Use of Tobacco for Weight Control across Products among Young Adults in the U.S. Military

BACKGROUND

Approximately 17% of young adults currently use tobacco, most commonly cigarettes and/or electronic cigarettes (e-cigarettes), followed by other products (i.e., cigarillos, pipe/hookah, smokeless tobacco). Cigarettes have been historically used to control weight. Little is known about use of non-cigarette products for weight control, particularly among non-college young adults. Tobacco use in the military is higher than civilians, and personnel have increased motivation for weight control due to military fitness standards. This population might be vulnerable to use tobacco for this purpose. Purpose: Exploring prevalence, as well as demographic and behavioral correlates, of using tobacco products for weight control, among a large, diverse sample of military young adults. Methods: U.S. Air Force recruits (N = 24,543) completed a questionnaire about tobacco use. Among users of tobacco products, recruits reported if they had ever used that product to maintain their weight. Results: Smokeless tobacco was most commonly used for weight control (12.2%), followed by cigarettes (7.3%), e-cigarettes (5.5%), cigarillos (3.3%), and hookah/pipe (3.2%). Using tobacco for weight control was associated with fewer harm beliefs and more regular use of that product. Among e-cigarette users, having a higher BMI and a lower educational background was associated with ever using this product for weight control. Conclusions: The belief that a tobacco product helps control one's weight might increase the prevalence, and frequency of use, of that product among military young adults. Tobacco cessation programs should assess for this motivation of use and provide education about tobacco harm and alternative strategies for weight maintenance.

Body esteem, peer difficulties and perceptions of physical health in overweight and obese urban children aged 5 to 7 years

OBJECTIVE

To determine whether there is an association between body mass index (BMI) and body esteem in young overweight and obese urban children, and to test peer relationship difficulties and perceived physical health as mediators of this relationship.

METHODS

Child self-reported body esteem, and parent-reported child peer relationship difficulties (being bullied by peers and peer rejection) and physical health perceptions were obtained from 218 overweight and obese children aged 5-7 years (81% racial/ethnic minority, M BMI = 25.3) and their primary caregivers.

RESULTS

Higher BMI was associated with lower body esteem for both girls and boys. This relation was mediated by poor physical health for boys but not for girls. Peer relationship difficulties did not mediate the observed association between BMI and body esteem in either group; however, girls with higher BMI experienced more bullying and being bullied by peers was associated with lower body esteem in girls.

CONCLUSIONS

Intervening with perceptions of physical health may buffer overweight and obese boys from developing low body esteem in early childhood.

Racial differences in the influence of body size on ambulatory blood pressure in youths

BACKGROUND

African Americans have higher night-time blood pressures than Caucasians do despite their having similar daytime blood pressures. It is well established that body size is related to casual blood pressure.

OBJECTIVE

To examine the influence of body size on racial differences in patterns of ambulatory blood pressure.

METHODS

Ambulatory blood pressure recordings were performed on 292 healthy children and adolescents (148 African Americans and 144 Caucasian) aged 10-18 years (mean 13+/-2 years). These blood pressures were related to height, weight, body surface area, and body mass index in separate regression models that also included race, sex, and age as factors.

RESULTS

The race-by-height interaction was significant for night-time systolic blood pressure (P<0.02), with a significant relationship for African Americans (P<0. 0001), but not for Caucasians. The race-by-weight interaction was significant for night-time systolic blood pressure (P<0.04), also with a greater relationship for African Americans (P<0.0001) than for Caucasians (P<0.03). In addition, the race-by-weight interaction was significant for night-time diastolic blood pressure (P<0.04), with a significant relationship for African Americans (P<0.01), but not for Caucasians. Finally, the race-by-body-surface-area interaction was significant for night-time diastolic blood pressure (P<0.05), again with a significant relationship for African Americans (P<0.02) but not for Caucasians.

CONCLUSION

Differences in the relationship between body size and blood pressure contribute to the racial differences in patterns of ambulatory blood pressure and should be considered when evaluating patterns of blood pressure in African American youths.

Pathological versus physiological left ventricular hypertrophy: a review

Left ventricular hypertrophy is recognized as an independent risk factor for cardiovascular morbid events. The primary mechanisms responsible for stimulating it are unknown. Epidemiological theories suggest that left ventricular hypertrophy is a continuous variable with no threshold, while morphological studies argue that it is the structure, or quality, and function of the myocardium (and therefore non-continuous), not the quantity of the myocardial mass, that poses the cardiovascular risk. Although left ventricular hypertrophy has been classically viewed as an adaptive response of the cardiovascular system to an imposed load, it has been demonstrated that haemodynamic overloading in selected hypertensive patients is not the sole determinant of left ventricular structure and function. Pathological and physiological states of left ventricular hypertrophy have been described primarily using criteria focusing on normal chamber performance and oxygen delivery as well as the reversibility of the hypertrophy once the overload is removed. Both states are also defined by the nature of the imposed load and the resulting myocardial adaptations. This review addresses the pathological and physiological states of left ventricular hypertrophy, the hypertrophy patterns, and the corresponding structural and functional characteristics, together with some of the biochemical factors thought to influence remodelling.

Racial differences in the age-related increase in left ventricular mass in youths

We determined the factors related to left ventricular mass adjusted for body size in 60 black (mean age, 13 +/- 2 years) and 40 white (mean age, 14 +/- 2 years) normotensive youths. The factors examined included age, sex, systolic blood pressure, diastolic blood pressure, plasma renin activity, plasma aldosterone concentration, and sodium and potassium intake as determined by 24-hour excretion. Sex (beta = 13.3, P < .003), age (beta = 2.88, P < .001), and systolic blood pressure (beta = 0.41, P < .02) were independent predictors in the sample as a whole, accounting for 37% of the variance of left ventricular mass adjusted for height. Separate analyses were performed for black and white subjects. In the black subjects, age (beta = 4.4, P < .004) followed by sex (beta = 11.85, P < .02) were independent factors, accounting for 43% of the variance of left ventricular mass adjusted for height. In contrast, in white subjects systolic blood pressure (beta = 0.4, P < .003) followed by sodium excretion (beta = 0.13, P < .05) were independent factors, with gender (beta = 8.89, P < .07) tending to account for 36% of the variance. Similar results were observed for left ventricular mass adjusted for body surface area. In conclusion, the age-related increase in adjusted left ventricular mass in black but not white youths may in part account for the early development of cardiovascular disease among the black population.