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Associations between Body Composition and Vitamin D Status in Children with Overweight and Obesity Participating in a 1-Year Lifestyle Intervention. Nutrients 2022; 14:nu14153153. [PMID: 35956333 PMCID: PMC9370728 DOI: 10.3390/nu14153153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/27/2022] [Accepted: 07/27/2022] [Indexed: 02/01/2023] Open
Abstract
Background: To examine associations between body composition and vitamin D status in children participating in a lifestyle intervention. Methods: Children (6−12 y, n = 101) with a body mass index (BMI)-for-age >85th percentile were randomized to six dietitian-led behavior counselling sessions or no intervention. Plasma 25-hydroxyvitamin D (25(OH)D), anthropometry, and body composition using dual-energy X-ray absorptiometry were assessed every 3 months for 1 year. For each anthropometry variable (z-scores), tertiles were created to test for differences in 25(OH)D over time (tertile-by-time), and for changes in the z-score (loss, maintain, gain)-by-time, and according to fat patterning (android vs. gynoid) using mixed effects models. Results: The baseline plasma 25(OH)D was 62.2 nmol/L (95%CI: 58.7−65.7), and none < 30 nmol/L. At 6 mo, children with gynoid fat patterning had higher 25(OH)D concentrations than in those with android fat patterning (64.5 ± 1.1 nmol/L vs. 50.4 ± 1.0 nmol/L, p < 0.003, Cohen’s f = 0.20). Children with the lowest lean mass index z-score at 9 mo had higher plasma 25(OH)D concentrations than children with the highest z-score at baseline, 3 mo, and 6 mo (p < 0.05, Cohen’s f = 0.20). No other significant differences were observed. Conclusion: In this longitudinal study, vitamin D deficiency was not present in children 6−12 y of age with obesity. Reductions in adiposity did not alter the vitamin D status.
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Sawicki CM, Van Rompay MI, Au LE, Gordon CM, Sacheck JM. Sun-Exposed Skin Color Is Associated with Changes in Serum 25-Hydroxyvitamin D in Racially/Ethnically Diverse Children. J Nutr 2016; 146:751-7. [PMID: 26936138 PMCID: PMC4807642 DOI: 10.3945/jn.115.222505] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 01/15/2016] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND UVB light from the sun increases serum 25-hydroxyvitamin D [25(OH)D] concentration, but this relation may depend on skin pigmentation among different racial/ethnic groups. OBJECTIVE We used quantitative measures of exposed (facultative) and unexposed (constitutive) skin color to examine relations between serum 25(OH)D concentration, tanning, race/ethnicity, and constitutive skin color over the summer, following winter vitamin D supplementation. METHODS The subjects (n= 426, mean age 11.7 ± 1.4 y, 51% female) were racially/ethnically diverse schoolchildren (57% non-white/Caucasian) enrolled in a 6-mo vitamin D supplementation trial (October-December to April-June). In this secondary analysis, measures of serum 25(OH)D concentration and skin color, with the use of reflectance colorimetry, were taken over a 6-mo period after supplementation, from pre-summer (April-June) to post-summer (September-December). Multiple linear regression was used to evaluate longitudinal relations. RESULTS Following supplementation, mean serum 25(OH)D concentration was 29.3 ± 9.5 ng/mL but fell to 25.6 ± 7.9 ng/mL (P< 0.0001) by the end of summer. The decrease in white/Caucasian children was less than in black/African American children (P< 0.01) and tended to be less than in Hispanic/Latino, Asian, and multiracial/other children (P= 0.19-0.50) despite similar changes in sun-exposed skin color among all groups. Tanning was significantly associated with post-summer serum 25(OH)D concentration (β = -0.15,P< 0.0001), as was race/ethnicity (P= 0.0002), but the later association disappeared after adjusting for constitutive skin color. CONCLUSIONS Tanning significantly contributed to serum 25(OH)D concentration over the summer, independent of race/ethnicity, but was not sufficient to maintain serum 25(OH)D concentration attained with supplementation. Much of the variation in serum 25(OH)D concentration between racial/ethnic groups may be explained by skin color. This trial was registered atclinicaltrials.govasNCT01537809.
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Affiliation(s)
- Caleigh M Sawicki
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA;
| | - Maria I Van Rompay
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
| | - Lauren E Au
- Nutrition Policy Institute, University of California, Agriculture and Natural Resources, Berkeley, CA; and
| | - Catherine M Gordon
- Divisions of Adolescent Medicine and Endocrinology, Hasbro Children’s Hospital, Alpert Medical School of Brown University, Providence, RI
| | - Jennifer M Sacheck
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
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Au LE, Harris SS, Dwyer JT, Jacques PF, Sacheck JM. Association of serum 25-hydroxyvitamin D with race/ethnicity and constitutive skin color in urban schoolchildren. J Pediatr Endocrinol Metab 2014; 27:1095-100. [PMID: 24945426 PMCID: PMC4435804 DOI: 10.1515/jpem-2014-0068] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Accepted: 05/08/2014] [Indexed: 12/12/2022]
Abstract
The objective of this study was to determine the extent to which constitutive skin color explains racial/ethnic differences in serum 25-hydroxyvitamin D (25OHD) concentrations in urban schoolchildren. Analysis of covariance (ANCOVA) was used to determine associations of 25OHD with parent-reported race/ethnicity and constitutive skin color as measured by reflectance colorimeter [individual typology angle (ITA°; higher value corresponds to lighter skin)] in 307 Greater Boston schoolchildren aged 9-15 during October-December 2011. Nearly 60% of all children were inadequate in 25OHD (<20 ng/mL). Prevalence of inadequate 25OHD differed by race/ethnicity (p<0.001): white (46.6%), black (74.5%), Hispanic (64.7%), Asian (88.9%), and multi-racial/other (52.7%). Serum 25OHD increased 0.6 ng/mL per 10° increase in ITA° value (p<0.001). The prediction of 25OHD by race/ethnicity was slightly stronger than the prediction by skin color in separate models (R2=0.19, R2=0.16, respectively). Most of the variability in 25OHD in race/ethnicity was due to constitutive skin color in this group of racially diverse US children.
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Affiliation(s)
- Lauren E. Au
- Corresponding author: Tufts University Friedman School of Nutrition Science and Policy, 150 Harrison Avenue, Boston, MA 02111, USA, Phone: + 1-415-302-9453, Fax: + 1-617-636-3727,
| | - Susan S. Harris
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA; and Jean Mayer USDA Human Nutrition Research Center on Aging, Boston, MA, USA
| | - Johanna T. Dwyer
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA; and Jean Mayer USDA Human Nutrition Research Center on Aging, Boston, MA, USA
| | - Paul F. Jacques
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA; and Jean Mayer USDA Human Nutrition Research Center on Aging, Boston, MA, USA
| | - Jennifer M. Sacheck
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
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Open-source colorimeter. SENSORS 2013; 13:5338-46. [PMID: 23604032 PMCID: PMC3673140 DOI: 10.3390/s130405338] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 04/11/2013] [Accepted: 04/16/2013] [Indexed: 11/17/2022]
Abstract
The high cost of what have historically been sophisticated research-related sensors and tools has limited their adoption to a relatively small group of well-funded researchers. This paper provides a methodology for applying an open-source approach to design and development of a colorimeter. A 3-D printable, open-source colorimeter utilizing only open-source hardware and software solutions and readily available discrete components is discussed and its performance compared to a commercial portable colorimeter. Performance is evaluated with commercial vials prepared for the closed reflux chemical oxygen demand (COD) method. This approach reduced the cost of reliable closed reflux COD by two orders of magnitude making it an economic alternative for the vast majority of potential users. The open-source colorimeter demonstrated good reproducibility and serves as a platform for further development and derivation of the design for other, similar purposes such as nephelometry. This approach promises unprecedented access to sophisticated instrumentation based on low-cost sensors by those most in need of it, under-developed and developing world laboratories.
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Gamble RG, Asdigian NL, Aalborg J, Gonzalez V, Box NF, Huff LS, Barón AE, Morelli JG, Mokrohisky ST, Crane LA, Dellavalle RP. Sun damage in ultraviolet photographs correlates with phenotypic melanoma risk factors in 12-year-old children. J Am Acad Dermatol 2012; 67:587-97. [PMID: 22406230 DOI: 10.1016/j.jaad.2011.11.922] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2011] [Revised: 09/25/2011] [Accepted: 11/10/2011] [Indexed: 11/26/2022]
Abstract
BACKGROUND Ultraviolet (UV) photography has been used to motivate sun safety in behavioral interventions. The relationship between sun damage shown in UV photographs and melanoma risk has not been systematically investigated. OBJECTIVE To examine the relationship between severity of sun damage in UV photographs and phenotypic melanoma risk factors in children. METHODS UV, standard visible and cross-polarized photographs were recorded for 585 children. Computer software quantified sun damage. Full-body nevus counts, skin color by colorimetry, facial freckling, hair and eye color were collected in skin examinations. Demographic data were collected in telephone interviews of parents. RESULTS Among 12-year-old children, sun damage shown in UV photographs correlated with phenotypic melanoma risk factors. Sun damage was greatest for children who were non-Hispanic white and those who had red hair, blue eyes, increased facial freckling, light skin and greater number of nevi (all P values < .001). Results were similar for standard visible and cross-polarized photographs. Freckling was the strongest predictor of sun damage in visible and UV photographs. All other phenotypic melanoma risk factors were also predictors for the UV photographs. LIMITATIONS Differences in software algorithms used to score the photographs could produce different results. CONCLUSION UV photographs portray more sun damage in children with higher risk for melanoma based on phenotype. Therefore sun protection interventions targeting those with greater sun damage on UV photographs will target those at higher melanoma risk. This study establishes reference ranges dermatologists can use to assess sun damage in their pediatric patients.
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Affiliation(s)
- Ryan G Gamble
- Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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Aalborg J, Morelli JG, Byers TE, Mokrohisky ST, Crane LA. Effect of hair color and sun sensitivity on nevus counts in white children in Colorado. J Am Acad Dermatol 2010; 63:430-9. [PMID: 20584558 DOI: 10.1016/j.jaad.2009.10.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2009] [Revised: 10/03/2009] [Accepted: 10/06/2009] [Indexed: 11/27/2022]
Abstract
BACKGROUND It has been widely reported that individuals with a light phenotype (ie, light hair color, light base skin color, and propensity to burn) have more nevi and are at greater risk for developing skin cancer. No studies have systematically investigated how phenotypic traits may interact in relation to nevus development. OBJECTIVE We sought to systematically examine whether any combinations of phenotype are associated with a greater or lesser risk for nevus development in white children. METHODS In the summer of 2007, 654 children were examined to determine full body nevus counts, skin color by colorimetry, and hair and eye color by comparison with charts. Interviews of parents were conducted to capture sun sensitivity, sun exposure, and sun protection practices. RESULTS Among 9-year-old children with sun sensitivity rating type II (painful burn/light tan), those with light hair had lower nevus counts than did those with dark hair (P value for interaction = .03). This relationship was independent of eye color, presence of freckling, sex, usual daily sun exposure, sunburn in 2004 to 2007, sun protection index, and waterside vacation sun exposure. The difference in nevus counts was further determined to be specific to small nevi (<2 mm) and nevi in intermittently exposed body sites. LIMITATIONS Geographic and genetic differences in other study populations may produce different results. CONCLUSION The standard acceptance that dark phenotype is a marker for low melanoma risk and light phenotype a marker for high risk may need to be reevaluated. In non-Hispanic white children, dark-haired individuals who burn readily and then tan slightly are more prone to nevus development, and may therefore be a previously underrecognized high-risk group for melanoma.
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Affiliation(s)
- Jenny Aalborg
- Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Denver, Aurora, Colorado, USA
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Aalborg J, Morelli JG, Mokrohisky ST, Asdigian NL, Byers TE, Dellavalle RP, Box NF, Crane LA. Tanning and increased nevus development in very-light-skinned children without red hair. ACTA ACUST UNITED AC 2009; 145:989-96. [PMID: 19770437 DOI: 10.1001/archdermatol.2009.193] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To examine the relationship between tanning and nevus development in very-light-skinned children. DESIGN Prospective cohort nested within a randomized controlled trial. Skin examinations in 3 consecutive years (2004, 2005, and 2006) included full-body counts of nevi, skin color and tanning measurement using colorimetry, and hair and eye color evaluation by comparison with charts. Telephone interviews of parents provided sun exposure, sun protection, and sunburn history. SETTING Large managed-care organization and private pediatric offices in the Denver, Colorado, metropolitan area. PARTICIPANTS A total of 131 very-light-skinned white children without red hair and 444 darker-skinned white children without red hair born in Colorado in 1998. MAIN OUTCOME MEASURES Full-body nevus counts at ages 6 to 8 years. RESULTS Among very-light-skinned white children, geometric mean numbers of nevi for minimally tanned children were 14.8 at age 6 years; 18.8 at age 7 years; and 22.3 at age 8 years. Mean numbers of nevi for tanned children were 21.2 at age 6 years; 27.9 at age 7 years; and 31.9 at age 8 years. Differences in nevus counts between untanned and tanned children were statistically significant at all ages (P < .05 for all comparisons). The relationship between tanning and number of nevi was independent of the child's hair and eye color, parent-reported sun exposure, and skin phototype. Among darker-skinned white children, there was no relationship between tanning and nevi. CONCLUSIONS Very-light-skinned children who tan (based on objective measurement) develop more nevi than children who do not tan. These results suggest that light-skinned children who develop tans may be increasing their risk for developing melanoma later in life.
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Affiliation(s)
- Jenny Aalborg
- University of Colorado Denver, 13001 E 17th Pl, Aurora, CO 80045, USA
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Dornelles S, Goldim J, Cestarl T. Determination of the Minimal Erythema Dose and Colorimetric Measurements as Indicators of Skin Sensitivity to UV-B Radiation¶. Photochem Photobiol 2007. [DOI: 10.1111/j.1751-1097.2004.tb01273.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Mayer JA, Slymen DJ, Clapp EJ, Pichon LC, Eckhardt L, Eichenfield LF, Elder JP, Sallis JF, Weinstock MA, Achter A, Balderrama C, Galindo GR, Oh SS. Promoting sun safety among US Postal Service letter carriers: impact of a 2-year intervention. Am J Public Health 2007; 97:559-65. [PMID: 17267715 PMCID: PMC1805012 DOI: 10.2105/ajph.2005.083907] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined whether US Postal Service letter carriers who received a sun safety intervention would wear wide-brim hats and sunscreen significantly more often than those who did not receive the intervention. METHODS We used a 2-group randomized design with 2662 evaluation cohort participants from 70 US postal stations. Evaluations were conducted at baseline, 3 months, 1 year, and 2 years. Questionnaire items assessed occupational use of sun-screen and wide-brim hats. The 2-year sun safety intervention included the provision of wide-brim hats, accessible sunscreen, reminders, and 6 educational sessions. RESULTS At the 3-month follow-up evaluations, the odds ratio (OR) for regular sun-screen use was 2.8 times higher among the intervention group than among the control group (95% confidence interval [CI]=2.2, 3.5); at the 2-year follow-up evaluations, the rate was still significantly higher (OR=2.0; 95% CI=1.6, 2.6). Intervention group participants also had significantly higher rates of hat use, with the differences remaining consistent across all follow-ups (OR=2.9; 95% CI=2.3, 3.6). CONCLUSIONS The intervention should be disseminated to postal stations nationwide and possibly to other occupational groups that work outdoors.
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Affiliation(s)
- Joni A Mayer
- Graduate School of Public Health, San Diego State University, San Diego 92123, USA.
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Glanz K, Mayer JA. Reducing ultraviolet radiation exposure to prevent skin cancer methodology and measurement. Am J Prev Med 2005; 29:131-42. [PMID: 16005810 DOI: 10.1016/j.amepre.2005.04.007] [Citation(s) in RCA: 98] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2004] [Revised: 04/01/2005] [Accepted: 04/12/2005] [Indexed: 11/22/2022]
Abstract
Skin cancer is the most common type of cancer, and is also one of the most preventable. This paper builds on an evidence review of skin cancer prevention interventions that was conducted for the Guide to Community Preventive Services (n=85 studies), and summarizes the state of knowledge about research methodology and measurement in studies of the effectiveness of interventions to reduce ultraviolet radiation (UVR) exposure. As this field advances, researchers should strive to minimize threats to validity in their study designs, as well as to consider the balance between internal and external validity. There is a need for more longer-duration interventions, and follow-up periods that make possible conclusions about the potential of these interventions to affect intermediate markers of skin cancer or at least sustained behavior change. Also, more work is needed to minimize attrition and characterize nonresponders and study dropouts. Verbal report measures of behavior are the most widely used measures of solar protection behavior. Given their limitations, investigators should routinely collect data about reliability and validity of those measures. They should also increase efforts to complement verbal data with objective measures including observations, skin reflectance, personal dosimetry, skin swabbing, and inspection of moles. Measures of environments and policies should incorporate observations, documentation, and direct measures of ambient UVR and shade. This article places the data derived from the evidence review in the context of needs and recommendations for future research in skin cancer prevention.
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Affiliation(s)
- Karen Glanz
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, USA.
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Dusza SW, Oliveria SA, Geller AC, Marghoob AA, Halpern AC. Student–parent agreement in self-reported sun behaviors. J Am Acad Dermatol 2005; 52:896-900. [PMID: 15858486 DOI: 10.1016/j.jaad.2004.11.039] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE We sought to describe agreement between parent proxy and student self-reported sun behaviors and sun protective practices in adolescents aged 10 to 14 years. METHODS We conducted a cross-sectional pilot study of students (n = 52) from two classrooms, grades 6 and 7, at a school system in Framingham, Mass. Data were collected using self-administered questionnaires. Students were asked to report their sun behaviors and sun protective practices. Proxy measures were obtained by asking parents to report sun behaviors and practices of their children. Agreement was measured using weighted kappa analysis for ordinal data. Mean differences (95% confidence intervals) were calculated. RESULTS The response rate for student/proxy pairs was 96% (n = 50). Agreement between student and proxy was good for skin color, sunscreen use, number of sunburns in the past summer, and application of sunscreen while in other outdoor places (range kappa = 0.52-0.73). Lowest agreement was found for questions relating to wearing a shirt, wearing a hat, sitting in the shade, and frequency of parental sunscreen application to the students' backs (range kappa = 0.08-0.28). Mean differences in responses between student and proxy respondents were relatively small ranging from -0.39 to +0.25. CONCLUSIONS The lack of a gold standard in the assessment of sun exposure and related sun protective practices limits the ability to validate these exposure measures in skin cancer studies. The assessment of sun exposure behaviors is especially problematic when relying on a child's ability to accurately recall these exposures. Parent proxy measures are often used as surrogate measures and for validation purposes. We found low to moderate student/proxy agreement in this pilot study suggesting that adolescents can effectively recall their recent sun behaviors and protective practices when compared with parent proxy measures.
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Affiliation(s)
- Stephen W Dusza
- Dermatology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, Boston, Massachusetts, USA.
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Saraiya M, Glanz K, Briss PA, Nichols P, White C, Das D, Smith SJ, Tannor B, Hutchinson AB, Wilson KM, Gandhi N, Lee NC, Rimer B, Coates RC, Kerner JF, Hiatt RA, Buffler P, Rochester P. Interventions to prevent skin cancer by reducing exposure to ultraviolet radiation: a systematic review. Am J Prev Med 2004; 27:422-66. [PMID: 15556744 DOI: 10.1016/j.amepre.2004.08.009] [Citation(s) in RCA: 107] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The relationship between skin cancer and ultraviolet radiation is well established. Behaviors such as seeking shade, avoiding sun exposure during peak hours of radiation, wearing protective clothing, or some combination of these behaviors can provide protection. Sunscreen use alone is not considered an adequate protection against ultraviolet radiation. This report presents the results of systematic reviews of effectiveness, applicability, other harms or benefits, economic evaluations, and barriers to use of selected interventions to prevent skin cancer by reducing exposure to ultraviolet radiation. The Task Force on Community Preventive Services found that education and policy approaches to increasing sun-protective behaviors were effective when implemented in primary schools and in recreational or tourism settings, but found insufficient evidence to determine effectiveness when implemented in other settings, such as child care centers, secondary schools and colleges, and occupational settings. They also found insufficient evidence to determine the effectiveness of interventions oriented to healthcare settings and providers, media campaigns alone, interventions oriented to parents or caregivers of children, and community-wide multicomponent interventions. The report also provides suggestions for areas for future research.
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Affiliation(s)
- Mona Saraiya
- National Center for Chronic Disease Prevention and Health Promotion, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA.
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Dornelles S, Goldim J, Cestari T. Determination of the Minimal Erythema Dose and Colorimetric Measurements as Indicators of Skin Sensitivity to UV-B Radiation¶. Photochem Photobiol 2004; 79:540-4. [PMID: 15291306 DOI: 10.1562/yg-03-08.1] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
There is a strong relation between chronic UV-B-induced sunburns and the development of skin cancer. Therefore, it is important to obtain a method that can be reproduced easily to detect individuals with similar skin color but different sensitiveness to sun exposure. The study evaluated 193 healthy volunteers (68% women; the average age was 38 years). They were divided into six groups of at least 30 subjects, according to skin type. The minimal erythema dose (MED) was assessed in two non-sun-exposed areas (thorax-infra-axillary area and on the buttocks), using a UV-B source (0.5 mW/cm2), with openings of 1 cm2, in increasing doses. The same areas were evaluated with a Minolta CR 300 Chromameter (L*a*b* system). The MED values ranged from 13 to 156 mJ/cm2; the coordinate L* (brightness) ranged from 75.96 to 30.15. The correlation between the MED and the brightness was negative in both areas (Pearson's correlation r = -0.91, P < 0.05). Color measurements, especially brightness, can be used to quickly assess skin sensibility. Considering the MED, there is a substantial overlapping of adjacent phototypes, but they could be separated into two groups: more sensitive individuals (Types I, II, III and IV) and less sensitive ones (Types V and VI).
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Affiliation(s)
- Sérgio Dornelles
- Department of Sanitary Dermatology of the Health and Environment Department of Rio Grande do Sul, Porto Alegre, RS, Brazil.
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Tsai TF, Bowman PH, Jee SH, Maibach HI, Paul BH. Effects of glycolic acid on light-induced skin pigmentation in Asian and caucasian subjects. J Am Acad Dermatol 2000; 43:238-43. [PMID: 10906645 DOI: 10.1067/mjd.2000.104894] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Topical use of alpha-hydroxy acid (AHA) may increase skin photosensitivity, as demonstrated by increased numbers of sunburst cells. However, effects of AHA on tanning have not been studied. OBJECTIVE Our purpose was to study whether short-term use of glycolic acid hastens resolution of pre-existing light-induced pigmentation and whether the skin becomes tan more easily in Asian and Caucasian subjects after such treatment. METHODS Six Asian and six Caucasian volunteers received separate irradiations of UVB and UVA to both sides of the lower back. In a double-blind fashion, patients then applied a 10% glycolic acid gel, pH 3.52, to one side of the back, including the irradiated area, and the contralateral extensor forearms once daily for 7 days and then twice daily for 2 weeks. A placebo gel, pH 5.75, was applied to the opposite sides. The subjects returned for measurement of residual tanning with a colorimeter and received additional irradiation to forearms and a second site on the back. Resulting pigmentation was measured immediately after irradiation, at 2 hours, and at 1 week. RESULTS Increased UVB-induced skin tanning occurred on the forearm and the lower back in both races in areas pretreated with glycolic acid. UVA also caused increased tanning, but only on the extensor forearms in Asian subjects. Treatment with glycolic acid for 3 weeks had no effect on pre-existing light-induced pigmentation. CONCLUSION Short-term topical treatment of glycolic acid caused an increase in UVB tanning as well as in UVA tanning in some subjects, even in the absence of overt irritation. The inclusion of UVB, and even UVA, sunscreen in AHA products may be warranted.
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Affiliation(s)
- T F Tsai
- Department of Dermatology, National Taiwan University Hospital, Taipei, ROC
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Abstract
Increasing sun protection for children may reduce their risk for skin cancer, so many health authorities recommend comprehensive sun safety for children. Sun protection of children in North America and Europe is generally lower than desired and lower than in Australia. This article provides a critical review of evaluations on the effects of 24 sun protection programs for children under age 14. Programs are classified based on the target population, setting, and features. Most programs improved sun safety knowledge, but changes in sun protection attitude and behaviors were smaller. Multiunit presentations were more effective than short-duration presentations. Peer education was effective but needs further evaluation. Some programs for parents have been shown to increase sun protection for children. Strategies to improve sun safety policies need further study. A few community-wide programs have effectively improved sun protection. Future research should address innovative strategies and issues of design and measurement. There is no gold standard for measuring sun protection behavior, but self-report, prospective diaries, and observational techniques show small positive correlations.
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Affiliation(s)
- D B Buller
- Center for Behavioral Research, AMC Cancer Research Center, Denver, CO 80214, USA.
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Creech LL, Mayer JA. Ultraviolet radiation exposure in children: a review of measurement strategies. Ann Behav Med 1998; 19:399-407. [PMID: 9706367 DOI: 10.1007/bf02895159] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Rates of skin cancer in the U.S. are high and have been increasing rapidly. Recommendations for primary prevention focus on the reduction of ultraviolet radiation (UVR) exposure, especially in childhood. Valid, reliable strategies are needed to measure UVR exposure in children, to document baseline levels, and to assess intervention impact. This article reviews strategies reported in observational and intervention studies and considers their potential usefulness for application with children. The strategies include verbal report (by self or parent), direct observation, visual inspection, ultraviolet (UV) sensitive film, the Erythema Meter, the spectrophotometer, and the colorimeter. Each strategy is described along several dimensions, including ease of use, cost, and whether it is suitable for measuring acute and cumulative exposure. The review describes the existing validity and reliability data and points out a need for further research assessing the reliability and validity of most of these measures. Additionally, suggestions for matching strategies with measurement and intervention objectives are presented.
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Affiliation(s)
- L L Creech
- Graduate School of Public Health, San Diego State University, CA 92182-4162, USA
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Koh HK, Geller AC. Public health interventions for melanoma. Prevention, early detection, and education. Hematol Oncol Clin North Am 1998; 12:903-28. [PMID: 9759586 DOI: 10.1016/s0889-8588(05)70030-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Worldwide melanoma control programs that include some combination of primary prevention, education, and screening activities have only recently begun to undergo an evaluation process. More studies with rigorous design and evaluation are needed. Until then, the proper public health policy guidelines for melanoma control, especially screening, are open to debate. Future studies must determine how screening, early detection, case finding, and education can best be used to reduce mortality and achieve optimal melanoma control.
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Affiliation(s)
- H K Koh
- Department of Dermatology, Boston University School of Medicine, Massachusetts, USA
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Mayer JA, Slymen DJ, Eckhardt L, Johnston MR, Elder JP, Sallis JF, Creech L, Lui KJ, Rosenberg C, Souvignier ST, Stepanski B. Reducing ultraviolet radiation exposure in children. Prev Med 1997; 26:516-22. [PMID: 9245674 DOI: 10.1006/pmed.1997.0166] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Project SUNWISE evaluated the effectiveness of a multicomponent intervention in reducing children's ultraviolet radiation (UVR) exposure. METHODS Across four YMCAs, 48 aquatics classes (N = 169 children, mean age = 7) were randomly assigned to either the intervention or the control condition. The 6-week intervention included a UVR reduction curriculum presented at poolside by aquatics instructors and home-based activities for children and their parents. Outcome measures were (a) tanness-associated skin color dimensions assessed with a colorimeter, (b) specific daily solar protection behaviors of children as reported by parents, and (c) general solar protection behaviors. RESULTS Controlling for intraclass clustering in all analyses, at posttest, no statistically significant between-group differences were found in tanness, daily solar protection scores, or general sunscreen use. The intervention group showed significantly greater general hat use relative to controls. CONCLUSIONS The intervention failed to impact most of the outcome measures. Supplementing the behavior-focused intervention package with environmental supports may be warranted.
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Affiliation(s)
- J A Mayer
- Graduate School of Public Health, San Diego State University, California 92182, USA
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Mayer JA, Sallis JF, Eckhardt L, Creech L, Johnston MR, Elder JP, Lui KJ. Assessing children's ultraviolet radiation exposure: the use of parental recall via telephone interviews. Am J Public Health 1997; 87:1046-9. [PMID: 9224196 PMCID: PMC1380950 DOI: 10.2105/ajph.87.6.1046] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES This study evaluated the validity of a parental report measure of children's solar protection behaviors. METHODS Fifty-eight children had skin color assessed twice with a colorimeter. Between measurement sessions, parents were interviewed by telephone to assess children's indoor-outdoor status and solar protection across 40 hourly intervals. RESULTS Parental report of child's indoor-outdoor status was significantly correlated with the colorimeter values, whereas the use of sunscreen and protective clothing was not. CONCLUSIONS This measure was feasible for assessing ultraviolet exposure in young children. The component that assessed the number of intervals spent outdoors evidenced predictive validity.
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