Do ethnic differences in cord blood leptin levels differ by birthweight category? Findings from the Born in Bradford cohort study

BACKGROUND

There is evidence that South Asian individuals have higher fat mass for a given weight than Europeans. One study reported that the greater fatness for a given birthweight may increase with increasing birth weight, suggesting that any attempt to increase mean birth weight in South Asians would markedly increase their fatness.

OBJECTIVE

Our objective was to examine whether differences in cord leptin values between White British and Pakistani infants vary by birth weight category.

METHOD

We examined the difference in cord leptin levels between 659 White British and 823 Pakistani infants recruited to the Born in Bradford cohort study, by clinical categories and thirds of the birth weight distribution.

RESULTS

Pakistani infants had a lower mean birthweight but higher cord leptin levels than White British infants [ratio of geometric mean(RGM) of cord leptin adjusted for birth weight = 1.36 (95% CI 1.26,1.46)]. Birthweight was positively associated with cord leptin levels in both groups, with no evidence that the regression lines in the two groups diverged from each other with increasing birthweight.The relative ethnic difference in cord leptin was similar in low (<2500 g), normal and high (≥4000 g) birthweight infants(P-value for interaction = 0.91). It was also similar across thirds of the birthweight distribution [RGM (95% CI) in lowest, mid and highest thirds were 1.37 (1.20, 1.57), 1.36 (1.20, 1.54) and 1.31 (1.16, 1.52), respectively, P-interaction = 0.51].

CONCLUSIONS

We found marked differences in cord leptin levels between Pakistani and White British infants but no evidence that this difference increases with increasing birthweight.

Ethnic/racial disparities in adolescents' home food environments and linkages to dietary intake and weight status

Research is needed to confirm that public health recommendations for home/family food environments are equally relevant for diverse populations. This study examined ethnic/racial differences in the home/family environments of adolescents and associations with dietary intake and weight status. The sample included 2374 ethnically/racially diverse adolescents and their parents enrolled in coordinated studies, EAT 2010 (Eating and Activity in Teens) and Project F-EAT (Families and Eating and Activity in Teens), in the Minneapolis/St. Paul metropolitan area. Adolescents and parents completed surveys and adolescents completed anthropometric measurements in 2009-2010. Nearly all home/family environment variables (n=7 of 8 examined) were found to vary significantly across the ethnic/racial groups. Several of the home/family food environment variables were significantly associated with one or more adolescent outcome in expected directions. For example, parental modeling of healthy food choices was inversely associated with BMI z-score (p=0.03) and positively associated with fruit/vegetable consumption (p<0.001). Most observed associations were applicable across ethnic/racial groups; however; eight relationships were found to differ by ethnicity/race. For example, parental encouragement for healthy eating was associated with lower intake of sugar-sweetened beverages only among youth representing the White, African American, Asian, and mixed/other ethnic/racial groups and was unrelated to intake among East African, Hispanic, and Native American youth. Food and nutrition professionals along with other providers of health programs and services for adolescents should encourage ethnically/racially diverse parents to follow existing recommendations to promote healthy eating such as modeling nutrient-dense food choices, but also recognize the need for cultural sensitivity in providing such guidance.

Physical characteristics associated with weight misperception among overweight and obese men: NHANES 1999-2006

OBJECTIVES

The purpose of this study was to (1) determine the prevalence of weight misperception among overweight and obese men with total body fat levels ≥ 25%, and (2) examine associations of weight misperception with anthropometric and body composition measures.

METHODS

Data came from 4,200 overweight or obese men from the 1999 to 2006 National Health and Nutrition Examination Survey. Weight misperception was operationalized as having a dual-energy X-ray absorptiometry-derived total body fat percentage ≥25% and classifying oneself as either "underweight" or "about right weight." Logistic regression was used to determine physical characteristics associated with weight misperception.

RESULTS

Weight misperception was highest among Mexican American (35.9%) followed by Black (30.8%) and White men (22.9%). Physical characteristics (OR, 95% CI) associated with weight misperception were decreased arm fat (0.95, 0.91-0.98), being overweight (9.02, 5.34-15.24), and having a waist circumference ≤ 94 cm (2.31, 1.72-3.09).

CONCLUSIONS

Findings suggest that future research should include a measure of adiposity in the operationalization of weight misperception among male populations.

Factors Associated with Underestimation of Weight Status among Caucasian, Latino, Filipino, and Korean Americans--DiLH Survey

OBJECTIVE

To describe weight misperception and to examine the influence of sociodemographic factors on underestimation of weight status in Caucasian, Latino, Filipino, and Korean Americans.

DESIGN

Data from 886 non-pregnant adults who participated in a cross-sectional survey administered in English, Spanish, and Korean were analyzed. The actual weight status derived from the participants' body mass index (BMI) categories and their perceived weight status were compared. A multiple logistic regression model was used to explore if underestimation of weight status was associated with ethnicity, sex, and education level.

RESULTS

Caucasians, Latinos, Filipinos, and Koreans represented 19.4%, 26.8%, 27.4%, and 26.4%, respectively, of the total sample of 886. Overall, two in three participants correctly perceived their weight status, but 42% of Latinos underestimated their weight status and 22% of Koreans overestimated their weight status. Latino ethnicity, male, and low education (high school) were related to greater underestimation of weight status (P < .05). In contrast, Korean ethnicity was related to less underestimation of weight status (P < .05).

CONCLUSIONS

Misperception of weight status should be counted in any efforts to develop a weight management intervention for Latino and Korean Americans.

Asian American mothers' perception of their children's weight: a comparison with other racial/ethnic groups in Los Angeles

OBJECTIVE

While mother's perception of child's weight is important for the success of early childhood obesity prevention programs, few studies have examined that of Asian Americans. Our study examined their perception and compared it to that of mothers of other racial/ethnic groups.

DESIGN

Cross-sectional study of 2,051 randomly selected mothers of children aged 2-5 years living in Los Angeles County who were enrolled in the Special Supplemental Nutrition Program for Women Infants and Children (WIC).

MAIN OUTCOME MEASURE

The primary outcome was mother's perception of child's weight.

RESULTS

We found that Asian American mothers were 2.12 (95% CI: 1.27-3.54) times as likely as Hispanic mothers to accurately perceive their children's weight, adjusting for child's age, sex and birthweight, and mother's age and education. However, this relationship disappeared after adjusting for mother's BMI. We did not find differences in perception of child's weight among non-Hispanic White, non-Hispanic Black and Hispanic mothers.

CONCLUSION

It appears that Asian American mothers' increased accurate perception of child's weight status can be partially explained by their lower prevalence of obesity. Our findings suggest that early childhood obesity prevention programs should consider the weight status of mothers.

Accuracy of self-reported versus measured weight over adolescence and young adulthood: findings from the national longitudinal study of adolescent health, 1996-2008

Many studies rely on self-reports to capture population trends and trajectories in weight gain over adulthood, but the validity of self-reports is often considered a limitation. The purpose of this work was to examine long-term trajectories of self-reporting bias in a national sample of American youth. With 3 waves of data from the National Longitudinal Study of Adolescent Health (1996-2008), we used growth curve models to examine self-reporting bias in trajectories of weight gain across adolescence and early adulthood (ages 13-32 years). We investigated whether self-reporting bias is constant over time, or whether adolescents become more accurate in reporting their weight as they move into young adulthood, and we examined differences in self-reporting bias by sex, race/ethnicity, and attained education. Adolescent girls underreported their weight by 0.86 kg on average, and this rate of underreporting increased over early adulthood. In contrast, we found no evidence that boys underreported their weight either in adolescence or over the early adult years. For young men, self-reports of weight were unbiased estimates of measured weight among all racial/ethnic and educational subpopulations over adolescence and early adulthood.

Accuracy of mothers' perceptions of their child's weight status

The study examined the accuracy of maternal-perceived child weight. Urban affluent mothers of 111 children aged 2-5 years were recruited. Nearly a quarter of mothers overestimated their underweight child as normal weight and all overweight/obese children were perceived as normal weight. Mothers, therefore, were unable to recognize their child's true weight status.

A mixed ecologic-cohort comparison of physical activity & weight among young adults from five populations of African origin

BACKGROUND

Examination of patterns and intensity of physical activity (PA) across cultures where obesity prevalence varies widely provides insight into one aspect of the ongoing epidemiologic transition. The primary hypothesis being addressed is whether low levels of PA are associated with excess weight and adiposity.

METHODS

We recruited young adults from five countries (500 per country, 2500 total, ages 25-45 years), spanning the range of obesity prevalence. Men and women were recruited from a suburb of Chicago, Illinois, USA; urban Jamaica; rural Ghana; peri-urban South Africa; and the Seychelles. PA was measured using accelerometry and expressed as minutes per day of moderate-to-vigorous activity or sedentary behavior.

RESULTS

Obesity (BMI ≥ 30) prevalence ranged from 1.4% (Ghanaian men) to 63.8% (US women). South African men were the most active, followed by Ghanaian men. Relatively small differences were observed across sites among women; however, women in Ghana accumulated the most activity. Within site-gender sub-groups, the correlation of activity with BMI and other measures of adiposity was inconsistent; the combined correlation across sites was -0.17 for men and -0.11 for women. In the ecological analysis time spent in moderate-to-vigorous activity was inversely associated with BMI (r = -0.71).

CONCLUSION

These analyses suggest that persons with greater adiposity tend to engage in less PA, although the associations are weak and the direction of causality cannot be inferred because measurements are cross-sectional. Longitudinal data will be required to elucidate direction of association.

The role of weight, race, and health care experiences in care use among young men and women

OBJECTIVE

Increases in overweight and obesity (O/O)-related morbidities and health care costs raise questions about how weight influences patients' health care use and care experiences. Past research has been inconsistent; however, prior study designs and samples have limited exploration of how this association might be influenced by gender, race, and the joint impact of these factors.

METHODS

This analysis of 1,036 young, relatively healthy, ethnically diverse, insured adults assessed the influence of O/O, gender, and race on, and the role of health care experiences in primary and preventive care use over a 12-month period.

RESULTS

The association of weight status with care use differed by gender. O/O men used more primary care visits; O/O women used fewer preventive care visits than their healthy weight counterparts. O/O men had poorer health care experiences than healthy weight men. African-American women reported poorer experiences, but those who were O/O reported greater trust in their provider. Care experience ratings did not explain the associations between BMI and care use.

CONCLUSIONS

Gender, race, and visit type together provide a context for O/O patient's care that may not be explained by care experiences. This context must be considered in efforts to encourage appropriate use of services.

Nurses' misperceptions of weight status associated with their body weight, demographics and health status

OBJECTIVE

To assess the agreement between self-perceived weight status and BMI status, calculated from self-reported height and weight, in nurses and to evaluate the relationship between weight status misperceptions and personal body weight, demographics and health status.

DESIGN

Cross-sectional questionnaire survey.

SETTING

A large university in London, UK.

SUBJECTS

Four hundred and fifty-six student nurses and 588 qualified nurses attending university were surveyed; 355 student nurses and 409 qualified nurses completed questionnaires representing a response rate of 78 % and 70 %, respectively.

RESULTS

The respondents were mainly female (90·0 %), 66·5 % were white and their mean age was 31 years. Sixty-eight per cent of qualified nurses and 77 % of student nurses correctly perceived their weight status. In logistic regression, (mixed) black ethnicity (OR = 2·53, 95 % CI 1·01, 6·32), overweight by BMI (OR = 3·10, 95 % CI 1·31, 7·33) and ≥3 family histories of obesity co-morbidities (OR = 2·51, 95 % CI 1·04, 6·08) were significantly associated with misperceptions in the sample of student nurses, whereas overweight by BMI (OR = 5·32, 95 % CI 2·66, 10·67) was the only significant variable in the sample of qualified nurses.

CONCLUSIONS

A substantial proportion of nurses misclassified their weight status. Nurses' misperception of weight status was related to their own BMI status, ethnic background and obesity-related family histories. Being aware of this may help nurses not only promote their own healthy weight, but also fulfil their public health role to practise weight management successfully with both patients and the public. While limitations of the sample mean that the study findings cannot be generalized, they do provide grounds for future larger-scale research.

How accurate are Americans' perceptions of their own weight?

As obesity/overweight has increased in the United States (Centers for Disease Control and Prevention, 2009 ), studies have found that Americans' perceptions of their own weight often are not aligned with their actual body mass index (BMI; Brener et al., 2004 ; Christakis, 2003; Johnson-Taylor et al., 2008 ). Taylor, Funk, and Craighill ( 2006 ) found that half of Americans whose BMI indicated they were overweight perceived their weight to be just about right. The purpose of this study was to examine factors that influence the accuracy of weight self-perceptions and whether accuracy influences health behaviors. Using data from the 2007 Health Information National Trends Survey, the authors compared respondents' weight self-perceptions to their actual BMI to determine the accuracy of their weight self-perceptions. About 28%of respondents were obese, 35%were overweight, 35%were of normal weight, and 2%were underweight. About three quarters of the sample's self-perceptions of weight were aligned with their BMI. About 10%of the sample had a BMI that indicated they were overweight, but they perceived themselves to be of normal weight; about 10%were of normal weight but perceived themselves to be overweight; and about 5%of respondents were of normal weight but thought they were underweight. Gender, race, and education were associated with the accuracy of respondents' weight perceptions. Results suggest that asking patients about their weight self-perceptions could be useful in clinical settings and that weight perception accuracy could be used to segment audiences and tailor messages.

US pediatric population-level associations of DXA-measured percentage of body fat with four BMI metrics with cutoffs

OBJECTIVE

Four body mass index (BMI) metrics--BMI, BMI z-score, BMI percentile and BMI%--are commonly used as proxy measures for children's adiposity. We sought to determine a BMI metric that is most strongly associated with measured percentage of body fat (%BF) in the US pediatric population stratified by sex, age and race/ethnicity, and to determine cutoffs that maximize the association for each BMI metric. SUBJECTS, DESIGN AND METHODS: %BF was measured by dual-energy X-ray absorptiometry among N=6120 US boys and girls aged 8.0-17.9 years old from the National Health and Nutrition Examination Survey 1999-2004. We fit piecewise linear regression models with cutoffs to %BF data using each BMI metric as the predictor stratified by sex, race/ethnicity and age. The slopes were modeled differently before and after the cutoffs which were determined on the basis of grid searches.

RESULTS

BMI z-score was in general most strongly associated with %BF for both boys and girls. The associations of the four BMI metrics were lowest for boys aged 12-13.9 years and girls aged 16-17.9 years, and strongest for Mexican-American boys and for non-Hispanic Black girls. Overall, the associations were stronger for girls than for boys. In boys, BMI had the lowest association with %BF (R(2)=0.39) for all ages combined. The fold changes in slopes before and after cutoffs were greatest in general for BMI percentiles regardless of age, sex and race/ethnicity. BMI z-score cutoffs were 0.4 for both boys and girls for all ages combined. Except for BMI, the slopes after the cutoffs were in general greater than those before.

CONCLUSIONS

All BMI metrics were strongly associated with %BF when stratified by age and race/ethnicity except that BMI was the least associated with %BF in boys for all ages combined. Overall, BMI z-score was superior for evaluation of %BF, and its cutoff of 0.4 can also serve as a threshold for careful monitoring of weight status.

An examination of postpartum African American adolescents' sociocultural beliefs, perceptions of body weight, and weight control behaviors

Obesity presents a public health challenge and is a serious chronic medical condition that is associated with multiple co-morbidities and reduced survivability/longevity. African American adolescents who retain weight after pregnancy are at the highest risk of becoming obese adults. Obesity is associated with 300,000 deaths per year and expected to cost the US. health care system over 237 million dollars within the next decade. The prevalence of obesity is cause for concern because of its economic costs and its toll in human suffering due to related morbidity and mortality. This study seeks to understand the meaning or essence of the lived experience of obesity among postpartum African American adolescents based on a literature review indicating the need for such a qualitative research. Understanding the influence of their developmental stage, sociocultural perceptions, and perceptions of postpartum weight retention could help develop population-specific interventions that could reduce the health risk of obesity.

The importance of campaign saliency as a predictor of attitude and behavior change: A pilot evaluation of social marketing campaign Fat Talk Free Week

Fat Talk Free Week (FTFW), a social marketing campaign designed to decrease self-disparaging talk about body and weight, has not yet been evaluated. We conducted a theory-informed pilot evaluation of FTFW with two college samples using a pre- and posttest design. Aligned with the central tenets of the Elaboration Likelihood Model (ELM), we investigated the importance of FTFW saliency as a predictor of fat talk behavior change. Our analytic sample consisted of 118 female participants (83% of original sample). Approximately 76% of the sample was non-Hispanic White, 14% Asian, and 8% Hispanic. At baseline, more than 50% of respondents reported engaging in frequent self fat talk; at posttest, this number dropped to 34% of respondents. Multivariable regression models supported campaign saliency as the single strongest predictor of a decrease in self fat talk. Our results support the social diffusion of campaign messages among shared communities, as we found significant decreases in fat talk among campaign attenders and nonattenders. FTFW may be a promising short-term health communication campaign to reduce fat talk, as campaign messages are salient among university women and may encourage interpersonal communication.

Weight discrepancy and body appreciation among women in Poland and Britain

Previous studies have suggested that the process of transmigration has detrimental effects on the body image of migrants relative to women in the country of origin. In the present work, we examined the body image of Polish migrants in Britain (n=153), Polish women in Poland (n=153), and a comparison group of British White women (n=110). Participants completed a measure of actual-ideal weight discrepancy and the Body Appreciation Scale (BAS). Contrary to hypotheses, our results showed that Polish women in Poland had significantly higher weight discrepancy than their counterparts in Britain. Further analyses showed that the BAS reduced to two dimensions among Polish participants, with Polish participants in Poland having significantly lower body appreciation than Polish migrants. We suggest that the sociocultural changes that have taken place in Eastern Europe may place women in that region at relatively high risk for developing negative body image.

Residency and racial/ethnic differences in weight status and lifestyle behaviors among US youth

PURPOSE

Elevated risk for obesity is found in rural environments and in some minority populations. It is unclear whether living in rural or nonmetropolitan areas and being a minority compound the risk of obesity beyond that of either factor acting alone. Our purpose was to examine adolescent obesity in light of the potential concomitant influences of race/ethnicity, residency, and obesity-related lifestyle behaviors.

METHODS

We assessed obesity prevalence, physical activity, consumption of fatty snack foods, and screen time in 8,363 US adolescents based on variation in race/ethnicity and residency. Descriptive, bivariate, and multivariate statistics were used to: (1) calculate race- and residency-based rates of obesity and obesity-related lifestyle behaviors and (2) generate race- and residency-based obesity odds ratios as a function of those same behaviors.

FINDINGS

The results indicated that nonmetropolitan black youth had the highest risk of obesity (26%), rate of consuming fatty snack foods on more than 2 days/week (86%), and rate of spending more than 2 hours/day in screen time (91%) compared to white metropolitan youth. Compared to their metropolitan counterparts, black nonmetropolitan youth had greater odds of being obese if they exercised less than daily (1.71 times), ate fatty snack foods on more than 2 days/week (1.65 times), or spent more than 2 hours/day in screen time (1.64 times).

CONCLUSIONS

Race/ethnicity and residency may have a compounding effect on the risk of obesity. Prevention and intervention must be viewed in a socioecological framework that recognizes the importance of culture and community on obesity-related behaviors.

Race/ethnicity-specific associations of urinary phthalates with childhood body mass in a nationally representative sample

BACKGROUND

Phthalates have antiandrogenic effects and may disrupt lipid and carbohydrate metabolism. Racial/ethnic subpopulations have been documented to have varying urinary phthalate concentrations and prevalences of childhood obesity.

OBJECTIVE

We examined associations between urinary phthalate metabolites and body mass outcomes in a nationally representative sample of U.S. children and adolescents.

METHODS

We performed stratified and whole-sample cross-sectional analyses of 2,884 children 6-19 years of age who participated in the 2003-2008 National Health and Nutrition Examination Survey. Multivariable linear and logistic analyses of body mass index z-score, overweight, and obesity were performed against molar concentrations of low-molecular-weight (LMW), high-molecular-weight (HMW), and di-2-ethylhexylphthalate (DEHP) metabolites, controlling for sex, television watching, caregiver education, caloric intake, poverty-income ratio, race/ethnicity, serum cotinine, and age group. We used sensitivity analysis to examine robustness of results to removing sample weighting, normalizing phthalate concentrations for molecular weight, and examining different dietary intake covariates.

RESULTS

In stratified, multivariable models, each log unit (roughly 3-fold) increase in LMW metabolites was associated with 21% and 22% increases in odds (95% CI: 1.05-1.39 and 1.07-1.39, respectively) of overweight and obesity, and a 0.090-SD unit increase in BMI z-score (95% CI: 0.003-0.18), among non-Hispanic blacks. Significant associations were not identified in any other racial/ethnic subgroup or in the study sample as a whole after controlling for potential confounders, associations were not significant for HMW or DEHP metabolites, and results did not change substantially with sensitivity analysis.

CONCLUSIONS

We identified a race/ethnicity-specific association of phthalates with childhood obesity in a nationally representative sample. Further study is needed to corroborate the association and evaluate genetic/epigenomic predisposition and/or increased phthalate exposure as possible explanations for differences among racial/ethnic subgroups.

Describing differences in weight and length growth trajectories between white and Pakistani infants in the UK: analysis of the Born in Bradford birth cohort study using multilevel linear spline models

OBJECTIVE

To describe the growth pattern from birth to 2 years of UK-born white British and Pakistani infants.

DESIGN

Birth cohort.

SETTING

Bradford, UK.

PARTICIPANTS

314 white British boys, 383 Pakistani boys, 328 white British girls and 409 Pakistani girls.

MAIN OUTCOME MEASURES

Weight and length trajectories based on repeat measurements from birth to 2 years.

RESULTS

Linear spline multilevel models for weight and length with knot points at 4 and 9 months fitted the data well. At birth Pakistani boys were 210 g lighter (95% CI -290 to -120) and 0.5 cm shorter (-1.04 to 0.02) and Pakistani girls were 180 g lighter (-260 to -100) and 0.5 cm shorter (-0.91 to -0.03) than white British boys and girls, respectively. Pakistani infants gained length faster than white British infants between 0 and 4 months (+0.3 cm/month (0.1 to 0.5) for boys and +0.4 cm/month (0.2 to 0.6) for girls) and gained more weight per month between 9 and 24 months (+10 g/month (0 to 30) for boys and +30 g/month (20 to 40) for girls). Adjustment for maternal height attenuated ethnic differences in weight and length at birth, but not in postnatal growth. Adjustment for other confounders did not explain differences in any outcomes.

CONCLUSIONS

Pakistani infants were lighter and had shorter predicted mean length at birth than white British infants, but gained weight and length quicker in infancy. By age 2 years both ethnic groups had similar weight, but Pakistani infants were on average taller than white British infants.

Gender and socioeconomic status in relation to weight perception and weight control behavior in Korean adults

AIM

In Korea, obesity is more prevalent among men and lower socioeconomic groups. To explain this obesity disparity, we compared weight perception and weight control behavior across gender and socioeconomic status (SES).

METHODS

We analyzed data from 16,260 participants aged 20 years or older in a nationally representative cross-sectional survey. SES indicators included education and income levels. Weight under-perception was defined when participants considered themselves lighter than their measured BMI status. Either no active or inappropriate weight control (i.e., trying to gain weight in obese individuals) was considered to be unhealthy patterns. Multivariate prevalence ratios were calculated using log-binomial regressions.

RESULTS

Men had a higher prevalence of weight under-perception (24.5 vs. 11.9%) and unhealthy patterns of weight control behavior (57 vs. 40%) than women. Low education level was associated with weight under-perception (ptrend = 0.022 in men, ptrend < 0.001 in women). Both education and income levels were significantly associated with patterns of weight control behavior (for education: ptrend < 0.001 in men and women; for income: ptrend = 0.047 in men, ptrend < 0.001 in women).

CONCLUSION

Weight perception and weight control behavior significantly varied by gender and SES. Public actions should be directed toward improving perception and behavior of high-risk populations.

The association between daily calcium intake and sarcopenia in older, non-obese Korean adults: the fourth Korea National Health and Nutrition Examination Survey (KNHANES IV) 2009

Recent data suggest that variations in calcium intake may influence body weight and composition; however, the relationship between daily calcium intake and muscle mass has not been well established. The objective of this study was to assess the relationship between daily calcium intake and sarcopenia. We analyzed data for older adults (over 60 years) from the fourth Korea National Health and Nutrition Examination Survey (KNHANES) conducted in 2009. A total of 1339 Non-Obese (BMI between 18.5 and 25 kg/m²), older adults (592 men and 707 women) were enrolled. Dietary variables were assessed using a nutrition survey that used a 24-hour recall method. Daily calcium intake based on the consumption of each food item was calculated. Sarcopenia was defined as an appendicular skeletal muscle mass divided by body weight less than 2 SD below the sex-specific mean for young adults. We found that daily calcium intake was negatively correlated with total body fat percentage and positively correlated with appendicular skeletal mass (p<0.001). Participants with sarcopenia appear to have significantly lower daily calcium intakes than participants without sarcopenia (p<0.001). The unadjusted prevalence of sarcopenia according to daily calcium intake tertiles were 6.3%, 4.3%, and 2.7% in tertiles 1, 2, and 3, respectively. After adjustment for age, sex, BMI, total energy intake, and lifestyle factors, compared with those in the lowest tertile of daily calcium intake, participants in the highest tertile had an odds ratio for sarcopenia of 0.295 (95% confidence interval, 0.087-0.768; p for trend = 0.014). We found that daily calcium intake, corrected for total energy intake and serum 25(OH)D status, was significantly lower in subjects with sarcopenia than in those without. Our results suggest a strong inverse association between daily calcium intake and sarcopenia in non-obese, older Korean adults.

Are nutrition knowledge, attitudes, and beliefs associated with obesity among low-income Hispanic and African American women caretakers?

The purposes of this descriptive study were to (1) describe nutrition knowledge, attitudes, beliefs (KAB), and self-efficacy among low-income African American and Hispanic women; (2) identify the associations these variables have on diet quality and weight status; (3) identify barriers to healthy eating. Data from three separate studies were combined and analyzed. The total sample included African Americans (N = 92) and Hispanics (N = 272). Descriptive statistics and bivariate analyses were used to identify associations between KAB and body mass index (BMI) and diet quality. The majority of African Americans had good knowledge in nutrition while Hispanics had fair knowledge. Attitudes toward eating a healthy diet were significantly associated with high fiber intake among African Americans and low fat consumption among Hispanics. A computed KAB score showed no significant relation to individuals' weight status or diet quality. However, attitudes and beliefs about healthy foods strongly correlated with participants' weight or diet consumption among Hispanics. The most common barrier to consuming a healthy diet reported by both groups was the cost of healthy foods. It is therefore recommended to address these variables when addressing obesity and poor dietary intake among low-income minority groups.

Underassessment of weight and weight management in patients with diabetes: one more reason in support of weight management advice

AIMS

The purpose of this study was to determine whether underassessment of weight affects weight management behaviors of overweight and obese individuals with diabetes and to determine whether weight management advice from health care professionals modifies the effect of underassessment of weight.

METHODS

Data (n=979) from the 2006 and 2008 National Health and Nutrition Examination Survey were analyzed. Multivariate logistic regression was used to identify factors associated with underassessment of weight, weight management behaviors, and receipt of weight management advice from health care professionals.

RESULTS

Underassessment of weight was common (26%). Men, overweight persons, Blacks and Hispanics were more likely to underassess their weight. Those who underassessed their weight were 53% less likely to report weight management behaviors, odds ratio 0.47 (95% CI=0.31-0.73). Weight management advice increased weight management behaviors among individuals who underassessed their weight, 3.49 (95% CI=1.70-7.18).

CONCLUSIONS

Underassessment of weight can negatively affect weight management behaviors of overweight and obese individuals with diabetes. Weight management advice from health care professionals is important, and can modify the effect of underassessment of weight on weight management behaviors in this high risk group.

Bright Start: Description and main outcomes from a group-randomized obesity prevention trial in American Indian children

The aim of the Bright Start study was to develop and test the effectiveness of a school environment intervention, supplemented with family involvement, to reduce excessive weight gain by increasing physical activity and healthy eating practices among kindergarten and first-grade American Indian children. Bright Start was a group-randomized, school-based trial involving 454 children attending 14 schools on the Pine Ridge Reservation in South Dakota. Children were followed from the beginning of their kindergarten year through the end of first grade. Main outcome variables were mean BMI, mean percent body fat, and prevalence of overweight/obese children. The goals of the intervention were to: increase physical activity at school to at least 60 min/day; modify school meals and snacks; and involve families in making behavioral and environmental changes at home. At baseline, 32% of boys and 25% of girls were overweight/obese. Although the intervention was not associated with statistically significant change in mean levels of BMI, BMI-Z, skinfolds or percentage body fat, the intervention was associated with a statistically significant net decrease of 10% in the prevalence of overweight. Intervention children experienced a 13.4% incidence of overweight, whereas the control children experienced a corresponding incidence of 24.8%; a difference of -11.4% (P = 0.033). The intervention significantly reduced parent-reported mean child intakes of sugar-sweetened beverages, whole milk, and chocolate milk. Changes in duration of school physical activity were not significant. Because obesity is the most daunting health challenge facing American Indian children today, more intervention research is needed to identify effective approaches.

Parity and Body Weight in the United States: Differences by Race and Size of Place of Residence

OBJECTIVE

In women, parity has been studied in relation to body weights. This study examined whether and how relationships between parity and body weight differ by race and size of place of residence, adjusting for sociodemographic factors (age, income, education, working status, and marital status) and health behaviors (alcohol consumption, birth control pills, diet, physical activity, and smoking).

RESEARCH METHODS AND PROCEDURES

A U.S. national sample of 3398 white and black women from the Third National Health and Nutrition Examination Survey was used to study the relationships using multiple linear regression analysis.

RESULTS

The parity-weight relationships varied by race and size of place of residence. After adjusting for the covariates, significant relationships between parity and body weight were found only in black women in metropolitan areas and white women in non-metropolitan areas. Compared with women with no children, white women with two children living in non-metropolitan areas tended to have lower BMIs, whereas black women in metropolitan areas with one or two children showed higher BMIs.

DISCUSSION

Overall, the parity-weight relationships in these groups of women were not strong or linear. The parity-weight relationships of black women in non-metropolitan areas warrant further examination.

Growth centile charts (anthropometric measurement) of Pakistani pediatric population

OBJECTIVE

To measure Anthropometric data (Height and Weight) of Pakistani school children (of different socioeconomic and cultural background) 3-16 year, to develop growth centile charts, based on the above measurement and to document obesity and stunting in Pakistani Paediatric population, based on the above measurement.

METHODS

A Cross-sectional study with multistage stratified sampling was done in a Nationwide project of Higher Education Commission (HEC, Ref no: 20-441/R&D/2008) to develop growth centile charts of Pakistani paediatric population. Study was conducted from 2006-2009. Children studying in private and government schools of the four provinces of Pakistan were included. Prior to starting the study permission from the principal of the respective school and parents was taken. A total of 12837 children with normal birth weight, complete immunization, no history of chronic infection from 36-192 months (3-16 year) were included. Heights (cms), weight (kg), for Body Mass Index (BMI) (kg/m2), 24 hour diet recall was obtained. All socioeconomic groups were included. Food records of the children were subjected to USDA food exchange list.

RESULTS

The average height (cms) of children was 139.11 +/- 18.44, average weight (kg) was 33.21 +/- 11.25 and average BMI was 16.76 +/- 3.22 kg/m2 (range from 11.3-41.98). The 95th centile according to CDC charts for the age groups 3-16 years were calculated. A total of 664 (5.1%) children were found to be obese. In the age group 3-5 years, > 5-10 year and > 10-16 year; 29 (8.1%), 272 (5.1%) and 363 (5.1%) were found to be obese, respectively. CDC height and weight in the three groups of Pakistani children > 3-5 year, > 5-10 year, > 10-16 year were at the 10-25 centile.

CONCLUSION

Overall, the prevalence of stunting was 14%. Height and weight was 10-25 centile of the CDC charts. Obesity was 5%. Pakistani centile charts of healthy children from Pakistan have been made.