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Third National Health (third + national_health)
Selected AbstractsThe association between incisor trauma and occlusal characteristics in individuals 8,50 years of ageDENTAL TRAUMATOLOGY, Issue 2 2004Jay D. Shulman Abstract,,, To explore the association between incisal trauma and occlusal characteristics using oral examination and health interview data from the Third National Health and Nutrition Examination Survey 1988,1994 (NHANES III). Incisal trauma examinations were performed on 15 364 individuals 6,50 years of age using an ordinal scale developed by the National Institute of Dental and Craniofacial Research. Occlusal examinations were performed on 13 057 individuals 8,50 years of age. We fitted separate multivariate logistic regression models for maxillary and mandibular incisor trauma adjusting for socio-demographic variables (age, gender, race-ethnicity) and occlusal characteristics (overbite, overjet, open bite). 23.45% of all individuals evidenced trauma on at least one incisor, with trauma more than four times more prevalent on maxillary (22.59%) than on mandibular incisors (4.78%). Males (OR = 1.67) had greater odds of trauma than females; Whites (OR = 1.37) and non-Hispanic Blacks (OR = 1.37) had greater odds of trauma than Mexican,Americans. The odds of trauma increased with age, peaked from age 21 to 30 (OR = 2.92), and declined. As overjet increased, so did the odds of trauma. Compared to individuals with ,0-mm overjet, odds of trauma increased from 1,3 mm (OR = 1.42) to 4,6 mm (OR = 2.42) to 7,8 mm (OR = 3.24) to >8 mm (OR = 12.47). Trauma to incisors is prevalent but mostly limited to enamel. Trauma to maxillary incisors is associated with overjet, gender, race-ethnicity, and age, while trauma to mandibular incisors is associated with gender, age, and overbite. [source] Elevated C-reactive protein in Native Canadian children: an ominous early complication of childhood obesityDIABETES OBESITY & METABOLISM, Issue 5 2006R. Retnakaran Aim:, Subclinical inflammation has been proposed as a pathophysiologic mechanism linking obesity with vascular and metabolic disease. Native North American populations are experiencing high prevalence rates of both (i) childhood obesity and (ii) adult cardiovascular disease (CVD) and type 2 diabetes. Thus, we sought to determine whether subclinical inflammation is an early complication of obesity in Native children. Methods:, Serum concentrations of the inflammatory biomarker C-reactive protein (CRP) were assessed in a population-based, cross-sectional study of the Sandy Lake Oji-Cree community of Northern Ontario, Canada, involving 228 children aged 10,19 years (mean age 14.8). Results:, Median CRP in this population was 0.5 mg/l (interquartile range 0.18,1.79 mg/l). CRP levels were higher than age-matched reference data from the Third National Health and Nutrition Examination Survey (NHANES III). Importantly, fully 15.8% of the children of this community had CRP concentrations between 3 and 10 mg/l, a range that identifies adults at high risk of CVD. Moreover, increasing CRP concentration in this paediatric population was associated with an enhanced CV risk profile, consisting of increased adiposity, higher insulin resistance, worsening lipid profile (higher total cholesterol, triglycerides, low-density lipoprotein cholesterol, apolipoprotein B and total cholesterol : high-density-lipoprotein cholesterol ratio), increased leptin and decreased adiponectin. On multivariate analysis, waist circumference and interleukin-6 (IL-6) emerged as independent determinants of CRP concentration. Conclusion:, Subclinical inflammation is an early complication of childhood obesity in Native children and may foreshadow an increased burden of CVD and type 2 diabetes in the future. [source] Structural Trends in the Aging Femoral Neck and Proximal Shaft: Analysis of the Third National Health and Nutrition Examination Survey Dual-Energy X-Ray Absorptiometry Data,JOURNAL OF BONE AND MINERAL RESEARCH, Issue 12 2000Thomas J. Beck Abstract Hip scans of U.S. adults aged 20,99 years acquired in the Third National Health and Nutrition Examination Survey (NHANES III) using dual-energy X-ray absorptiometry (DXA) were analyzed with a structural analysis program. The program analyzes narrow (3 mm wide) regions at specific locations across the proximal femur to measure bone mineral density (BMD) as well as cross-sectional areas (CSAs), cross-sectional moments of inertia (CSMI), section moduli, subperiosteal widths, and estimated mean cortical thickness. Measurements are reported here on a non-Hispanic white subgroup of 2719 men and 2904 women for a cortical region across the proximal shaft 2 cm distal to the lesser trochanter and a mixed cortical/trabecular region across the narrowest point of the femoral neck. Apparent age trends in BMD and section modulus were studied for both regions by sex after correction for body weight. The BMD decline with age in the narrow neck was similar to that seen in the Hologic neck region; BMD in the shaft also declined, although at a slower rate. A different pattern was seen for section modulus; furthermore, this pattern depended on sex. Specifically, the section modulus at both the narrow neck and the shaft regions remains nearly constant until the fifth decade in females and then declined at a slower rate than BMD. In males, the narrow neck section modulus declined modestly until the fifth decade and then remained nearly constant whereas the shaft section modulus was static until the fifth decade and then increased steadily. The apparent mechanism for the discord between BMD and section modulus is a linear expansion in subperiosteal diameter in both sexes and in both regions, which tends to mechanically offset net loss of medullary bone mass. These results suggest that aging loss of bone mass in the hip does not necessarily mean reduced mechanical strength. Femoral neck section moduli in the elderly are on the average within 14% of young values in females and within 6% in males. [source] Achieving Goal Blood Pressure in Patients With Type 2 Diabetes: Conventional Versus Fixed-Dose Combination ApproachesJOURNAL OF CLINICAL HYPERTENSION, Issue 3 2003George L. Bakris MD Data from the Third National Health and Nutrition Examination Survey (NHANES III) demonstrate that only 11% of people with diabetes who are treated for high blood pressure achieve the blood pressure goal of <130/85 mm Hg recommended in the sixth report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI). The current study tests the hypothesis that initial therapy with a fixed-dose combination will achieve the recommended blood pressure goal in patients with type 2 diabetes faster than conventional monotherapy. This randomized, double-blind, placebo-controlled study had as a primary end point achievement of blood pressure <130/85 mm Hg. Participants (N=214) with hypertension and type 2 diabetes received either amlodipine/benazepril 5/10 mg (combination) or enalapril 10 mg (conventional) once daily for 4 weeks, titrated to 5/20 mg/day or 20 mg/day, respectively at this time, if target blood pressure was not achieved. Hydrochlorothiazide (HCTZ) 12.5 mg/day was added for the final 4 weeks, if target blood pressure was still not reached. Time from baseline to achieve blood pressure <130/85 mm Hg was shorter in the combination group (5.3±3.1 weeks combination vs. 6.4±3.8 weeks conventional; p=0.001). At 3 months, more participants in the combination group achieved treatment goal (63% combination vs. 37% conventional; p=0.002). Data analysis at 3 months comparing blood pressure control rates between the fixed-dose combination group (with out HCTZ) to the conventional group (receiving HCTZ) showed an even greater disparity in blood pressure goal achievement (87% combination without HCTZ vs. 37% conventional group with HCTZ; p=0.0001). We conclude that initial therapy with a fixed-dose combination may be more efficacious than conventional monotherapy approaches for achieving blood pressure goals in the diabetic patient. A fixed-dose combination approach appears as safe as the current conventional approaches. [source] Alcohol consumption and periodontal diseaseJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 7 2004Nutrition Examination Survey, The Third National Health Abstract Objective: This study was carried out to evaluate the effect of alcohol consumption on the severity of periodontal disease. Material and Methods: This cross-sectional study employed 13,198 subjects of the Third National Health and Nutrition Examination Survey (NHANES III) aged 20 and older who have at least six natural teeth. Alcohol intake was represented both as a continuous variable and dichotomized using 5, 10, 15, and 20 drinks/week as cut-points. Periodontal disease was represented by clinical attachment loss (CAL) and was assessed both as a continuous variable and dichotomized as <1.5 mm and 1.5 mm. Independent effect of alcohol on CAL was assessed by weighted multiple linear and logistic regression analyses adjusting simultaneously for the effects of age, gender, race, education, income, smoking, diet, diabetes, gingival bleeding, number of remaining teeth. Results: There was a significant linear relationship between number of drinks per week and log CAL (p=0.0001). Odds ratios for the risk of attachment loss using 5, 10, 15, and 20 drinks/week as cut-points were 1.22 [1.02,1.47], 1.39 [1.13,1.71], 1.54 [1.22,1.93], and 1.67 [1.25,2.23], respectively. Conclusion: Alcohol consumption may be associated with increased severity of CAL in a dose-dependent fashion. Prospective studies and studies of mechanism are needed to confirm the role of alcohol as a risk factor for periodontal disease. [source] Prevalence and Trends in Overweight in Mexican-American Adults and ChildrenNUTRITION REVIEWS, Issue 2004Katherine M. Flegal Ph.D. Overweight and obesity have been increasing in many countries. Our objective is to describe the trends in overweight and obesity occurring in the Mexican-American population in the United States. Data on measured height and weight for Mexican Americans come from the following surveys: the Hispanic Health and Nutrition Examination Survey (HHANES, 1982,84), the Third National Health and Nutrition Examination Survey (NHANES III, 1988,94), and NHANES 1999,2002. In 1999,2002, 73% of Mexican-American adults were overweight and 33% were obese. Obesity increased between NHANES III and NHANES 1999,2002, from 24% to 27% for men and from 35% to 38% for women. Increases were also seen for children and adolescents. The Mexican-American population in the United States, both children and adults, is showing trends in overweight and obesity over time that are similar to those seen in other segments of the U.S. population and indeed in many countries [source] Changes in body fat distribution in relation to parity in American women: A covert form of maternal depletionAMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY, Issue 2 2006William D. Lassek Abstract Using data from the Third National Health and Nutrition Examination Survey (NHANES III), conducted from 1988,1994, we investigated the effect of reproduction on the distribution of body fat in well-nourished American women. While women tend to gain weight and fat with succeeding pregnancies, if age and body mass index are controlled, increasing parity is associated with a decrease in hip and thigh circumferences, suprailiac and thigh skinfolds, and body fat estimated from skinfolds, while waist circumference increases, resulting in a relative decrease in lower-body fat. The mobilization of fat stores in the lower body during late pregnancy and lactation may help to meet the special needs of the developing brain for essential fatty acids and energy during the time of peak growth. When fat is regained after the postpartum period, relatively more is stored in central vs. peripheral depots, resulting in a patterned change in body shape with parity. Am J Phys Anthropol 131:295,302, 2006. © 2006 Wiley-Liss, Inc. [source] Testing Hardy-Weinberg Equilibrium using Family Data from Complex SurveysANNALS OF HUMAN GENETICS, Issue 4 2009Dewei She Summary Genetic data collected during the second phase of the Third National Health and Nutrition Examination Survey (NHANES III) enable us to investigate the association of a wide variety of health factors with regard to genetic variation. The classic question when looking into the genetic variations in a population is whether the population is in the state of Hardy-Weinberg Equilibrium (HWE). Our objective was to develop test procedures using family data from complex surveys such as NHANES III. We developed six Pearson ,2 based tests for a diallelic locus of autosomal genes. The finite sample properties of the proposed test procedures were evaluated via Monte Carlo simulation studies and the Rao-Scott first order corrected test was recommended. Test procedures were applied to three loci from NHANES III genetic databases, i.e., ADRB2, TGFB1, and VDR. HWE was shown to hold at 0.05 level for all three loci when only families with genotypic information available for two parents and for one or more children were used in the analysis. [source] Prevalence of rheumatoid arthritis in persons 60 years of age and older in the United States: Effect of different methods of case classificationARTHRITIS & RHEUMATISM, Issue 4 2003Elizabeth K. Rasch Objective To determine prevalence estimates for rheumatoid arthritis (RA) in noninstitutionalized older adults in the US. Prevalence estimates were compared using 3 different classification methods based on current classification criteria for RA. Methods Data from the Third National Health and Nutrition Examination Survey (NHANES-III) were used to generate prevalence estimates by 3 classification methods in persons 60 years of age and older (n = 5,302). Method 1 applied the "n of k" rule, such that subjects who met 3 of 6 of the American College of Rheumatology (ACR) 1987 criteria were classified as having RA (data from hand radiographs were not available). In method 2, the ACR classification tree algorithm was applied. For method 3, medication data were used to augment case identification via method 2. Population prevalence estimates and 95% confidence intervals (95% CIs) were determined using the 3 methods on data stratified by sex, race/ethnicity, age, and education. Results Overall prevalence estimates using the 3 classification methods were 2.03% (95% CI 1.30,2.76), 2.15% (95% CI 1.43,2.87), and 2.34% (95% CI 1.66,3.02), respectively. The prevalence of RA was generally greater in the following groups: women, Mexican Americans, respondents with less education, and respondents who were 70 years of age and older. Conclusion The prevalence of RA in persons 60 years of age and older is ,2%, representing the proportion of the US elderly population who will most likely require medical intervention because of disease activity. Different classification methods yielded similar prevalence estimates, although detection of RA was enhanced by incorporation of data on use of prescription medications, an important consideration in large population surveys. [source] Recurrent herpes labialis in US children and youthCOMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY, Issue 6 2004Jay D. Shulman Abstract , Objective:, This study reports data from the Third National Health and Nutrition Examination Study, 1988,1994 (NHANES III). Methods:, NHANES III was a complex, multistage sample of 33 994 civilian, non-institutional individuals from 19 528 households. Dentist examiners were trained to recognize, classify oral mucosal lesions to include recurrent herpes labialis (RHL). Subjects ,8 years of age were asked if they had cold sores in the past year and serologic tests for herpes virus type 1 (HSV-1) and type 2 (HSV-2) were performed on blood of youth >12 years of age. Results:, Examinations were performed on 10 032 individuals 2,17 years of age. Overall point prevalence was 1.42% (0.69,2.15); annual prevalence in individuals 8,17 years of age was 14.77% (12.74,16.80); and serologic prevalence of HSV-1 in youth 12,17 years of age was 43.18% (38.88,47.48). When the data were subset to youth 12,17, annual prevalence for seropositives was 24.13% (20.44,27.82) compared with 16.87 (14.16,19.57) for all subjects. Approximately 25% of the seropositive youth had at least one recurrence in the past year. Conclusion:, As RHL is a recurrent infection, prevalence in a population will be related to the proportion of the population that has been infected with herpes simplex virus. When lesion-specific prevalences are cited in the literature, they should be stratified by covariates known to be associated with them. Future studies should examine RHL prevalence in infected individuals. [source] Age Trends in Femur Stresses From a Simulated Fall on the Hip Among Men and Women: Evidence of Homeostatic Adaptation Underlying the Decline in Hip BMDJOURNAL OF BONE AND MINERAL RESEARCH, Issue 9 2006Thomas J Beck ScD Abstract Age trends in proximal femur stresses were evaluated by simulating a fall on the greater trochanter using femur geometry from hip DXA scans of 5334 white men and women in the NHANES III survey. Expansion of femur outer diameter seems to counter net bone loss so that stresses remain similar across age groups, but stresses are higher in older women than in older men. Introduction: The age decline in hip BMD is caused by both bone loss and expansion of outer diameter that increases the region size over which mass is measured in a DXA scan. Because expansion has an opposing effect on structural strength, it may be a homeostatic adaptation to net bone loss to ensure that load stresses are kept within a narrow range. Materials and Methods: Age trends in femur stresses were evaluated with an engineering beam simulation of a fall on the greater trochanter. Hip geometry was extracted from hip DXA scans using the Hip Structure Analysis (HSA) software on 2613 non-Hispanic white men and 2721 women from the third National Health and Nutrition Examination Survey (NHANES III). Using body weight as load, stresses were computed on the inferior-medial and superior-lateral femur neck at its narrowest point and the medial and lateral shaft 2 cm distal to the midpoint of the lesser trochanter. Stresses and the underlying geometries in men and women >50 years oaf age were compared with those 20,49 years of age. Results: Compared with men <50 years of age, stresses in older men were 6% lower on both surfaces of the shaft, 4% lower on the inferior-medial neck, and not different on the superior-lateral neck. In women >50 years of age, stresses on the proximal shaft and inferior-medial neck remained within 3% of young values but were 13% greater on the superior-lateral neck. Neck stresses in young women were lower on the superior-lateral than the inferior-medial neck, but lateral stress increased to the level on the medial surface in older women. Stresses were higher in women than in men, with a greater gender difference in those >50 years of age. Conclusions: We conclude that femur expansion has a homeostatic effect in men and women that opposes bone loss so that stresses change little with age. Because expansion preserves stresses with progressively less bone mass, the process may reduce structural stability in the femoral neck under fall conditions, especially in the elderly female. [source] Prescription and non-prescription analgesic use among the US adult population: results from the third National Health and Nutrition Examination Survey (NHANES III),PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 4 2003Ryne Paulose-Ram PhD Abstract Purpose To estimate prescription and non-prescription analgesic use in a nationally representative sample of US adults. Methods Data collected during the third National Health and Nutrition Examination Survey (1988,1994), for persons 17 years and older were analyzed (n,=,20,050). During the household interview, respondents reported use, in the last month, of prescription and non-prescription analgesics. Results An estimated 147 million adults reported monthly analgesic use, Prescription analgesic use was 9% while non-prescription use was 76%. Females were more likely than males to use prescription (11 vs. 7%, p,<,0.001) and non-prescription (81 vs. 71%, p,<,0.001) analgesics. Across race,ethnicity groups, males (,8%) and females (11,13%) had similar age-adjusted prescription analgesic use. Non-prescription analgesic use was higher among non-Hispanic whites than non-Hispanic blacks and Mexican,Americans for males (76 vs. 53% (p,<,0.001) and 59% (p,<,0.001), respectively) and females (85 vs. 68% (p,<,0.001) and 71% (p,<,0.001), respectively). With increasing age, prescription analgesic use increased whereas non-prescription use decreased. Approximately 30% of adults used multiple analgesics during a 1-month period. This was more common among females (35%) than males (25%, p,<,0.001) and among younger (17,44 years, 33%) rather than older age groups (45+ years, 26%, p,<,0.001). Conclusions Analgesic use among US adults is extremely high, specifically of non-prescription analgesics. Given this, health care providers and consumers should be aware of potential adverse effects and monitor use closely. Published in 2002 by John Wiley & Sons, Ltd. [source] Brains versus brawn: An empirical test of Barker's brain sparing modelAMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 2 2010Jack Baker The Barker model of the in utero origins of diminished muscle mass in those born small invokes the adaptive "sparing" of brain tissue development at the expense of muscle. Though compelling, to date this model has not been directly tested. This article develops an allometric framework for testing the principal prediction of the Barker model,that among those born small muscle mass is sacrificed to spare brain growth,then evaluates this hypothesis using data from the third National Health and Nutrition Examination Survey (NHANES III). The results indicate clear support for a negative relationship between the allometric development of the two tissues; however, a further consideration of conserved mammalian fetal circulatory patterns suggests the possibility that system-constrained patterns of developmental damage and "bet-hedging" responses in affected tissues may provide a more adequate explanation of the results. Far from signaling the end of studies of adaptive developmental programming, this perspective may open a promising new avenue of inquiry within the fields of human biology and the developmental origins of health and disease. Am. J. Hum. Biol., 2010. © 2009 Wiley-Liss, Inc. [source] Prevalence of cigarette smoking by occupation and industry in the United States,AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 3 2001Ki Moon Bang PhD Abstract Background This study was undertaken to estimate the most recent prevalence of cigarette smoking by occupation and industry in the US, using the data from the third National Health and Nutrition Examination Survey (NHANES III), 1988,1994. Methods Included in NHANES III are data on the cigarette smoking status, occupation, industry, and other demographic information of US non-institutionalized civilians obtained through household interview surveys. The study population included 20,032 adults aged 17 years and older. To estimate the prevalence of cigarette smoking across occupation and industry groups, we used the Survey Data Analysis (SUDAAN) software. Results The prevalence of cigarette smoking was highest among material moving occupations, construction laborers, and vehicle mechanics and repairers. The lowest smoking prevalence was found among teachers. Among industry groups, the construction industry had the highest prevalence of cigarette smoking. Conclusions These findings provide information useful for targeting education activities focusing on adverse health effects of cigarette smoking and also for indirect adjustments in analysis of morbidity and mortality by occupation. Am. J. Ind. Med. 40:233,239, 2001. Published 2001 Wiley-Liss, Inc. [source] | |||||||||||||