Examining the evidence for policy and environmental strategies to prevent childhood obesity in black communities: new directions and next steps.

Exposure to physical and policy environments that limit availability, affordability and appeal of healthy eating and active living options is higher for U.S. blacks than whites. This may contribute to high risk of obesity in black communities and limit effectiveness of preventive interventions. Here, we assess applicability to black Americans of findings from a prior evidence review system designed to accelerate the discovery and application of policy and environmental strategies for childhood obesity prevention and assess external validity. The database included 600 peer-reviewed articles reporting data from 396 sets of studies (study groupings) published from January 2000 through May 2009 and pertained to 24 types of policy and environmental strategies. Only 33 study groupings (~8%) included ≥ 50% black Americans or reported subgroup analyses. Of 10 evaluation studies for interventions rated as effective for all populations in the primary review, 8 suggested effectiveness of child-focused interventions in school or child care settings for obesity- or physical activity-related outcomes in black Americans. Overall findings highlight the need for rigorous evaluations of interventions that reach black children in community or institutional settings, and conceptual frameworks and research designs geared to identifying ethnic or ethnicity-income group differences in intervention effects.

Environmental and policy determinants of physical activity in the United States.

OBJECTIVES: This study examined (1) descriptive patterns in perceived environmental and policy determinants of physical activity and (2) associations between these factors and behavior. METHODS: A cross-sectional study was conducted from 1999 to 2000 among US adults; individuals at lower income levels were oversampled. RESULTS: Availability of areas for physical activity was generally higher among men than among women. The 4 most commonly reported personal barriers were lack of time, feeling too tired, obtaining enough exercise at one's job, and no motivation to exercise. Neighborhood characteristics, including the presence of sidewalks, enjoyable scenery, heavy traffic, and hills, were positively associated with physical activity. There was a high level of support for health policy-related measures. Up to one third of individuals who had used environmental supports reported an increase in physical activity. CONCLUSIONS: An array of environmental and policy determinants, particularly those related to the physical environment, are associated with physical activity and should be taken into account in the design of interventions.

Effect of halothane on the oligomerization of the sarcoplasmic reticulum Ca(2+)-ATPase.

The exact molecular mechanism of inhalational anesthetics remains obscure. Since the enzyme activity of the sarcoplasmic reticulum Ca(2+)-ATPase from skeletal muscle fibres is modified by halothane and because protein-protein interactions play an important role in the regulation of Ca(2+)-regulatory proteins, we investigated the effect of this volatile drug on the oligomerization of the fast-twitch Ca(2+)-ATPase. Using electrophoretic separation following incubation with halothane, increases in relative molecular mass were determined by immunoblotting with a monoclonal antibody to the SERCA1 isoform of the Ca(2+)-ATPase. Distinct drug-induced decreases in electrophoretic mobility indicated oligomerization of the native Ca(2+)-pump by halothane, comparable to crosslinking-mediated formation of homo-tetramers. Determination of the effect of halothane on enzyme activity suggested that halothane-mediated protein aggregation triggers a partial inhibition of Ca(2+)-pump units. Thus, halothane appears to exert its action via specific peptide binding sites and not indirectly by lipid perturbation. These findings support the protein theory of anesthetic action.

Physician recommendations for diet and physical activity: which patients get advised to change?

BACKGROUND: National objectives and guidelines call upon physicians to help reduce the population burden of chronic diseases by advising patients to eat less fat and get more physical activity. However, studies show physicians are most likely to provide behavioral recommendations to patients who are already sick. Understanding factors that influence physicians' advising decisions can help broaden the reach of these activities. METHODS: Subjects were 915 adult patients and 27 physicians from four community-based family medicine clinics in southeastern Missouri. To participate, patients completed a self-administered behavioral and health questionnaire while waiting to see their doctor. RESULTS: Having a high body mass index was the strongest predictor of receiving advice to increase physical activity (OR = 1.6; 95% CI 1.3, 2.0), and having a high cholesterol level was the strongest predictor of receiving advice to eat less fat (OR = 1.9; 95% CI 1.5, 2.4). Neither the actual content of patients' diets nor their levels of physical activity were associated with receiving advice. CONCLUSIONS: Physicians' advising may be guided by quick but fallible heuristics that systematically exclude patients whose needs are not easily visible. This pattern misses the opportunity to reduce future needs for therapeutic counseling by taking preventive action now.

Do nutrition label readers eat healthier diets? Behavioral correlates of adults' use of food labels.

BACKGROUND: Reading and understanding nutrition labels on foods may be an important precursor to dietary change. However, little is known about how nutrition labels are used by consumers and what effect reading labels has on dietary behaviors. METHODS: This article identifies behavioral and health status correlates of nutrition label reading and describes patterns of label use among 885 adult patients from four family medicine clinics in southeastern Missouri. To participate, patients completed a self-administered survey while waiting to see their physicians. RESULTS: Analyses revealed patients eating diets lower in fat were much more likely (51% versus 26%) than patients whose diets were higher in fat to report labels influencing their food purchase decisions, as were patients eating diets higher in fruits, vegetables, and fiber. Patients with high blood pressure were 63% more likely than those with normal or low blood pressure to look for sodium on the nutrition label (odds ratio [OR] = 1.63, 95% confidence interval [CI] = 1.35, 1.97), but no more likely to look for other nutrition label information. Similarly, patients with high cholesterol were more likely than those with normal or low cholesterol to look for saturated fat (OR = 1.39, 95% CI = 1.13, 1.72) and cholesterol (OR = 1.60, 95% CI = 1.29, 1.98) on the label, but no more likely to look for other nutrition label information. CONCLUSIONS: Findings consistently supported a relationship between patients' label reading and their dietary practices.