Physiological predictors of increasing total and central adiposity in aging men and women. E.T. Poehlman, M.J. Toth, L.B. Bunyard, et al. Archives of Internal Medicine 155 (December 11/25 1995): 2443-48.
Increasing levels of physical activity helps to decrease total and central body fatness.
Healthy men (n=427) and healthy women (n=293) age 17-90 were measured for body fatness, waist circumference, peak volume of oxygen utilization (VO2), leisure-time physical activity (LTA), resting metabolic rate and respiratory quotients, and energy intake.
Fat mass increased with age, and women had a greater rate of increase.
Increase in waist circumference was also greater in women. Both increases were strongly
associated with declines in peak VO2 and LTA. Increase in fat mass was reduced from 17
percent to 3 percent per decade in men and from 26 percent to 5 percent in women when VO2
and LTA were controlled for. Similarly, waist circumference decreased from 2 percent to 1
percent in men, and from 4 percent to 1 percent in women. No other variables showed such a
strong association, leading researchers to conclude that physical activity-related
expenditures, more than resting energy expenditures, predict increases in total and
central fatness with age.
US Adults' Fruit and Vegetable Intakes, 1989 to 1991: A Revised Baseline for the Healthy People 2000 Objective. S.M. Krebs-Smith, A. Cook, A.F. Subar, et al. American Journal of Public Health 85 (December 1995): 1623-29.
Identification of the barriers to eating fruits and vegetables, and the development of strategies to overcome those barriers, are needed if Americans are to meet the Healthy People 2000 objective of consuming five or more daily servings of vegetables (including legumes) and fruits.
Using dietary data from 8,181 participants in the U.S. Department of Agriculture's 1989-1991 Continuing Surveys of Food Intakes by Individuals, the authors disaggregated foods into their components, assigned weights that correspond to servings delineated in the current dietary guidelines, and tallied the number of servings.
Although intakes were close (4.3 servings per day) to meeting the objective, only 32 percent actually met the objective. In separate calculations that accounted for higher calorie levels and for balance between fruits and vegetables, even more people fell short of the recommendations.
The authors claim that their data were the most accurate for monitoring food intake because of the disaggregation and the adherence to definition of a serving as established in current dietary guidelines. They suggest that the data serve as revised estimates for the Healthy People 2000 baseline period.
Tobacco information in two grade school newsweeklies: A content analysis. E.D. Balbach and S.A. Glantz. American Journal of Public Health 85 (December 1995): 1650-53.
To ensure that informational materials for children are consistent with public health messages, health educators and professionals must review not only "health" materials, but general use materials such as Scholastic News and Weekly Reader.
In this study of articles printed in the two general use school newsletters, each of which reach between 1 and 2 million fourth, fifth, and sixth grade students, researchers found that tobacco industry viewpoints prevailed over public health viewpoints, especially in Weekly Reader. Weekly Reader is owned by K-III, the firm that formerly owned RJR Tobacco. Over a 5-year period, Weekly Reader mentioned short-term consequences of using tobacco less often than Scholastic News (32 percent v. 64 percent), gave a clear "no-use" message less often (35 percent), and presented the tobacco industry position more often (68 percent versus 32 percent). No-use messages were less likely to appear in Weekly Reader after it was acquired by K-III.
Occupational injuries in a poor inner-city population. H. Frumkin, M. Williamson, D. Magid, et al. Journal of Occupational and Environmental Medicine 37 (December 1995): 1374-82.
Better emergency department-based surveillance could provide a clearer understanding of people affected by occupational injuries and could aid in the development of more effective training and prevention measures.
Drawing on the Philadelphia Injury Prevention Report, this study characterized occupational injuries in a predominantly black, poor, inner-city population. One hundred and seven of 335 patients who had been treated at emergency departments in the previous 2 to 3 years were contacted by telephone. The patients, who were approximately 50 percent male with a median age of 32, were employed in a number of industries mostly the health care industry and the service sector. Causes of injuries included overexertion, contact with sharp objects, and falls, which resulted in sprains, strains, and lacerations. Although almost 40 percent of the participants reported ongoing health problems, only one quarter had received workers' compensation.
The authors recommend an increased use of emergency department personnel for occupational injury surveillance, noting that minority and underserved populations would benefit greatly because of preexisting social and financial insecurities that are exacerbated with loss of work.
Risk of fluorosis in a fluoridated population: Implications for the dentist and hygienist. D.G. Pendrys. Journal of the American Dental Association 126 (December 1995): 1617-24.
Dentists and hygienists can help to prevent caries and reduce the occurrence of fluorosis by educating patients on appropriate fluoride supplementation and brushing practices.
In this study of 916 subjects age 12 to 16 years, 146 subjects were found to have mild to moderate fluorosis. Of the fluorosis cases, 71 percent had brushed more than once a day with more than a pea-sized amount (the recommended amount) of toothpaste throughout the first 8 years of life. Brushing more than once a day with the correct amount was not associated with fluorosis. Twenty-five percent had received inappropriate fluoride supplements during the first 8 years of life.
The association between midlife blood pressure levels and late-life cognitive function: The Honolulu-Asia Aging Study. L.J. Launer, K. Mastic, H. Petrovitch, et al. Journal of the American Medical Association 274 (December 20, 1995): 1846-51.
In light of the aging U.S. population and the reduction in cognitive function that occurs with old age, a public health strategy may be necessary to reduce mildly elevated systolic blood pressure (SBP) and the cognitive impairment associated with it.
Researchers studied 3,735 Japanese-American men, all of whom were participants in the Honolulu Heart Program. Participants' cognitive function, scored by the 100-point Cognitive Abilities Screening Instrument (CASI), was good if it ranged from 92-100, intermediate between <92-82, and poor if <82. Midlife blood pressure values, both systolic and diastolic, were measured in 1965, 1968, 1971, and again in 1991-1993.
Controlling for age and education, the authors found that the risk for intermediate and poor cognitive function increased in accordance with increased midlife SBP. For every 10 mmHg increase in SBP there was an increase in risk for intermediate cognitive function of 7 percent and for poor cognitive function of 9 percent. Midlife diastolic blood pressure, however, was not associated with the level of cognitive function.
Factors affecting cervical cancer screening behavior among Cambodian women in Houston, Tex. J.K. Yi. Family and Community Health 18 (January 1996): 49-57.
In order to reach the American Cancer Society's goal for the year 2000that 80 to 90 percent of women will have Pap tests every 3 years significant health education efforts will be needed for minority women, especially less acculturated women.
Findings from this study of cervical cancer screening among 216 Cambodian women in Houston, Texas, revealed that only about 25 percent of the women had had a Pap test. Those women had at least a high school education and had more children than women who had not obtained a Pap test. Written language was an independent predictor: women who could write in both Khmer and English were more likely to report having had a Pap test.
The authors note that health education materials are often printed materials, which pose a problem for women who are illiterate or who are not fluent in English. Alternative materials may need to be developed to educate minority populations about the benefits of clinical preventive services.
The prevalence of sexually transmitted diseases in children and adolescents evaluated for sexual abuse in Cincinnati: Rationale for limited STD testing in prepubertal girls. R.M. Siegel, C.J. Schubert, P.A. Myers et al. Pediatrics 96 (December 1995): 1090-94.
Testing for sexually transmitted diseases (STDs) in abused children should be limited
to gonorrhea testing in prepubertal girls who present with a vaginal discharge, but
pubertal girls should be tested according to American Academy of
Pediatrics recommendations because of the high prevalence of asymptomatic
infection.
Researchers studied 855 children (704 girls and 151 boys) over a 1-year period. The children ranged in age from 3 weeks to 18 years. Pubertal girls had an STD prevalence of 14.6 percent, compared with a 3.2 percent prevalence in prepubertal girls. In prepubertal girls with a vaginal discharge, the prevalence of gonorrhea was 11 percent; it was 0 percent for those without a discharge. Chlamydia was diagnosed in 7 percent of pubertal girls compared with 0.8 percent of prepubertal girls. No children tested positive for syphilis or HIV, and no males had an STD.
Continuing risk for hepatitis B virus transmission among Southeast Asian infants in Louisiana. F.J. Mahoney, M. Lawrence, C. Scott, et al. Pediatrics 96 (December 1995): 1113-16.
Prevention of hepatitis B virus (HBV) in Asian and Pacific Islander communities could be enhanced by ensuring that infants receive 3 doses of vaccine in the first 12 months of life and by vaccinating older children who were not immunized earlier.
In this study of a Southeast Asian community in Louisiana, researchers performed baseline serologic testing on 96 percent of the people in 225 households. Chronic HBV infection was found in 28 (4.1 percent) of 676 U.S.-born children. Sixty-one percent of the children with chronic HBV were born to hepatitis B surface antigen (HBsAg)-negative women. The prevalence of chronic infection increased with age, even among those children born to HBsAg-negative mothers. Children living with carriers were 5.4 times more likely to be infected than those who had no carriers in the household.
The researchers noted that the prevalence of HBV among U.S.-born Southeast Asian children approaches that of the countries of origin. They recommend not only vaccinating, but monitoring the vaccination programs, especially by race and ethnicity, to be sure that high-risk populations are effectively immunized.
Annual screening mammography among diabetic women: Demographics, psychological stress, and family functioning. J.G. Spangler and J.C. Konen. Family and Community Health 18 (January 1996): 1-8.
Because of their frequent interaction with healthcare providers, women with chronic diseases such as non-insulin-dependent diabetes mellitus (NIDDM) offer physicians an opportunity to encourage healthy behaviors such as obtaining mammograms and clinical breast examinations as well as practicing monthly self breast examinations.
This study found the prevalence rate of screening mammography (SM) to be 48.8 percent up to 9 times that of the general population in this group of 129 women with NIDDM who were over the age of 49. Although the prevalence rate for SM was high in this group, family functioning influenced the women's behavior. Severe family dysfunction was found to be a barrier to obtaining mammograms. Education and age at first birth had positive correlations, but exercise had a negative correlation.
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