Annals of Behavioral Medicine

, Volume 23, Issue 1, pp 59–67 | Cite as

The role of gender and family support on dietary compliance in an African American adolescent hypertension prevention study

Article

Abstract

Social support experiences vary markedly across gender groups, and little is known about the role of social support in promoting healthy dietary compliance in African American adolescents who are at increased risk for developing hypertension. This study examined the relation between gender, dietary social support, and compliance to a low sodium diet. Casual blood pressures were also examined in relation to dietary compliance and gender. One hundred eighty-four healthy African American adolescents (83 boys, 101 girls) participated in an intensive 5-day low sodium diet (50 mEq/24 hr) as part of a hypertension prevention program. Emotional dietary social support from family members and friends was measured at baseline. Compliance was defined as urinary sodium excretion of≤ 50 mEq/24 hr at postsodium restriction. The results indicated a significant Gender × Compliance effect for positive family support (p > .05). Girls who were compliant reported higher levels of dietary support from family members (19.2 ± 7.8) than boys who were compliant (16.9 ± 7.0). In contrast, boys who were compliant reported lower levels of dietary support from family members (16.9 ± 7.0) than boys who were not compliant (20.2 ± 7.5). Systolic blood pressure showed a trend toward decreasing in compliant participants (104.4 ± 8.4 vs. 101.7 ± 8.0, mm Hg, p > .06), but the effect diminished when Quetelet Index (kg/m2) was controlled for in the analyses (p > .12). These results suggest that higher levels of emotional dietary support from family members are associated with better adherence to short-term sodium restriction for African American girls as compared to boys. Further research is needed to determine the long-term impact of social support on sodium restriction in adolescent populations.

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References

  1. (1).
    Roberts J, Rowlands M:Vital and Health Statistics (Series 11, No. 221), DHEW Publication No. PHS 81-1671. Washington, DC: U.S. Government Printing Office, 1981.Google Scholar
  2. (2).
    Berenson GS, Frank GC, Hunter SM, et al.: Cardiovascular risk factors in children.American Journal of Diseases in Children. 1990,136:855–862.Google Scholar
  3. (3).
    Bao W, Threefoot SA, Srinivasan SR, Berenson GS: Essential hypertension predicted by tracking elevated blood pressure from childhood to adulthood: The Bogalusa heart study.American Journal of Hypertension. 1995,8:657–665.PubMedCrossRefGoogle Scholar
  4. (4).
    Michels VV, Bergstralh EJ, Hoverman VR, O‘Fallen WM, Weidman WH: Tracking and prediction of blood pressure in children.Mayo Clinic Proceedings. 1987,62:875–881.PubMedGoogle Scholar
  5. (5).
    Labarthe DR: The rationale for treatment of “mild” hypertension. In Kaplan RM, Criqui MH (eds),Behavioral Epidemiology and Disease Prevention. New York: Plenum, 1985,135–159.Google Scholar
  6. (6).
    Newman WP, Freedman DJ, Voors AW, et al.: Relation of serum lipoprotein levels and systolic blood pressure to early atherosclerosis: The Bogalusa heart study.New England Journal of Medicine. 1986,314:138–144.PubMedCrossRefGoogle Scholar
  7. (7).
    Law MR, Frost CD, Wald NJ: By how much does dietary salt reduction lower blood presssure? III. Analysis of data from trials of salt reduction.British Medical Journal. 1991,302:819–824.PubMedGoogle Scholar
  8. (8).
    Cutler JA, Follmann D, Elliott P, Suh I: An overview of randomized trials of sodium reduction and blood pressure.Hypertension. 1991,17(Suppl. I):I–I–2733.Google Scholar
  9. (9).
    Swales JD: Dietary sodium restriction in hypertension. In Laragh JH, Brenner BM (eds),Hypertension: Pathophysiology, Diagnosis and Management. New York: Raven, 1995, 283–298.Google Scholar
  10. (10).
    Midgley JP, Matthew AG, Greenwood DMT, Logan AG: Effect of reduced dietary sodium on blood pressure: A meta-analysis of randomized controlled trials.Journal of the American Medical Association. 1996,275:1590–1597.PubMedCrossRefGoogle Scholar
  11. (11).
    Graudal NA, Galloe AM, Garred P: Effects of sodium restriction on blood pressure, renin, aldosterone, catecholamines, cholesterols, and triglyceride.Journal of the American Medical Association. 1998,279:1383–1391.PubMedCrossRefGoogle Scholar
  12. (12).
    Cutler JA, Follmann D, Allender PS: Randomized trials of sodium reduction: An overview.American Journal of Clinical Nutrition. 1997,65(Suppl.):643s-651s.PubMedGoogle Scholar
  13. (13).
    Dimsdale JE, Ziegler M, Mills P, Berry C: Prediction of salt sensitivity.American Journal of Hypertension. 1991,3:429–435.Google Scholar
  14. (14).
    Luft FC, Miller JZ, Grim CE, et al.: Salt sensitivity and resistance of blood pressure: Age and race as factors in physiological responses.Hypertension. 1991,17(Suppl. I):I–102–I–108.Google Scholar
  15. (15).
    Cooper R, Liu K, Trevisan M, Miller W, Stamler J: Urinary sodium excretion and blood pressure in children: Absence of a reproducible association.Hypertension. 1983,5:135–139.PubMedGoogle Scholar
  16. (16).
    Howe P, Cobiac L, Smith R: Lack of effect of short-term changes in sodium intake on blood pressure in adolescent school children.Journal of Hypertension. 1991,9:181–186.PubMedCrossRefGoogle Scholar
  17. (17).
    Miller J, Weinberger M, Daugherty S, et al.: Blood pressure response to a dietary sodium restriction in healthy normotensive children.American Journal of Clinical Nutrition. 1988,47:113–119.PubMedGoogle Scholar
  18. (18).
    Berenson GS, Voors AW, Webber LS, Dalferes Jr ER, Harsha DW: Racial differences of parameters associated with blood pressure levels in children—the Bogalusa heart study.Metabolism. 1979,28:1218–1228.PubMedCrossRefGoogle Scholar
  19. (19).
    Voors AW, Berenson GS, Shuler SE, et al.: Blood pressure, electrolyte clearance, and plasma renin activity in children sampled from an entire community.Journal of Applied Biochemistry. 1980,2:87–99.Google Scholar
  20. (20).
    Langford HG, Watson RL: Electrolytes and hypertension. In Paul O (ed),Epidemiology and Control of Hypertension. New York: Stratton Intercontinental Medical Book Corporation, 1975, 119–130.Google Scholar
  21. (21).
    Blumenthal JA, Burg MM, Barefoot J, et al.: Social support, Type A behavior, and coronary artery disease.Psychosomatic Medicine. 1987,49:331–339.PubMedGoogle Scholar
  22. (22).
    Seeman TE, Syme SL: Social networks and coronary artery disease: A comparison of the structure and function of social relations as predictors of disease.Psychosomatic Medicine. 1987,49:340–353.Google Scholar
  23. (23).
    Haynes S, Feinleib M: Women, work and coronary heart disease: Prospective findings from the Framington heart study.American Journal of Public Health. 1980,70:133–141.PubMedGoogle Scholar
  24. (24).
    Reed D, McGee D, Yano K, Feinlab M: Social networks and coronary heart disease among Japanese men in Hawaii.American Journal of Epidemiology. 1983,117:384–396.PubMedGoogle Scholar
  25. (25).
    Cohen S, Wills TA: Stress, social support, and the buffering hypothesis.Psychological Bulletin. 1985,98:310–357.PubMedCrossRefGoogle Scholar
  26. (26).
    Cohen S: Psychosocial models of the role of social support in the etiology of physical disease.Health Psychology. 1988,7:269–297.PubMedCrossRefGoogle Scholar
  27. (27).
    Manuck SB, Kaplan JR, Matthews KA: Behavioral antecedents of coronary heart disease and atherosclerosis.Arterio Sclerosis. 1986,6:2–14.Google Scholar
  28. (28).
    Manuck SB, Harvey A, Lecheiter S, Neil K: Effects of coping on blood pressure responses to threat of aversive stimulation.Psychophysiology. 1978,15:544–549.PubMedCrossRefGoogle Scholar
  29. (29).
    Glass DC:Behavior Patterns, Stress, and Coronary Disease. Hillsdale, NJ: Lawrence Erlbaum Associates, Inc., 1977.Google Scholar
  30. (30).
    Wilson DK, Moody K, Harshfield G, Alpert BS: Dietary social support augments sodium reduction in Black children. 99th Annual Convention of the American Psychological Association. San Francisco, CA: 1991.Google Scholar
  31. (31).
    Wilson DK, Nicholson S, Krishnamoorthy J: The role of diet in minority adolescent health promotion. In Wilson DK, Rodrigue JR, Taylor WC (eds),Health-Promoting and Health-Compromising Behaviors Among Minority Adolescents. Washington, DC: American Psychological Association, 1997, 129–151.CrossRefGoogle Scholar
  32. (32).
    Nader PR, Baranowski T, Vanderpool NA, et al.: The family health project: Cardiovascular risk reduction education for children and parents.Developmental and Behavioral Pediatrics. 1983,4:3–10.CrossRefGoogle Scholar
  33. (33).
    Elliot TR, Gramling SE: Personal assertiveness and the effects of social support among college students.Journal of Counseling Psychology. 1990,37:427–436.CrossRefGoogle Scholar
  34. (34).
    Barrera M: Distinctions between social support concepts, measures and models.American Journal of Community Psychology. 1986,14:413–445.CrossRefGoogle Scholar
  35. (35).
    Wilson DK, Kliewer W, Bayer L: Cardiovascular reactivity in Black adolescents: Influences of gender and emotional social support.Journal of Gender, Culture, and Health. 1996,1:37–50.Google Scholar
  36. (36).
    Wilson DK, Kliewer W, Bayer L, et al.: The influence of gender and emotional versus instrumental support on cardiovascular reactivity in African-American adolescents.Annals of Behavioral Medicine. 1999,21:235–243.PubMedGoogle Scholar
  37. (37).
    Nelson-LeGall SA: Necessary and unnecessary help seeking in children.Journal of Genetic Psychology. 1987,148:53–62.CrossRefGoogle Scholar
  38. (38).
    Bryant B: The neighborhood walk: Sources of support in middle childhood.Monographs for the Society for Research in Child Development. 1985,50(Serial No. 210): 122.Google Scholar
  39. (39).
    Belle B: Gender differences in social moderators of stress. In Barnett RC, Biener L, Baruch GK (eds),Gender and Stress. New York: Free Press, 1987, 257–277.Google Scholar
  40. (40).
    Belle B: Gender differences in children‘s social networks and supports. In Belle D (ed),Children‘s Social Networks and Social Supports. New York: Wiley, 1989, 173–188.Google Scholar
  41. (41).
    Copeland EP, Hess RS: Differences in young adolescents‘ coping strategies based on gender and ethnicity.Journal of Early Adolescence. 1995,15:203–219.CrossRefGoogle Scholar
  42. (42).
    Bird GW, Harris RL: A comparison of role strain and coping strategies by gender and family structure among early adolescents.Journal of Early Adolescence. 1990,10:1411–1458.Google Scholar
  43. (43).
    Rook KS, Pietromonaco P: Close relationships: Ties that heal or ties that bind? In Jones WH, Perlman D (eds),Advances in Personal Relationships (Vol. 1). Greenwich, CT: JAI, 1987, 1–35.Google Scholar
  44. (44).
    Voors, AW, Webber, LS, Berenson GS: Blood pressure of children, ages 2–5 years, in a total community—the Bogalusa heart study.American Journal of Epidemiology. 1978,107:403–411.PubMedGoogle Scholar
  45. (45).
    (45)Update on the 1987 Task Force Report on High Blood Pressure in Children and Adolescents: A Working Group Report From the National High Blood Pressure Education Program.Pediatrics. 1996,98:649–658.Google Scholar
  46. (46).
    Sallis JF, Grossman RM, Pinski RB, Patterson TL, Nader PR: The development of scales to measure social support for diet and exercise behaviors.Preventive Medicine. 1987,16:825–836.PubMedCrossRefGoogle Scholar
  47. (47).
    Wilson DK, Bayer L, Sica DA: Variability in salt-sensitivity classification in Black male versus female adolescents.Hypertension. 1996,28:250–255.PubMedGoogle Scholar
  48. (48).
    Wilson DK, Bayer L, Krishnamoorthy JS, et al.: The prevalence of salt-sensitivity in an African-American adolescent population.Ethnicity & Disease. 1999,9:350–358.Google Scholar
  49. (49).
    Wilson DK, Sica DA, Miller SB: Effects of potassium on blood pressure in salt-sensitive and salt-resistant adolescents.Hypertension. 1999,34:181–186.PubMedGoogle Scholar
  50. (50).
    Voors AW, Webber LS, Frerichs RR, Berenson GS: Body height and body mass as determinants of basal blood pressure in children—the Bogalusa heart study.American Journal of Epidemiology. 1977,106:101–108.PubMedGoogle Scholar
  51. (51).
    Mitchell CL: Relationship of femininity, masculinity, and gender to attribution of responsibility.Sex Roles. 1987,16:151–163.CrossRefGoogle Scholar
  52. (52).
    Burg MM, Seeman TE: Families and health: The negative side of social ties.Annals of Behavioral Medicine. 1994,16:109–115.Google Scholar
  53. (53).
    Block JH: Differential premises arising from differential socialization of the sexes: Some conjectures.Child Development. 1983,54:1335–1354.PubMedCrossRefGoogle Scholar
  54. (54).
    Brehm JW:A Theory of Psychological Reactance. New York: Academic, 1966.Google Scholar
  55. (55).
    Staub E: The use of role playing and induction in children‘s learning of helping and sharing behavior.Child Development. 1971,42:805–817.CrossRefGoogle Scholar
  56. (56).
    Shell RM, Eisenburg N: Children‘s reactions to the receipt of direct and indirect help.Child Development. 1996,67:1391–1405.PubMedCrossRefGoogle Scholar
  57. (57).
    Rudolph KD, Hammen C: Age and gender as determinants of stress exposure, generation, and reactions in youngsters: A transactional perspective.Child Development. 1999,70:660–677.PubMedCrossRefGoogle Scholar
  58. (58).
    La Greca AM, Auslander WF, Greco P, et al.: I get by with a little help from my family & friends: Adolescents‘ support for diabetes care.Journal of Pediatric Psychology. 1995,20:449–476.PubMedCrossRefGoogle Scholar
  59. (59).
    Skinner TC, White J, Johnston C, Hixenbaugh P: Interaction between social support and injection regimen in predicting teenagers‘ concurrent glycosylated haemoglobin assays.Journal of Diabetes Nursing. 1999,3:140–144.Google Scholar
  60. (60).
    Skinner TC, John M, Hampson SE: Social support and personal models of diabetes as predictors of self-care and well-being: A longitudinal study of adolescents with diabetes.Journal of Pediatric Psychology. 2000,25:257–267.PubMedCrossRefGoogle Scholar
  61. (61).
    Brown BB: Peer groups and peer cultures. In Feldman S, Elliott G (eds),At the Threshold: The Developing Adolescent. Cambridge, MA: Harvard University Press, 1990, 171–196.Google Scholar
  62. (62).
    Savin-Williams RC, Berndt TJ: Friendships and peer relationships. In Feldman S, Elliott G (eds),At the Threshold: The Developing Adolescent. Cambridge, MA: Harvard University Press, 1990, 277–307.Google Scholar
  63. (63).
    Smith EA, Udry JR: Coital and non-coital sexual behaviors of White and Black adolescents.American Journal of Public Health. 1985,75:1200–1203.PubMedCrossRefGoogle Scholar
  64. (64).
    Luft FC, Morris CD, Weinberger MH: Compliance to a low-salt diet.American Journal of Clinical Nutrition. 1997,65(Suppl.):698S-703S.PubMedGoogle Scholar
  65. (65).
    Swales J: Population advice on salt restriction: The social issues.American Journal of Hypertension. 2000,13:2–7.PubMedCrossRefGoogle Scholar
  66. (66).
    Cutler JA, Follmann D, Allender PS: Randomized trials of sodium reduction: An overview.American Journal of Clinical Nutrition. 1997,65(Suppl.):643S-651S.PubMedGoogle Scholar
  67. (67).
    Linas SL: The role of potassium in the pathogenesis and treatment of hypertension.Kidney International. 1991,39:771–786.PubMedCrossRefGoogle Scholar
  68. (68).
    Perry IJ, Whincup PH, Shaper AG: Environmental factors in the development of essential hypertension.British Medical Bulletin. 1994,50:246–259.PubMedGoogle Scholar
  69. (69).
    Hypertension Prevention Collaborative Research Group. The effects of nonpharmacologic interventions on blood pressure of persons with high normal levels: Results of the Trials of Hypertension Prevention, Phase I.Journal of the American Medical Association. 1992,267:1213–1220.CrossRefGoogle Scholar
  70. (70).
    Sullivan JM: Borderline hypertension and sodium sensitivity.Journal of Cardiovascular Pharmacology. 1986,8:S31-S35.PubMedGoogle Scholar
  71. (71).
    Ando K, Fujita T: Abnormal renal hemodynamics in salt-sensitive patients with essential hypertension.Japanese Circulation. 1985,49:984–989.Google Scholar
  72. (72).
    Luft FC, Miller JZ, Grim CE, et al.: Salt-sensitivity and resistance of blood pressure: Age and race as factors in physiological responses.Hypertension. 1991,17(Suppl. I):I–102–I–108.Google Scholar

Copyright information

© The Society of Behavioral Medicine 2001

Authors and Affiliations

  1. 1.Department of Medicine, Division of Clinical Pharmacology and HypertensionVirginia Commonwealth University/Medical College of VirginiaRichmondUSA

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