Predictors of premarital sexual activity among unmarried youth in Vientiane,Lao PDR: The role of parent–youth interactions and peer influence

Research indicates that adolescents in low-income countries have an early sexual debut and engage in risky sexual behaviours. Few studies in low-income countries however, have explored the factors that influence young people's sexual behaviours. This study examined individual, family and peer-level factors associated with premarital sexual behaviours in the Lao People's Democratic Republic (PDR). A cross-sectional survey was undertaken with unmarried youth aged 18 to 24 years (N = 1200) in Vientiane Capital City. Logistic regression models, controlling for confounding variables, were employed to test for the contribution of factors influencing premarital sexual activity. Most respondents held positive attitudes towards premarital sex, with males having more liberal attitudes than females (mean score of 2.68 vs. 2.32, p < 0.001). Prevalence of premarital sexual activity was higher among males than females (44.7% and 19.2%, respectively). Predictors of premarital sex for males were age, sexual attitudes, perceived parental expectations regarding sex, dating and peer influence. For females, predictors were father's level of education, parent-youth sexual communication, peer influence and liberal sexual attitudes. The results highlight the role of parent-youth interaction and peer influence. The results suggest the need for a range of strategies at the individual, peer and family level, as well as a gender-specific focus.     

The influence of physical activity, socioeconomic status, and ethnicity on the weight status of adolescents

OBJECTIVE: This study examined the effects of physical activity, television viewing, video game play, socioeconomic status (SES), and ethnicity on body mass index (BMI). RESEARCH METHODS AND PROCEDURES: The sample was 2389 adolescents, 10 to 16 years of age (12.7 +/- 1.0 years); 1240 (52%) females and 1149 (48%) males; 77% white and 23% African American; from rural (77%) and urban (23%) settings. BMI and skinfolds were directly assessed. All other data were obtained from questionnaires. RESULTS: Watching television on non-school days was related to being overweight (p < 0.005). However, when BMI analyses were adjusted for ethnicity and SES, there were no significant effects of television viewing on BMI (p > 0.061). Increased hours of video game play enhanced the risk of being overweight for both genders when analyses were adjusted for ethnicity and SES (p < 0.019). In males, participation in as little as one high-intensity physical activity 3 to 5 days a week decreased the ethnic- and SES-adjusted relative risk of being overweight (RR = 0.646; CI: 0.427 to 0.977). For females, the ethnic- and SES-adjusted relative risk for being overweight was not significantly altered by physical activity. The logistic analyses further indicated the influence of low SES and African American ethnicity overshadowed any direct effect of television or videos. DISCUSSION: Because weight status of male adolescents appears to be more related to exercise habits than to television or video game habits, increased participation in high-intensity exercise appears to be important. For females, neither videos nor exercise habits appear to be related to risk of being overweight. However, ethnicity and SES may be important factors that can influence body weight status, while television viewing may be of some importance. Thus, programs to reduce obesity in female adolescent should focus their efforts in lower SES communities.     

Sex difference in free erythrocyte protoporphyrin (FEP) level. I. Sex difference in FEP level in healthy rural residents]

FEP and other hematological parameters were measured in 157 healthy rural residents (98 females and 59 males). The mean FEP in females was higher than in males (p less than 0.05); mean +/- SD = 62.98 +/- 19.36 and 54.57 +/- 21.20 micrograms/dl.pcv, respectively, although both of the means were within normal limits. There was no significant sex difference in erythrocyte ALA-D activity. Whole blood lead (Pb-B) level in females showed a tendency to be lower than in males, but there was no significant sex difference in erythrocyte lead level. The mean value of hematocrit (Ht), hemoglobin (Hb) and iron in serum (Fe-S) were lower in females than in males (p less than 0.01). Serum GOT and GPT level tended to be lower in females than in males (0.05 less than p less than 0.1). There was hardly any significant relationship between Pb-B and each parameter of lead exposure, because the subjects in this study were only rural residents with no occupational lead exposure and with their Pb-B levels being extremely low. As for the parameters of anemia, Fe-S was positively correlated with Ht and Hb level and negatively correlated with FEP level. By sex, Fe-S was correlated with Ht and FEP level only in females. As for the possible reasons why FEP level in females in higher than in male, women tended to have iron-deficiency induced by blood loss due to menstruation, pregnancy, and difference in dietary pattern from males.     

Television viewing and its associations with overweight,sedentary lifestyle,and insufficient consumption of fruits and vegetables among US high school students: differences by race,ethnicity, and gender

Television (TV) viewing has been associated with overweight, decreased physical activity, and unhealthy dietary behavior among children and adolescents, and may represent a modifiable cause of childhood obesity. This study examined race, ethnic, and gender-specific differences in these associations among high school students in the United States. The study analyzed data from the 1999 national Youth Risk Behavior Survey, a representative sample (N = 15,349) of US high school students. Logistic regression tested for significant associations. TV viewing on an average school day exceeded 2 hours/day among 43% of students; it was greater among Black (74%) and Hispanic (52%) than White (34%) students. Overall, 11% of students were overweight, 31% of students were sedentary (i.e., did not participate in moderate or vigorous physical activity at recommended levels), and 76% ate less than five servings/day of fruits and vegetables. Watching TV more than 2 hours/day was associated with being overweight, being sedentary, and eating insufficient fruits and vegetables among White females, and with being overweight among Hispanic females. No significant associations were found among Black females. TV viewing was associated with being overweight and eating insufficient fruits and vegetables among White males. No significant associations were found among Hispanic males. Among Black males, TV viewing was associated with greater participation in physical activity. These findings suggest the presence of cultural factors to consider when developing interventions to promote physical activity, healthy eating, and healthy weight through reduced TV viewing among adolescents.     

Association between self-reported physical activity and indicators of body composition in Malaysian adolescents

BackgroundObesity and lack of physical activity are fast becoming a concern among Malaysian adolescents.ObjectiveThis study aims to assess physical activity levels among Malaysian adolescents and investigate the association between physical activity levels and body composition such as body mass index (BMI), waist circumference (WC) and percentage of body fat.Subjects and methods1361 school-going 13 year old multi-ethnic adolescents from population representative samples in Malaysia were involved in our study. Self-reported physical activity levels were assessed using the validated Malay version of the Physical Activity Questionnaire for Older Children (PAQ-C). Height, weight, body fat composition and waist circumference (WC) were measured. Data collection period was from March to May 2012.Results10.8% of the males and 7.4% of the females were obese according to the International Obesity Task Force standards. A majority of the adolescents (63.9%) were physically inactive. There is a weak but significant correlation between physical activity scores and the indicators of obesity. The adjusted coefficient for body fatness was relatively more closely correlated to physical activity scores followed by waist circumference and lastly BMI.ConclusionThis study demonstrates that high physical activity scores were associated with the decreased precursor risk factors of obesity.     

Clustering patterns of behavioural risk factors for cardiovascular diseases in Bangladeshi adolescents: A population-based study

ObjectivesTo examine the clustering of major behavioural risk factors for cardiovascular diseases (CVD) among adolescents in Bangladesh.MethodsNationally representative data from the 2014 Bangladesh Global School-based Student Health Survey were analysed in 2,978 adolescents (mean age: 14.2 SD 0.99; 60.0% females). We compared the observed (O) to expected (E) prevalence ratios of 64 possible combinations of the six behavioural risk factors (i.e., physical inactivity, sedentary behaviour, tobacco smoking, alcohol drinking, low fruit and vegetable intake, and overweight/obesity) to determine their clustering patterns. Poisson regression was used to examine the associations.ResultsThe most common single risk factor was low fruit and vegetable intake, followed by physical inactivity (87% and 59%, respectively). Overall, 18% of the adolescents had three or more risk factors, with males reporting higher prevalence than females (21% vs. 11%). The simultaneous occurrence of low fruit and vegetable intake, and physical inactivity was 30% greater in males (O/E ratio: 1.3, 95% CI: 1.2–1.4) and 20% greater in females (1.2, 1.2–1.3) than what was expected if there was no clustering. The analysis also demonstrated clustering of low fruit and vegetable, overweight/obesity, and high sedentary behaviour (2.5, 1.3–4.9), and low fruit and vegetable, overweight/obesity, and physical inactivity (1.4, 1.1–2.0) for males.ConclusionsThis study fills the gap in the scientific literature by providing evidence that behavioural risk factors tend to cluster among adolescents in Bangladesh. Early prevention programs with evidence-based strategies need to target adolescents who are at a greater risk of engaging in multiple risk behaviours.     

A Preliminary Investigation of Inner City Adolescents'' Perceptions of Guns

Three hundred seventy-seven African-American and 201 white adolescents, primarily of low socioeconomic status, were surveyed on perceptions of guns. Chi-square analyses found significant differences by gender and ethnicity. African-American males were more likely to have a pistol at home (47%); both African-American males and females were more likely to have known someone who took a gun to school (57% and 47%) and to have personally known someone who had been shot (87% and 91%). Differences between African-American and white adolescents and between males and females regarding gun control, gun safety, and consequences of gun use are described.     

Physical activity during leisure and commuting in Tianjin,China

OBJECTIVE: To investigate physical activity during leisure time and commuting among persons aged 15-69 years in the urban population of Tianjin, China, and to assess its associations with demographic and health-related characteristics. METHODS: In 1996 a cross-sectional survey of 2002 males and 1974 females provided information on physical activity during leisure time and commuting and on demographics and health behaviours. FINDINGS: No leisure-time physical activity was engaged in by 67% of females and 61% of males. However, only 4% of females and 9% of males reported an absence of physical activity during commuting. The mean duration of leisure-time physical activity for the whole population was about 10 min per day. The average commuting time on foot or by bicycle was about 30 min. Leisure-time physical activity was more frequent among highly educated people, people with high incomes, white-collar workers, married people, non-smokers, or people commuting on foot or by bicycle than among other people. Persons with low incomes, male blue-collar workers and married people were more likely than others to engage in 30 min or more per day of physical activity on foot or by bicycle when commuting. CONCLUSION: People in Tianjin engaged in a high level of physical activity when commuting and a low level of leisure-time physical activity.     

Physical activity trajectories and cognitive function: A national cohort study

ObjectiveTo examine the prospective associations between physical activity trajectories, measured from repeated assessments over time, and cognitive function.MethodA total of 2972 participants aged 45 years old and over (median age: 56.0 [interquartile range - IQR 50.0–62.0], 50.8% males]) from the Chinese Health and Retirement Longitudinal Study (CHARLS) study were included. First, our study used the growth mixture modeling to identify physical activity trajectories from the first three surveys of the CHARLS. Second, we performed regression analysis to explore the associations of the trajectories with 3-year cognitive function.ResultsWe identified four physical activity trajectories, characterized by persistently low (N = 1880), initially low then increasing (154), initially moderate then decreasing (584), and initially high then decreasing (354). After 3-year follow-up, compared to individuals with persistently low trajectory, those with initially moderate then decreasing (β = −0.74, 95% CI = (−1.38, −1.10), p = 0.024) and initially high then decreasing (β = −1.12, 95% CI = (−1.91, −0.33), p = 0.005) were significantly associated with cognitive decline. The effects of the decline in physical activity on cognitive function varied by sex. Females’ cognitive function (β = −1.79, 95% CI = (−2.82, −0.77) was more likely to be influenced by decreasing physical activity, but this association was not significant in males. We did not find the significant effect of initially low then increasing trajectory on cognitive function.ConclusionsFast decline in physical activity is related to a higher risk of cognitive decline, especially in females.     

Adolescents involved in weight-related and power team sports have better eating patterns and nutrient intakes than non-sport-involved adolescents

OBJECTIVE: To examine eating habits and energy and nutrient intake among adolescents participating in weight-related and power team sports and non-sport-involved adolescents. DESIGN: Data were drawn from Project EAT (Eating Among Teens), which was conducted with 4,746 adolescents from 31 middle and high schools in the Minneapolis/St Paul metropolitan area. SETTING: Urban secondary schools. SUBJECTS: Adolescents reporting participation in a weight-related sport, a power team sport, or no consistent participation in a sport. MAIN OUTCOME MEASURES: Meal and snack frequency, mean energy and nutrient intake, and mean physical activity. STATISTICAL ANALYSES PERFORMED: Analyses were conducted by sex across the three groups. General linear models were used to compare mean energy and nutrient intake, composite nutrient adequacy, and mean physical activity across the three groups. Percentages of youth meeting nutrient recommendations were compared across the three groups using chi(2) tests. RESULTS: For both males and females, youth involved in weight-related sports ate breakfast more frequently than non-sport-involved peers (females: 3.6 and 3.2 times per week, respectively, P<0.01; males: 4.7 and 3.7 times per week, respectively, P<0.01). Weight-related and power team sport-involved youth also had higher mean protein, calcium, iron, and zinc intakes than non-sport-involved peers. However, adolescent females had low calcium intake, regardless of sports involvement (weight-related sports 1,091 mg/day, power team sports 1,070 mg/day, and non-sport-involved 1,028 mg/day, P<0.05). CONCLUSIONS: Sport-involved adolescents have better eating habits and nutrient intake than their non-sport-involved peers. However, they are still in need of nutrition interventions, particularly around calcium intake.     

Evaluation of diet quality and its associated factors among adolescents in Kuala Lumpur,Malaysia

BACKGROUND/OBJECTIVES

This study aims to determine contribution of meal frequency, self-efficacy for healthy eating, and availability of healthy foods towards diet quality of adolescents in Kuala Lumpur, Malaysia.

SUBJECTS/METHODS

This study was conducted among 373 adolescents aged from 13 to 16 years old. Diet quality of the respondents was assessed using the Healthy Eating Index for Malaysians. Meal frequency, self-efficacy for healthy eating, and availability of healthy foods were assessed through the Eating Behaviours Questionnaire (EBQ), self-efficacy for healthy eating scale, and availability of healthy foods scale, respectively.

RESULTS

The majority of the respondents (80.7%) were at risk of poor diet quality. Males (mean = 34.2 ± 8.2%) had poorer diet quality than females (mean = 39.9 ± 9.0%) (t = -5.941, P < 0.05). Malay respondents (mean = 36.9 ± 8.7%) had poorer diet quality than Indian respondents (mean = 41.3 ± 10.0%) (F = 2.762, P < 0.05). Age (r = 0.123, P < 0.05), self-efficacy for healthy eating (r = 0.129, P < 0.05), and availability of healthy foods (r = 0.159, P < 0.05) were positively correlated with the diet quality of the respondents. However, meal frequency was not correlated with the diet quality of the respondents. Multiple linear regression analysis showed that being a male, being a Malay, low self-efficacy for healthy eating, and low availability of healthy foods contributed significantly towards poor diet quality among respondents.

CONCLUSIONS

In short, sex, ethnicity, self-efficacy for healthy eating, and availability of healthy foods were associated with diet quality among adolescents. Health practitioners should take into consideration of differences in sex and ethnicity during implementation of nutrition-related intervention programs. Self-efficacy for healthy eating and availability of healthy foods should be included as important components in improving diet quality of adolescents.     

Health Attitudes and Behaviors of African American Adolescents

African Americans continue to die disproportionately from chronic diseases such as diabetes, hypertension and heart disease. Eating fruits and vegetables have been shown to reduce those risks yet little is known about the health attitudes of African American adolescents and their eating habits and engagement in physical activity. A survey was administered to African American adolescents in a Midwestern city to determine the health attitudes and behaviors related to dietary intake and physical activity. The total sample consisted of 448 African American adolescents aged 12-17. Forty-seven percent were males and 53% were females. The findings show that African American adolescents did have poor fruit and vegetable intake and fairly low rates of exercise. The study also showed there were statistically significant differences between males and females regarding eating a balanced diet, reducing the amount of fat in diets and engaging in physical activity. African American females were more likely to eat a balanced diet and have reduced the fat in their diets than males but African American males were more likely to engage in physical activity in the past 7 days than females. Findings suggest more efforts are needed to curb the poor eating and exercising habits of African American adolescents if a reduction in chronic disease is to be met for this population.     

Serum lipid levels in an Iranian population of children and adolescents: Tehran lipid and glucose study

Data from 3148 participants aged 3–19years (1447 males and 1701 females) in the cross-sectional phase of Tehran lipid and glucose study (February 1999–May 2000) were used to determine serum lipid levels [total cholesterol (TC), triglycerides (TGs), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C)] after 12–14 hours overnight fast. The values were analyzed by sex and age. Mean serum TC concentration was 170 mg/dl. TC was significantly greater in females than males (173 vs. 167 mg/dl, p < 0.05). The 90th and 95th percentiles for serum TC were 211 and 227 mg/dl, respectively. There was a significant decrease in mean TC in males during puberty. Thirty-one percent of population had TC values between 170 and 199 mg/dl and 16% had values of 200 mg/dl or greater. The mean TGs values were 103 for males and 108 mg/dl for females [non-significant (NS)]. The prevalence of high-risk values of TGs increased with age in males, reaching a peak at 17–19years. The mean HDL-C level was 45 mg/dl. Mean HDL-C was highest at 7–10years of age and decreased thereafter. The mean LDL-C was 102 in males and 107 mg/dl in females (NS). Twenty-two percent had LDL-C values between 110 and 129 mg/dl and 17% had values 130 mg/dl or greater. The results showed higher levels of TC, LDL-C and TGs and lower HDL-C in Tehranian children and adolescents than other studies. To design comprehensive public health programs to reduce serum lipid levels among Iranian children and adolescents, underlying factors for the high prevalence of dyslipoproteinemia should be sought.     

Cardiovascular diseases in Chinese, Malays, and Indians in Singapore. I. Differences in mortality.

STUDY OBJECTIVE--The aim of the study was to analyse differences in mortality from the main cardiovascular diseases (ischaemic heart disease, hypertensive disease, and cerebrovascular disease) among Chinese, Malays, and Indians in Singapore. DESIGN--The study was a survey using national death registration data in Singapore for the five years 1980 to 1984. The underlying cause of death, coded according to the ninth revision of the International Classification of Diseases, was taken for the analyses. SETTING--The study was confined to the independent island state of Singapore, population 2.53 million (Chinese 76.5%, Malays 14.8%, Indians 6.4%, Others 2.3%). Death registration is thought to be complete. SUBJECTS--All registered deaths in the age range 30-69 years during the study period were analysed by ethnic group. MEASUREMENT AND MAIN RESULTS--Indians had higher mortality from ischaemic heart disease than the other ethnic groups in both sexes, with age-standardised relative risks of Indian v Chinese (males 3.8, females 3.4), Indian v Malay (males 1.9, females 1.6), and Malay v Chinese (males 2.0, females 2.2). The excess mortality in Indians declined with age. For hypertensive disease Malays had the highest mortality, with age-standardised relative risks of Malay v Chinese (males 3.4, females 4.4), Malay v Indian (males 2.0, females 2.5), and Indian v Chinese (males 1.6, females 1.6). For cerebrovascular disease there was little ethnic difference except for lower rates in Chinese females, with age-standardised relative risks of Malay v Chinese (males 1.1, females 1.9), Malay v Indian (males 1.0, females 1.1), and Indian v Chinese (males 1.1, females 1.7). CONCLUSIONS--There are significant differences in mortality from the three main cardiovascular diseases in the different ethnic groups in Singapore.     

Gender differences in the consequences of a coercive sexual experience among adolescents attending alternative schools

Of 490 middle and high school students attending alternative schools who participated in this study, 18.2% of females and 6.7% of males reported a past unwanted sexual experience. Relative to nonabused subjects, female and male adolescents who reported a forced sexual experience were more likely to exhibit externalizing problems such as sexual risk behaviors and internalizing problems such as depression and suicidal thoughts in the past two weeks. Females with a history of a coercive sexual experience also had increased odds of drug and alcohol use, and violence-related behaviors. The magnitude of these associations ranged from a twofold increase to a tenfold increase. Controlling for ethnicity, family income, and family support had less impact on the strength of associations between a forced sexual experience and sexual risk behaviors for females than for males. A forced sexual experience remained significantly associated with depression for females and suicidal thoughts for males. Alcohol use in the past 30 days was the only substance use-related problem that remained significant for females. Violence-related behaviors did not remain significant in the presence of control variables for females. Interventions focusing on adolescents with a history of a coercive sexual experience in general, and in alternative schools in particular, are suggested by these results. More research focusing on the differential impact of a coercive sexual experience on males and females is crucial.     

Associations between physical activity and other health behaviors in a representative sample of US adolescents.

OBJECTIVES: This study examined the associations between physical activity and other health behaviors in a representative sample of US adolescents. METHODS: In the 1990 Youth Risk Behavior Survey, 11631 high school students provided information on physical activity; diet; substance use; and other negative health behaviors. Logistic regression analyses examined associations between physical activity and other health behaviors in a subset of 2652 high-active and 1641 low-active students. RESULTS: Low activity was associated with cigarette smoking, marijuana use, lower fruit and vegetable consumption, greater television watching, failure to wear a seat belt, and low perception of academic performance. For consumption of fruit, television watching, and alcohol consumption, significant interactions were found with race/ethnicity or sex, suggesting that sociocultural factors may affect the relationships between physical activity and some health behaviors. CONCLUSIONS: Low physical activity was associated with several other negative health behaviors in teenagers. Future studies should examine whether interventions for increasing physical activity in youth can be effective in reducing negative health behaviors.     

Development and validation of a physical activity assessment questionnaire for adolescents

OBJECTIVE: To develop a physical activity questionnaire aimed at Brazilian adolescents and to assess its validity and reproducibility. METHODS: A total of 94 adolescents (30 males and 64 females) aged 11-16 years were included in the study, which was conducted in 2004. The questionnaire comprised 17 questions on habitual physical activity in the last 12 months (15 questions on sports and physical exercise and two on transportation physical activity), and was standardized to yield final scores for weekly and yearly activity. As a reference, we used the multistage 20-meter shuttle run test, measuring variables maximum time in minutes, maximum speed, maximum oxygen uptake and maximum heart rate. For validity analysis, we used the Spearman coefficient and age-adjusted correlation. For reproducibility analysis, we repeated evaluations after 15 days and measured the intraclass correlation coefficient. RESULTS: For the weekly score, the highest correlations were obtained for maximum time for the entire sample (r=0.19), maximum speed for males (r=0.20), and both maximum oxygen uptake and maximum time for females (r=0.17). For the yearly score, the highest correlations were obtained for maximum time for the entire sample (r=0.30), maximum heart rate for males (r=0.22), and maximum time for females (r=0.23). In reproducibility analyses, correlations were 0.61 for weekly score and 0.68 for yearly score. CONCLUSIONS: The questionnaire was valid and reproducible. Its use is recommended for the evaluation of physical activity in epidemiological studies with adolescents.     

Comparing Two Days of Dietary Intake in What We Eat in America (WWEIA), NHANES, 2013–2016

The objective of this research is to compare the Day 1 and Day 2 dietary intakes of adults in What We Eat in America, National Health and Nutrition Examination Survey (WWEIA, NHANES) 2013–2016. Dietary recalls of males (n = 2599) and females (n = 2624) 20+ years who had both a Day 1 and Day 2 recall and reported their intake as usual on both days in WWEIA, NHANES 2013–2016 were examined. Mean (±SE) energy intake for males was 2425 ± 26 kcal for Day 1 and 2334 ± 32 kcal for Day 2 (p = 0.004). For females, 1832 ± 18 kcal and 1775 ± 26 kcal were reported for Day 1 and 2, respectively (p = 0.020). There were no significant differences between energy intake on Day 1 and Day 2 within males and females by ten-year age groups. Comparing 20 year age groups for males and females by race/ethnicity (non-Hispanic White, non-Hispanic Black, non-Hispanic Asian, and Hispanic) and income (<131%, 131–350%, and >350% of poverty level) also showed no significant differences in energy intake between Day 1 and Day 2. Mean energy intake of adults was not statistically different between the two days of recall by sex, race/ethnicity or income within selected age groups. Overall, the difference in energy intake was less than 4% for both males and females.     

Increases in physical activity may affect quality of life differently in men and women: the PACE project

Purpose

Obesity is associated with impaired quality of life (QoL), but less is known about physical activity. We investigated how decreases in body mass index (BMI) and increases in activity affect obesity-specific QoL and potential gender differences in associations.

Methods

In a large worksite randomized trial of a multilevel intervention on diet and physical activity behaviors, we conducted a cohort analysis at two years of follow-up. Self-reported activity and Obesity and Weight Loss Quality of Life (OWLQOL) were analyzed for individual-level associations using linear mixed models accounting for random worksite effects.

Results

Gender modified the BMI–OWLQOL relationship, so analyses were conducted for males and females separately. Adjusting for demographic confounders, baseline OWLQOL, and several worksite-level variables including intervention arm, a 1.9 unit decrease in BMI (the interquartile range) was associated with an OWLQOL increase of 1.7 (95 % CI: 1.2, 2.2) in males and 3.6 (95 % CI: 3.2, 4.0) in females. Similarly, a 23 unit increase in physical activity score was associated with an OWLQOL increase of 0.9 (95 % CI: 0.5, 1.4) in males and 1.6 (95 % CI: 1.0, 2.3) in females. Physical activity associations were attenuated when adjusting for change in BMI, but remained significant for women (mean BMI 27.8 kg/m²).

Conclusions

This is the first study to demonstrate that increasing physical activity may improve obesity-specific QoL to a greater extent in women, particularly among overweight women, independent of BMI. Results may inform the design of interventions tailored to women targeting well-being through messages of increasing physical activity.     

A critical evaluation of high density lipoprotein cholesterol as an index of coronary artery disease risk in Malaysians

Fasting serum specimens from (a) 217 male and 46 female patients with coronary artery disease (CAD), aged 35-75 years, who had undergone angioplasty (PTCA) / coronary artery bypass graft (CABG), and (b) 160 apparently healthy controls (106 males, 54 females, aged 30-75 years), were assessed for serum lipid profile. Both sex and ethnicity significantly influenced the levels of serum high density lipoprotein cholesterol (HDLC); in the controls, females had higher HDLC levels than males (46.7 mg/dl vs 38.5 mg/dl, p<0.00l), while the Indian males possessed significantly lower HDLC values than the male Malay or Chinese. HDLC, triglycerides (TG) and the atherogenic index- LDLC/HDLC ratio were significantly different between the CAD patients and the healthy controls, while total cholesterol (TC) and LDLC did not seem to be of diagnostic value. Serum HDLC was lower in the CAD patients compared to the healthy controls in both sexes (p<0.001), either expressed as HDLC per se or as % HDLC. This observation combined with the odds ratio (OR) values of 0.24 and 0.28 for HDLC and % HDLC respectively in males, firmly establishes HDL as a protective factor of CAD in Malaysians. Significance testing for the X2 values associated with the OR values for the various lipid indices, together with the findings on the receiver-operating characteristices (ROC) curves, i.e. plots of sensitivity vs 1-specificity, indicated that HDLC, % HDLC and TQ were equally efficient as a means of risk assessment to CAD in Malaysians.