Use of calorie information at fast food and chain restaurants among US youth aged 9-18 years, 2010.

BACKGROUND: To examine whether youth use calorie information when it is available at fast food/chain restaurants and what factors are associated with using this information to make their food selection. METHODS: A cross-sectional analysis was conducted on a sample of 721 youth (9-18 years) using the 2010 YouthStyles and HealthStyles surveys. The outcome measure was reported use of calorie information at fast food/chain restaurants. Multivariable logistic regression was used to examine the associations between sociodemographic variables and the use of calorie information at fast food/chain restaurants. RESULTS: Of those who visited fast food/chain restaurants, 42.4% reported using calorie information at least sometimes. Girls were more likely than boys (adjusted odds ratio (aOR) = 1.8, 95% confidence interval (CI) = 1.2-2.5) and youth who were obese were more likely than those at a healthy weight (aOR = 1.7, 95% CI = 1.04-2.9) to use calorie information, and youth eating at a fast food/chain restaurant twice a week or more versus once a week or less were half as likely to report using calorie information (aOR = 0.5, 95% CI = 0.4-0.8). CONCLUSION: Public health education efforts can benefit from research to determine how to increase usage among youth so that their food choices are appropriate for their caloric needs.

Factors associated with errors in self-reported height and weight in older adults.

OBJECTIVES: Describe the distribution and direction of self-reported versus measured height and weight using variables associated with aging such as cognition, health status, age, and bone mineral density (BMD), and examine the effect of these measurement differences on body mass index (BMI) classification. DESIGN: Data was derived from the third National Health and Nutrition Examination Survey (NHANESIII) conducted from 1988-1994, a nationwide probability sample. PARTICIPANTS: 4,590 non-institutionalized older adults aged 60 and older. MEASUREMENTS: Self-reported and measured height and weight, demographic and lifestyle characteristics, BMD, and subscales from the Mini Mental State Exam were used. Values were considered correct if self-reported height was within one inch of measured height, self-reported weight was within 5 lbs of measured weight, and self-reported BMI was within the same classification as measured BMI. RESULTS: Over-reported height increased with age in both men and women, occurring in 70% of those aged 80 and older. Compared to people with normal BMD, a significantly higher proportion of osteoporotic men (76% versus 47%, P<0.001) and women (52% versus 35%, P<0.001) over-reported their height. Additionally, significant misclassifications of self-reported height and weight occurred among people in poor health and those with poor performances on memory and calculation tests. Nevertheless, there was agreement in BMI classification among almost 80% of the population and among 90% of individuals in the healthy BMI category. CONCLUSION: This study suggests that among an older population, self-reported height and weight may be strongly related to age-associated changes in health status, cognition and BMD.

Secular trends in desired weight of adults.

CONTEXT: The prevalence of overweight and obese adults in the United States is at record levels. OBJECTIVE: The primary purpose is to describe secular trends in desired weight among adults from 1994 to 2003, and secondarily, to examine the hypothetical impact of achieving desired weight on obesity prevalence. DESIGN: Data were from the Behavioral Risk Factor Surveillance System (1994, 1996, 1998, 2000, 2003), a random-digit-dialed telephone survey. SETTING: Sample included respondents from 47 states and the District of Columbia. PARTICIPANTS: Non-institutionalized adults aged 18 years or older were included (N=703 286). MAIN OUTCOME MEASURES: Primary outcome measures included reported weight and desired weight. RESULTS: Means for desired weight increased 2.3 kg between 1994 and 2003, and reported weights increased 3.9 kg. The increased trend was observed across several subgroups for age, race/ethnicity and education. Within subgroups of weight status, the trend has remained relatively stable, particularly when examined in relation to the difference between reported and desired weight as a percentage of reported body weight. Generally, overweight men desired weights approximately 4.5% less than their reported weight, and obese men desired weights approximately 15% less than their reported weight for each corresponding year. For women, approximate values of desired weight were 12% less than reported weight for overweight women and 24% less for obese women. The prevalence of obesity would decrease to 4.4% if individuals weighed their desired weight. CONCLUSIONS: Americans are shifting their desired weight upward, concomitantly with an increase in their reported body weight.

Relation of BMI to fat and fat-free mass among children and adolescents.

OBJECTIVE: Although the body mass index (BMI, kg/m2) is widely used as a surrogate measure of adiposity, it is a measure of excess weight, rather than excess body fat, relative to height. We examined the relation of BMI to levels of fat mass and fat-free mass among healthy 5- to 18-y-olds. METHODS AND PROCEDURES: Dual-energy X-ray absorptiometry was used to measure fat and fat-free mass among 1196 subjects. These measures were standardized for height by calculating the fat mass index (FMI, fat mass/ht2) and the fat-free mass index (FFMI, fat-free mass/ht2). RESULTS: The variability in FFMI was about 50% of that in FMI, and the accuracy of BMI as a measure of adiposity varied greatly according to the degree of fatness. Among children with a BMI-for-age > or =85th P, BMI levels were strongly associated with FMI (r=0.85-0.96 across sex-age categories). In contrast, among children with a BMI-for-age <50th P, levels of BMI were more strongly associated with FFMI (r=0.56-0.83) than with FMI (r=0.22-0.65). The relation of BMI to fat mass was markedly nonlinear, and substantial differences in fat mass were seen only at BMI levels > or =85th P. DISCUSSION: BMI levels among children should be interpreted with caution. Although a high BMI-for-age is a good indicator of excess fat mass, BMI differences among thinner children can be largely due to fat-free mass.

Sex differences in bone mass acquisition during growth: the Fels Longitudinal Study.

Risk of osteoporosis in later life may be determined during adolescence and young adulthood. The present study used longitudinal data to examine the accumulation of bone mineral content (BMC) and bone mineral density (BMD) in Caucasian subjects ages 6-36 yr. Growth in BMC and BMD (measured by dual X-ray absorptiometry; Lunar, Madison, WI) of 94 males and 92 females was monitored for a mean period of 4.29 yr. The main findings were that there were no sex differences in BMC or BMD during the prepubertal stage; however, females had significantly higher BMD of the pelvis and BMC and BMD of the spine during puberty, and postpubertal males generally had significantly higher BMC and BMD than their female counterparts. In addition, the longitudinal rate of bone accumulation in both sexes increased rapidly during childhood and adolescence and was nearly complete at the end of puberty. Finally, peak BMC and BMD was achieved between the ages of 20 and 25 and occurred earlier in females than in males. The rates of growth and timing of peak bone mass as reported here define the crucial period during which intervention protocols should be developed for maximizing skeletal mass to prevent the development of osteoporosis.

Childhood body composition in relation to body mass index.

OBJECTIVE: The aim is to describe body composition in relation to body mass index (BMI; body weight/stature(2)) to provide health care professionals insight into the meaning, significance, and limitations of BMI as an index of adiposity during childhood. METHODS: Data from 387 healthy, white children 8 to 18 years of age from the Fels Longitudinal Study were analyzed. Measurements were scheduled annually and each child was examined 1 to 11 times, totaling 1748 observations. Total body fat (TBF) and fat-free mass (FFM) were determined from hydrodensitometry. Stature and weight were measured using standard methods and BMI and the components of BMI, TBF/stature(2), and FFM/stature(2) were calculated. Analyses included correlations between BMI and body composition variables; age-related patterns of BMI, TBF/stature(2), and FFM/stature(2); and annual changes in BMI, TBF/stature(2), and FFM/stature(2). RESULTS: Generally, correlations between BMI and body composition variables were strong and significantly different from zero. Means for BMI throughout childhood were similar for boys and girls, although significantly larger values were observed for girls at ages 12 to 13 years. Age-related patterns of TBF/stature(2) and FFM/stature(2) differed between sexes. In each sex, annual increases in BMI were driven primarily by increases in FFM/stature(2) until late adolescence, with increases in TBF/stature(2) contributing to a larger proportion of the BMI increases in girls than in boys. CONCLUSIONS: Unlike adults, annual increases in BMI during childhood are generally attributed to the lean rather than to the fat component of BMI. Because the properties of BMI vary during childhood, health care professionals must consider factors such as age and sex when interpreting BMI.

High levels of dietary carnosine are associated with increased concentrations of carnosine and histidine in rat soleus muscle.

The aims of this investigation were to: 1) determine the effect of a moderately high dose of carnosine on muscle concentrations of carnosine, histidine and vitamin E at deficient, minimally adequate and sufficient levels of dietary vitamin E and 2) compare the effects of moderately high and pharmacological doses of carnosine on muscle concentrations of carnosine, histidine and vitamin E when dietary vitamin E is minimally adequate. Muscle concentrations of carnosine, histidine and vitamin E were measured in the lateral gastrocnemius and red and white vastus lateralis; carnosine and histidine concentrations were also measured in soleus muscle. Male Sprague-Dawley rats (n = 12/group) were fed a basal vitamin E-deficient diet supplemented with either 0, 0.001 or 0.01% vitamin E and 0, 0.1 or 1.8% carnosine. After 8 wk, 1.8% carnosine resulted in significant fivefold increases in carnosine and twofold increases in histidine in the soleus muscle (P < or = 0.05). Muscle vitamin E concentrations were not significantly affected by dietary carnosine. Thus, very high levels of dietary carnosine are associated with increases in carnosine and histidine concentrations in rat soleus muscle.

Body mass index during childhood, adolescence and young adulthood in relation to adult overweight and adiposity: the Fels Longitudinal Study.

BACKGROUND: Childhood overweight develops during 'critical periods', but the relationship of body mass index (BMI) patterns during 'critical periods' from childhood into adulthood with subsequent overweight and adiposity has not been previously investigated. BMI patterns during early childhood, pubescence and post-pubescence and their independent effects on overweight and body fatness at 35-45 y of age were examined along with birth weight and the effects of adult lifestyle factors. METHODS: BMI parameters describing the timing, velocity minimum (min) and maximum (max) values from 2 to 25 y of age were related to adulthood BMI values and total and percentage body fat (TBF, %BF) at 35-45 y. These data were from 180 males and 158 females in the Fels Longitudinal Study. RESULTS: There was no sex difference in the timing of BMI rebound, but the age of BMI maximum velocity and maximum BMI were both earlier in girls. Children with an earlier BMI rebound had larger BMI values at rebound and at maximum velocity. Children who reached maximum BMI at later age had larger maximum BMI values. Maximum BMI was a strong predictor for adult BMI and in females, a strong predictor of adulthood TBF and %BF. Maximum BMI was closely related to maximum BMI velocity in females and in males, BMI at maximum velocity is a strong predictor of TBF and %BF. CONCLUSIONS: Changes in childhood BMI were related to adult overweight and adiposity more so in females than males. BMI rebound is a significant important period related to overweight at 35-45 y in females but not in males. However BMI patterns during and post-adolescence were more important than the BMI rebound for adulthood TBF and %BF status. There is marked tracking in BMI from approximately 20 y into 35-45 y. The pattern of BMI changes from 2 to 25 y had stronger effects on subsequent adult overweight than birth weight and adult lifestyle variables.

Lifetime overweight status in relation to serial changes in body composition and risk factors for cardiovascular disease: The Fels Longitudinal Study.

OBJECTIVE: The aims were to determine if 1) individuals who became and maintained overweight during their entire lifetime differ from those who were never-overweight in terms of annual changes in adiposity and concurrent changes in cardiovascular disease (CVD) risk factors; 2) the changes and their relationships to each other varied between these groups or by sex within the groups; and 3) alcohol usage, smoking habits, and level of physical activity differed between groups. RESEARCH METHODS AND PROCEDURES: Data from 16,315 examinations of 414 individuals were utilized to assess lifetime overweight (body mass index [BMI] > 25 kg/m2) status. A regressive analytic approach was used to determine the average annual changes for each individual over an adult serial interval ranging from 4 to 20 years. RESULTS: Men and women who have become and maintained overweight have higher blood pressure and a poorer lipid/lipoprotein risk profile than those who have never been overweight. There is an accelerated deterioration in the atherogenic profile of overweight men and women as indicated by annual changes in CVD risk factors about double that of their never-overweight counterparts. In women, increased risk is derived from increasing systolic and diastolic blood pressure, whereas in men the increased risk comes not only from increasing diastolic blood pressure but also cholesterol, triglycerides, and low-density lipoprotein cholesterol levels and, to a lesser extent, decreasing high-density lipoprotein cholesterol. DISCUSSION: The reduced physical activity observed in the overweight adults may be related to their accumulation of adipose tissue at a rate about double their never-overweight counterparts, and this may be driving the higher rate of increase of CVD risk factors in the overweight groups.

Childhood weight, stature, and body mass index among never overweight, early-onset overweight, and late-onset overweight groups.

OBJECTIVE: To determine the effects of timing of onset of overweight (OW) on childhood anthropometric adiposity levels using long-term serial data from the Fels Longitudinal Study. CLASSIFICATION: OW was defined as body mass index (BMI; kg/m(2)) >25, and the age at first measurement of BMI >25 was the age of onset of OW. Early onset of OW (early-OW) and late onset of OW (late-OW) were defined as having onset of OW before and after 25 years of age, respectively, whereas never OW (never-OW) was defined as never having a BMI >25. SUBJECTS: Subjects consisted of 67 males and 47 females in early-OW groups, 62 males and 48 females in late-OW groups, and 80 males and 114 females in never-OW groups. RESULTS: Levels of weight and BMI in early-OW males and females were significantly greater than those in never-OW and late-OW males and females beginning at the time of adiposity rebound, which generally occurs between 4 and 8 years of age. Median BMI and weight patterns between never-OW and late-OW males were similar throughout childhood. However, significant differences in median levels of BMI for never-OW and late-OW females began at 11 years of age, although onset of OW was not until >25 years of age in the latter group. CONCLUSIONS: For both males and females, adiposity rebound is likely an effective time in a child's development to detect and initiate prevention for childhood and early adulthood onset of OW. Although later-onset OW needs additional study, puberty seems to be a critical phase in the development of later adult onset of OW in females.

Total-body and regional bone mineral content and areal bone mineral density in children aged 8-18 y: the Fels Longitudinal Study.

BACKGROUND: Techniques for cross-calibration of bone mineral content (BMC) and bone mineral density (BMD) between manufacturers of dual-energy X-ray absorptiometry (DXA) instruments are currently inadequate for total body measurements. Therefore, manufacturer-specific data for BMC and BMD in children are needed. OBJECTIVE: We provided age- and sex-specific means and SDs for total-body and regional BMC and areal BMD in 8-18-y-old white children. DESIGN: BMC and BMD of the head, arms, legs, pelvis, spine, and total body were determined by DXA. Data include 465 annual measurements from 148 healthy children with body weights between 30 and 100 kg and statures <190 cm. RESULTS: There were significant sex differences in BMC at ages 15-18 y for the total body and legs, at ages 12 and 15-18 y for arms and pelvis, at ages 11-13 and 16-18 y for the spine, and at ages 10-11 y for the head. There were significant sex differences in BMD at ages 16-18 y for total body, arms, and legs; at ages 12-13 and 16-18 y for the pelvis; at ages 12-14 and 18 y for the spine; and at ages 13-18 y for the head. CONCLUSIONS: Data presented in this investigation can be used to compare the BMC and BMD of 8-18-y-old white children (with statures <190 cm and body weights between 30 and 100 kg) using DXA.

Serial changes in body composition throughout adulthood and their relationships to changes in lipid and lipoprotein levels. The Fels Longitudinal Study.

Few studies have examined the relationships between measures of body composition and lipid and lipoprotein levels in long-term serial data from individuals unselected for cardiovascular disease- or obesity-related variables, and none have considered such extensive serial data as used in the current study. The aim was to examine in such individuals the associations between annual changes in lipid and lipoprotein levels and concurrent changes in total body fat, fat-free mass, percent body fat, and body mass index. Serial data from 1304 examinations of 423 adult white participants in the Fels Longitudinal Study were analyzed sex-specifically in 2 age groups, 18 through 44 years and 45 to 65 years. A regressive analytic approach utilized the long-term (4 to 20 years) serial data of individuals. Annual changes in adiposity, independent of levels of lean tissue changes, before and after age 45 for men and women were significantly correlated with corresponding annual changes in cholesterol and low density lipoprotein cholesterol. In men before age 45, changes in triglycerides and high density lipoprotein cholesterol were also significantly associated with changes in adiposity, with the relationship remaining after age 45 in high density lipoprotein cholesterol. Increases in adiposity in individuals are associated with changes in lipid and lipoprotein levels in the direction of increased risk for cardiovascular disease. Adult levels of total cholesterol and low density lipoprotein cholesterol across age and sex and high density lipoprotein cholesterol in men are responsive to changes in adiposity, independent of initial adiposity or lipid and lipoprotein levels.