious for its
reputed feeding problems, Table 5.17 presents the results
of the mothers' reSponses to certain frequently encountered
problems. In general, mothers did not feel that their
children were eating inapprOpriate amounts of foods or
were consuming the wrong types of foods. The exception
to this was that more mothers (61.6% compared with 38.4%)
felt that the child chose a limited variety of foods.
116
Table 5.17.
Period
Extent of Feeding Problems in the Preschool
Do you think your child:
Eats too little food?
Eats too much food?
Chooses a limited variety of foods?
Eats too few fruitS.and vegetables?
Plays or dawdles with his food?
Eats too much meat?
Eats too little meat?
'DrinkS too much milk?
Drinks too little milk?
.Eats too.many sweets? .
No Yes
76.0% 24.0%
‘89.0% 11.0%
38.4% 61.6%
'59.9% 40.1%
55.2% 44.8%
91.0% 9.0%
69.4% 30.6%
88.4% 11.6%
85.6% 14.4%
...;Q.63.8% ...... 36-2%,
In order to gain a better understanding of families'
food buying practices, a series of questions pertaining
to this topic were included in the interview.
In nearly
threeefourths of the families (71.4%), the mother alone
decides what foods should be purchased.
others, the mother and father decide together, in 5.4%
In 19.1% of the
the entire family decides, and in 2% each, the father alone
or the mother and children (without the father) have a
voice in the decision-making.
In nearly half (49.0%) of the families interviewed,
the mother did the grocery shopping alone, while in 20.1%
the grocery Shopping was done by the mother and the‘
children, in 12.8% by the entire family, in 10.7% by.the
mother and father together without the children, in 6.7%
117
by the father alone, and in only one family (0.7% of the
entire sample) by the father and children. Over half
(53%) of the families did the grocery shopping once a
week. Over 97% of the families shopped in supermarkets
rather than in small,independent grocery stores. Table
5.18 shows the reasons the mothers gave for Shopping in
the stores they preferred. Families Spent, on the
average, $35.66 for food each week. Table 5.19 indicates
the distribution of family food Spending.
Table 5.18. Reasons for Shopping in Particular Markets
......................................
Number Percentage
No reason given 1 0-7
Lower food prices 37~ 25.7
More convenient and/or personal 21 14-6
loyalty
Store offers trading stamps, etc. 1 0.7
Combination of better quality and 58 40.3
lower food prices
Better quality and/or variety and/ 26 18.1
.or ethnic foods, .. , _ . ,,, ,
Table 5.19. Weekly Food Expenditure
NUmber Percentage
.<$20. 6 4.1
$20-30 45 30.6
30—40 51 34.7
40—50 18 12.2
.I_>$50,. .. .. ,7 _ . . 27_:_ , ... . f 18.4.
118
Because "convenience" foods are increasingly being
used, mothers were asked how frequently they used certain
food items. Table 5.20 presents the results of these
data. The use of ready-to-eat cereal is so widespread
that it can hardly be considered a "convenience" food
item by most peOple. On the other hand,_the fact that
approximately two-thirds of the families interviewed
never used items such as frozen TV dinners, frozen dessert
pies and pie crust mix, indicates that other items are not
universally well accepted.
83.1% of the families in the sample were not using
Food Stamps at the time of the interview., Eight families
were using them.and eleven others said that although.they
thought they were eligible.they were not using Food Stamps;
the most frequently cited reasons for their not using
them were that they did not know.enough,about them or
that the inconvenience caused by a lack of transportation
was a detriment.
In an attempt to assess the mother's level of know-
ledge of nutrition, two techniques were used. Mothers were
asked to name.the foods thought to be necessary for her
child every day; responses were evaluated in regard to
the number of the "Basic Four" named (Table 5.21). Only
one mother did not name any of these food_groups. Over
half of the sample (54.7%) were able to name all four.
A true‘false "Nutrition Knowledge Test" (Appendix C-Be)
was administered and scored. Three-fourths of the mothers
119
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120
xvere able to answer fifteen of the twenty-three.items (a
score of 65%) correctly (Table 5.22).
Table 5.21. Number of "Basic 4" Named
None 0.7%
One 1.4%
Two 14.2%
Three 29.1%
.Four... _ ..54.7%..
Table 5.22. Score on Nutrition Knowledge Test
(23 total correct responses)
9 4.2%
9-14 20.8%
15-19 59.7%
,20923f 15-3%H
Mothers were asked which classes, persons, or sources
<Df information had been most influential on their planning
lof'meals to meet the nutrient needs of their families.
.3unior and senior high school home economics classes
accounted for nearly three-fourths of the responses.
(Others, in order of decreasing frequency, were professional
«or college training (19.0%), prenatal classes (4.2%),
adult education classes (3.2%), as well as youth groups
(such.as 4—H or Girl Scouts) and cooking classes (1.1%
each). (Approximately 36% of the mothers interviewed felt
121
that they had never attended any classes in which they
learned about food and nutrition.)
Half of the mothers named their own mothers as the
person who had exerted the most influence on their ways
of feeding their families. Others named were: the
physician (by 6.3%), friends or neighbors.(hy 4.7%), a
home economist or dietitian (by 3.9%), the nurse (by
0.8%), and a combination of the above individuals (most
frequently it was the mother and physician) for 34.4% of
the sample. 14% said that they had not been influenced
by any other persons in regard to nutrition knowledge.
Mothers were also asked where they would go if they had
a question about the nutritive content of various fruits
and vegetables. 37.2% said they would go to books (Other
than cookbooks), 29.1% would go to cookbooks, 11.5% would
_ go to an extension agent or home economist, 10.1% to food
articles in magazines or newspapers, 4.7% to her mother
Tor another relative, 2.7% to food advertisements, and
the remainder to TV, neighbors and friends, members of
'the immediate family, and teachers.
Using a computer program Specifically written to
average individual item scores into a mean "scale score",
scales.were develOped from items contained in the home
interview schedule. Table 5.23 presents a breakdown of
items which were included in the final scales for the
large inter-scale correlation matrix in Appendix E-Z.
122
(Only those scales which were composed of more than one
item are listed in the table.)
Table 5.24 is an intercorrelation matrix showing the
relationships among selected demographic and resource
characteristics of families in the sample. Those figures
enclosed in parentheses denote a significant correlation,
i.e., a correlation coefficient of 0.23 is considered
significant at the 0.01 level (Dixon and Massey, 1969:
569). The following chart describes the significant
correlations found between these variables.
123
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126
Table 5.23. Scales Developed From Items in Interview Schedule
Scale Name
Parents' occupation and
education
Income ItfltUB
Mother away from child
condition of home and
neighborhood
Infantile behavior
Feeding problems
Family eats together
Frequency of snacking
Use of convenience foods
Items
Fathers' schooling
Mothers' schooling
Fathers' occupation rating
Mothers' occupation rating
Fathers' employment status
Father have steady work?
Source of family income
Mother's employment status
Hours/week child is cared for by someone else
Framed pictures
Decorative accessories
Green plants
State of housekeeping condition
Observation of home exterior condition
Rating of neighborhood
Use of car, truck?
Telephone in home?
Land use in neighborhood
Drinks from bottle?
Uses pacifier?
History of food allergy?
Special diet?
History of feeding problems?
Age of feeding problems?
Child's attitude toward food, meals
Meals ever missed?
Child's appetite in past three months
Child eats too little food?
Child eats too much food?
Child eats too few fruits and vegetables?
Child dawdles with food?
Child eats too little meat?
Child drinks too little milk?
Eats breakfast together?
Eats lunch together?
Eats dinner together?
Snacks together?
Snacking before breakfast?
Snacking between breakfast and lunch?
Snacking.between lunch and dinner?
Snacking between dinner and bedtime?
Use of cake and muffin mixes
Use of ready-to-eat cereal
Use of pie crust mix
Use of pudding mix
127
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128
Psychosocial Attributes of Mothers
Items in the Parent Attitude Research Instrument were
analyzed using the PACKAGE multipleégroups cluster analysis
programs. Items were initially grouped on the basis of
the original scales as elaborated by Cross and Kawash
(1968). These initial procedures indicated that, for this
sample, the original scales were not consistent with
expectations. Thus, it was deemed necessary to develOp
new scales from these data. The scales and the items of
which they are composed are presented in Table 5.25. The
matrix formed from the multiplegroups cluster analysis
_ is in Appendix E-l. Following are brief descriptions of
the eleven clusters of items which were formed from the
original fifty-three items in the questionnaire.
Table 5.25. Development of New PARI Scales
'Scales Used from Parent Attitude Research Instrument
Questionnaire Items
1. Rejection of the Homemaking 5,10,15,20,25,30,35,40
Role
2- Irritability 6,17,28,39,49
3- Equalitarianism 2,13,24,36,46
4. Encouraging Verbalization 1,12,23,34,45
5. Excluding Outside 4,16,27,38,48
Influences
5- Parental Deification 9,21,32,43,52
7
~ Deception 7,18,29,41,50
129
Table 5.25. (Cont'd)
Questionnaire Items
, f; I I
8. Deification (reflected)* 3,14,26,37,47
9. Excluding outisde : . ; 7
Influences (reflected) 8,19,31,42,51
10. Irritability (reflected) “11,22,23,44,53
As result of "multiple-groups cluster analysis":
Items
1. Parents are "all-wise" 48,51,21,38,9
2. Children should be treated 45,1,23,12,13,34,19,8,42
as equals
3. Children should only 4,16,27
listen to and trust
parents
4. Unquestioned loyalty 32,52,43,47,26
5. Deception 7,18,29,41
6. Homemaking is being 25,15,35,20,30
trapped in a dull job
7. Homemakers would like 5,10
to get out!
8. Raising children is 17,28,49
nerve—wracking
9. Occasional dissatis— 39,11,6
faction with being a
homemaker '
10. Frequent dissatisfaction 53,44,22
11- Residuals 2,3,14,24,31,33,36,37,40,46
Cluster No. 1: "Parents are all-wise."
Those who agree with these items indicate a feeling
thuat children should implicitly trust their parents because
*Reflected means that the wording of the item as it
aPpears in the questionnaire was reversed for scoring.
£3 reversed score was used for all subsequent correlational
analyses.
130
of the parents' superior knowledge and experience.
The general content of items in thisgroup pre-
sent a type of mother who feels that children
have undevelOped judgment and therefore should
always trust their parents without question.
Cluster No. 2: "Children should be treated as equals."
All of the items in this cluster deal with encour—
agement of the child to verbalize disagreement
with this parents' views. This cluster was
inversely related to Cluster No. l.
Cluster No. 3: “Children should listen to and trust
only parents."
This cluster was positively related to Cluster
No. 1 and inversely correlated with Cluster No.
2. All items deal with external forces which
potentially cause the parents to appear inferior
in the child's eyes or to lose the confidence of
their children. Although the relationship to
Cluster No. l is positive, the discriminating
aSpect of the relationship is the fact that here
forces outside the parents' control cause a loss
of confidence, while in the first cluster,
children are not to express any lack of confidence
in the parents.
Cluster No. 4: "Unquestioned loyalty."
This cluster consists of items which were all con-
cerned indirectly with the unquestioning loyalty
131
of the child to his parents. It is positively
correlated with the Clusters No. l, 3, yet is
negatively correlated with the Cluster No. 2.
Cluster No. 5: "Deception."
This cluster contained all of the items from
the original "deception" scale, with the
exception of item 50. The content of the items
implies a viewpoint that tricking children to
get them to do what the parents want is a
legitimate and common device of control. Item 50
does not use the concept of trickery in quite
the same context, in that it implies a more subtle
guiding rather than overt deception. An inter-
esting point is the positive correlation of this
cluster with item 40, "raising children is very
much more difficult than most jobs men do."
This finding implies the attitude on the part of
the mother that raising children is difficult
because the parent is forced to out-smart them
by trickery.
Cluster No. 6: "Homemaking is being trapped in a
dull job."
This cluster is composed of some items from the
original "rejection of the homemaking role" scale.
All items imply that the children are the
ultimate cause of the mother's perceived loss of
132
freedom. Items 20 and 25 suggest that the mother
is not free to do temporary activities, such as
shOpping, while items 15 and 35 imply that the
mother feels restrained from doing more time-
demanding activities, such as taking a trip or
taking a job. It is interesting to note that
items 25, 15, and 35 correlate positively with
the anomie scale, all implying a sense of
helplessness on the part of the mothers.
Cluster No.‘7: "Homemakers would like to get out!"
Items in this cluster were strongly related to the
previous cluster because they deal with the
mother's feeling of being trapped by the demands
of caring for a home and children. The
differentiating aspect of the content between
these items and Cluster No. 6 is the implication
in Cluster No. 7 of the mother's feeling of being
isolated from the happenings in the "outside
world." This attitude is somewhat different from
that expressed in the previous cluster because it
reflects an inability on the part of the mother
to experience a sense of accomplishment. This
cluster correlates positively with Clusters 8, 9,
and 10 which deal with the parents' irritability
with children. Such relationships may be expected,
since, if a mother feels trapped by the demands of
133
the children, she is more likely to feel
resentful and irritable because of them.
Cluster No. 8: "Raising children is a nerve-
wracking job!"
This cluster is composed of items which deal with
the mother's feeling that she is justified in a
sense of irritability with children because of
her agreement that the job of raising children is
certainly "nerve-wracking."
'Cluster No. 9: â€Occasional dissatisfaction."
This cluster is composed of three items which
imply that parents occasionally get upset with
their children for no specific reason. The fact
that no reasons were stated in the items of this
cluster as they were in the previous scale
(e.g., when children are demanding), seems to be
the single difference with reSpect to content
between this cluster and Cluster No. 8.
Cluster No. 10: "Frequent dissatisfaction."
This cluster is composed of items which deal with
the mother's becoming frequently irritated with
children.' While this scale was related to the
Clusters 8 and 9, it is distinct because of the
unique content of the items and lower inter-item
correlations with other clusters.
134
Cluster No. 11: "Residuals"
Ten items were placed in the "residuals" cluster
because some contained independent information
and others added nothing to the analysis. This
cluster was not considered in subsequent
analyses.
Scales formed from items contained in the Parent
.Attitude Research Instrument (PARI) were used in all sub-
:sequent data analyses as representative of the psychosocial
aattributes of the mothers in regard to authoritarian
aattitudes about child-rearing.
Anomie and Powerlessness Scales
The five-item anomie test, developed by Srole,
underwent item analysis and the scale was found
to be unidimensional; consequently, further scale
refinement was unnecessary. The final powerless-
ness scale was develOped using only those items
which were consistently strong in the inter-item
correlation matrix. These items were 2, 3, 5
through 8, 10 through 16, and 18 through 24
(Appendix C-3d).
Semantic Differential Scales
The semantic differential instrument (Appendix
C-3f) served as the basis for the development of
two scales. The first, composed of items 1, 2,
4 through 15, 17 through 22, 24, 25, 28 and 30,
135
was felt to be measuring a general self
concept or worthiness of the mother, while
the second scale develOped from this instru-
ment (composed of items 26, 29, 32, and 33)
was felt to be related to a more general concept
of feminity or "womanliness."
Nutrition Attitudes Scales
The permissiveness in feeding attitude from the
Nutrition Attitudes Instrument (Appendix C-3e)
was drawn from the following items 1, 4, 8, 9,
11, 16, and 18. Inter-item analysis revealed
that all items appeared consistent throughout
and therefore were retained for the final scale.
The remainder of items in the instrument
measured the "nutrition is important" attitude.
Homemaker Values
The mothers' ranking of values rated as "most
important", "second most important", and "least
important" were tabulated and the results appear
in Table 5.26. The values of health, family
centrism, and education received the largest
number of "most important" ratings. Prestige and
freedom values were rated as "least important"
by the greatest number of mothers. Each value
rating reSponse was considered as an independent
measure in subsequent data analyses.
136
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o.v
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137
Inte‘rr‘e’l‘a‘t‘ion‘ships Among Family Characteristics
Selected demographic and resource characteristics of
the families studied were analyzed to. determine the nature
of the relationships with the psychosocial attributes of
of the mothers (Table 5.27) . Again, a correlation co-
efficient of 0.23 is considered to be significant at the
0.01 level (Dixon and Massey, 1969:569) . It is noted that
although the correlations do vary considerably, these do
not necessarily reflect differences in the degree of
association between variables but rather show the variation
in the reliability of the measurement. The following chart
depicts the relationships revealed.
, Variable Positively Correlated Inversel'y Related
Total number of 1) Parents are all-wise 1) Nutrition is
persons in the 2) Unquestioned loyalty important
home. 3) Deception attitude
4) Trapped in a dull
job
5) Powerlessness
Number of child- 1) Parents are all-
ren under five wise
Years of age in 2) Unquestioned loyalty
the home. 3) Trapped in a dull
job
ordinal position 1) Unquestioned loyalty 1) Nutrition is
of child 2) Trapped in a dull important
job attitude
3) Powerlessness
Mother's marital 1) Parents are all-
StatUS (high wise
:901‘9 indicates 2) Trapped in a dull
lng 1e parent job
Statlas) 3) Anomie
Variable
Parental occu—
pation and
education scale
Income status
scale
Family income
biilbank socio-
economic status
scale '
M0 Flier away from
child scale
SFa-ge in family
life cycle
Race (white
k¥1£a<2kg /
138
Positively Correlated Inversely Related
1) Treating child as 1)
an equal
2) Nutrition is 2)
important
3) Importance of edu- 3)
cation--value
rating 4)
5)
6)
7)
8)
l)
2)
l)
2)
3)
4)
1) Treating child 1)
as an equal
2) Nutrition is 2)
important
3) Family centrism 3)
and education values
4)
5)
6)
7)
1) Friendship as a 1)
value
1) Trapped in a dull 1)
job
2) Powerlessness
3) Powerlessness
Parents are all-
wise
Only listen to
parent
Unquestioned
loyalty
Deception
Trapped in a dull
job
Powerlessness
Prestige value
Religion value
Trapped in a dull
job
Anomie
Parents are all-
wise
Unquestioned
loyalty
Trapped in a dull
job
Powerlessness
Parents are all-
wise
Listen only to
parent
Unquestioned
loyalty
Deception
Trapped in a dull
job
Powerlessness
Prestige value
Importance of
religion value
Nutrition is
important attitude
'Black: White:
I) Only listen to 1) Frequent
parent dissatisfaction
2) Trapped in a dull
job
Variable
Times moved in
the past three
years
Crowding index
(persons/rooms
in house)
Condition of
.home—neighborhood
scale
Number of "Basic
Four" named
139
Positively Correlated
Inversely Related
1) Nutrition is
important
None
1) Nutrition is
important
Score on nutrition 1) Nutrition is
Jenowledge test
Amount of money
Spent for food
per week
important
1) Deception
2) Powerlessness
1Ejraluation of Dietary Data
Nutrient Intake of Children
1)
l)
2)
l)
2)
3)
1)
2)
l)
2)
3)
4)
5)
6)
Treating child
as an equal
Trapped in a dull
job
Powerlessness
Deception
Trapped in a dull
job
Powerlessness
Parents are all-
wise
Trapped in a dull
job
Trapped in a dull
job
Parents are all—
wise
Listen only to
parent
Unquestioned
loyalty
Deception
Powerlessness
Food records completed for three days were analyzed
to determine the nutrient content of preschool children's
‘11E31:sq the prOportion of the Recommended Dietary Allow-
ances (RDA) provided by the diets, and the pattern of
consmnption for calories and protein.
For purposes of
data reduction, results of the three food records were
redBleed by computing the mean nutrient intake.
140
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142
Mean intakes of calories and ten nutrients calculated
from the food records for the entire sample are presented
in Table 5.29. In order to assess the nutrients contri-
buted from foods, vitamin supplements were not included
in the calculations. According to responses from the
mothers of the children, approximately 63% of the children
‘were receiving some type of additional vitamin-mineral
supplement.
Table 5.29. Average Nutrient Intake for
Total Sample
Amount
(Mean t Standard Deviation)
Calories 1836 £484
Protein (gm) 66.8 i 17.6
Fat (gm) 75.8 i 26.6
Carbohydrate (gm) 225.6 : 65.2
Calcium (mg) 942 i324
Iron (mg) 8.6 t. 4.3
Vitamin A (I.U.) 4573 :2967
Thiamin (mg) 1.02: 0.42
Riboflavin (mg) 1.70: 0.55
Niacin (mg) 11.19: 3.46
- Ascorbiancid (mg) _ ,93.4 i 57-1
Table 5.30 indicates the prOportion of the Recommended
Di£3116â€)! Allowances which were fulfilled by the mean dietary
111*:EUKe of nutrients. The average intakes for all nutrients,
eXCth iron, either met or exceeded the recommended
a1 lowance .
143
Table 5.30. Percentage of Recommended Dietary Allowances
Met by Mean Intake of Nutrients from Food
Recommended Dietary
Allowances for children % of RDA
3-4 years old
Calories 1400 129.6
Protein (gm) 30 223.9
Vitamin A (I.U.) 2500 180.3
Ascorbic Acid (mg) 40 145.7
Niacin (mg equiv.) 9 248.0*
Riboflavin (mg) 0.8 212.5
Thiamin (mg) 0.7 145.7
Calcium (mg) 800 115.9
.Iron (mg) . , 7 1.0. . n . 9.6.9
*Calculated on the assumption that 1% of the dietary
protein was tryptophan and that 60 mg tryptophan yields
1 mg. niacin.
While the mean intakes of the children appeared
adequate, some children had diets that furnished less than
the reconunended amounts of some nutrients. Since it is
recognized that the RDA include a "safety factor", some
Workers have used two-thirds of the allowance as a level
of dietary adequacy (Metheny et al., 1962; Kerrey et al.,
1968) . When individual diets were evaluated using two-
thirds of the allowance as the criterion of adequacy,
iron, ascorbic acid, and calcium were the most limiting
for the largest number of children (Table 5-31) -
Table 5.31.
144
Percentage of Sample Meeting Specified
PrOportions of Recommended Dietary
Allowances
Nutrient
% of Recommended Dietary Allowances
Calories
Protein
‘Vitamin A
Ascorbic Ac id
Niacin
Riboflavin
{Thiamin
Calcium
ZIron
. <67%" 67‘100% ...... >100%
0 19.7 81.3
0 0 100.0
8.6 21.1 70.4
13.2 7.2 79.6
5.9 23.7 70.4
0 1.3 98.7
4.6 22.4 73.0
11.2 27.6 61.2
11.5 44.1. 41.4
For the average subject, approximately half of the
calories was provided by carbohydrate.
Fat provided
about 37% and protein the remaining 15% of calories
(Table 5. 32) .
Table 5 . 32 .
Â¥
Nutrient
Percentage of Calories Supplied by Carbo-
hydrate, Fat, and Protein
Carbohydrate
Fat
'IEES313ein.
\
Percentiles Percentage
Mean 25 50 75 Lowest Highest
49.3% 44.9 49.7 54.0 35.1 64.7
37.6% 34.4 37.4 41.3’ 23.9 50.1
15.0%. 13.4, 14-8),16.5. ..9.4 21.7
145
In order to determine the pattern of consumption for
calories and protein, food items were originally coded
according to where it was eaten (whether at home or
elsewhere), with whom it was eaten, and if it was part
of a meal or snack. Table 5.33 presents the results of
this analysis. Table 5.34 indicates the consumption of
calories and protein as expressed per kilogram of body
weight. In general, consumption of both calories and
protein was more than adequate.
146
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147
Table 5.34. Consumption of Calories and Protein Expressed
by Kilogram of Body Weight
Calories/kg Body Weight Percentage of Sample
50 0
50- 75 14.1
76—100 35.6
101-125 29.6
126-150 14.8
150 5.0.
MEAN = 105 Cal/kg
Gm Protein/kg Body Weight Percentage of Sample
1 8.9
2 37.8
3' 33.3
4 14.8
5 4.4
MEAN 2-66 gm/kg
When assessing the dietary intake of preschool
children by servings of certain food groups (Table 5.35),
it is interesting to note that although the mean intake
resembles that which would be expected, some children
ate no fruits or vegetables while others ate voluminous
quantities of certain foods, such as_grain products.
148
Table 5.35. Food Intakes of Preschool Children as
Expressed by Servings of Food Groups
Number of Servings
Fbod Group ‘Mean 'Median 'Range
Dairy products 2.9 _ 2.8 0.2— 7.1
Protein foods 2.3 2.0 0.3- 6.0
vegetables 1.4 1.3 0.0- 7.1
Fruits 1.5 1.4 0.0- 4.7
Grain products 5.7 5.5 1.0-13.0
Fats and oils 1.7 1.4 0.0- 7.8
Sugar products 1.6 . 1.4 t .0.0- 6.3
Beal found in analyzing the results of the dietary
data from children that the skewness of the distribution
prevented accurate description of the results merely in
terms of the mean and standard deviation scores. In her
papers (Beal, 1953, 1954, 1955, 1956), she presented
results of the nutrient intake data in terms of the
range of intake and corresponding percentile values.
Table 5.36 presents a comparison between Beal's data
(computed as the mean intake of children three to five
years of age) and the nutrient intake data obtained in
the present study. For the most part, the nutrient
intakes of children in the present study exceeded those
of children participating in the Denver project.
149
Table 5.36. Nutrient Intake Data (By Percentiles) in
Comparison with Beal Data
Percentile
Lowest 25th 50th 75th Highest
Calories 863' 1458 1801 2059 3569
Bea1* 984 1200 1384 1572 2063
Protein (gm) 26.2 54.5 66.2 76.6 140.3
25.1 40.6 47 54.9 87.6
Fat (gm) 30.2 57.9 . 175.6 91.7 170
38.5 51.4' “59.5 70.4 87.6
CHO (gm) 90 174 218 263 460
106 138 159 177 265
Calcium (mg) 297 707 889 1120 1785
438 716 891 1060 1490
Iron (mg) 3.92 7.6 9.2 11.4 37.7
3.46 5.1 6.1 7.1 10.76
Vitamin A (I.U.) 1260 2391 3644 5353 14000
1375 2806 3931 4900 7588
Thiamin (mg) .48 .85 1.06 1.34 2.88
.39 .64 .75 .85 1.15
Riboflavin (mg) .62 1.38 1.71 2.12 3.33
.753 1.28 1.52 1.78 2.39
Niacin (mg) 3.70 8.73 10.98 13.02
3.23 5.14 6.40 7.62 11.09
Ascorbic Acid (mg) 7 56 92 117 350
14 43 57 82 130
Cal/kg b.w. 54 84 102 117 192
61 74 87 106 126
Pro/kg b.w. (gm) 1.60 3.1 3.7 4.4 6.2
... .... A .7 1.62 _ 2.5 2-9 . 3.5 .2 .4.6
*Computed as mean intake of children 3&5 years
150
Relationship'of‘Nutrient Intake to Other Variables
Examination of the correlation coefficients among
the various nutrients revealed that all were quite signi-
ficantly inter-correlated (Table 5.37). The most
notable eXception to this was ascorbic acid, which was
not correlated with protein, fat, calcium, or riboflavin;
this fact supports the contention that vitamin C was not
supplied to any great extent by any of the foods high in
those other nutrients.
Correlations among nutrients and selected demo-
(graphic and resource characteristics of families in the
sample failed to reveal any significant patterns of
association (Table 5.38). Ascorbic acid intake did
correlate positively with the Milbank socioeconomic
status index.
Table 5.39 shows the nutrient intake (expressed as
the percentage of RDA) in relation to categorized values
for family income. In most cases, well over half of the
children in the sample had nutrient intakes which met or
exceeded the Recommended Dietary Allowance. Exceptions
here were calcium (for children in the highest and lowest
income categories) and iron intake. Protein and ribo-
flavin were provided in the most liberal amounts for all
children. The intake of ascorbic acid shows a definite
trend with.increasing family income, thus confirming the
conclusion reached from examining the correlation
coefficients.
151
oo.H Hm._ ma. em.,, mm. mm. NH._ av]. ma. Hm. um. .cwofl OHnHoomm .HH
oo.a mm. mm. mm. mm. ma. cm. .54. so. om. chomuz .oa
oo.a mm. mm. 54. am. mm. as. mm. mm. cu>mauonem .m
oo.a mm. No. we. mm. mm. mm. mm. shamans .m
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oo.H mmuuoumo .H
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mucmHHunz mGOE¢ mGOHumHmHHooumucH .hm.m manna
.152
0H. H0. 0H. H0.- 00. 00.- 0N. NH. N0.- 00. 00. 000» .3ocx .u»:0 so muoom
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0.0H 0.0 0.0 0.0H 0.0 0.0 0.0N
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154
Table 5.40 is a comparison of children from families
with â€high" incomes ($20,000 and above) with.chi1dren
from "low-income" families ($4,000 and below).
nutrients, except ascorbic acid, the percentages are
remarkably similar.
For most
In a few instances, particularly for
calories and vitamin A, the percentages of children from
high—income families having less than two-thirds of the
Recommended Dietary Allowances are greater than for low-
income children .
Table 5.40.
Comparison Between "Low-income" Children
and "High-income" Children in Relation to
Nutrient Intake
Nutrient
Calories
low
Income : high
Protein
low
high
Calcium
low
high
Iron
low
high
Vitamin A
low
high
Riboflavin
low
_ high
Niacin
low
high
% of Children
‘<2/3 RDA‘ '213-a11‘RDA ‘>RDA
0 35.3 64.7
14.3 14.3 71.4
0 0 100.0
0 14.3 85.7
23.5 29.4 47.1
14.3 42.9 42.9
29.4 41.2 29.4
28.6 42.9 28.6
12.5 31.3 56.3
28.6 14.3 57.1
0 0 100.0
0 14.3 85.7
11.8 29.4 58.8
14.3 28.6 57.1
155
Table 5.40 (Cont'd).
Nutrient ‘ <2/3'RDA 2/3-a11 RDA“ “'>RDA
'Ascorbic Acid
flow 35.3 11.8 52.9
high . 0 . 14.3 .. _ ..85.7
Figure 5 is a graph showing the relationship between
dietary intake (expressed as a composite figure for all
nutrients) and family income. A curvilinear relationship
is evident, implying that the lowest nutrient intakes
are consumed by children from the very lowest and the
very highest income strata.
The association between family income with protein
and calorie intake (expressed on a per kilogram of body
weight basis) (Table 5.41) indicates that the highest
intakes per unit of weight are consumed by children in
the two lowest income categories. The lower intakes
observed in the higher income groups may reflect the
mother's knowledge of and concern with the increasing
prevalence of childhood obesity.
Examination of the children's nutrient intake with
the sociOpsychological attributes of the mothers indicated
that two of the PARI scales were significantly correlated
with nutrient intake (Table 5.42). These scales were
Wtreating child as an equa1"(negatively correlated with
intake of calories, carbohydrate, iron, and thiamin) and
156
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159
"trapped in a dull job" (negatively related to calcium
and ascorbic acid intakes). The group of nutrients to
which the "treating child as an equal" scale is inversely
related is provided by the bread and cereals food group.
In contrast, the fact that the "trapped in a dull job"
scale inversely relates to calcium and ascorbic acid may
mean that these mothers who do not feel "trapped" are
more apt to provide their children with more milk, fruits
and vegetables. The only other scale which shows a
relationship to nutrient intake is that of the "nutrition
is important" attitude which is positively related to
calcium and riboflavin. This may mean that mothers who
feel that nutrition is of particular concern tend to
provide their children with a greater amount of dairy
products.
Results of Blood Tests
Finger prick blood samples were analyzed for
hemoglobin, hematocrit, serum albumin and total serum
proteins, using accepted procedures previously described.
Results from these analyses are expressed in relation to
the ICNND categories, designated as deficient, low,
acceptable, or high values (Table 5.43). Less than 2%
of the sample had hemoglobin and hematocrit values in
the "low" category while none were “deficient." No
children had serum protein levels in the "deficient"
category, and less than 3% were classified as having "low"
160
values. None of the children for whom blood samples
were obtained had values for serum albumin in either the
deficient or low category.
Table 5.43. .Results of Blood Tests of Preschool Children
Expressed in Relation to ICNND Categories
ICNND Categories Deficient Low Acceptable High
<10 "' 10.0-10.9"'11;0—12.4‘ 312.5
Hemoglobin (2,) (60) (55)
Mean = 12.38
<30 ' -'3o.o—33.9"-34.o—36.9* 237.0
Hematocrit (2). (5.7) (62)
(PCV) 0 1.7% 47.1% 51.2%
Mean = 36.69
‘ <6‘ ‘ 6.00 6.4' ‘ 6.5- 6.9 *‘27.0
Total Serum (3) (19) (79)
Proteins 0 2.9% 18.8% 78.2%
(gm/100 m1)
Mean = 7.23
<2.8 ‘ 2.8-3.51 '3.52—4.24‘ £4.25
Sermm Albumin (14) (97)
(gm/100 m1) 0 0 12.6% 87.4%
Mean :,4.551
Random urine samples, collected for approximately one—
third of the children in the total sample, were analyzed
for hydroxyproline and creatinine content. These values
were then expressed as the hydroxyproline:creatinine ratio
161
and the "hydroxyproline index" (Whitehead, 1965). The
mean values for these two entities were 0.251 t 0.090 and
3.577 t 1.374. These results are comparable to those
listed by Whitehead (1965) for the more affluent children
in his sample.
Relationship of Biochemical Data to Other variables
Data from the analyses of blood and urine were com-
pared with the other variables selected for study by
means of Pearson productdmoment correlation coefficients.
Table 5.44 indicates how the blood and urine variables
compare among themselves as well as with nutrient intake.
Assuming that a correlation coefficient of 0.23 is
significant at the .01 level (Dixon and Massey, 1969:569),
it is seen that hemoglobin and hematocrit, total serum
proteins and serum albumin, as well as the hydroxyproline:
creatinine ratio and the hydroxyproline index are highly
related, as would be expected. Hematocrit and serum
albumin values are negatively related. None of the blood
values are significantly related to protein or iron intake,
although some of the B-complex vitamins, namely riboflavin
and niacin are associated with the hydroxyproline
variables.
The relationships between the biochemical data and
the anthrOpometric measurements are somewhat more
definitive (Table 5.45). Hemoglobin is positively related
162
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163
to most of the anthropometric values, particularly the
scaled weight and height measurements.
This tendency is not shown to any great extent by
the hematocrit data, except for its significant
association with the height-weight-age scale and upper
arm circumference. Neither the serum albumin nor the
total serum proteins show any signifccant association
with any of the anthrOpometric measurements. The
hydroxyproline:creatinine ratio is positively related to
several of the scaled measurements, namely heightdweight-
age and Sargent's weight-height scale; it is negatively
related to the Fels' weight-age scale, the weightzheight
ratio and chest circumference. Whitehead's (1965)
hydroxyproline index is significantly related to the
develogmental index for weight and shoulder diameter,
while it shows a negative correlation with the gain in
height and sitting height.
Although the degree of correlation between the
demographic characteristics of families and the biochemical
data is inconclusive for the most part, the hydroxy-
proline:creatinine ratio and hydroxyproline index are
significantly associated with the number of children in
the household under five years of age (Table 5.46).
Table 5.47 indicates the relationship of family income
to the blood data, classified according to the ICNND
standards. This table reveals no significant association
between low family income and an increased prevalence of
164
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165
low or unacceptable blood values. The proportion of
children from families with an income of less than
$4,000 who have high blood values is quite comparable to
the proportion from families having annual incomes of
$20,000 or more. For both hemoglobin and hematocrit
values, children from families with an income of $10,000-
16,000 seem to have a greater share of children in the
low and acceptable categories.
The correlations between the biochemical data and
the sociOpsychological attributes of the mothers
(Table 5.48) revealed essentially no significant relation-
ships. The semantic differential scales do show a
positive association with hemoglobin, the hydroxyproline:
creatinine ratio and the hydroxyproline index. The
"frequent dissatisfaction" scale (from the PARI) was
negatively correlated with the hydroxyproline index. The
health value was also positively related to the
hydroxyproline:creatinine ratio.
Moderator Effects
Table 5.49 indicates the effects of certain variables
identified as "moderating" the effects of certain
independent variables, i.e., the nutrients, on the
dependent variables, in this case the blood components.
The association between protein and hemoglobin was
(positive for those children who mothers disagreed with
the following PARI scales: only listen to parent,
166
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169
unquestioned loyalty, deception, trapped in a dull job,
and with powerlessness. This same relationship was
also noted in terms of those who were above the mean
on the socioeconomic status scale, family income,
parents' occupation and education scale, the family
centrism value, and were of the Caucasian race. A
significant positive correlation between iron intake and
hemoglobin was observed among those who disagreed with
the following PARI scales: only listen to parents,
unquestioned loyalty, and trapped in a dull job,
powerlessness, as well as the following variables--
socioeconomic status scale, parents' occupation and
education scale. A negative correlation between iron and
hemoglobin was indicated for the white children. The
relationship between hemoglobin and calorie intake was
positive for children whose mothers disagreed with the
PARI "parents are all-wise" scale and the family centrism
value and for those who agreed with the "would like to
get out" scale.
The relationship between serum albumin and dietary
protein intake was positive for those children below the
mean on the socioeconomic status scale, and whose mothers
scored in the lower percentiles on the nutrition knowledge
test. This correlation was negative for those mothers
who rated less than the mean for the education value. The
association between serum albumin and calorie intake was
1370
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171
positive for children whose mothers disagreed with the
PARI "would like to get out" scale. The correlation
between total serum proteins and dietary protein intake
was positive for children whose mothers scored in the
less than fiftieth percentile in the nutrition knowledge
test and who agreed with the "would like to get out"
scale.
Results of Anthropometric Measurements
Height and weight measurements for all children in
the sample were taken at three intervals throughout the
school year, while a complete set of anthrOpometric
measurements (including certain diameters, circumferences,
and skinfold thicknesses) were obtained towards the end
of the school year.
Results of the incrementalgains in height and weight
throughout the school year revealed certain seasonal
differences. The mean weight gain during the spring
months (March to May) was nearly half of that which was
gained throughout the winter months of November through
March. Height gains did not indicate such seasonal differ-
ences. In general, children gained nearly two and one-half
pounds in weight and approximately one and one-quarter
inches in height throughout the school year when
measurements were made.
Recognizing the influences of age, sex, and genetic
differences on physical growth, any discussion of gross
172
height and weight measurements would be somewhat mis-
leading. In an attempt to correct for such influences,
height and weight data of children in the present study
were compared with height-age and weight-age percentile
values from two accepted growth standards, the Fels data
(Children's Bureau, 1967) and the Boston standards
(Nelson, 1968:1007). Tables 5.50 and 5.51 present the
distribution of heights and weights of the children
studied in relation to the percentiles of these two
«growth.standards. On the average, over 15% of the sample
was at the ninety-fifth percentile or above for weight
on the Fels standard, while only 4.4% of the sample were
below the fifth percentile for weight. In terms of
height, 4.4% of the sample was at the ninety-fifth
percentile or above on the Fels standard while over 11%
were at the fifth percentile or below. In reference to
the Boston percentiles for weight, over 7% of the sample
was at the ninety—seventh percentile or above, while
slightly more than 5% were at the third percentile or
below. Approximately 3% of the sample was in the highest
percentile for height while nearly 9% were at the third
percentile for height. Table 5.52 presents a comparison
of the height and weight measurements as expressed by the
Fels and Boston standards. These data suggest that the
children studied were somewhat stockier for their age
than were children from the standard pOpulations.
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175
Table 5.52. Comparison of Height and Weight Data in
Reference to Fels and Stuart Standards
Lower 10th percentile Upper 10th
(percentage of sample)
Fels Boston Fels Boston
Weight-age (mean) 9.9 16.2 28.8 22.4
Height-age (mean) 19.8 16.7 13-4 (14.8
Height and weight data for children in the study were
also classified in relation to a certain height-weight-
age classification devised by Smith and Brown (1970).
This information is presented in Table 5.53. This
classification also supports the contention that children
in the sample were heavier and stockier than their
counterparts in the Fels pOpulation. Over 31% of the
sample were in the large and overweight categories com—
pared to slightly more than 25% in the underweight and
small categories.
According to Sargent's (1961) weight-for-height
classification, most children were classified in the
"normal" category. A somewhat higher percentage of the
sample were in the underweight-slender categories than
were in the stocky-overweight—obese categories.
The index, weight/height, has been proposed as a
(useful means for evaluating physical measurements. In
this sample of children, the mean ratio was 1.588 t
0.121,with the range from 1.21 to 1.94.
176
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177
The "develogmental age" concept was used to express
the height—age or weight-age (calculated as the
chronological age at which the child's height or weight
crosses the fiftieth percentile of the Boston (Stuart)
percentile in relation to the child's chronological age.
Ideally, this term would approximate 1.0. For this
‘group of children the develOpmental index for weight
averaged 0.978 i 0-196, while that for height averaged
0.949 t 0.126. The ratio develOpmental index for height/
developmental index for weight averaged 0.99 i 0.137.
â€Relationships of Anthropometric Measurements to Other
‘Variables
The intercorrelations among the various anthropometric
measurements and scaled values for height and weight reveal
some rather contrasting relationships (Table 5.54). For
example, the total increments of height and weight are
highly related to each other, but the change in weight
is correlated only to weight-age in May, while the total
height change is related only to the develOpmental index
for height. The scaled weight-age and height-age values,
as evaluated by the Fels and Stuart standards, are highly
related (r = 0.96), so it seems that both scales are
measuring the same dimension. Weight—age is significantly
correlated with all other measurements, except head
(circumference and index of trunk breadth. Scaled height-
age is highly related to the other scaled weight and
height values, but is not related to the other
178
anthrOpometric measurements, with the exception of pelvic
diameter. The height- and weight-age indexes are inter-
correlated, but are not related to head circumference.
Skinfold thicknesses are not related to the height and
weight increments or to the height indices.
When the relationships between anthropometric
measurements and nutrient intake are examined (Table 5.55),
few significant correlations are evident. Protein intake
is highly related to the scaled weight-age values and to
the weight-age (in May) value. The weight—age/height-age
index is correlated with both calcium and riboflavin.
Riboflavin intake is also associated with the scaled
weight-age values. Iron is related to the height increment,
while Vitamin A intake is correlated with the scaled
Stuart weight-age value.
Although there are few significant correlation
coefficients between the anthrOpometric measurements and
the sociOpsychological attributes of the mothers, it is
interesting to note that the PARI "trapped in a dull job"
scale was inversely correlated with four scaled height-
weight values and with sitting height and triceps skinfold
thickness (Table 5.56).
When anthropometric measurements were examined in
relation to selected demographic and resource character-
‘istics of the families (Table 5.57), several showed
significant relationships. The mother's marital status
179
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-.0 oo.0 oa. ma. no. do. no.0 H~.0 no.0 a~.0 no.0 on.0 no.0 ~A.0 ~a.0 oa.+ o~.+ vo.+ mo.0 Ao~.0o v~.0 H~.0 o~.0 ~o.+ no.0 odoucaxn amouï¬uh
do. no.0 ~o. no. mo. «o. ~o.0 oo.0 o n~.0 ao.0 vo.+ no.0 oa.0 mo.0 vo.+ ~o.0 no.0 oo.+ ma.0 no.0 no.0 Ho.+ o vo.0 .laouwu Ina human
mo.0 vo. ea. NH. o vo.0 o«.0 o~.0 co. m«.0 oo.0 no.0 vo.+ oo.0 a~.0 vo.+ «o.+ no.0 Ho.0 o~.0 «.0 oo.0 oo.0 o 0 oo.0 sundoun deuu «0 xaucn
no. no. go. No. No.0 no. oH.0 vo.0 no. o~.0 no.0 n~.+ No.0 o~.0 no.0 mo.+ o ~o.0 m~.+ ~a.0 aa.0 no.0 Ho.+ o~.+ no.0 oucououasuuflo uuogu
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oo. co. AH. no. o o~.0 no.0 ~A.0 no. o~.0 vo.0 no.0 mo.+ -.0 no.0 no.+ no.0 o -.¢ o~.0 no.0 no.0 oo.0 oo.+ m~.0 nouoalwv nooaaozw
oo. mo. vo. ma. ao.0 o va.0 na.0 mo. na.0 no.0 v~.¢ ao.+ -.0 no.0 -.+ «o.+ no.0 mo.+ .o~.0. o~.0 va.0 o«.0 ~H.+ oa.0 unawuz ocwuuom
we. no. go. no.0 no.- .o.- .o. .o.- .o. Ho.+ o~.+ no.0 oo.0 vo.0 no.0 0 no.+ "0.. ~o.- a~.- .o.- oo.+ v~.+ no.+ o~.- on. .unxoo. .9: uuuvcn
ma. «H. oo.0 oo. «a.0 ma. ~H.0 v~.0 oa. o~.+ o~.+ -.o no.+ o~.0 n«.0 vo.+ no.0 -.0 no.0 H~.0 no.0 no.0 -.0 oa.+ n~.0 unoaonuxovca .>oo
NA. oH. n~.0 no.0 HH.: mo. no. no.0 oo. no.0 o~.+ m~.+ vo.0 -.0 m~.0 no.0 no.0 no.0 Ho.0 .mn.0o a«.0 no.0 ~o.+ n~.+ ma.0 unouoa0noocd .>uo
~A. ca. -.0 o no.0 «a. do.0 no.0 .o. o~.+ ~H.+ oa.¢ no.0 «A.. «4.0 no.0 no.0 mo.0 Ho.+ .v~.0. 0H.- v0.0 o~.- HH.+ ~«.0 nu: a“ no~-u:oqou
NH. no. no.0 no.0 m~.0 no. no. no.0 no. no.0 v~.+ n~.¢ no.0 -.0 o~.0 vo.+ no.0 no.0 ~o.0 .o~.0. -.0 o no.0 oo.+ .A.0 nut a“ ooa0ucouol
oo. no.0 no. mo. we. oo.0 o oa.0 no.0 n~.0 o~.+ o«.0 no.0 no.0 -.0 ~o.+ o~.+ vo.0 n~.+ no.0 mo.+ no.+ o no.0 «o.0 ouuau unodonuucuauz
o no.0 ma. mo. na. no.0 no.0 va.0 no. v~.0 do.0 no.0 no.0 no.0 no.0 ao.0 -.+ no.0 m~.+ «a.0 no.0 oo.0 vo.0 no.+ no.0 canon unouoc0u20wu3
ad. no. no. «a. no.0 «a.0 Hfl.- oo.0 no. no.- no.0 .o.0 vo.- -.0 «o.. oo.0 no.+ oo.- .~.+ .~.0 No.0 H0.+ .o.- no.0 nH.- oo--uzodo)-ucouom
VA. on. no.0 AA. no.0 ea. n10 nu... no. no.+ na.+ Cu... 00.4 -.0 n~.0 no.0 v0.0 NN.! no.9 «.70 no.0 no.0 v~.l ON.+ ou.0 .Mot sum .ouulucowvm
ma. no. ~o. no. no.0 no. oo.0 ~H.0 vo. no.0 va.+ no.+ no.0 o~.0 o~.0 no.0 oo.+ nu.0 o~.+ .m~.0o no.0 ~o.0 na.0 no.4 o«.0 .uox sum .oonuunoï¬ol
om. «A. no.0 ma. no.0 ~H. m~.0 v~.0 no. no.0 n~.+ na.+ vo.+ a~.0 m~.0 no.0 «o.0 o«.0 oo.+ on.0 no.0 vo.0 Av~.0o o~.+ n~.0 naom .oou0unowoz
«a. co. no. AA. «o. «o. no.0 va.0 no. Ao.0 m~.+ no.+ no.0 o~.0 A~.0 ~o.+ oo.+ n~.0 o~.+ -.0 no.0 ~o.+ na.0 oa.+ v~.0 mach .oo-0ucoaos
no. me. an.0 ao.0 AH. vo.0 no.0 no. no. mo.+ ~o.+ no.0 no.0 Ho.+ ao.0 no.+ vo.0 no.0 ao.+ ~a.+ o~.+ na.+ no.0 no.0 no.0 ucoiduuco ucmflom
mo. m~.0 -.0 No. va. oo. «o. «o. no. ao.0 No.0 ~H.¢ no.0 no.0 o~.0 ~a.+ no.0 o o~.0 o «H.+ oo.+ o~.+ o~.0 va.+ :«cv usual) "duos
mm on MN nu HH. on 9H. oH ha mH VHF le. hH\ no. HH ow .b 9 \IP w m .P\ n ~ H
muozuot
no unusnuuuu< Havaooaozonnmo«oom can nunDluusnaot vauu0I0n0u£un< 020.4 accuuuauuuou .om.m vanah
182
correlated negatively with six of the scaled height—
weight values. The parents' occupation and education
scale.showed a positive association with several
anthrOpometric measurements, namely Fels' height—age,
the deVeIOpmental index for height, sitting height,
pelvic diameter, and triceps skinfold thickness. The
socioeconomic status index (composed of parents' occupa-
tion, education and famlly income) correlated
significantly with weight-age, and height-age,.the
develogmental index for weight, sitting height, pelvic
diameter and triceps skinfold thickness. The mother's.
ability to name the "Basic Four" food groups needed by
the child daily showed a significant relationship to
scaled height-age and weight-age values, and the
develOpmental indices for height and weight. (Interest—
ingly, the mother's performance on the nutrition
knowledge test did not show similar significant
correlations.)
Moderator Effects
In analyzing the correlations between the scaled
height-weight values and nutrient intake, as moderated by
selected family characteristics, the following relation-
ships are indicated (Table 5.59). The weight-age value
(according to both the Fels and Stuart standards) and
‘for other scaled height- and weight-age values were
183
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xooco ocootouu .mo
ucoo\c)o .vo
vo>oa manna .na
oxuaonxuuooao «on: .no
o~o>o Ouoo nonidm .AA
noose econ nu). noose: .oo
canuaosvo + canuuasooo
3003\000u Ham m .
xenon mum
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nauaun oaoocH
annoy» onuono:
canunnoa unanouo
undo» mv convancu
030: :« Icouuom
I
amnvmonaa
no. no. oo. no. oo.- no.- oo.- oo. no.- oo. no. on. oo.- oo. oo.- no. on.- no. nooncoxn oaoammunnam
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no.- oo. oo.- no. no.. vo.- oo.- o no. oo.- no. no. oo.. oo. no.+ oo.- oo.- vo.- oocouooasooou sun noon:
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no.- no.- o oo. no.- oo.- o.- oo.- oo. no.. no. oo. no.+ oo. no.+ no.- oo.- oo.- ouoouooasouou noon
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oo. oo. oo. no. no.- no.0 no.- no.- no.- no.0 no. no. oo.. no. oo.+ no.- no.- no.- nouoauoo uaooooom
no. no. no. no. no. oo.- oon.-. nn.- no. no.- oon. o no. .o.+ onn. . no.+ Rn.- no.- non:& unmoao ncouuom
oo. nn. no. no.- o - o no.0 o - o - oo. on. oo. no.+ no. no.+ oo.- oo. oo.- oo. .uoxooa .uy-xocco
oo. oon. . no. no.- no. no.- no.- no.- no.- no.- on. no. nn.+ ovn. . onn.+o no.- oo.- no.- unnoon-xocco .>oo
no. oon. o oo. no.- no. no.- no.- o oo.- no. own o oo. oo.+ oo. nn.+o no.- no.- no.- unnooa-xmoco .>wo
no. no. o oo.- no. oo.- oo.- no. no.- no.- oon. o no. nn.+ ann.o no.+o no.- oo.- oo. nu: no .ooa-uooooz
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oo. nn. o no. no.- no.0 no.- no. oo. oo. oo. oo. oo.+ oo. no.+ no. no.- no. cue-unnoua-unnooz
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no. oon. o oo. oo.- no.- no.- no.- no. no. oo. on. no. on.+ no. onn.+. no. no.0 no. coon .ona-uomou:
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no no oo no no no no oo oo n o n o n v n n o
nooooaan
uo abounnhououuddu DonaqquEDo and nucoï¬uusnouz Unuuuaom0u£uc< vocal accouaawouoo .nm.n canon
184
significantly associated with calorie intake and with
fat, carbohydrate and protein in those children whose
mothers indicated high agreement for the "nutrition is
important" attitude. Similar trends were shown between
fat intake and the develOpmental index for weight and
the weight-age/height-age index.
There was a significant positive correlation for
"low" powerlessness mothers between the height-weight
age scale, Sargent's height-weight scale and the weight:
height ratio and calories (as well as the calorie-
providing nutrients, fat, carbohydrate and protein).
The Opposite trends in the relationships between these
variables were evident for mothers who had agreed with
items on the powerlessness scale.
Positive relationships were shown between calories
(also for fat, protein, and carbohydrate) and the various
height-weight scales for children whose mothers disagreed
the following PARI scales: trapped in a dull job,
deceptioned, unquestioned loyalty, and would like to get
out. An inverse correlation was shown between calories
and the energy-yielding nutrients and the scaled values
for children with mothers who did not agree with the
"only listen to parent" scale.
A high value on the Milbank socioeconomic status
yindex moderated a positive correlation between calories
and Sargent's height—weight scale, the weight:height
Table 5.50.
185
Anthroposetric Heasurenents
Effects of Selected Moderator Variables on the Relationship Between Nutrient Intake and
:Eoderator
Independent Variable
Dependent Variable
'Nutrition is inportant'
attitude
Powerlessness
833 Index
PARI Scales0
Trapped in a dull job
Deception
Unquestioned loyalty
Only listen to parent
Would like to get out!
Occasional dissatisfaction
Occasional dissatisfaction
Frequent dissatisfaction
Parents are all-wise
Calories
Protein
Carbohydrate
Calories
Protein
Carbohydrate
Pat
Calories
Protein
Carbohydrate
Calories
Protein
Carbohydrate
Calories
Protein
Pat
Carbohydrate
Calories
Protein
Carbohydrate
Calories
Carbohydrate
Calories
Carbohydrate
Calories
rat
Carbohydrate
Calories
Calories
Carbohydrate
Iel's weight age
Stuart weight age
Ht-wt-ege
Ht-wt-scale
Weight-height ratio
Ht-wt-sge
Ht-wt-scale
Height-height ratio
Height-weight-age
Dev. index-weight
Ht-age/ht-age index
Ht-wt-age
Ht-wt scale
weight-height ratio
Ht-wt-age
Ht-wt scale
Height-height ratio
Height-weight-age
Ht-wt scale
weight-height ratio
Height-weight-sge
Height-height ratio
height-weight-age
Height-weight scale
Height-height ratio
Dev. index for weight
Isight-age/height-sge
Height-weight scale
Neight-age/height-sge
Height-weight scale
Height-height ratio
Dev. index for weight
Neight-age/height-sge
Height-weight-sge
Height-weigh: scale
leight-height ratio
Height-weight-age
height-weight scale
weight-height ratio
Height-weight-age
Height-weight scale
Height-height ratio
Height-weight-sge
Height-weight scale
Height-height ratio
Height-weight-age
Height-weight-age
Height-weight-age
Height-height ratio
fleight-weight-sge
weight-height ratio
Height-weight-age
Height-weight-age
Height-weight scale
Height-height ratio
Height-age/height-age
Height-weight scale
Height-height ratio
Height-weight scale
Height-height ratio
Dev. index for weigh:
leight—age/height-age
height-weight scale
Weight-height ratio
leight—age/height-age
Height-weight scale
Height-height ratio
Dev. index for weight
weight-age/height—age
Height-weight scale
Height-weight scale
Weight-height ratio
leight-sge/height-age
Dev. index for weight
Dev. index for weigit
Correlation
Hbderator Score
Disagreement Agreeuent
-.21 .25
-.13 .29
-.26 .34
-.58 .38
-.68 .48
-.07 .49
-.21 .45
.23 .53
-.21 .37
-so‘ .38
-.26 .36
-.31 .27
-.39 .27
‘055 .33
.34 -.26
.10 -.30
.19 -.39
.51 -.09
.32 -.00
.39 -.09
02‘ -eJ°
.12 -.34
.31 -.15
.25 405
-e13 s‘?
-.10 .62
.37 -.13
.02 .50
.20 -.32
e1‘ -s37
-.14 .34
’el‘ .00
.27 -.19
.16 -.36
.23 '0‘:
.44 -.02
s30 ..06
03‘ -so‘
.22 -.26
.13 -.25
e13 -s35
.15 -.35
.11 -.31
015 -.35
.49 -.07
.20 -.12
e32 -e36
.10 -.32
.28 -021
.09 -.29
.42 0
.22 -.26
-.‘1 .21
-.39 .19
.46 -.02
-.34 .22
-.34 .12
.30 -.50
.31 -.51
-.02 .36
-.08 .52
.23 -.35
.20 -.42
-009 033
.14 -.34
.21 -.41
-.07 .41
-.14 .50
.13 -.29
.14 -.26
.13 -.35
.03 .41
-.07 .41
-.13 .33
186
ratio; an Opposite relationship was seen between
mothers low on the SES index for the develOpmental index
for weight and the weight-age/height-age index.
CHAPTER‘VI
DISCUSSION, CONCLUSIONS, AND IMPLICATIONS
Discussion of Results
The nature of the ecological approach forces the
researcher to investigate the nature of relationships
which might exist between (in this case) factors which
characterize the family environment and the nutritional
status of the preschool child who is living and_growing
in that environmental setting. \This discussion will
focus on those relationships elucidated by the present
research. Computer-assisted data analysis revealed that
certain variables did not provide any additional
information. Therefore, the following discussion is
based on only those data which were revealed by multi—
variate analysis to be particularly pertinent to the
problem as defined.
The nutrients were highly inter-correlated among
themselves, with the exception of ascorbic acid which
acted independently of the rest. The nutrients exhibited
no strong correlations with the blood components. It
is acknowledged that since nutrient intakes for most
. children either met or exceeded the RDA, such intakes
could be considered limiting. Therefore, one cannot
187
188
expect to find significant correlations with the
occurrence of clinical lesions. Only protein (for the
energy-yielding nutrients) showed a positive correlation
with several weight-for-age scales.
The literature suggested that the degree of
correlation which could be expected among dietary,
biochemical, and clinical data is limited. In general,‘
dietary and biochemical data for most nutrients have been
shown to be more closely related, than either of these
criteria alone correlated with clinical findings (Pike
and Brown, 1967:478). Such inter-relationships have been
routinely sought in the nutrition surveys conducted by
the Interdepartmental Committee on Nutrition for National
Defense (ICNND), but these efforts have met with little
success (Plough and Bridgforth, 1960).
While realizing that the three approaches to the
determination of nutritional status (clinical vs dietary
vs biochemical) measure different chronologies of
nutritional deficiency (Figure 3), Plough and Bridgforth
(1960) undertook to determine the nature of the inter-
relations between these three procedures, with.the
expectation that each method would be comparable to the
others. The following are but a few of their findings:
no correlations were noted between caloric intake and
pheight, weight, or skinfold thicknesses. Neither
calories nor the parameters of body composition
correlated with any of the clinical or biochemical
189
findings. The level of serum protein did not appear to
be related to dietary protein intake. In that study,
no relationships were found between dietary iron and
hemoglobin or hematocrit levels.
Pearson (1966) suggested the following reasons for
the poor correlations found between biochemical and
clinical findings: 1) the known non-Specificity of the
clinical lesions; 2) the marked differences in the criteria
and diagnostic expertise of different examiners; and
3) the different chronologies in the sequence of the
development of nutritional deficiency signs associated
with the clinical and biochemical lesions.
Beal (1970) indicated that analysis of the
longitudinal data of the subjects studied in the Child
Research Council study has shown no clear relationship
between dietary intake of iron or protein with levels of
hemoglobin or hematocrit. Likewise, Davis et a1. (1967)
concluded that a dietary survey of healthy subjects
showed that no relation between iron intake and
hematological status. They suggested that iron content
of food is not a lbmiting factor in maintaining iron
balance in normal individuals. Burroughs and
Huenemann (1970) were unable to show consistent signifi-
cant correlations between the nutrient levels and blood
(variables; however, they did indicate that in general,
children whose weights were in the lowest percentiles
190
received diets low in calories and other nutrients, and
more of these children had less favorable blood values.
Crumrine and Fryer (1970), studying blood components
and dietary intake of preschool children, found that
only protein was significantly correlated with hemo-
Vglobin concentration; they attributed this finding to
the fact that as an indicator of inadequate nutrition,
hemoglobin is determined by many, rather than a single,
nutrient. These investigators also found significant
correlations between blood values and nutrient intakes
for albumin and Vitamin A, between albumin and niacin,
and between the albumin:globu1in ratio and fat.
In the present study, examination of the correlation
matrices supplemented by the findings of the moderator
programs suggested a patterning of associations between
family environment characteristics, nutrient intake and
the physical status of the child. Thus, emerges a
typology of maternal characteristics and family patterns
which, in turn, act to influence the dietary intake and
consequent nutritional status of the child. The Type I
mother displayed many of the following characteristics:
a. Non—authoritarian attitudes toward child rearing,
indicating a basic disagreement with.the items in
the following scales,
Parents are all-wise
Listen only to parents
Unquestioned loyalty
Trapped in a dull job
Deception
and showing agreement with the items in the "treating
child as an equal“ scale.
191
Low feeling of powerlessness
Values ranked of highest importance: family centrism,
freedom, education.
Values ranked of least importance: prestige and
religion.
High.agreement with the "nutrition is important"
attitude.
The Type I families were characterized by:
Higher socioeconomic status
higher family income
higher parental education and occupations
Higher score on nutrition knowledge test and number
of "Basic Four" named.
Fewer persons in the home and fewer children under five
years of age in the family.
Most mothers are married and living with their husbands.
Families were at lower stages in the family life cycle.
Less money is spent for food per week.
In contrast, the Type II mother exhibited many of
the following characteristics:
a.
Authoritarian attitudes toward child-rearing,
evidenced by agreement with items on the "unques-
tioned loyalty" scale, and by disagreement with
the "treating child as an equal" items.
Sense of powerlessness
Lower-self-concept as mother (measured by semantic
differential instrument)
Lack of agreement with the "nutrition is important"
attitude
Value of greatest importance: prestige, religion
Value of least importance: education
Lower scores on nutrition knowledge test and number
of "Basic Four" named.
192
The Type II family was characterized by:
a. Lower socioeconomic status
lower family income
lower parental education and occupation rating
b. Later stages in family life cycle
c. More persons in the home and a greater number of
children under five years of age in the family
d. Mother is away from the child more time
e. Greater amount of money spent for food per week
f. Increased crowding in the home
9. Increased mobility patterns.
The typology of family and maternal characteristics
related, in turn, to certain patterns of nutrient intake.
Children of the more affluent, non-authoritarian mothers
tended to have higher intakes of calcium and ascorbic
acid. On the other hand, children of mothers with more
authoritarian attitudes toward child-rearing had higher
intakes of calories, carbohydrate, iron and thiamin, all
of which are typically provided by enriched bread and
cereal products. The simple correlations between the
biochemical measures and family characteristics were
largely inconclusive.
The MODERATOR programs indicated the correlation
between blood components or anthropometric measurements,
as they were moderated (or influenced) by the various
family environment characteristics. Results of this
.analysis revealed that for the Type I mothers (high
socioeconomic status, non-authoritarian), there was a
193
positive correlation between calories and the energy—
yielding nutrients and the various scaled height-weight
for age values. In contrast, for the Type II mothers
(low socioeconomic status, authoritarian) there was a
positive relationship between calories and weight indices,
namely the developmental index for weight and the
weight-age/height-age index, but there were essentially
no other significant correlations with the remaining
scaled height-weight values. Such findings suggest that
the children of Type II mothers may weigh more in relation
to their height, while children of Type I mothers may
have a more balanced physique, i.e., these children are
more likely to be neither overweight or underweight.
The tendency existed for children of mothers with a
lower self-concept rating (characteristic of Type II)
to have a higher hydroxyproline:creatinine ratio and
hydroxyproline index. This finding suggests that
children of Type II mothers may be growing at a more
rapid rate. Whether these children weighed more for
height because of a greater muscle mass or increased
adipose tissue cannot be adequately determined from the
data collected for this study.
Correlational analysis revealed that children of
mothers with a lower self-concept (characteristic of the
Type II mothers) tended to have higher hemoglobin and
hematocrit values. MODERATOR further indicated that there
194
was a positive association between both protein and iron
with hemOglobin, when moderated by variables characteristic
of the Type I mothers. Such relationships may suggest
that in cases where hemOglobin is at acceptable or higher
levels, such as was found of children of Type II mothers,
that excess dietary iron remains unabsorbed and as a
result, no correlations were made apparent. For children
of the more authoritarian, lower income mothers (Type II),
MODERATOR showed that positive correlations existed
between dietary protein and serum albumin and total serum
protein levels, even though dietary protein intake
exceeded 100% of the RDA for these children.
Limitations of the Present Research
1. Because of the nature of the sample selection, a
bias was introduced. Information was obtained only for
children whose mothers were c00perative in providing the
information requested by the researcher. The "invisible
poor" child, who is mistreated and possibly unwanted in
the home is not likely to be attending a nursery school
program or visiting a public health clinic.
2. Psychosocial data was obtained only for the
mother. The focus of the present research was primarily
on the dyadic relationship between the mother (as the
supplier of nutrients) and the developing child rather on
-the transactional patterns which may be evidenced by the
entire group of family members.
195
3. Dietary intake information was obtained by food
records completed by mothers of the children in the
sample. The validity of this instrument as a data-
collection device is controversial.
Summary and Conclusions
Analysis of the food records revealed that for the
most part, children in the present study were quite amply
nourished. On the average, all nutrients, except iron,
met or exceeded the Recommended Dietary Allowances.
However, in terms of the few children who had intakes
less than two-thirds of the RDA for any one nutrient,
the nutrients which were most limiting were iron, ascorbic
acid, calcium, and vitamin A. These nutrient totals were
calculated exclusive of the contribution of the vitamin
supplement which many of the children were taking.
Snacking was quite prevalent; approximately 10% of the
total protein intake and 19% of the calories were
contributed by snacks.
Evaluation of blood components and various anthropo-
metric measurements failed to reveal any evidences of
gross malnutrition. In reference to the ICNND standards,
all but two children had either "acceptable" or "high"
values for hemoglobin and hematocrit. Total serum
proteins were either acceptable or high for 97% of the
Children, while all children had serum albumin levels which
were either acceptable or high.
196
When height and weight measurements of the children
were studied in reference to accepted standards, it was
revealed that far more children were at the highest
percentiles for weight than were at the lower ends of the
scales. This inequitable distribution did not hold true,
however, for the height values. Such findings lead to
the conclusion that more children in the sample were
overweight for their age than were underweight.
An analysis of the demographic characteristics of
the families in the sample indicated that a wide variation
existed among the families sampled. Nearly two-thirds
of the families were white, while approximately one-fourth
were black; others in the sample were Mexican-American,
Oriental or East Indian. The average annual family
income was about $9,000, yet 13% of the families had an
income of less than $4,000 per year. The parents in the
sample were quite highly educated; mothers had completed
an average of fourteen years of schooling while the fathers
had completed approximately seventeen years. The
"typical family" in the sample consisted of five persons--
two adults and three children, two of whom were less than
five years of age.
Using correlational and multiple-group cluster
analysis procedures, a typology of family characteristics
and maternal attributes was developed which bore a
direct relationship to the dietary intake and resultant
physical status of the children. The Type I mother
197
exhibited more equalitarian attitudes toward child-
rearing and represented a higher socioeconomic strata.
In contrast, the Type II mother was from the lower
socioeconomic groups and displayed more authoritarian
attitudes toward child-rearing.
This typology of maternal characteristics related
directly to certain patterns of nutrient intake.
Children of the more affluent, non-authoritarian
mothers tended to have higher intakes of calcium and
ascorbic acid, while children of the Type II mothers
ate more calories, carbohydrate, iron, and thiamin.
The tendency existed for children of the more
authoritarian, lower income mothers to have higher
hemoglobin and hematocrit values. Yet, analysis of
interactions among variables indicated that there was a
positive association between both protein and iron with
hemoglobin for children of the Type I mothers. Such
associations suggest that in cases where hemoglobin
levels are at higher levels, any dietary iron that is
ingested which may not be needed remains unabsorbed,
and as a result, does not contribute to any correlations
with the blood value.
The primary contribution of the present research
is the demonstration that multivariate analysis procedures
may be effectively utilized to establish a typology of
family characteristics and maternal attributes which,
in turn, exerts a direct influence on the dietary intake
198
and the consequent nutritional status of children within
particular family environmental settings.
Suggestions for Future Research
.The suggestions for future research which emanate
from the present study relate quite closely to the
limitations previously cited.
1. The ecological approach should be applied in
analyzing the nature of the relationships between
nutritional status and family environment characteristics
in populations of children different from the one studied.
These might include.the "invisible poor", the."battered"
child, or the mentally retarded. Cross cultural approaches
as well may be useful.
2. Children from a younger age group (e.g., one.to
three years of age) should be studied to.determine if they
are more sensitive to alterations and/or extreme conditions
which may occur in the family environment.
3. Studies should be performed utilizing research
techniques designed to assess transactional patterns of
exchange amongfamily members, rather than the dyadic
relationship between mother and child. In any event,_
attempts should be made to include more members of the
family in the research design than just the mother.
4. A study is recommended to determine the most
accurate yet practical method (i-e., comparing the food
199
record vs recall vs observational teChniques) for.use in
field studies particularly with.low—inCome mothers.
Implications
Theory
The present research demonstrates the viability of
the ecological approach in studies designed to assess the
nutritional status of individuals.
Action'Programs
The value of the present study to.potential
application in programs carried out by change agents lies
both in the conceptual orientation, i.e., the edological
approach, and the typology of family characteristics which
was revealed.
If more authoritarian, low-income mothers have
children who consume.fewer fresh fruits andvegetables,
as evidenced by lower ascorbic acid intakes, techniques
which would encouroge an increased consumption of these
foods should be emphasized in nutrition education pro-
.grams. Furthermore, the entire constellation of family
characteristics must be evaluated before any change
programs can be effectively implemented.
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APPENDICES
O‘U‘iubWNl"
APPENDIX A
Correspondence
Letter to mothers, December 1969.
Letter to mothers, February 1970.
Letter to mothers, May 1970.
Permission request for blood tests.
Letter to teachers scheduling measurements.
Letter of thanks and appreciation.
216
APPENDIX A-l
Letter to mothers, December 1969
Michigan State University
Department of Foods and Nutrition
December, 1969
Dear
As part of an ongoing project to study the growth
and eating habits of preschool children, we request your
help in completing the attached form.
We would like you to record everything that your
child eats from the time he gets up in the morning until
he goes to bed at night--for a day when he is not attending
Nursery School. Since accuracy of information—is important
to the success of the project, please be as descriptive and
as accurate about the quantities and types of food eaten
as possible.
Your cooperation is most appreciated. Thank you!
Very truly yours,
Mrs. Laurie Sims
Graduate Assistant
Portia Morris
Associate Professor
Foods and Nutrition
LS:PM/gjn
Enclosure
217
APPENDIX A-Z
Letter to mothers, February 1970
MICHIGAN STATE UNIVERSITY
Department of Foods and Nutrition
February, 1970
Dear
As you recall, last term you cooperated on a study of
the growth and eating habits of preschool children by
completing a one-day's food intake record for your child.
This information has been most helpful.
We are now requesting your further c00peration to
complete our study. In order to learn not only what children
eat, but why they eat it, we feel it is important to also
learn about the children's families. This study should
answer several fundamentally important questions, & you alone,
as a parent of a preschool child can supply the information
we need.
Enclosed are a set of questionnaires designed to let us
know about how you feel about certain important tOpics.
There are no right or wrong answers. All participants will
be assigned a code number and responses will be analyzed by
a computer, so you may be sure that all answers will be kept
strictly confidential.
These forms will be collected at the time you have
agreed upon for the interview on at .
Your cooperation is most appreciated. Thank you!
Sincerely,
Student Interviewer
Mrs. Laurie Sims
Graduate Assistant
Mrs. Portia M. Morris
Associate Professor
Foods & Nutrition
Enclosures
218
APPENDIX A-3
Letter to mothers, May 1970
MICHIGAN STATE UNIVERSITY
Department of Foods and Nutrition
May, 1970
Dear
As you recall, you have cooperated with us this year
on a study of the physical growth and eating habits of
young children by completing a one day's food intake record
for your child. This information has been most helpful,
and we are again requesting your help one more time.
Please complete the attached food record form again.
(Only by averaging several day's meals can we determine a
representative intake for your child.)
We would like you to record everything that your child
eats from the time he gets up in the morning until he goes
to bed at night--for a day when he is not attending Nursery
School. Since accuracy of information—is important to the
success of the project, please be descriptive and accurate
about the quantities and types of food eaten (e.g., whether
fresh, frozen or canned) and how the food was cooked (fried,
boiled, broiled). Brand names are always helpful!
Please return the completed forms in the attached
envelope by June 1, 1970. Your continuing c00peration is
most appreciated. Thank you!
very truly yours,
Mrs. Laurie Sims
Graduate Assistant
Portia Morris
Associate Professor
Foods and Nutrition
LS:PM/gjn
Enclosure
219
APPENDIX A-4
Permission Request for Blood Tests
MICHIGAN STATE UNIVERSITY East Lansing! Michigan 48823
Family and Child Study Unit College of Home Economics
April 16, 1970
Dear
In conjunction with the ongoing study of the physical growth
and eating habits of preschool children, it is important
for us to assess your child's growth by several methods.
These include food intake records, height and weight measure-
ments, and a simple blood test.
We are asking that you complete and return the enclosed
permission form allowing us to obtain one drop of blood by
pricking the finger of your child. This procedure is
painless and will be carried out by a registered medical
technologist from the 01in Health Center on campus. This
work will be done the latter part of May, and you are
invited to be present if you so desire. You will later be
informed of the exact date and time.
If any medical problems are detected, you will be informed
and referral will be then made to your family physician.
Please return the signed form to us by May 1, 1970. Your
cooPeration is greatly appreciated. Thank you.
Sincerely,
Robert P. Boqer, Chairman
Preschool Research Committee
220
APPENDIX A-5
Letter to Teachers Scheduling Measurements
MICHIGAN STATE UNIVERSITY East Lansing, Michigan 48823
CoIlege of Home Economics
Department of Foods and Nutrition Home Economics Building
April 27, 1970
To:
From: Laurie Sims
During the weeks of May 4-8 and May 11-15, I plan to
take the third, and final, set of physical measures on
the nursery school children.
In addition to the usual height and weight measure-
ments, this set will also include skinfold thickness
measures as well as several diameters and circumferences
of the body.
The finger prick blood sample will (hOpefully!) be
taken the last two weeks of May (May 18-22, and May 25-29).
I shall inform you later of the specific time.
I shall contact you later this week to arrange a time
for these measurements when it will be most convenient for
your class. Thank you for your cooperation.
221
APPENDIX A-6
Letter of Thanks and Appreciation
June 9, 1970
Dear
Now that the data for your study are nearly complete,
the time has come to thank each of you for your help and
c00peration this past year.
As you may know, there are many misconceptions about the
eating habits of preschool children and the factors ,
influencing food intake. We hope that by this compre-
hensive study we will be able to make a meaningful
contribution to knowledge in this area.
This study was possible only with the cooperation of‘a
great many people--parents, teachers, children and others.
We extend to each of you our heartfelt thanks. We will
be happy to share with you our findings following com-
pletion of the data analysis next year.
Sincerely,
(Mrs.) Laurie Sims Dr. Portia M. Morris
Graduate Student Associate Professor
APPENDIX B
Guidelines for Interviewers
222
APPENDIX B
Guidelines for Interviewers
1. Set up appointment with mother of child. Explain that
you are an MSU student who is involved with the study
dealing with the physical growth and eating habits of
preschool children. Suggest that in order to learn
not only what children eat, but why they eat it, it's
important to learn something about their families.
Since she is a parent, only she can supply the infor-
mation and insights about children which we need to
know.
Set up an appropriate time when you can talk with her.
Explain that you will be sending ahead a few short
forms which you would like her to complete before you
get there.
2. Conduct the interview. Record the information concisely
and'accurately. Try to make the respondent feel as
much at ease as possible.
Pick up the completed questionnaire forms which you
had previously mailed. Check to see that all items
have been correctly filled out. There should be six
separate forms:
1) Parent Attitudes
2) "Now, we would like you..."
3) "Some statements concerning nutrition..."
4) Homemaker Values
5) Parent Opinions Scale
6) "Read each of the statements..."
Leave the "Food Record" form to be filled out. Remind
the mother that she is to record a one-day's food
intake for a day when her child is n22 attending
nursery school, and that she should return the form
within one week. (A stamped self-addressed envelope
is attached to the form for her convenience in
returning it.) Emphasize that accuracy is extremely
important and that she should record only what the
child actually eats and not what she thinks he should
be eating.
Thank her for her time and generosity in supplying the
information we need.
3. Return all completed forms to me.
223
Appendix B (cont'd)
4. You may call me anytime if questions or problems arise:
Home: 351-3895
Nutrition "Grad Room" (108 Home Ec.):353-2937
5. Your rate of pay is $1.90 per hour (maximum allowed for
student employment) plus mileage. Record all mileage
accrued.
Thanks--and good luck!
Laurie Sims
APPENDIX C
Instruments
1. Food Record Recording Form
2. Home Interview Schedule
3. Attitude-Measuring Questionnaires
a.
b.
c.
d.
e.
f.
Parent Attitudes
Homemaker Values
Parent Opinions Scale
Powerlessness
Nutrition Knowledge and Attitudes Test
Semantic Differential Instrument
224
APPENDIX C-l
Food Record Recording Form
RECORD OF FOOD EATEN IN ONE DAY
Name N.S. Code
Date Recorded: Code No.
SUGGESTIONS FOR RECORDING INFORMATION:
Milk, fruit juice and other liquids:
Record in terms of measuring cup or ounces. (1 measuring
cup equals 8 ounces.)
Butter: Record as level teaSpoons. (1 average pat
equals I level teaspoon.)
Sugar: Record as level teaSpons.
Egg: Note whether egg, or yolk or white only.
Cereals and vegetables:
Record in terms of measuring cup or tablespoons. (1/2
measuring cup equals 4 heaping tablespoons equals 8 level
tablespoons.)
Fruit or vegetable:
If whole, give sizeITas small, medium, or large.) If
sliced or canned, express in terms of measuring cup or
tablespoons, as above. Note whether fresh, frozen, or
canned.
Meat:
Record as ounces or level tableSpoons, if possible.
(1 ounce equals 2 level tableSpoons.) Note how cooked,
e.g., fried, boiled, broiled.
Other foods:
Record as accurately as possible in terms of ordinary
household measures. Note flavor of a baked product and
whether it was iced. Brand names are always helpful.
225
Appendix C-l (cont'd.)
COMPLETE RECORD OF THE DAY'S FOOD
BREAKFAST: Time a.m.
Did child eat alone?
If not, with whom?
Fruit or juice, (circle one): Kind Amt.
Cereal: Kind Amt.
Milk on cereal: Amt. oz. Sugar tsp.
Bread: Kind No. slices
Butter or Margarine, (circle one used): ' tSp.
Other Spread: Kind Amt.
Egg: How cooked? Amt.
Bacon or other meat: Kind Amt.
Milk: Kind Amt. oz.
Other beverage: Kind Amt. oz.
Other foods: (Specify)
Kind: Amt.
BETWEEN BREAKFAST AND NOON MEAL:
Food (Kind) Amount Time Where With whom?
226
Appendix C-l (cont'd.)
NOON MEAL: Time
Did child eat alone?
If not, with whom?
Soup: Kind Amt.
Meat or Main Dish: Kind ' Amt.
Potato: How cooked? No. and size
Vegetables: Kind Amt.
Sandwich: Filling: Kind Amt.
Bread: Kind Amt.
Butter/Margarine, (circle) on bread, etc. tSp.
Salad dressing: Kind Amt.
Milk: Kind Amt. oz.
Other beverage: Kind Amt. ' oz.
Dessert: Kind Amt.
Other Foods: (Specify)
Kind: Amt.
BETWEEN NOON AND EVENING MEALS:
Food (Kind) Amount Time Where With whom?
227
Appendix C-l (cont'd.)
EVENING MEAL
Did child eat alone?
If not, with whom?
Time
Meat or Main Dish: Kind
Amt.
Potato: How cooked?
No. and size
Vegetables: Kind Amt.
Kind Amt.
Kind Amt.
Bread: Kind No. slices
Butter or Margarine (circle one) on bread, etc. tsp.
Gravy: Amt.
Salad dressing: Kind Amt. oz.
Milk or
Other beverage: Kind Amt. oz.
Dessert: Kind Amt.
Other Foods:
Kind: Amt.
Amt.
BETWEEN EVENING MEAL AND BEDTIME:
Food (kind) Amount Time Where With whom?
Is this day's intake usual?
Less than usual?
Vitamin supplements: Kind
More than usual?
Amt.
If any of the above meals were not eaten at home,
indicate which: where?
228
APPENDIX C-2
Home Interview Schedule
NUTRITION INTERVIEW
Child's name Parent's name
Address:
Preschool: LPS = 1 SNS = 2
Oflwr=u3
Identification number
Sex 1 Male Phones: Home
2 Female Office
Birthdate Interviewer:
(Month, day, year) - -
INTRODUCTION:
We are conducting a study to learn more about the
growth and eating habits of preschool children. In order
to learn not only what children eat, but why they eat it,
we need to know certain things about the children's
families. This study should answer several important
questions, and you glgng, as a parent of a young child,
can supply the information we need!
There are no "right" or "wrong" answers to the ques-
tions you will be asked. All participants will be assigned
a code number and reSponses will be analyzed by a computer,
so you may be sure that your answers will be kept
confidential. Please answer the questions as frankly and
accurately as possible.
229
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231
Appendix C-2 (cont'd.)
10.
"Are you now married?
If 11.
No, ask, "Have you ever
been married?
12.
1.
2.
O‘U’lbw
(If applicable only,
Married and living
with husband
Married, but hus-
band temporarily
absent (e.g., in
Army, jail, etc.)
Separated
Widowed
Divorced
Single, never
married
"Do you now have a paid
job?“
No, not working and
not looking for
work (housewife)
No, not working but
looking for work
No, retired or
disabled
No, full-time
student
Yes, employed part-
time (less than 35
hours per week)
Yes, employed full
time (35 hours per
week or more)
If response to question is
ask) "What about your Yes, ask, "What is your job?"
husband? Is he now or, "What kind of work do
employed?" you do?"
Specify:
1. No, not working and
not looking for work " . ,
2. No, not working but 13' (£22? izbgeur husband 3
looking for work S ecifj-
3. No, retired or p Y'
4 gdsangI—time 14. How far did you go in
‘———— ‘ student school? (Record as number
5. Yes, employed part- school years completed.)
time (less than 35
hours per week) . _
6. Yes, employed full 15. (If applicable ask.) How
time (35 hours per
week or more)
Does your husband have
steady work?
far did your husband go
in school?"
16. How many hours each week
is
X cared for by
someone else?
No. hrs/week
Where
Within own home
Home of relatives
Home of someone
else
Nursery school
Other, specify:
232
Appendix C-2 (cont'd.)
17.
18.
19.
20.
21.
22.
23.
24.
About how much money in all does your family make (or
get)?
(Record verbatim answer, including whether amount given
is per week, month, or year.
"Would you tell me where most of your money comes from?"
(DO NOT PROBE). Specify:
"Some peOple believe that food habits are related to
religious affiliation: what is yours?"
0. None 1. Protestant
2. Catholic 3. Jewish
4. Mixed 5. Other, specify:
â€How long has your family lived at this address?"
(Record answer verbatim)
"How many times have you moved within the last three
years?â€
(Actual number of moves)
"Do you own or rent your house?"
1. Own the house
2. Rent from private agency or person
3. Rent from public housing
4. MSU-student married housing
"How many rooms are there in this house?" (Exclude
bathroom, utility rooms, halls and other areas unsuitable
for sleeping or general living purposes. Include porch
if used for living at least 9 months of the year.)
Number of rooms.
"Do other persons regularly sleep in the same room as
X ?"
0. No
1. Yes How many?
233
Appendix C—2 (cont'd.)
26.
27.
28.
29.
30.
31.
32.
33.
34.
36.
37.
38.
39.
40.
41.
"I would like to find out about the following items you
have in your home and their condition." (If more than
one of a particular appliance is present, place an
apprOpriate check for the one in the best condition.)
Do you have a " Not Yes, but Yes, work- Yes
present not in 0p. ing, but works
(1) condition not satis. well
(2) (3) (4)
Telephone, Number in
home
Radio, Numberdin home
Television, Number in
home
Automobile or trudk,
Number in home
Refrigerator
Freezer (as separate
unit, not part of
refrigerator
Range (with oven)
Hotplate (or range
with no oven)
HEATH RECORD. "We would like some information about your
child's health record and medical history."
Birth Weight 35. Was X l. Premature?
2. Full term?
Did you receive prenatal care during your pregnancy
with X ?
Ask: "How old were you when you were first pregnant?
"How old were you when you were pregnant with
X ?
Present height Mother Father
Present weight
Which method was used in feeding X as an infant?
Breast-fed
Bottle-fed
Both breast and bottle
Did not receive any milk
#WNH
Approximately how long was X fed by the above method(s)?
42. Bottle months
43. Breast months
234
Appendix C-2 (cont'd.)
44.
45.
46.
47.
48.
49.
50.
Does X ever drink from a bottle now? 1. No 2. Yes
Does X use a pacifier now? 1. No 2. Yes
Is X allergic to any foods?
I. No
2. Yes
If so, which foods is X allergic to now?
1. Milk 4. Fruit, Specify which:
2. Eggs 5. Combination of foods:
3. Meat 6. Other, Specify:
Is X on a Special diet now?
I. No
2. Yes
Why is he on this diet?
1. Weight reduction (own prescription)
2. Weight reduction (physician's prescription)
3. For gaining weight
4. Other Specify:
Has X eVer been anemic?
-_I} No
2. Yes
At what age was anemia present?
1. Before 6 months
2. 6 months to 1 year
3. l to 2 years
4. 3 to 4 years (recently)
Was medication prescribed for the anemia?
0. Not applicable ("No" above)
1. No
2. Yes
3. Don't remember
Have you ever consulted a physician about feeding
problems with X ?
1. No __—'
2. Yes
what age?
1-6 months old
6 months to 1 year old
1 to 2 years old
3 to 4 years old (recently)
Combination of above
UIhwdhOF‘W
t
235
Appendix C-2 (cont'd.)
51.
52.
53.
54.
55.
56.
57.
Do you give _X_ a vitamin/mineral supplement?
1. No
2. Yes
Name:
1. Multivitamin
. Vitamin-mineral
. Multivitamin plus iron
. Single vitamin (e.g. Vitamin C)
. Group of vitamins (e.g. B complex, ADEC, etc.)
Iron
Other, Specify:
\lmUluwa
How often is this given:
0. Not applicable ("No" above)
1. Daily
3-6 times a week
3. Once a week
4. Only occasionally
Do you give X any other kind of supplement or health
food (e.g. wheat germ, cod liver oil, etc.)?
1. No
2. Yes
Kind:
Reason:
If you do give any supplements, on whose recommendation?
0. Not applicable (none given)
1. Physician
2. Friend or relative
3. On your own
Do any members of your immediate family have any disease
or condition (e.g. diabetes, kidney disease) which
requires a Special diet?
1. No
2. Yes
Who? Condition
How much sleep (including naps) does _X_ get (on the
average) each day?
1. Less than 8 hours 4. 13-15 hours
2. 8-9 hours 5. More than 15 hours
3. 10-12 hours
When was the last time that X was examined by a
physician?
1. Less than 1 mo. age 4. More than 1 year ago
2. 1-6 months ago 5. Never
3. 7-12 months ago
236
Appendix C-2 (cont'd.)
58. What was the reason for _X_ last seeing a physician?
1. Don't know 4. Illness
2. Routine checkup 5. Injury
3. Immunizations
59. Has _X_ ever been examined by a dentist?
1. No
2. Yes
When was the last time?
1. Less than 1 month ago
2. 1-6 months ago
3. 7-12 months ago
4. More than 12 months ago
5. Never
60. What was the reason for his seeing the dentist?
1. Don't know 4. Tooth extraction
2. Routine checkup 5. Injury
3. Tooth filled
61. Does X have any filled teeth?
1. No 2. Yes
HOUSEHOLD MEAL PROACTICES
"Some people believe that food habits are related to
mealtime practices. The following questions have to do
with the mealtime practices of your family." How often
does your total family eat meals together during the major
part of the week?
Meal Never Less than 11? the time Almost
(I) 1/2 the time or more alwa s
(2) (35' _TYL(
62. Breakfast
63. Noon meal
64. Evening meal
65. Other, (in-
cluding snacks)
66. Do children eat at the same time as the adults in your
family?
1. Yes, almost always
2. Usually
3. Only occasionally (4-6 times a week)
4. Rarely
5. Never
237
Appendix C-2 (cont'd.)
67.
Which of the following describes _X_'S attitude toward
food or meals?
1. Enjoys eating 4. Has to be urged to eat
2. Attitude varies 5. Presents an eating problem
3. Indifferent to food
68. How important do you think it is that a child eats
everything he has been served on his plate?
1. Not at all 4. Considerably
2. Slightly 5. Extremely
3. Moderately
69. What is your usual action when X dawdles at his food
or refuses food served to him?
1. Insist that he finish his meal promptly.
2. Insist that he complete a certain portion of each
food.
. Threaten punishment, e.g. withholding of dessert,
if food is not eaten.
Promise reward, e.g. dessert for completion of food.
Tell child there will be nothing to eat until the
next meal, then remove food.
Coax, but do not force eating.
Say nothing at the time; talk to child later about it.
Say nothing to child; do not like arguments at the
table.
mum U‘lnhh U
C O
9. Say nothing; do not think this is important.
SNACKS
70. Does X eat in the morning before breakfast?
71.
72.
73.
How ofiEn? 1. Every day
2. 2 to 3 times/week
3. Less than once a week
4. Never
Does X eat between breakfast and lunch?
How offEn? 1. Everyday
2. 2 to 3 times/week
3. Less than once a week
4. Never
Does _X_ eat between lunch and dinner?
How often? 1. Everyday
2. 2 to 3 times a week
3. Less than once a week
4. Never
Does _X_ eat between dinner and bedtime?
How often? 1. Everyday
2. 2 to 3 times/week
3. Less than once a week
4. Never
238
Appendix C-2 (cont'd.)
74.
75.
76.
77.
78.
83.
84.
85.
86.
87.
88.
89.
90.
91.
92.
Does X ever miss any meals?
iT_YeS
2. No
Which does he miss most often? 1. Breakfast
2. Lunch
3. Dinner
If so, why does X miss meals?
0. Does not apply—T"No" above)
1. Lack of time
2. Lack of appetite
3. Too tired to eat
4. Illness
At what time of day does _X_ seem to be the most hungry?
1. Morning 2. Afternoon 3. Evening
Would you describe X 'S appetite in the past 3 months
as:
1. Excellent 2. Good 3. Fair 4. Poor
Does _X__feed himself?
0. No
1. Yes 79. Does he use a Spoon? 1. No 2. Yes
80. Drink from a cup or glass? 1. No 2. Yes
81. Use a fork? 1. No 2. Yes
82. Use a knife? 1. No 2. Yes
What foods does X like particularly well? Itemize
Specific foods:
What is X '5 favorite food? Specify:
What foods does X dislike? Itemize:
Does _X_ refuse to eat any foods?
0. No
Yes
What are they? Specify:
When planning meals for your family, are you influenced
by the following?
No (1) Yes (2)
Cost of the food
Time required for preparation
Likes of the family
Your own likes
Health needs of family
Nutritive value of food
93. Which do you believe is the most important influence?
(Circle number above)
239
Appendix C-2 (cont'd.)
94.
95.
99.
100.
101.
102.
103.
104.
105.
106.
107.
108.
109.
110.
FOOD
113.
How does your family generally accept new foods or new
methods of preparation?
1. Enthusiastically 4. Reluctantly
2. Willingly 5. Not at all
3. Cautiously
Would you consider your child's mealtime pattern to be:
(Or Does your child eat at the same time every day?)
1. Regular 0. No
2. Irregular 1. Yes (usually)
What time does X usually eat?
96. Breakfast_ :i— _ 97. Lunch _ _:_ _p 98. Dinner
Are all meals usually eaten at home?
0. Yes
No.
Which meals are eaten elsewhere?
1. One meal such as 2. Two meals such as
Breakfast, Breakfast and lunch, or
Lunch, or Lunch and dinner, or
Dinner Breakfast and dinner
3. All meals
Where are these meals usually eaten?
1. Relative's home 3. Restaurant
2. Babysitter's home 4. Home of friends, neighbors
Do you think X :
No (1) Yes (2)
Eats too little food
Eats too much food
Chooses a limited variety of
foods
Eats too few fruits and
vegetables
Dawdles with his food
Eats too much meat
Eats too little meat
Drinks too much milk
Drinks too little milk
Eats too many sweets
PURCHASING
Who in the family usually decides what foods to buy?
1. Mother only 4. Mother & children
2. Father only 5. Entire family
3. Mother and father together
240
.Appendix C-2 (cont'd.)
114.
115.
116.
117.
118.
119.
120.
121.
122.
123.
124.
125.
126.
127.
128.'
Who usually does the grocery ShOpping?
1. Mother alone 5. Father and children
2. Father alone 6. Entire family
3. Mother & father together 7. Non-family member
(no children)
4. Mother and children
How often does your family buy groceries?
1. Daily 5. Once erery 2-3 weeks
2. 2-3 times a week 6. Once a month
3. Major ShOpping weekly, 7. Varies, no pattern
other foods as needed
4. Once a week
In what kind of store do you do most of your Shopping?
1. Neighborhood store; small independent market
2. Supermarket or discount store
Other
Why do you shop there? (order by no.)
1. Can buy on credit
. Don't know
Lower food prices
More convenient and/or personal loyalty
Offer trading stamps or other sales promotions
Cbmbination of better quality and lower prices
Better quality and/or variety and/or sells ethnic
foods
gaunt-awn
About how much money did you spend for food last
week? 8
How often do you generally use the following foods?
Never Rarely Occasion- Nearly All
1 2 ally all the the
3 time time
4 5
Frozen meat pies
Frozen "TV" dinners
Canned soups, stews
Frozen dessert pies
Cake, muffin mixes,
inc. prepared mixes
such as Bisquick
Instant coffee
Ready-to-eat cereal
Pie crust mix
Pudding mix
Other,
Specify:
241
Appendix C-2 (cont'd.)
129.
130.
131.
132.
133.
Do you receive Federal Food Stamps at the present time?
1. No; not eligible
2. No; eligible but do not participate (to next item)
3. Yes
If eligible & answered N9 (#2), why do you not use
stamps?
1. Family applied, but told "not eligible"
. Family applied; eligibility not yet determined
. Family chose not to participate temporarily, plans
to reapply
Cannot afford them
Do not know enough about them
Inconvenient, tranSportation problems
Family says, "do not need them"
\lO‘U‘IIb um
If Yes (#3), do you buy any foods now that you did not
buy‘EEfore you got food stamps? Or do you buy more of
any foods now than you did before?
1. No
2. Yes
Which ones? Specify:
NUTRITION EDUCATION
What foods do you think you should serve your child
every day? (Record answer verbatim; probe for specific
foods)
"Have you ever had any classes or attended any group
activities concerned with food and nutrition?"
0. No
Yes.
Which? Junior high school
Senior high school
Professional training (e.g. nurse's)
Adult education classes
Public health classes, clinics
Prenatal classes
Youth group: eg. 4-H, Girl Scouts
Course in cooking
mummwat-I
o o o o o o o o
134. "Which do you believe has been the most helpful
to you in preparing your family's meals?"
(Circle number above)
242
Appendix C-2 (cont'd.)
135.
136.
"There are many pe0p1e from whom homemakers can get
information concerning needs of families. Which of
the following persons has influenced you the most?â€
(Circle number.)
0.
\lO‘U‘lukwNH
No one
Mother or other relative
Friends or neighbors
Physician
Dentist
Nurse
Home economist, dietitian, or nutritionist
Combination of above
"If you wanted to know more above the nutritive value
of various fruits or vegetables, what sources of infor-
mation do you think you would find most helpful?"
(Circle number of the most helpful.)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
ll.
Cookbooks
Books (other than cookbooks), extension bulletins
Food articles in magazines or newspapers
Food advertisements in magazines or newspapers
Radio
TV
Neighbors and friends
Mother or other relatives
Members of immediate family (husband, children)
County extension agent or home economist
Teacher
243
Appendix C-2 (cont'd.)
COMPLETE THIS PAGE AFTER YOU LEAVE THE HOME
INTERVIEWER'S OBSERVATIONS
To Interviewer: Code one as appropriate:
The dwelling is a:
1. Single house, one family
2. Duplex or row house, one unit for each family
3. Converted Single house, converted rowhouse, multi-
family
4. Apartment (privately owned; garden-type)
5. Trailer
6. Apartment (public housing; garden-type - housing
project)
7. Apartment (privately owned; multi-story)
8. Apartment (public housing; multi-story - housing
project)
When interviewing, did you observe:
Yes No Not
Applicable
Bed‘in'livingrroom?
Rug on living room floor?
Cléan7neat home?
Bed made?
Temperature adequate/comfortable?
Bad smell in housleoom?
********** **********
Did children appear sick? (runny eyes,
sores, etc.)
Did children appear clean?
Did you see mother (or caretaker) hit
a child?
Did’mother yell at a child?
Did mother offer you anything to eat
or drink?
Did mother ask you for any help or
information?
Were accessories visible in the home?
framed pictures 1. No 2. Yes
green plants 1. No 2. Yes
decorative
accessories 1. No 2. Yes
244
Appendix C-2 (cont'd.)
Evaluate the general state of cleanliness and housekeeping
condition of the home, the furnishings, and appliances:
. very dirty and unkept
. dirty and unkept
. fairly clean and orderly
. very clean and orderly
uwaH
245
Appendix C-2 (cont'd.)
APPRAISAL OF A "SAMPLE OF THE IMMEDIATE NEIGHBORHOOD" OF THE
DWELLING
[d] X = dwelling in which interview was
conducted
[a] [X] [c] a,b,c,d = dwelling, structures or
lots adjacent to or facing X
[b]
Comments:
Evaluation of the structure or lot:
Land Use Condition
Vacant Residential Non- Description Sound Dilap- Deteri-
residential of non- idated orating
residential
use
a
b
c
d
Structural observation of exterior: 1. Poor quality
2. Fair quality
3. Good quality
4
. Excellent quality
Rate the person interviewed as to cooperativeness:
1. Very cooperative. Appeared friendly and relaxed with
interviewer. No defensiveness. VOlunteered informa-
tion readily. Showed interest in the study and became
involved in the interview.
2. COOperative. Appeared friendly and relaxed with the
interviewer. Answered questions readily, but did not
volunteer information beyond that requested. May or
may not have shown interest in the study.
3. Slightly unc00perative. Generally answered questions
readily, but mayihave Shown some defensiveness;
maintained distance from interviewer.
246
Appendix C-2 (cont'd.)
Uncooperative. Tenseness and defensiveness in
answering questions. Expressed reservations about
amount of time Spent. An undercurrent of resistance
to the interview. Little interest in the study.
very uncooperative. Explicit resistance to the
interviewer or the interview. No interest in the
study.
Much of the information obtained may be unreliable
because person interviewed seemed so concerned with
making a "good impression" that questions may not
have been answered validly.
ANY OTHER COMMENTS:
247
APPENDIX C-3a
Parent Attitudes
Read each of the statements below and then rate them as
follows:
A a d D
Strongly mildly mildly strongly
agree agree disagree disagree
Indicate your opinion by drawing a circle around the
"A" if you strongly agree, around the "a“ if you mildly
agree, around the â€d" if you milding disagree, and around
the "D" if you strongly disagree.
There are no right or wrong answers, so answer according
to your own Opinion. It is very important to the study that
all questidns be answered. Many of the statements will seem
alike, but all are necessary to Show slight differences of
opinion.
Agree Disagree
1. Children Should be allowed to disagree A a d D
with their parents if they feel their
own ideas are better.
2. When a parent asks a child to do some- A a d D
thing the child should always be told
why.
3. A child Should be taught that there are A a d D
many other peOple he will love and
respect as much or more than his own
parents.
4. Children Should never learn things A a d D
outside the home which make them doubt
their parents' ideas.
5. Having to be with the children all the A a d D
time gives a woman the feeling her
wings have been clipped.
6. Parents very often feel that they can't A a d D
stand their children a moment longer.
7. There's no excuse wasting a lot of time A a d D
explaining when you can get kids doing
What you want by being a little clever.
248
Appendix C-3a (cont'd.)
10.
11.
12.
13.
14.
15.
l6.
17.
18.
19.
20.
Children have every right to question
their parents' views.
A child should grow up convinced his
parents always know what is the right
thing to do.
One of the worst things about taking
care of a home is that a woman feels
that she can't get out.
Most parents can spend all day with
the children and remail calm and even
tempered.
Children should be encouraged to tell
parents about it whenever they feel
family rules are unreasonable.
Parents Should adjust to the children
sometimes rather than always expecting
the children to adjust to the parents.
Most children soon learn that their
parents were mistaken in many of their
ideas.
A young mother feels "held down"
because there are lots of things she
wants to do while She is young.
There is no excusing someone who up-
sets the confidence a child has in his
parents' ways of doing things.
The things children ask of a parent
after a hard day's work are enough to
make anyone lose his temper at times.
Often you have to fool children to get
them to do what they Should without a
big fuss.
If a parent is wrong he should admit
it to his child.
Most young mothers are bothered more
by the feeling of being shut up in the
home than by anything else.
Agree
A a
A a
A a
Disagree
d
D
249
Appendix C-3a (cont'd.)
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
A child soon learns that there is no
wisdom than that of his parents.
A parent should keep control of his
temper even when children are
demanding.
A child's ideas should be seriously
considered in making family decisions.
In a well-run home, children should
have things their own way as often as
the parents do.
One of the bad things about raising
children is that you aren't free
enough of the time to do just as you
like.
Loyalty on the part of children to
their parents is something that the
parents Should earn.
A parent should never be made to look
wrong in a child's eyes.
It's natural for a parent to "blow
his top" when children are selfish
and demanding.
It's best to trick a child into doing
something he doesn't want to do instead
of having to argue with him.
Husbands Should know how "hemmed in" a
woman feels staying in the home a great
deal.
A good parent can tolerate criticism of
himself even when the children are
around.
Loyalty to parents comes before anything
else.
Raising children is an easy job.
When a child is in trouble he ought to
.know he won't be punished for talking
about it with is parents.
Agree
A a
A a
Disagree
d D
250
Appendix C-3a (cont'd.)
35.
36.
37.
38.
39.
40.
41.
42.
43.
44.
45.
46.
47.
48.
49.
It isn't fair that men have a chance
for interesting work and women mostly
have to do the hard job of keeping the
home.
AS much as it is reasonable, a parent
Should try to treat a child as an
equal.
A parent Should not expect to be more
highly esteemed than other worthy
adults in their children's eyes.
It's best for the child if he never
gets started wondering whether his
parents' view are right.
It's a rare parent who can be even
tempered with his children all day.
Raising children is very much harder
than most jobs men do.
You have to fool children into doing
many things because they wouldn't
understand anyway.
When a child thinks his parent is wrong
he should say so.
More parents should teach their children
to have unquestioning loyalty to them.
Most parents never get to the point
where they can't stand their children.
A child has a right to his own point
of view and ought to be allowed to
express it.
Children are too often asked to do all
the compromising and adjustment and that
is not fair.
Loyalty to parents is an overemphasized
virtue.
The child Should not question the
thinking of his parents.
Raising children is a nerve-racking job.
Agree
A a
Disagree
d D
251
Appendix C-3a (cont'd.)
50.
51.
52.
53.
When a child is doing something he
shouldn't do, one of the best ways
of handling it is to just get him
interested in something else.
A child Should be encouraged to look
for answers to his questions from
other people even if the answers con-
tradict his parents'.
A child should always love his parents
above everything else.
There is no reason why a day with the
children Should be upsetting.
Agree
A a
Disagree
d D
252
APPENDIX C-3b
Homemaker Values
Below is a list of value descriptions. Most peOple
hold several or all of these values in varying degrees.
Please read all nine value descriptions. Now select the
value that describes you BEST; put a "l" in the blank pre-
ceding this description. Put a "2" in front of the one
that describes you NEXT BEST. From the remaining seven
descriptions, select the one that is LEAST LIKELY to des-
cribe you. Put a (/) in the blank preceding it.
1. I WANT TO GET THE MOST FOR MY MONEY. I shop around
for bargains. I try not to waste things, money, or
time. I consider myself economical.
2. I WANT THE THINGS MY FAMILY DOES TO BE SOCIALLY
ACCEPTABLE AND INFLUENTIAL. I would always want
my family to do things that other people like and
would want to copy. I want other people to reSpect
my house and family. I want to be admired by other
peOple.
3. I LIKE TO DO THINGS THAT KEEP MY FAMILY HEALTHY AND
GOOD-NATURED. I want to prevent illness in my
family and avoid accidents. I see that the family
gets nutritious meals and arrange the house and
activities so they get enough rest.
4. I LIKE TO DO THINGS WITH MY FAMILY BECAUSE I THINK
IT'S IMPORTANT FOR FAMILY MEMBERS TO BE TOGETHER BOTH
IN WORK AND PLAY. I want to help my family be con-
tent. I arrange the home atmOSphere so that family
members can be with each other in work and play.
5. I LIKE THE THINGS THAT I DO TO AGREE WITH THE
TEACHINGS AND BELIEFS OF MY RELIGION. I arrange
it so that my family can practice our religion--
attend religious services, hear prayers, and the
like. I teach my family to be honest and kind to
other people.
6. I ENJOY MY FRIENDS AND LIKE TO DO THINGS FOR THEM.
I like to be around people. I like to get together
with my friend. I think it is important to have
close friends.
7. I WANT LOTS OF FREEDOM TO DO THE THINGS I WANT TO
DO. I would prefer to come and go as I please. I
would like to do things as I want, without restric-
tions of daily duties. I take the time to do things
that interest me.
253
Appendix C-3b (cont'd.)
8.
I LIKE TO DO THINGS THAT INCREASE MY EDUCATION AND
FITNESS FOR PRESENT AND FUTURE TIMES. I want to
know what is going on around me. I want my family
to be interested in learning. I arrange house and
activities for new experiences for my family. Reading
material is available for all the family.
I WANT TO HAVE THINGS ATTRACTIVE AND ORDERLY. I
would like my surroundings to be harmonious. I
enjoy working with pretty things. I arrange it so
that my family can express themselves artistically.
254
APPENDIX C-3C
Parent Opinions Scale
We'd like your Opinion on a few different things. Tell
me if you strongly agree, agree, disagree, or strongly
disagree with each statement by circling the number.
Strongly Unde- Dis- Strongly
Agree Agree cided Agree Disagree
1. In spite of what some
pe0ple say, the lot
of the average man is
getting worse. 1 2 3 4 5
2. It's hardly fair to
bring children into
the world with the way
things look for the
future. 1 2 3 4 5
3. Nowadays a person has
to live pretty much
for today and let
tommorow take care of
itself. 1 2 3 4 5
4. These days a person
doesn't really know
who he can count
on. 1 2 3 4 5
5. There's little use
writing to public
officials because
often they aren't
really interested in
the problems of the
average man. 1 2 3 4 5
255
APPENDIX C-3d
Powerlessness
Read each of the statements below and then rate them as
follows:
A a d D
strongly mildly mildly strongly
agree agree disagree disagree
Indicate your opinion by drawing a circle around the
"A" if you strongly agree, around the "a" if you mildly
agree, around the "d" if you mildly disagree, and around
the "D" if you strongly disagree.
Below are a number of statements about various t0pics.
They have been collected from many groups of peOple and state
some of their opinions. There are no right or wrong answers;
for every statement there are large numbers of people who
agree and disagree. Please Show whether you agree or
disagree as follows:
Agree Disagree
1. I think we will always have wars between A a d D
countries no matter what we do to try to
stop it.
2. If you are a success you will usually have
more good breaks than bad breaks. A a d D
3. Many times I feel that it does not do
any real good to think about what to A a d D
do. You might just as well flip a
coin.
4. A man who gets a good job is just lucky A a d D
to be at the right place at the right
time.
5. I don't understand why other people act A a d D
the way toward me that they do.
6. Much of what happens to me is probably A a d D
a matter of chance and luck.
7. I feel I have little influence over A a d D
the way other people act.
8. It is very hard to figure out what the A a d D
future will be.
256
Appendix C-3d (cont'd.)
10.
ll.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
The ordinary person has very little
control over what the politician does
in office.
The things that happen to most peOple
are outside their own control.
It isn't wise to plan too far ahead
because most things turn out to be a
matter of good or bad fortune anyhow.
I don't see how you can really tell
how other people are going to act.
When things are going well for me I
usually think of it as a run of good
luck.
Most people don't realize how much
their lives are influenced by things
that happen just accidently.
I have usually found that what is
going to happen will happen no matter
what I do or think about it.
Most of the things that have dis-
appointed me in my life have come
because my luck ran out.
I don't really believe the saying
that a person can be "The master of
his fate."
Success is mostly a matter of
getting good breaks.
What happens in the world seems to
be beyond the control of most peOple.
I feel that most peOple can't really
be held reSponsible for themselves
since no one has much choice about
where he was born or raised.
Many times the way people act has
absolutely no reason behind it.
'Success in working with people de-
pends much more on the way they feel
than on what I do.
ree
A a
Disagree
d D
257
Appendix C-3d (cont'd.)
23. Many times I feel that I have little
influence over the things that happen
to me.
24. Sometimes I feel that I don't have
enough control over the way my life is
going.
25. To get ahead you have to gamble on
things that you are not sure of.
PLEASE SEE THAT YOU HAVE GIVEN YOUR OPINION
Agree Disagree
A a d D
A a d D
A a d D
FOR EACH QUESTION
258
APPENDIX C-3e
Nutrition Knowledge and Attitudes Test
Some statements concerning nutrition are given below.
Please indicate whether or not you think a statement is true
or false. Circle "T" for true and "F" for false. After you
have reached this decision indicate how certain you are about
the answer. If you are very confident of your decision,
circle "1"; if you are very doubtful, circle "5". Circle
other numbers to indicate degrees of certainty between these
extremes.
Please be sure to respond twice True How sure are you?
to every statement: or Very Pretty Very
False Confi- Sure Doubt-
dent ful
l. Protein-rich foods, such as T 1 2 3 4 5
meat, milk and eggs, provide F
liberal amounts of several
nutrients needed for the
growth of small children.
2. It is better not to include T l 2 3 4 5
orange juice and milk in the F
same meal because the orange
juice causes the milk to
curdle in the stomach.
3. By the end of the first year T l 2 3 4 5
babies Should have learned F
to use a variety of foods
besides milk because a one-
Sided milk diet may be
inadequate for total growth
and development.
4. School age children need T l 2 3 4 5
multiple vitamin pills every F
day to ensure good health.
5. Chemicals now used to bleach T l 2 3 4 5
flour are harmful to human F
beings.
6. When children have enough food T l 2 3 4 5
to satisfy their appetites F
their diets are certain to be
nutritionally adequate.
7. A good nutritional practice is T l 2 3 4 5
to eat a wide variety of types F
of foods from day to day.
259
Appendix C-3e (cont'd.)
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
Citrus fruits include straw-
berries, raspberries, and
blueberries.
Skim milk contains about the
same amounts of the body-
building minerals and protein
as whole milk.
No reducing diet Should con-
tain bread or potatoes.
Most fat children and adults
have a glandular disturbance.
Milk is a food needed mainly
for infants and growing
children.
Apples are an excellent
source of Vitamin C.
Foods enriched with Vitamin D
help to ensure the normal
develOpment of bones and the
prevention of rickets.
Gelatin, or "Jello" desserts
are a good source of
protein.
All people should use a low-
fat, low-cholesterol diet to
prevent heart disease and
strokes.
Cheese is constipating.
A glass of lemonade can be
substituted for a glass of
orange juice so far as the
Vitamin C in the two products
is concerned.
Grape juice is an important
source of nutrients which
guard against anemia.
True How sure are you?
or Very Pretty Very
False Confi- Sure Doubt-
dent ful
T l 3 4 5
F
T l 3 4 5
F
T l 3 4 5
F
T l 3 4 5
F
T 1 3 4 5
F
T l 3 4 5
F
T l 3 4 5
F
T l 3 4 5
F
T l 3 4 5
F
T 1 3 4 5
F
T 1 3 4 5
F
T l 3 4 S
F
260
Appendix C-3e (cont'd.)
20.
21.
22.
23.
The green leafy and yellow
vegetables are stressed in
daily food plans because they
help to ensure meeting the
Vitamin A needs of the
individual.
Healthy, active, young child-
ren require some concentrated
sweets each day for energy
needs.
Pasteurization destroys much
of the food value of milk.
The "Basic Four" includes
(1) Dairy Foods (2) Meat &
Eggs (3) Breads & Cereals
(4) Fruits & vegetables.
True
or
False
“18
'11P] â€16
How sure are you?
Very Pretty Very
Confi- Sure Doubt-
dent ful
l 2 3 4 5
l 2 3 4 5
1 2 3 4 5
l 2 3 4 5
ATTITUDE TOWARD NUTRITION AND EATING HABITS OF CHILDREN
1.
If the statement describes how you feel about your child's
nutrition or eating habits, circle the "A" if you strongly
agree, the "a" if you mildly agree, the "d" if you mildly
disagree and the "D" if you strongly disagree.
I let the child choose whatever he wants
for breakfast.
Children's foods have so many vitamins
added that I don't have to bother about
nutrition.
I feel the foods my child eats now will
affect his future health.
AS long as the child doesn't pick the
same thing constantly, I feel it is all
right to let him select his own food.
As long as my child is not sick, I guess
I must be feeding him right.
Agree Disagree
A a
A a
A a
d D
261
Appendix C-3e (cont'd.)
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
Nutrition is important, and one should
not be careless about it.
Even if I give vitamins, I feel that I
should be concerned about my child's
diet.
Children are more likely to eat well if
they select the meat for the meal.
If my child says, "Let's have for
lunch," I feel that I should do so.
I feel that if the child drinks milk,
I don't have to worry about nutrition.
Because the children are fussy about
what they eat, I feel it is necessary
to let them pick what they want for
meals.
AS long as the doctor doesn't say any-
thing to me about nutrition, I don't
think I need to worry about it.
I feel that as long as my child is
gaining weight, I don't have to worry
about his nutrition.
I just don't have time to think much
about nutrition.
Nutrition is not so important as long
as my child eats a lot.
I believe a child should be allowed to
choose what he wants for breakfast and
lunch, even if it means a little more
preparation for me.
I am concerned about getting my child
to eat nutritious foods throughout the
day.
Children should be allowed to eat what-
ever they want.
Nutrition is not so important if my
‘child has plenty of liquids.
Agree
A a
A a
d
Disagree
D
262
.Appendix C-3e (cont'd.)
Agree Disagree
20. Young children don't grow correctly A a d D
when they have improper diets.
21. I believe that a child should not be A a d D
permitted to have a diet which is
deficient in protein, minerals and
vitamins.
263
APPENDIX C-3f
Semantic Differential Instrument
Now, we would like you to think about yourself and how
you might describe yourself as a mother. On the next page
are some pairs of words used by many people in describing
themselves. Each pair of words is separated by a broken
line. Somewhere on the broken line please place an "X".
Put the "X" where you now feel or see yourself to be.
If you feel that one or the other end of the line is
extremely like what you are like as a mother, place your
X as follows:
warm X : : : : : : cold
or
warm : : : : : X cold
If one end is quite closel like what you are like as
a mother, place your X as follows:
warm : X : : : : : cold
or
warm : : : : : X : cold
If one end is only sli htl like what you are like as
a mother, place your X as follows:
warm : : X : : : : cold
or
warm : : : : X : : cold
If you do not feel either one way or the other, place
your X as follows:
warm : : : X : : : cold
Remember, you are describing yourself 32 yourself. Do
as well as you can in describing yourself.
Please be sure to mark each line with an X.
264
Appendix C-3f (cont'd.)
MYSELF AS MOTHER
happy : : : : : sad
strange : : : : : : familiar
unusual : : : : : usual
cruel : : : : : kind
sharp : : : : : dull
high : . . : : low
comfortable : : : : : . uncomfortable
good : : . : : : bad
enjoyable : : : : : : distasteful
negative : : : : positive
valuable : : : : - worthless
worst : : : : : best
dislike : : . . . like
relaxed : : : : tense
hesitant : : . : . eager
easy : . : : : : hard
unfair : : : : : fair
active : : : : : . passive
fast : : : : : : slow
insecure : : - : : : secure
weak : : . : : strong
interesting : : : : : boring
heavy : : : . : : light
warm : : . : : : cool
mean : : : : : nice
neat : : : : : : sloppy
Appendix C-3f (cont'd.)
soft
impulsive
clean
plain
loud
woman-like
265
hard
stable
dirty
fancy
quiet
man-like
APPENDIX D
Guidelines for Data Coding
l. Coding Form for Food Records
2. Coding Guide for All Variables
3. Identification Codes for Derived Scales
266
APPENDIX D-l
Coding Form for Food Records
INPUT:
Card 1
COLUMN
1 Card number
2 Preschool identification code
3-5 Child identification number
6 Sex of child 1 = male, 2 = female
7 Vitamin supplement 1 = no, 2 = yes
8 Mother's assessment of child's intake for the day
l = less than usual, 2 = usual; 3 = more than usual
9-10 Total number of food items consumed
ll-l6 Food Identification Number
17-19 Units food consumed (e.g. 100= l serv; 050 = 1/2 serv.)
20-21 Time consumed - (code)
22 Meal (1) or snack (2)
23 With whom eaten: l = alone
2 = all of family
3 = some of family
4 = friends, other
24 Where eaten l = home; 2 = elsewhere
25-38
39-52
53-66
67-80 Repeat columns 11-24 for each food item consumed
267
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NNHHN mHHmHHhH
HOHHmHHmHHHHHOHHOHOHmH«HN*
mmHONHwHHmHHHmHHH
mEmuH
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0p mmumm hHmcouumO vIH
coflumoflmflma AH
HuHHHQHuHHHH AH
mmoamSHmcH
memuso mchsHoxm AN
mHou mcmeE
ImEos map mo coHuomflmm AH
"mmamom
=ucmaduumcH noummmmm
mosuHuu4 usmumm: Eoum meuH
szHao map How coflpfluusa
@000 Mo mocmuuomafl= Am
Avmmum>mu OGHOHOB Emuflv
=mmmam>HmmHEme= Am
=cmuoaï¬so Hcflommm
psonm mmmcm>HmmHEHmm= AH
"mmHmom
mmmcommmu mmHmw pomuuoo
mmmcommmn msuu uomuuoo
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mcflcmmm
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mmIm MH
NhINm NH
mMDA¢> m0 mwz<m
midz mqdem¢>
.oz om¢o .oz
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A©.u:ouv mun chammm¢
293
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wadm HMHHoEmz xcmnHHz uwmx
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mmvaHmmHNNHHHw
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memmHHNHMHHmt
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muoa Ho oomwm
mEOocH NHHEmm
mnmxnoz .>Hmm a @Honmmsom
amï¬muom cam cmEmummuu
mmHMm Uzm HMUHHmHU
Haï¬ummmcme a Hmaonmmmoum
coHummdooo
Hoonom HmEEmum meow
m#msvmnm Hoonom HmEEmuw
Hoosom ans meow
mamsommm Hoonom nmflm
mmmHHoo meow
coHumoswm
mHmom msumum GHEocoomoHoom
mHmom mHEocd
Acmmum>muv HuflaflnmufluuH HHH
Avmmum>muv mmocmsHmcH
mvflmuso mcflvsHoxm Am
Avmmum>muv GOHHMUHmeQ Am
EqumHHmuHHmsvm an
coHumNHHMQHm> mchmusoocm Aw
coflummomo Am
Below MH
mmImm MH
mMDH<> ho mwz<m
m2¢z mqmflHmd>
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A©.ucoov NIQ xflccmmmm
294
AmHmmv
m>onm mm mIH mooo OHIm mo mm HmOMIuanmz O OH
m>onm mm mIH mcou “mammv
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nuom .m
nunm .m numm .w
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nuom .5 sum .m AmHmmv
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"mmHHucmoumm mHmm
moflumnummm .H OHIHH
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ucmuuomEH umoe ocoomm u H+ . . I
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HmHmm
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ucmEduum
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mmDA¢> mo mwz<m m2¢z mqdem<> .oz omdu .oz
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295
m>onm mm OIH mvou
m>onm mm mIH mvoo
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m>onm mm HIH mooo
m>onm mm hIH 0000
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m>onm mm OIH mvoo
m>onm mm mIH mvoo
m>onm mm mIH mcoo
OHIO
«0 mm mmMIuanm3Iganmm
OHIm
mo mm HmOMIuanm3Iuanmm
OOIHH
mo mm Hmmquzme3Iuanmm
HHIH mo mm .mHquOHHmm
OHIO mo mm HmOMIuanwm
mOIHH MO mm HmmMIuanmm
OHIH mo mm .mHqunHHmz
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OOIHH mo mm HmOMImeHmB
AmHmmO
OHIO mo mm HmOMIuanmm
AmHmmv
OHIO mo mm HmmMIuanmm
AmHmmO
HOIHH mo mm HmOMIuanmm
ON OH
OH OH
OH OH
OH OH
OH OH
OH OH
vH OH
MH OH
NH OH
HH OH
OH OH
O OH
m MDH¢> .mO MUS
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296
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GHHHcmoumm nuom mmmmouo
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OHIO
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OHIO
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OHIO
m>onm mm OIH mnou mo mm HmHmom uanmnluanmz MN OH
m>onm mm OIH mcoo OHIm
ucmmumm mo mm HmHmom uanwnIuanmz NN OH
mmmno .O
uanm3Hm>o .m
onoum .v
Hmauoz .H
umocmHO .H HOIHH
HOHHmsumOcO .H O0 OH .mHmom OOHHmnIunHHmz HO OH
HOHH .ucmmumm
OmOH¢> Oo moz<m mzdz mammHm<> .oz ammo .oz
.Hoo .m«>
HO.ucoov NIQ chcmmm<
297
APPENDIX D-3
Identification Codes for Derived Scales
CARD VAR.
NO. NO. VARIABLE NAME
1 l Calories
2 Protein
3 Fat
4 Carbohydrate
5 Calcium
6 Iron
7 Vitamin A
8 Thiamin
9 Riboflavin
lO Niacin
ll Ascorbic acid
2 21 Parents are all-wise male (PARI)
22 Treating child as an equal scale (PARI)
23 Only listen to parent scale (PARI)
24 Unquestioned loyalty scale (PARI)
25 Deception scale (PARI)
26 Trapped in a dull job scale (PARI)
27 Anomie scale
28 Would like to get out! scale (PARI)
29 Children are very demanding scale (PARI)
30 Occasional dissatisfaction scale (PARI)
31 Frequent dissatisfaction scale (PARI)
32 Socio-economic status index
3 41 Sex of child
42 Age of child (in months)
43 Hemoglobin
44 Hematocrit
45 Serum albumin
46 Serum proteins
47 Change in weight of child
48 Change in height of child
4 51 Weight-age, Fels
52 Height-age, Fels
53 Weight-age, Stuart-Meredith
54 Height-age, Stuart-Meredith
55 Height-weight-age
56 Weight-height scale (Sargent)
57 Weight-height2 ratio
58 Weight-age, in May
59 Height-age, in May
60 Developmental index for weight
61 Developmental index for height
62 Weight-age/height-age, developmental index
298
Appendix D-3 (cont'd.)
CARD VAR.
NO. NO. VARIABLE NAME
5 71 Sitting height
72 Shoulder width
73 Pelvic width
74 Head circumference
75 Chest circumference
76 Index of trunk breadth
77 Upper arm circumference
78 Skinfold thickness for triceps
79 Sucscapular skinfold thickness
80 Hydroxyproline: creatinine ratio
81 Hydroxyproline index
6 91 Permissiveness attitude about child's eating
habits scale
92 Nutrition is very important for the child scale
93 powerlessness scale
94 Semantic differential (l)
95 Semantic differential (2)
96 Values: Economy
97 Prestige
98 Health
99 Family centrism
100 Religion
101 Friendship
102 Freedom
103 Education
7 104 Aesthetics
8 111 Child premature or full term?
112 Mother received prenatal care?
113 Mother's age when pregnant with child
114 Mother's present height
115 Mother's present weight
116 Father‘s present height
117 Father's present weight
118 Child bottle or breast fed?
119 Age at weaning
120 Infantile behavior scale
121 Child has ever been anemic?
122 Feeding problems scale
123 Child receives vitamin supplement?
124 Child received other supplement or health food?
125 Amount sleep per day
126 Last medical exam
127 Reason for last seeing physician
128 Dental record
129 Amount of time that family eats together
130 Children eat at the same time as parents?
131 Mother's Opinion about eating everything on
child's plate
299
Appendix D-3 (cont'd.)
CARD VAR.
NO.
NO.
10
12
13
132
133
134
135
136
137
138
139
140
141
142
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
VARIABLE NAME
Mother's action when child dawdles or plays with
food
Frequency of snacking scale
Time of day when child seems most hungry
Child uses spoon?
Child uses fork?
Child uses knife?
Child's favorite food
Food child refuses to eat
Most important influence on the mother's meal
planning
Family acceptance of new foods
Meal pattern of child--regular or irregular?
Total number of persons in home
Number of children five years or younger in home
Ordinal position of child
Mother's marital status
Parents' occupation and education scale
Income status scale
Family income
Mother away from child scale
Stage in family life cycle
Race: white vs. black
Number of times moved in last three years
Own or rent dwelling?
Crowding index: rooms in house/persons in family
Condition of house and neighborhood scale
Child's birth weight
Mother's Opinion that child eats too many sweets
Person who decides foods to buy
Frequency of grocery sh0pping
Amount of money spent for food per week
Frequency of use: convenience foods scale
Family receives food stamps?
Number of Basic Four named
Score on Nutrition Knowledge test
Calories/kg body weight
Gm protein/kg body weight
APPENDIX E
Correlation Matrices
1. Multiple Group Analysis for Develogment
of New PARI Scales
2. Final Inter-Scale Matrix
'ACYOI INYERCO'IFL|YIOIS AND LOADI“G â€47.1!
Is 09 32 no a:
100 .
‘I 100
30 35 100
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-12 -11 .9 0’4 '13
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30 39 11 I2 12
2 a 91 J
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98 92 62 94
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24 ~17 o o .1 .5 10 22 79 74 32 70 ’30 zoo
91 ~5 ~10 ~1 .9 5 t 12 I2 15 16 15 23 36 109
21, 1 I 1 .2 1 1 -0 70 71 21 1n 2 27 23 100 1
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12 ~23 os, ~1, 1g 3 ~11 ~I 19 ~1 JO ~1 ~19 .2, .9 :1 11 11
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a: ~10 ~13 n ~s ~9 3 7 4 ~2 7 11 14 14 7 1 21 I4 13 0
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65 ~9 ~5 7 ~12 ~21 ~12 H ~12 ~10 5 ~0 ~14 ~16 ~0 ~15 5 1 79 29
44 -5 ~7 -4 -4 4 ~3 ~4 ~3 12 ~23 10 ~3 ~0 1 3 0 ~0 ~3 1o
03 ‘1 ~1 L3! 1 ~5 1 12 ~23 ~2 ~4 20 ~1 ~19 ~12 2 ~1 ~9 ~0 ~3
74 9 ~I3 1 ~12 ~o ~13 ~9 ~19 2 ~23 a 7 ~10 ~13 ~7 ~10 ~2 ~13 2o
71 J ~11 7 ~s ~o ~11 v ~4 1 ~4 11 ~0 ~2 ~4 ~9 -3 4 5 14
41 ~10 ~o 11 ~15 4 ~4 I1 11 3 ~4 7 1 I ~3 5 ~3 3 ~14 ~1
501 40 32 4 77 71 0 4 ~11 13 0 o 10 ~10 .5 ~1 ~11 ~2 ~17 ~27
502 I: 14 ~1 14 o 3 ~0 ~30 ~17 ~7 4 ~2 ~19 ~J ~2 ~27 ~10 ~22 ~4
503 ~~ ~10 II .2 -3 21 u 25 0 7 ~2 ~4 15 0 9 ~2 .4 .0 ~13
504 31 6 17 29 11 11 4 ~14 ~O I 21 19 ~15 ~19 ~0 ~10 ~9 ~10 ~12
505 35 4 ~s 7 1 ~5 2 ~19 ~l ~4 10 10 ~19 ~13 ~3 ~10 1 ~10 ~0
304 19 13 n 13 ~1 ~3 I ~4 12 12 17 20 4 14 4 9 10 ~| ~17
907 *0 96 23 ‘9 25 11 7 ~12 14 19 ~3 10 ~15 ~15 ~4 ~16 3 ~10 ~21
500 22 10 75 so 70 71 90 31 44 21 21 24 13 4 8 ~5 8 ~2 ~27
509 ~10 ~s In 32 20 30 21 P1 I1 1| 2! 22 32 17 29 20 10 0 ~23
510 11 12 27 13 7 2s 31 20 19 7O 71 74 ‘0 72 23 27 14 4 ~17
511 ~I ~o s ~2 1 1! 10 2| 22 32 21 SI 75 73 A, 2‘ 22 ~12 ~15
512 ’19 3 ~2 3 c4 ~9 0 2! I 12 11 21 1 29 13 01 79 67 9
513 6 ~9 0 ~12 ~a ~9 14 ~11 3 ~11 22 14 ~9 3 ~2 7 I 2 39
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100
73
100
O 61 69
64
68
70
71
29
521
15
85
32
84
81
14
31
55
51
53
52
62
54
82
13
11
12
33
35
34
75
73
42
44
43
41
105
104
103
101
102
302
APPENDIX E-l
Item Names: PARI Scales
The child should not question the thinking of his parents
Child should look for answers from other peOple even if
controdict parents
Child soon learns that there is no greater wisdom than
parents
When a child thinks his parent is wrong he should say so
Children have every right to question their parents views
Its best for the child if he never gets started wondering
whether his parents views are okay
Child should grow up convinced parents know what is right
thing to do
Child has right to own point of view and ought to be
allowed to express it
Children should be allowed to disagree with parents if
own ideas are better
A childs ideas should be seriously considered in making
family decisions
Children should be encouraged to tell parents if family
rules are unreasonable
Parents should adjust to children sometimes
When child is in trouble, should know he wo't be punished
for talking with parents
If a parent is wrong he should admit it to his child
Parent should never be made to look wrong in childs eyes
Children should never learn things outside home which
make them doubt parents ideas
There is no excusing someone who upsets the confidence a
child has in his parents
Loyalty to parents comes before anything else
Child should always love his parents above everything sele
More parents should teach childrentto have unquestioning
loyalty to them
Loyalty to parents is an overemphasized virtue
Parents should earn loyalty from children
Often you have to fool children to get them to do what
they should
You have to fool children into doing many things because
they wouldn't understand
18% best to trick a child into doing something he doesn't
want to do
There's no excuse wasting time explaining when you can be
a little clever
Little use in writing public officials because don't
care about average man'
These days a person doesn't really know who he can count
on
Today peOple has to live pretty much for today and let
tomorrow take care of itself
The lot of the average man is getting worse
Because of the future it us hazardly fair to bring
children into it
One of bad things about raising children is that you
aren't free enough to do as like
303
Appendix E-l (Cont'd)
3
7
25
22
23
95
94
92
24
91
21
72
83
61
65
64
63
74
71
45
Young mother feels held down because there are lots
of things she wants to do while young
It isn't fair that men have a chance for interesting
work and most women to do jobs of home
Most young mothers are bothered more by feeing of
being shut up in home
Husbands should know how hemmed in a woman feels
staying at home a lot
One of worst things about care of a home is women
feels can't get out
Having to be with child all the time gives women feeling
wings are clipped
Raising children is a nerve racking job
The things children ask a parent after a hard days work
are enough to make any lose temper
Its natural for parent to blow his 0p when children
are selfish and demanding
There is no reason why a day with the children should
be upsetting
Most parents never get to the point where they can't
stand their children
A parent should keep control of his temper even when
child is demanding
Its a rare parent who can be even tempered with his
children all day
Most parents can spend all day with their children and
remain calm and even tempered
Parents very often feels that they can't stand their
children a moment longer
Children soon learn that parents were wrong about many
of their ideas
A good parent can tolerate criticism even when children
are around
Raising children is an easy job
Raising children is very much harder than most jobs
men do
When parent asks child to do something, child should
always be told why
Children are too often asked to do all the compromising
and adjustment
As much as reasonable, parent should try to treat child
as an equal
In well-run homes children should have things their own
way as often are parents '
Parents should not expect to be more esteemed than oother
worth adults by child
Child should be taught that will love and respect many
other people besides parents
When child does something he shouldn't, bet him inter-
ested in something else
304
Appendix E-l (Cont'd)
Multiple Groups Program
Becomes
GRPC (111) 501
GRPC (15,85,32,84,81,l4,31) 502
GRPC (55,51,53,52,62,54,82) 503
GRPC (13,11,12) 504
GRPC (ll,35,34,75,73) 505
GRPC (42,44,43,4l) 506
GRPC (105,104,103,101,102) 507
GRPC (5,3,7,4,6 508
GRPC(1,2) ' 509
GRPC (22,23,25) 5l0
GRPC (24,91,21) 511
GRPC (95,94,92) 512
GRPC (72,83,83,8,6l,65,64,63,74,7l,
45) 513
Standard Score Coefficient Alphas
100 79 71 69 74 69 74 71 47
59 55 59 41
305
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APPENDIX E-Z
Item Names: Inter-Scale Matrix
Calories
Protein
Fat Intake
Carbohydrate
Calcium
Iron
Vitamin A
Thiamin
Riboflavin
Niacin
Vitamin C
Parents are all-wise cale (PARI)
Treating child as an equal scale (PARI)
Only listen to parent scale (PARI)
Unquestioned loyalty scale (PARI)
Deception scale (PARI)
Trapped in a dull job scale (PARI)
Anomie scale
Would like to get out scale (PARI)
Children are very demanding scale (PARI)
Occasional dissatisfaction scale (PARI)
Frequent dissatisfaction scale (PARI)
SES index scale
Sex of child
Age ï¬n months)
Hemoglobin
Hematocrit
Serum albumin
Total serum proteins
Change in weight
Change in height of child
Weight-age, Fels
Height-age, Fels
Weight-age, Stuart-Meredith
Height-age, Stuart-Meredith
Height-weight-age
Weight-height-scale
Weight-height ratio
Weight-age, May
Height-age, May
Developmental index for weight
Deve10pmental index for height
Weight-age/height-age, develOpment index
Sitting height
Shoulder width
Pelvic width
Head circumference
Chest circumference
Index of trunk breadth
326
Appendix E-2 (Cont'd)
77
78
79
80
81
91
92
93
94
95
96
97
98
99
100
101
102
103
104
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
151
Upper arm circumference
Skinfold thickness for triceps
Subscapular skinfold thickness
Hydroxyproline/creatinine ratio
Hydroxyproline index
Permissiveness about feeding-attitudes scale
Nutrition is very important for child scale
Powerlessness scale
Semantic differential (1)
Semantic differential (2)
Economy
Prestige
Health
Family centrism
Religion
Friendship
Freedom
Education
Aesthetics
Premature vs full term
Mother received prenatal care
Mothers age when pregnant with child
Mothers present height
Mothers present weight
Fathers present height
Fathers present weight
Bottle vs breast fed
Age at weaning
Infantile behavior scale
Child ever anemic
Feeding problems scale
Child receives vitamin supplement
Child receives other supplement or health food
Amount sleep per day
Last medical exam
Reason for last seeing doctor
Dental record
Amount of time family eats together
Children eat at same time as parents
Mothers opinion about eating everything on plate
Mothers action when child dawdles or plays with food
Frequency of snacking scale
Time when child seems most hungry
Child uses spoon
Child uses fork
Child uses knife
Childs favorite food
Food child refuses to eat
Most important influence on mothers meal planning
Family acceptance of new foods
Meal pattern of child--regular or irregular
Total persons in home
327
Appendix E-2 (Cont'd)
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
Number of children 5 years or younger in home
Ordinal position of child
Mothers marital status
Parents occupation and education scale
Income status scale
Family income
Mother away from child scale
Stage in family life cycle
Race--white vs black
Times moved in last 3 years
Own or rent
Crowding index (rooms/person in house)
Condition of house and neighborhood scale
Childs birth weight
Mothers Opinion that child eats too many sweets
Who decides foods to buy
Frequency of grocery shopping
Amount spent for food per week
Frequency of use-convenience foods scale
Family receives food stamps
Number of basic four named
Score on nutrition knowledge test
Calories/kg body weight
gm protein/kg body weight