Validation of self-reported anthropometrics in the Adventist Health Study 2

Background  

Relying on self-reported anthropometric data is often the only feasible way of studying large populations. In this context, there are no studies assessing the validity of anthropometrics in a mostly vegetarian population. The objective of this study was to evaluate the validity of self-reported anthropometrics in the Adventist Health Study 2 (AHS-2).     

Parent-reported appetite of a child and the child's weight status over a 2-year period in Korean children

This study sought to examine the association between the parent-reported appetite of a child and the child's weight status after 2 years. The design was a 2-year prospective study. A total of 531 Korean children aged 11 to 12 years were followed up for change in weight status (persistent overweight, persistent nonoverweight, recently overweight, recently nonoverweight) between 2001 and 2003 after the measurement of their appetite (low, moderate, and high) using a questionnaire administered to their parents in 2001. Weight status of each child was determined based on the criteria of body mass index (BMI) recommended by the International Obesity Task Force reference. The statistical analyses performed were multiple logistic regression analysis with adjustment for parental factors (parents' weight and height, education level, and income) and the child's characteristics (baseline BMI, physical activity, and television viewing). Main outcome measures were child's mean BMI and weight status, and the proportions of overweight children at the baseline and at the end of the follow-up were greater among those children whose parents reported that they had high appetites (P<0.001). Compared with the children with a low appetite, the odds ratio for overweight at the end of follow-up was 3.7 (95% confidence interval 1.2 to 11.7) in children with a high appetite. Subgroup analysis of overweight children at baseline showed that the risk of being persistently overweight over the 2-year follow-up was 5.5 times (95% confidence interval 1.1 to 27.5) higher in children with a high appetite than in those with a low appetite. There was a strong association between the parent-reported appetite of a child and being overweight after 2 years. Identifying children with higher appetites and targeting them for lifestyle modification may provide an effective way of reducing the incidence of childhood overweight.     

Dietary patterns of adolescent girls in Hawaii over a 2-year period

OBJECTIVE: To describe changes in dietary patterns of adolescent girls in Hawaii from 2001 to 2003. DESIGN: Cohort study, with exams 2 years apart. SUBJECTS/SETTING: One hundred fifty-one girls of Asian, white, and mixed ethnicity who were aged 9 to 14 years at exam 1 and aged 11 to 16 years at exam 2 and lived on the island of Oahu, HI. METHODS: Three-day diet records were obtained at each exam. Mean nutrient and food group intakes and weight, height, and body mass index were determined and compared between the two exams. STATISTICAL ANALYSES: Data are summarized as means+/-standard deviation unless otherwise stated. Differences in values between groups were analyzed for significance using paired t tests and multiple regression. RESULTS: Girls at exams 1 and 2 had mean carbohydrate intakes of 233 g and 241 g, respectively, and protein intakes of 67 g and 65 g, respectively. None of the carbohydrate intakes were below the Estimated Average Requirement (EAR) at exam 1 and only one girl was below at exam 2. Three percent of girls had protein intakes that were below the EAR at exam 1 whereas 9% were below at exam 2. For iron intakes, 3% of girls were below the EAR at exam 1 and 14% of girls were below at exam 2. Girls at exams 1 and 2 had mean calcium intakes of 733 mg and 732 mg, respectively, and fiber intakes of 11.2 g and 11.4 g, respectively; lower than the Adequate Intake recommendation. The percentage of energy from macronutrients in exams 1 and 2, respectively, was in range of the Appropriate Macronutrient Distribution Range for more than 70% of girls (76% for exam 1, 79% for exam 2), but the mean percentage intake of saturated fat intake was higher than the recommended range for more than 65% of the girls at both exams 1 and 2 (69% at exam 1, 73% at exam 2). However, no significant differences were found in percent contribution of or in total intake of macronutrients between the two exams. More than half of girls (51% to 100%) did not consume the recommended number of Food Guide Pyramid Servings for any food group at either exam 1 or 2. A significant increase was found for sweetened carbonated beverage intake (from 130 g to 179 g; P<0.05) and for added sugar intake (from 16 tsp to 18 tsp; P<0.01) between exams 1 and 2, a level well above recommendations. As expected, mean body weight and mean body mass index increased significantly between exams 1 and 2 (P<0.05). CONCLUSIONS: These data suggest high dietary intakes of dietary fat and sugar, and increasing intakes of sweetened carbonated beverages and other high-sugar drinks during adolescence among girls in Hawaii.     

Stability of dietary patterns in young women over a 2-year period

OBJECTIVE: To examine the stability of dietary patterns in young women over a two-year period and to identify factors that influence stability. DESIGN: A food frequency questionnaire was used to assess diet. In a subgroup, this was repeated after 2 years. Questions were asked about major changes to diet over this time. Dietary patterns were identified using principal components analysis and pattern scores were compared at the two time points. The consumption of foods was also examined. The relationship between change in pattern scores and socio-demographic factors and body mass index was assessed. SETTING: The Southampton Women's Survey, a prospective study of diet, health and lifestyle in young women and their influences on fetal growth. SUBJECTS: A subgroup of 94 women from a cohort of 6129 nonpregnant women aged 20-34 years. RESULTS: Two dietary patterns, labelled 'prudent' and 'high energy', were identified. Spearman correlation coefficients between the initial and repeat scores for the prudent and high-energy patterns were 0.81 and 0.64, respectively. Average changes (repeat - initial) were 0.13 and -0.01 SD of initial score. Change in prudent dietary pattern score was influenced by amount of strenuous exercise taken and by changes in partnership status. An increase in high-energy pattern score was associated with lower social class. CONCLUSIONS: Dietary patterns in young women are reasonably stable over a 2-year period. This suggests that dietary patterns identified in the recent past may provide useful information about current dietary patterns.     

Bladder cancer in a low risk population: results from the Adventist Health Study

A cohort study of bladder cancer was conducted in a population of California Seventh-day Adventists. Most Seventh-day Adventists use neither tobacco nor alcohol yet experience a large degree of variation in dietary habits. Therefore, diet and other lifestyle habits were evaluated in this unique population. In 1976, 34,198 non-Hispanic white Seventh-day Adventists in California completed a detailed lifestyle questionnaire which included a 51-item food frequency section. This cohort was then followed until the end of 1982 during which time all newly diagnosed malignancies were detected. In order to evaluate the relation between several variables hypothesized to be associated with altered bladder cancer risk, age-, sex-, and smoking-adjusted relative risks (incidence rate ratios) were calculated using the method of Mantel-Haenszel adopted for person-time data. Multivariate analyses were conducted using the Cox Proportional Hazards Regression model. Between the return of the questionnaire and the end of follow-up, there were 52 histologically confirmed bladder cancers detected in the cohort. Increasing age, male gender, and a history of cigarette smoking were all significantly associated with increased bladder cancer risk. In addition, residence in a rural area was associated with significantly increased risk (relative risk (RR) = 1.80) as was high consumption of meat, poultry, and fish (RR = 2.57).     

Dietary restraint and self-esteem as predictors of weight gain over an 8-year time period

The study aimed to assess dietary restraint and self-esteem as predictors of weight change over a time period of 8 years. Questionnaires assessing self-reported weight, body dissatisfaction, dietary restraint, and self-esteem were completed by 77 young adults (19 men and 58 women) on two occasions separated by 8 years. On average, participants gained approximately 6 kg over the 8 years. Although neither dietary restraint nor self-esteem predicted weight change on its own, their interaction did. Furthermore, the relationship between restraint and weight change was best described as curvilinear. It was concluded that dietary restraint is predictive of subsequent weight gain, but in a more complex way than previously assumed.     

Persistence of personal health practices over a 1-year period

A large amount of research has been devoted to identifying the psychosocial and demographic correlates of personal preventive health practices. An additional factor to consider, however, is the stability of personal health practices over time. At least over short periods, the prediction of current behavior may be substantially improved by having information about an individual's previous performance of the practice being studied. To address this question, data from Wave 1 (1979) and Wave 2 (1980) of the National Survey of Personal Health Practices were examined. Using nine health practices as indices, performance reported at Wave 1 was used to predict performance of that same practice as reported at Wave 2, 1 year later. A two-step analysis strategy was followed to estimate how much more variance could be explained when the behavioral reports were added to a list of psychosocial and demographic predictors. Results showed that over the 1-year interval, the Wave 1 behavioral reports were by far the strongest predictors of their corresponding measures obtained at Wave 2. The explained variance was increased substantially for most of the nine health practices, suggesting a strong tendency for persistence of the practices. Psychosocial and demographic variables tended to account for much smaller amounts of variance and often dropped out of the prediction equation when the Wave 1 behavior report was entered in the second step of analysis. Health practices other than the corresponding Wave 1 index did not improve prediction of the Wave 2 index greatly. The tendency for previous behavior to persist may overshadow the influence of other factors and account for the modest amounts of explained variance that are usually found for psychosocial and demographic indices in cross-sectional surveys. Although stability does not imply rigidity or impossibility of change, the strength of prediction found in these data attest to the "force of habit" that community interventions can encounter.     

Association between perceived interpersonal everyday discrimination and waist circumference over a 9-year period in the Midlife Development in the United States cohort study

The relation between perceived interpersonal experiences of discrimination and measures of obesity is of great interest to many. This study examined the relation between changes in waist circumference and changes in perceived interpersonal everyday discrimination using the 1995-2004 Midlife Development in the United States cohort study (N = 1,452). After controlling for potential confounding variables that assessed behavioral and sociodemographic characteristics, sex-stratified ordinary least squares regression analyses suggested that the waist circumference of adult males who reported consistently high levels of interpersonal everyday discrimination increased 2.39 cm more than that of adult males who consistently reported low levels of interpersonal everyday discrimination (P < 0.05). Similarly, the waist circumference of adult females who reported an increase in interpersonal everyday discrimination increased 1.88 cm more than that of adult females who reported consistently low levels of interpersonal everyday discrimination (P < 0.05). These findings suggest that perceived interpersonal everyday discrimination may be associated with an increase in waist circumference over time among adults in the United States.     

Teleconsultation: changes in technology and costs over a 12-year period

In our previous study, in 1997, we evaluated the cost of teleconsultations in a primary care centre compared with the cost of the conventional alternative, travelling to the hospital. The results showed that teleconsultations were cheaper than patient travel when the annual workload was more than 110 patients in ophthalmology and 115 patients in dermatology. Using the same method of analysis for 2009 data showed that cost savings would occur if the annual workload was 20 patients in ophthalmology and 17 patients in dermatology. The main differences between the two studies are the reduced cost of the technology (which was based on PCs in 2009) and the increased cost of staff. Both studies show that teleconsultations can be cost-effective in a relatively small health centre. The cost of technology continues to decrease, although the other costs in our break-even analysis continue to increase. However, the usability of technology continues to improve, and this will make telemedicine a more attractive alternative in the future.     

Orthopaedic operations: variation in case-mix over a 10-year period.

The variation in case-mix of patients admitted for routine (non-emergency) orthopaedic surgery at a Staffordshire orthopaedic hospital over a 10-year period was studied, with the aid of the BUPA Schedule of Surgical Procedures. Over this period there was a 2% decrease in the total number of operations performed. There was a marked reduction in the number of 'minor' operations performed, and a marked increase in the number of 'major' and more complex operations performed. The overall workload, as judged by estimated surgeons' fees, rose by 43%. This study offers clear support to the claim that the complexity of orthopaedic operations performed has significantly increased over a ten-year period.     

Trends in diagnosis over a 10-year period in a Swedish primary care district

In a study that covers ten years, the panorama of diagnosis was studied at three health centres in a Swedish primary care district with the aid of an encounter form. Frequencies for the different diagnosis groups varied considerably. In the case of malignant tumours, diseases of the thyroid, other endocrine diseases, symptoms and check-up visits there were more than 3-fold differences in diagnosis frequencies between various years. The results for individual years, therefore, were not representative of diagnosis distribution in the long-term perspective. Both systematic changes and temporary fluctuations occurred during the period. There was no evident lowest common denominator for the six diagnosis groups that increased (benign tumours, diseases of the thyroid and symptoms) or decreased (urinary tract infections, other urogenital diseases and back complaints). Although frequencies for individual diagnosis groups varied sharply from year to year, the diagnosis panorama in its entirety did, however, not change decisively. Permanent district physicians took charge mainly of the chronically ill, while other doctors were more involved with acute illness. It can be concluded that with such a varied diagnosis panorama in primary care it is difficult, based on temporary statistics from individual health centres, to draw general conclusions about the composition of patients. Thus, reliable figures on diagnosis should probably be founded on continuous registration at each clinic rather than on data collected periodically from especially selected reference centres.     

贵阳地区10年间孕产妇死亡分析

目的 监测贵阳地区10年来孕产妇死亡情况,为降低孕产妇死亡率提供科学依据.方法 对1998～2007年孕产妇死亡率资料、年报数据卡册资料进行分析.结果 10年间孕产妇死亡率呈下降趋势,其间2002～2003年出现了增高;产科出血死因顺位连续9年均为第1位;1998～2006年间,农村地区孕产妇死亡率均高于城市,而2007年城市孕产妇死亡率(61.71/10万)高于农村(49.98/10万).结论 提高产科出血的抢救诊治能力,提高农村住院分娩率,完善危重孕产妇的抢救、转诊网络是贵阳地区降低孕产妇死亡的关键.     

Variations in arsenic methylation capacity and oxidative DNA lesions over a 2-year period in a high arsenic-exposed population

Objective  To assess long-term variations in arsenic methylation and oxidative DNA lesions of chronic high arsenic-exposed populations. Methods  A follow-up study was conducted in 64 chronic high arsenic-exposed subjects from 2004 to 2006. Urinary arsenic species and 8-hydroxydeoxyguanine were measured. Results  Percentages of urinary inorganic arsenic, monomethylarsonate and urinary 8-hydroxydeoxyguanine (8-OHdG) level were significantly higher, but the percentage of dimethylarsinate, the primary methylation index (PMI) and secondary methylation index (SMI) was lower in the ninth year of arsenic exposure compared with the seventh year. Substantial differences in relative arsenic methylation capacity were observed between the seventh and ninth year. Percentages of arsenic species, PMI and SMI were significantly correlated between siblings, and between parents and children. Conclusions  Arsenic methylation may decrease, but oxidative DNA lesions may increase with the increase of cumulative arsenic exposure level. Both genetic and environmental factors may contribute to variability in arsenic methylation.     

An analysis of bacteraemia in a university hospital in Japan over a 10-year period

Details of positive blood cultures obtained from 357 inpatients attending the Toyama University Hospital were collected over a 10-year period in order to document changes in microbiological and clinical features of bacteraemia. Fifty-one per cent of patients were over 60 years old, 48% had intravascular catheters in-situ, and 17% had had surgical procedures within 30 days prior to the isolation of organisms from the blood. The proportion of underlying diseases other than malignancies increased over the 10-year period (42–60%, P < 0·05). Patients from surgical departments other than the Academic Department of Surgery increased over the study period (16–55%, P < 0·05). Staphylococcus aureus bacteraemia increased significantly (29 to 49%, P < 0·05) as did pseudomonas and anaerobic bacteraemia. Most bacteria showed no significant changes in their antibiotic sensitivity pattern over the 10 years. Clinical features in patients with bacteraemia varied with the infective organisms and the underlying disease. Mortality was high in patients with haematological malignancy, usually in association with Pseudomonas aeruginosa     

Paediatric head injury admissions over a 10-year period in a regional neurosurgical unit

Traumatic brain injury is a leading cause of death and disability in childhood. A retrospective study of all paediatric head injuries admitted to the neurosurgical unit for the West of Scotland over a 10-year period was performed to assess the impact of the National Institute for Health and Clinical Excellence head injury guidelines on the admission rate and to determine the associated risk factors, causes, severity and outcomes of these injuries. There were 564 admissions between 1998 and 2007. The median age at presentation was nine years and two months. There was no change in the admission rate, injury mechanism or severity of head injury admitted over the period studied. A relationship was observed between the Scottish Index of Multiple Deprivation Score and the incidence of head injury (P = 0.05). Alcohol was reported as a causative factor in only a small number of cases, and moderate to severe head injuries were more commonly identified as a result of road traffic accidents.     

DNA Methylation Profiles of Vegans and Non-Vegetarians in the Adventist Health Study-2 Cohort

We sought to determine if DNA methylation patterns differed between vegans and non-vegetarians in the Adventist Health Study-2 cohort. Genome-wide DNA methylation derived from buffy coat was profiled in 62 vegans and 142 non-vegetarians. Using linear regression, methylation of CpG sites and genes was categorized or summarized according to various genic/intergenic regions and CpG island-related regions, as well as the promoter. Methylation of genes was measured as the average methylation of available CpG’s annotated to the nominated region of the respective gene. A permutation method defining the null distribution adapted from Storey et al. was used to adjust for false discovery. Differences in methylation of several CpG sites and genes were detected at a false discovery rate < 0.05 in region-specific and overall analyses. A vegan diet was associated predominantly with hypomethylation of genes, most notably methyltransferase-like 1 (METTL1). Although a limited number of differentially methylated features were detected in the current study, the false discovery method revealed that a much larger proportion of differentially methylated genes and sites exist, and could be detected with a larger sample size. Our findings suggest modest differences in DNA methylation in vegans and non-vegetarians, with a much greater number of detectable significant differences expected with a larger sample.     

First epidemiological study on occupational radar exposure in the French Navy: a 26-year cohort study

This retrospective cohort study deals with the causes of death among 57,000 military personnel who served in the French Navy surface vessels and were observed over the period 1975–2000. We successively compared the mortality rate and the specific causes of death between two groups differing in their potential exposure levels to radar. Occupational exposure was defined according to the on-board workplace (radar and control groups). The age-adjusted death ratios of the navy personnel were compared. For all causes of death, the results showed that 885 deaths in the radar group and 299 in the control group occurred (RR = 1.00 (95?% CI: 0.88–1.14)). RRs were 0.92 (95?% CI: 0.69–1.24) for neoplasms. For the duration of follow-up, the results did not show an increased health risk for military personnel exposed to higher levels of radio frequencies in the radar group, but the number of deaths was very small for some cancer sites.