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Nutrition Examination Survey (nutrition + examination_survey)
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] Impact of substance use on the physical health of patients with bipolar disorderACTA PSYCHIATRICA SCANDINAVICA, Issue 6 2010M. P. Garcia-Portilla Garcia-Portilla MP, Saiz PA, Benabarre A, Florez G, Bascaran MT, Díaz EM, Bousoño M, Bobes J. Impact of substance use on the physical health of patients with bipolar disorder. Objective:, To describe the impact of tobacco, alcohol and cannabis on metabolic profile and cardiovascular risk in bipolar patients. Method:, Naturalistic, cross-sectional, multicenter Spanish study. Current use of tobacco, alcohol and cannabis was determined based on patient self-reports. Metabolic syndrome was defined using the National Health and Nutrition Examination Survey 1999,2000 and the American Heart Association/National Heart, Lung and Blood Institute criteria, and cardiovascular risk using the Framingham and the Systematic Coronary Risk Evaluation functions. Results:, Mean age was 46.6 years, 49% were male. Substance use: 51% tobacco, 13% alcohol and 12.5% cannabis. Patients who reported consuming any substance were significantly younger and a higher proportion was male. After controlling for confounding factors, tobacco was a risk factor for coronary heart disease (CHD) (unstandardized linear regression coefficient 3.47, 95% confidence interval 1.85,5.10). Conclusion:, Substance use, mainly tobacco, was common in bipolar patients. Tobacco use negatively impacted CHD risk. [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] Self-reported prevalence and awareness of metabolic syndrome: findings from SHIELDINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 8 2008S. J. Lewis Summary Purpose:, This study assessed awareness of metabolic syndrome and evaluated health knowledge, attitudes and behaviours of respondents at risk. Methods:, Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes (SHIELD), a longitudinal US population-based survey initiated in 2004, included respondents, , 18 years of age, reporting a diagnosis of metabolic syndrome. Prevalence of metabolic syndrome was compared in SHIELD and National Health and Nutrition Examination Survey (NHANES) 1999,2002 survey. The proportion of SHIELD respondents who had heard of and/or understood metabolic syndrome was estimated. Respondents at high risk for metabolic syndrome were stratified into attitude-behaviour categories of ,Already Doing It', ,I Know I Should' and ,Don't Bother Me' and differences in attitudes and behaviours were evaluated with chi-square tests. Results:, Prevalence of reported metabolic syndrome was 0.6% in SHIELD screening questionnaire respondents (n = 211,097) vs. 25.9% in NHANES (n = 10,780). Less than 15% of SHIELD baseline questionnaire respondents (n = 22,001) had heard of or understood metabolic syndrome. Attitudes toward health status were more favourable in the ,Doing' group (27% reported fair/poor health) compared with those in the ,Should' (38%) and ,Don't' (54%) groups (p < 0.0001). The ,Don't' group was most likely to prefer medications to lifestyle change (13% vs. 2,4%) compared with ,Should' and ,Doing' groups (p < 0.0001). More ,Doing' respondents (79%) than ,Should' (59%) and ,Don't' (48%) respondents reported exercising regularly (p < 0.0001). Conclusions:, The lack of knowledge about metabolic syndrome reported in SHIELD indicates limited penetration of this concept into public awareness. With behaviour categories, respondents who report healthy attitudes are more likely to embrace lifestyle changes, while respondents who do not care may be more difficult to treat. [source] Isokinetic Leg Muscle Strength in Older Americans and Its Relationship to a Standardized Walk Test: Data from the National Health and Nutrition Examination Survey 1999,2000JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 6 2004Yechiam Ostchega PhD Objectives: To describe isokinetic knee extensor muscle strength in older U.S. men and women by age and race/ethnicity and to ascertain its relationship to a standard, timed walking-speed test. Setting: The U.S. National Health and Nutrition Examination Survey (NHANES) 1999,2000. Design: A cross-sectional nationally representative health examination survey. Participants: All surveyed persons aged 50 and older (N=1,499) who performed muscle strength and timed walk examinations in the NHANES mobile examination center. Measurements: Concentric peak torque (strength) of the knee extensors at 1.05 rads/ s,1 velocity and a 6-m walk timed in seconds. Results: Knee extensor strength was inversely associated with age (P<.01), and women had less knee extensor muscle strength than men (P<.01). After adjustment for standing height, no significant difference in muscle strength was found across the three race/ethnicity groups (Mexican Americans, non-Hispanic blacks, and non-Hispanic whites) for men or women. After adjustment for age, race/ethnicity, weight, and height, increasing knee extensor strength was associated with significant increases in meters walked per second (P<.01). Conclusion: Knee extensor muscle strength is affected by age and sex but not by race/ethnicity and it is significantly associated with timed walk. [source] Prevalence and trends in low femur bone density among older US adults: NHANES 2005,2006 compared with NHANES IIIJOURNAL OF BONE AND MINERAL RESEARCH, Issue 1 2010Anne C Looker Abstract Hip fracture incidence appears to be declining in the United States, but changes in bone mineral density (BMD) of the population have not been evaluated. We used femur BMD data from the National Health and Nutrition Examination Survey (NHANES) 2005,2006 to estimate the prevalence of low femoral BMD in adults age 50 years and older and compared it with estimates from NHANES III (1988,1994). Dual-energy X-ray absorptiometry systems (pencil-beam geometry in NHANES III, fan-beam geometry in NHANES 2005,2006) were used to measure femur BMD, and World Health Organization (WHO) definitions of low BMD were used to categorize skeletal status. In 2005,2006, 49% of older US women had osteopenia and 10% had osteoporosis at the femur neck. In men, 30% had femur neck osteopenia and 2% had femur neck osteoporosis. An estimated 5.3 million older men and women had osteoporosis at the femur neck, and 34.5 million more had osteopenia in 2005,2006. When compared with NHANES III, the age-adjusted prevalence of femur neck osteoporosis in NHANES 2005,2006 was lower in men (by 3 percentage units) and women (by 7 percentage units) overall and among non-Hispanic whites. Changes in body mass index or osteoporosis medication use between surveys did not fully explain the decline in osteoporosis. Owing to the increase in the number of older adults in the US population, however, more older adults had low femur neck BMD (osteoporosis + osteopenia) in 2005,2006 than in 1988,1994. Thus, despite the decline in prevalence, the estimated number of affected older adults in 2005,2006 remained high. Copyright © 2010 American Society for Bone and Mineral Research [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] 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] Prevalence of Pelvic Paget's Disease of Bone in the United StatesJOURNAL OF BONE AND MINERAL RESEARCH, Issue 3 2000R. D. Altman M.D. Abstract The objective of this article was to estimate the prevalence of Paget's disease of bone in the United States from a statistically derived sample of the general population. Pelvic radiographs obtained in the First National Health and Nutrition Examination Survey (NHANES-I) were reviewed for the presence of Paget's disease. Age, sex, and geographic distribution of Paget's disease of the pelvic region were determined. The overall prevalence of Paget's disease in the United States was estimated. Pelvic Paget's disease is estimated to be present in 0.71 + 0.18% of the radiographs of the general population. The disease was higher in frequency in people who were in the older decades of life with the highest prevalence of 2.32 + 0.54% in the 65- to 74-year-old people. There is a slight male predominance in the 45- to 74-year age group. The regional distribution suggests the highest prevalence in the Northeast (1.48 + 0.52%) with the lowest prevalence in the South (0.26 + 0.25%). The prevalence was equal in white people and black people. An estimate of the overall prevalence of Paget's disease in the United States was at least 1% and perhaps as much as 2% of the general population with near equal sex distribution and the highest prevalence in the northeastern United States. [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] ORIGINAL ARTICLE: Prevalence and correlates of metabolic syndrome based on a harmonious definition among adults in the US,JOURNAL OF DIABETES, Issue 3 2010Earl S. FORD Abstract Background:, Recently, a Joint Scientific Statement bridged differences between previous definitions of metabolic syndrome. Our objective was to estimate the prevalence of metabolic syndrome in a representative sample of US adults and to examine its correlates. Methods:, We analyzed data for up to 3461 participants aged ,20 years of the 2003,2006 National Health and Nutrition Examination Survey. Results:, Using waist circumference thresholds of ,102 cm for men and ,88 cm for women, the age-adjusted prevalence of metabolic syndrome was 34.3% among all adults, 36.1% among men, and 32.4% among women. Using racial- or ethnic-specific International Diabetes Federation criteria for waist circumference, the age-adjusted prevalence of metabolic syndrome was 38.5% for all participants, 41.9% for men, and 35.0% for women. Prevalence increased with age, peaking among those aged 60,69 years. Prevalence was lower among African American men than White or Mexican American men, and lower among White women than among African American or Mexican American women. In a multivariate regression model, significant independent associations were noted for age (positive), gender (men higher than women), race or ethnicity (African Americans and participants of another race lower than Whites), educational status (inverse), hypercholesterolemia (positive), concentrations of C-reactive protein (positive), leisure time physical activity (inverse), microalbuminuria (positive), and hyperinsulinemia (positive). Additional adjustment for body mass index weakened many of the associations, with educational status and microalbuminuria no longer significant contributors to the model. Conclusion:, Metabolic syndrome continues to be highly prevalent among adults in the US. [source] Serum concentrations of vitamin D and parathyroid hormone and prevalent metabolic syndrome among adults in the United StatesJOURNAL OF DIABETES, Issue 4 2009Earl S. FORD Abstract Background:, Some reports suggest that concentrations of vitamin D are inversely, whereas concentrations of parathyroid hormone (PTH) are directly, associated with prevalent metabolic syndrome. Because of lingering uncertainty about these associations, we examined the cross-sectional associations between serum concentrations of 25-hydroxyvitamin D3 and PTH with metabolic syndrome in a representative sample of adults in the US. Methods:, We used data from 1705 participants in the 2005,2006 National Health and Nutrition Examination Survey. Vitamin D was measured by radioimmunoassay, whereas PTH was measured using an electrochemiluminescent process. Results:, The mean concentration of vitamin D for participants with and without metabolic syndrome was 20.3 and 22.9 ng/mL, respectively (P = 0.001). The mean concentration of PTH for participants with and without metabolic syndrome was 44.5 and 41.0 pg/mL, respectively (P = 0.002). The age-adjusted mean concentrations of vitamin D (P for linear trend <0.001) decreased linearly, whereas PTH (P for linear trend = 0.002) increased linearly, as the number of components of metabolic syndrome increased. After adjusting for age, gender, physical activity, urinary albumin creatinine ratio, and concentrations of C-reactive protein and calcium, concentrations in the highest quintile of vitamin D [prevalence ratio (PR) = 0.59; 95% confidence interval (CI) 0.44,0.79], but not PTH (PR = 1.18; 95% CI 0.97,1.43), was significantly associated with prevalent metabolic syndrome. Conclusion:, Concentrations of vitamin D, but not PTH, were significantly associated with prevalent metabolic syndrome among US adults. [source] The Effect of Functional Dentition on Healthy Eating Index Scores and Nutrient Intakes in a Nationally Representative Sample of Older AdultsJOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 4 2009R. Bethene Ervin PhD Abstract Objective: The objectives of this study were to examine the associations between functional dentition and the Healthy Eating Index (HEI) scores and nutrient intakes among older adults in the United States. Methods: The sample consisted of 2,560 adults, 60 years and over from the National Health and Nutrition Examination Survey 1999-2002. We used multivariate linear regression to examine associations between functional dentition and HEI scores or nutrient intakes controlling for the potential confounding effects of age, race/ethnicity, education, smoking status, body mass index (BMI), self-reported health, and caloric intake. Dentate status was classified as: edentulous (no natural permanent teeth or implants), 1-20 teeth, or,21 teeth. A functional dentition was defined as having 21 or more teeth present. HEI scores and nutrient intakes were based on one 24-hour dietary recall. Results: Males with a functional dentition consumed slightly more fruit and had higher alpha- and beta-carotene intakes than edentulous males. Females with any natural teeth had higher vitamin C intakes than edentulous females. There were no significant associations between dentate status and any of the remaining HEI scores or nutrient intakes for either sex. Conclusions: Having a functional dentition did not contribute substantially to higher HEI scores or nutrient intakes in this nationally representative sample of older adults. However, older men and women with no teeth or those who wear dentures consumed fewer servings of fruits and vegetables, especially those rich in carotenes and vitamin C, than those with teeth. [source] Dental Insurance and Clinical Dental Outcomes in NHANES IIIJOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 4 2005Tonya R. Stancil PhD Abstract Objectives: The National Health and Nutrition Examination Survey (NHANES III) 1988,1994 is one of the few nationally representative data sets with information on both private dental insurance and a clinical dental exam. The objective of this analysis was to examine the possible associations between private dental insurance and clinical exam outcomes, demographic variables, and dental visits. Methods: Using NHANES III data, analysis was limited to persons aged 20 years or older who had a dental exam and reported on their private dental insurance status. Initial analyses were based on comparisons between those with and without private dental insurance. Propensity scoring method was used to examine the effects of dental insurance on clinical exam variables. Results: The percentage of individuals with private dental insurance was significantly greater among non-Hispanic blacks, those with higher educational attainment, those living at/above the federal poverty level, and those with a dental visit in the past year compared to their respective counterparts. Those with untreated caries, those with a loss of attachment of greater than 4 mm, and those with 12,27 missing teeth were significantly less likely to have dental insurance (p<0.05) than their respective counterparts. Conclusions: These results suggest that having private dental insurance is associated with better clinical oral health status. [source] Can Nutritional Label Use Influence Body Weight Outcomes?KYKLOS INTERNATIONAL REVIEW OF SOCIAL SCIENCES, Issue 4 2009Andreas C. Drichoutis SUMMARY Many countries around the world have already mandated, or plan to mandate, the presence of nutrition related information on most pre-packaged food products. Health advocates and lobbyists would like to see similar laws mandating nutrition information in the restaurant and fast-food market as well. In fact, New York City has already taken a step forward and now requires all chain restaurants with 15 or more establishments anywhere in US to show calorie information on their menus and menu board. The benefits were estimated to be as much as 150,000 fewer obese New Yorkers over the next five years. The implied benefits of the presence of nutrition information are that consumers will be able to observe such information and then make informed (and hopefully healthier) food choices. In this study, we use the latest available dataset from the US National Health and Nutrition Examination Survey (2005,2006) to explore whether reading such nutrition information really has an effect on body weight outcomes. In order to deal with the inherent problem of cross-sectional datasets, namely self-selection, and the possible occurrence of reverse causality we use a propensity score matching approach to estimate causal treatment effects. We conducted a series of tests related to variable choice of the propensity score specification, quality of matching indicators, robustness checks, and sensitivity to unobserved heterogeneity, using Rosenbaum bounds to validate our propensity score exercise. Our results generally suggest that reading nutrition information does not affect body mass index. The implications of our findings are also discussed. [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] 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] Dairy and milk consumption and child growth: Is BMI involved?AMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 4 2010An analysis of NHANES 199 Humans are unique among mammals in that many consume cow's milk or other dairy products well beyond the traditional age of weaning. Milk provides various nutrients and bioactive molecules to support growth and development, and the question arises as to whether this dietary behavior influences growth parameters. There is evidence that milk makes positive contributions to growth in height, but its associations with other aspects of body size, such as body mass index (BMI), are not well-established. National Health and Nutrition Examination Survey (NHANES) data from 1999 to 2004 and multivariate regression analysis were used to test the hypothesis that milk (g) or total dairy product consumption (kJ) is associated with higher BMI percentile among US White, Black, and Mexican-American children of age 2,4 years (n = 1,493) and 5,10 years (n = 2,526). Younger children in the highest quartile of dairy intake had higher BMIs (, = 7.5,8.0; P < 0.01) than those in the lowest two quartiles. Controlling for energy intake eliminated differences between QIV and QI. Among children of 5,10 years of age dairy intake had no relationship to BMI. Young children in the highest quartile of milk intake had higher BMIs than all lower quartiles (, = 7.1,12.8; , = 6.3,11.8 in energy-controlled models; P < 0.05). Among children of 5,10 years of age, those in QIV for milk intake had higher BMIs than those in QII (, = 8.3; , = 7.1 in energy-controlled model; P < 0.01). Controlling for total protein or calcium did not change the results. Milk had more consistent positive associations with BMI than did dairy products, and these were strongest among children of 2,4 years of age. Am. J. Hum. Biol., 2010. © 2010 Wiley-Liss, Inc. [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] Growth and market integration in Amazonia: A comparison of growth indicators between Shuar, Shiwiar, and nonindigenous school childrenAMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 2 2009Aaron D. Blackwell We describe and compare the growth of three groups of juveniles, aged 0,18, who experience different degrees of market integration and acculturation in the Ecuadorian Amazon. These include 1,384 indigenous Shuar from the Upano Valley of Ecuador and surrounding areas, 570 nonindigenous colono (or colonist) children from the same area, and 42 Shiwiar from the interior of Ecuador. We use differences between these populations in National Health and Nutrition Examination Survey (NHANES) z -scores to assess the effects of changing subsistence patterns on Shuar growth and nutrition. Although, for all three groups, mean height-for-age z -scores were negative, Shuar z -scores were significantly lower than either colono or Shiwiar z -scores. Mean weight-for-age z -scores were also negative for Shuar and colono juveniles, while mean BMI-for-age and weight-for-height z -scores were greater than zero for all three groups. Using NHANES standards, 41% of male and 38% of female Shuar were classified as stunted, versus 16% of male and 20% of female colonos. Compared to Shuar, colonos were three times less likely to be stunted (OR = 0.33, P < 0.01) and Shiwiar were eight times less likely to be stunted (OR = 0.13, P = 0.01). These differences suggest that changes in diet have negatively affected Shuar growth and nutrition. Am. J. Hum. Biol, 2009. © 2008 Wiley-Liss, Inc. [source] Prevalence of asthma by industry and occupation in the U.S. working populationAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 5 2010Michelle K. McHugh MS Abstract Background Workers are potentially exposed to asthmagens daily. Our study was conducted to estimate the prevalence of asthma among working adults in the U.S. by industry and occupation. Methods Using data from the National Health and Nutrition Examination Survey (2001,2004), multiple logistic regression was used to investigate associations between industry and occupation and current asthma as defined by positive responses to "Has a doctor or other health professional ever told you that you have asthma?" and "Do you still have asthma?" Results Workers in mining (17.0%), health-related industries (12.5%), teaching (13.1%), or in health-related occupations (12.6%) had the highest prevalence of asthma. As compared to construction industry workers, workers in mining (aOR,=,5.2, 95% CI: 1.1,24.2) or health-related (aOR,=,2.3, 95% CI: 1.1,4.8) industries had significantly higher odds of asthma. Conclusion Our study adds to the increasing evidence that miners, healthcare workers and teachers remain high-risk working populations and appropriate evaluation and control measures are needed to protect these workers. Am. J. Ind. Med. 53:463,475, 2010. © 2010 Wiley-Liss, Inc. [source] Airways obstruction among older construction and trade workers at Department of Energy nuclear sitesAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 3 2010John M. Dement PhD Abstract Background A study of chronic obstructive pulmonary disease (COPD) among 7,579 current and former workers participating in medical screening programs at Department of Energy (DOE) nuclear weapons facilities through September 2008 was undertaken. Methods Participants provided a detailed work and exposure history and underwent a respiratory examination that included a respiratory history, respiratory symptoms, a posterior,anterior (P,A) chest radiograph classified by International Labour Office (ILO) criteria, and spirometry. Statistical models were developed to generate group-level exposure estimates that were used in multivariate logistic regression analyses to explore the risk of COPD in relation to exposures to asbestos, silica, cement dust, welding, paints, solvents, and dusts/fumes from paint removal. Risk for COPD in the study population was compared to risk for COPD in the general US population as determined in National Health and Nutrition Examination Survey (NHANES III). Results The age-standardized prevalence ratio of COPD among DOE workers compared to all NHANES III data was 1.3. Internal analyses found the odds ratio of COPD to range from 1.6 to 3.1 by trade after adjustment for age, race, sex, smoking, and duration of DOE employment. Statistically significant associations were observed for COPD and exposures to asbestos, silica, welding, cement dusts, and some tasks associated with exposures to paints, solvents, and removal of paints. Conclusions Our study of construction workers employed at DOE sites demonstrated increased COPD risk due to occupational exposures and was able to identify specific exposures increasing risk. This study provides additional support for prevention of both smoking and occupational exposures to reduce the burden of COPD among construction workers. Am. J. Ind. Med. 53:224,240, 2010. © 2009 Wiley-Liss, Inc. [source] Exposure to hazardous workplace noise and use of hearing protection devices among US workers,NHANES, 1999,2004,,AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 5 2009SangWoo Tak ScD Abstract Background To estimate the prevalence of workplace noise exposure and use of hearing protection devices (HPDs) at noisy work, NIOSH analyzed 1999,2004 data from the National Health and Nutrition Examination Survey (NHANES). Methods A total of 9,275 currently employed workers aged ,16 years were included in the weighted analysis. Hazardous workplace noise exposure was defined as self-reported exposure to noise at their current job that was so loud that the respondent had to speak in a raised voice to be heard. Industry and occupation were determined based on the respondent's current place and type of work. Results Twenty-two million US workers (17%) reported exposure to hazardous workplace noise. The weighted prevalence of workplace noise exposure was highest for mining (76%, SE,=,7.0) followed by lumber/wood product manufacturing (55%, SE,=,2.5). High-risk occupations included repair and maintenance, motor vehicle operators, and construction trades. Overall, 34% of the estimated 22 million US workers reporting hazardous workplace exposure reported non-use of HPDs. The proportion of noise-exposed workers who reported non-use of HPDs was highest for healthcare and social services (73.7%, SE,=,8.1), followed by educational services (55.5%). Discussion Hearing loss prevention and intervention programs should be targeted at those industries and occupations identified to have a high prevalence of workplace noise exposure and those industries with the highest proportion of noise-exposed workers who reported non-use of HPDs. Am. J. Ind. Med. 52:358,371, 2009. Published 2009 Wiley-Liss, Inc. [source] The relationship between chronic rhinosinusitis and occupation: The 1998, 2001, and 2005 Korea National health and nutrition examination survey (KNHANES),AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 3 2009Dong-Hee Koh MD, DrPH Abstract Objectives We examined the relationship between chronic rhinosinusitis and occupation. Methods We analyzed data from the 1998, 2001, and 2005 Korea National Health and Nutrition Examination Survey (KNHANES). Men and women aged 20,59 who participated in the three KNHANES were included to analyze the relationship between chronic rhinosinusitis and occupation. Trained interviewers visited subjects' homes and administered a standardized questionnaire on diagnosed diseases. Subjects were asked if they had experienced chronic rhinosinusitis during the previous year or had had rhinosinusitis for three or more consecutive months. Occupational classification followed the major groups of the Korean Standard Classification of Occupations (KSCO). We calculated the prevalence ratios (PRs) of chronic rhinosinusitis by major groups compared with clerical workers in the three KNHANES. Poisson regression with robust standard error was conducted, adjusting for age in 10-year strata. Results There were significantly increased PRs of chronic rhinosinusitis in plant and machinery operators and assemblers, elementary occupations, crafts and related trade workers, and the unemployed. Conclusions These results support the relationship between chronic rhinosinusitis and occupational exposure at the macro level. Am. J. Ind. Med. 52:179,184, 2009. © 2008 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] 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] Modeling multiple-response categorical data from complex surveysTHE CANADIAN JOURNAL OF STATISTICS, Issue 4 2009Christopher R. Bilder Abstract Although "choose all that apply" questions are common in modern surveys, methods for analyzing associations among responses to such questions have only recently been developed. These methods are generally valid only for simple random sampling, but these types of questions often appear in surveys conducted under more complex sampling plans. The purpose of this article is to provide statistical analysis methods that can be applied to "choose all that apply" questions in complex survey sampling situations. Loglinear models are developed to incorporate the multiple responses inherent in these types of questions. Statistics to compare models and to measure association are proposed and their asymptotic distributions are derived. Monte Carlo simulations show that tests based on adjusted Pearson statistics generally hold their correct size when comparing models. These simulations also show that confidence intervals for odds ratios estimated from loglinear models have good coverage properties, while being shorter than those constructed using empirical estimates. Furthermore, the methods are shown to be applicable to more general problems of modeling associations between elements of two or more binary vectors. The proposed analysis methods are applied to data from the National Health and Nutrition Examination Survey. The Canadian Journal of Statistics © 2009 Statistical Society of Canada Quoique les questions du type « Sélectionner une ou plusieurs réponses » sont courantes dans les enquêtes modernes, les méthodes pour analyser les associations entre les réponses à de telles questions viennent seulement d'être développées. Ces méthodes sont habituellement valides uni-quement pour des échantillons aléatoires simples, mais ce genre de questions apparaissent souvent dans les enquêtes conduites sous des plans de sondage beaucoup plus complexes. Le but de cet article est de donner des méthodes d'analyse statistique pouvant être appliquées aux questions de type « Sélectionner une ou plusieurs réponses » dans des enquêtes utilisant des plans de sondage complexes. Des modèles loglinéaires sont développés permettant d'incorporer les réponses multiples inhérentes à ce type de questions. Des statistiques permettant de comparer les modèles et de mesu-rer l'association sont proposées et leurs distributions asymptotiques sont obtenues. Des simulations de Monte-Carlo montrent que les tests basés sur les statistiques de Pearson ajustées maintiennent généralement leur niveau lorsqu'ils sont utilisés pour comparer des modèles. Ces études montrent également que les niveaux des intervalles de confiance pour les rapports de cotes estimés à par-tir des modèles loglinéaires ont de bonnes propriétés de couverture tout en étant plus courts que ceux utilisant les estimations empiriques. De plus, il est montré que ces méthodes peuvent aussi êtres utilisées dans un contexte plus général de modélisation de l'association entre les éléments de deux ou plusieurs vecteurs binaires. Les méthodes d'analyse proposées sont appliquées à des données provenant de l'étude américaine « National Health and Nutrition Examination Survey » (NHANES). La revue canadienne de statistique © 2009 Société statistique du Canada [source] Prostate-specific antigen levels in relation to cadmium exposure and zinc intake: results from the 2001,2002 national health and nutrition examination surveyTHE PROSTATE, Issue 2 2008Edwin van Wijngaarden Abstract BACKGROUND Cadmium exposure has been suggested as a risk factor for prostate cancer, and experimental literature suggests that the carcinogenic effect of cadmium is modified by the presence of zinc. We evaluated total prostate-specific antigen (PSA) levels in relation to urinary cadmium concentrations and dietary zinc intake. METHODS PSA levels were determined in 1,320 men over the age of 40 in the 2001,2002 National Health and Nutrition Examination Survey (NHANES). Urinary cadmium concentrations were measured in about one-third of the sample population, whereas dietary zinc intake was based on participants' 24-hr recall. Information on all three variables was available for 422 men in the 2001,2002 NHANES survey. We performed linear regressions to evaluate the relationships these factors after accounting for age and other covariates. RESULTS Little evidence for an association between cadmium and elevated PSA level was observed. However, the data provide suggestive evidence for an interaction between zinc intake and cadmium exposure (P for interaction,=,0.09). Among men with zinc intake less than the median level of 12.67 mg/day, an increase in 1 µg/g creatinine cadmium exposure was associated with a 35% increase in PSA level. In contrast, among men with greater than median zinc intake, little evidence for an association between cadmium and PSA was found. CONCLUSIONS These findings suggest a protective effect of zinc intake on cadmium-induced prostatic injury, and may provide further rationale for investigating the impact of these factors individually and jointly on the etiology of prostate cancer. Prostate 68: 122,128, 2008. © 2007 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] | ||||||||||||||||