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1.
Med Sci Sports Exerc ; 32(8): 1445-54, 2000 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-10949011

RESUMEN

PURPOSE: This report describes the development and use of two self-report methods and an objective measure to assess longitudinal changes in physical activity in a large biethnic cohort of young girls from childhood through adolescence. METHODS: The NHLBI Growth and Health Study (NGHS) is a multicenter study of obesity development in 2379 black and white girls followed from ages 9-10 yr to 18-19 yr (NGHS years 1-10). A Caltrac activity monitor was used to objectively quantify activity levels in years 3-5. A 3-d diary (AD) and a habitual patterns questionnaire (HAQ) were administered annually and biannually, respectively, to subjectively quantify physical activity levels. The changing pattern of activities as the girls matured during the 10-yr study period necessitated periodic form changes. Empirical analytic approaches were developed to help distinguish between true longitudinal changes in activity levels from potential numerical artifacts resulting from modifications in forms. RESULTS: The longitudinal activity data indicate a steep decline in the level of reported activity from baseline to year 10 as indicated by AD scores (446.8 to 292.1 MET-min x d(-1), 35%) as well as by HAQ scores (29.3 to 4.9 MET-times x wk(-1), 83%). This parallel trend in the pattern of the decline in activity among the two self-report methods was mirrored by a similar decline using the Caltrac method of physical activity assessment. From years 3 to 5, the AD decreased by 22%, whereas both the HAQ and Caltrac declined by 21%. CONCLUSION: The longitudinal data on physical activity collected in the NGHS cohort further confirm a dramatic decrease in the overall level of physical activity during the transition from childhood to adolescence. The consistency among the three methods indicate that both the AD and HAQ are useful tools for the assessment of activity levels in adolescent girls.


Asunto(s)
Negro o Afroamericano , Ejercicio Físico , Estilo de Vida , Población Blanca , Adolescente , Niño , Estudios de Cohortes , Humanos , Estudios Longitudinales , Estados Unidos
2.
J Adolesc Health ; 23(1): 7-19, 1998 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-9648018

RESUMEN

PURPOSE: We examined changes in self-esteem and feelings of competence with physical appearance and social acceptance over approximately 5 years in 1166 white and 1213 black girls, aged 9 and 10 years at baseline. METHODS: Maturation stage and body mass index (BMI) were assessed annually. Biennially girls completed Harter's Self-Perception Profile for children. Changes were analyzed in the context of race, sexual maturation, BMI, and household income. Longitudinal regression models were used to compare trends with age in global self-worth, physical appearance, and social acceptance. RESULTS: Mean global self-worth showed little change over ages 9-14 years in blacks (p = 0.09) but decreased in whites (p < 0.001). Mean physical appearance scores for both races declined between ages 9 and 14 years (blacks, p < 0.001; whites, p < 0.001). Mean social acceptance scores increased for both races between ages 9 and 14 years (blacks, p < 0.001; whites, p < 0.001). For all three scores, these changes differed between blacks and whites (all three p values, < or = 0.002). Adjustment for maturation stage, BMI, and household income did not alter the significance or direction of racial differences in the changes with age in global self-worth and physical appearance scores. Self-worth, physical appearance, and social acceptance scores decreased with increasing BMI. Decreases in physical appearance and social acceptance scores with increasing BMI were smaller in blacks than in whites (p < 0.05). After adjustment for maturation stage and household income, racial differences in social acceptance scores depended on BMI (p < 0.05) but not on age (p = 0.008). CONCLUSIONS: This article reports the first data on self-esteem scores by age for a large population of black girls aged 9 and 14 years and concludes that self-esteem does not follow the same developmental pattern in black as in white girls. A reason for black girls' higher and more stable self-worth and their greater satisfaction with their physical appearance compared to white girls may be racial differences in attitudes toward physical appearance and obesity.


Asunto(s)
Negro o Afroamericano/psicología , Autoimagen , Población Blanca/psicología , Adolescente , Conducta del Adolescente , Factores de Edad , Índice de Masa Corporal , Niño , Femenino , Humanos , Análisis de los Mínimos Cuadrados , Estudios Longitudinales , Pruebas Psicológicas , Psicometría , Maduración Sexual , Ajuste Social , Clase Social , Deseabilidad Social
3.
Hypertension ; 31(1): 97-103, 1998 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-9449398

RESUMEN

The objective of this study was to assess the longitudinal changes in blood pressure in black and white adolescent girls and evaluate potential determinants of changes in blood pressure, including sexual maturation and body size. A total of 1213 black and 1166 white girls, ages 9 or 10 years at study entry, were followed up through age 14 with annual measurements of height, weight, skinfold thickness, stage of sexual maturation, systolic and diastolic blood pressures, and other cardiovascular risk factors. Average blood pressures in black girls were generally 1 to 2 mm Hg higher than in white girls of similar age over the course of the study. Age, race, stage of sexual maturation, height, and body mass index (kg/m2) were all significant univariate predictors of systolic and diastolic blood pressures in longitudinal regression analyses. Black girls had a significantly smaller increase in blood pressure for a given increase in body mass index compared with white girls. The predicted increases in blood pressure per unit increase in body mass index (mm Hg per kg/m2) were as follows: systolic, 0.65+/-0.04 in whites and 0.52+/-0.04 in blacks (P<.001); diastolic fourth Korotkoff phase, 0.31+/-0.04 in whites and 0.15+/-0.03 in blacks (P<.001); and diastolic fifth Korotkoff phase, 0.31+/-0.05 in whites and 0.16+/-0.04 in blacks (P<.001). Understanding of the determinants of the racial differences in blood pressure could provide the rationale for future interventions to reduce the excess cardiovascular mortality in black compared with white women.


Asunto(s)
Envejecimiento/fisiología , Población Negra , Presión Sanguínea , Población Blanca , Adolescente , Constitución Corporal , Índice de Masa Corporal , Niño , Femenino , Humanos , Estudios Longitudinales
4.
J Natl Med Assoc ; 89(9): 594-600, 1997 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-9302856

RESUMEN

The association of sociodemographic and family composition data with obesity was studied in 1213 black and 1166 white girls, ages 9 and 10, enrolled in the National Heart, Lung, and Blood Institute's Growth and Health Study. Obesity was defined as body mass index at or greater than age- and sex-specific 85th percentile as outlined in the Second National Health and Nutrition Examination Survey. The prevalence of obesity was higher for pubertal girls than for prepubertal girls and for girls with older mothers/female guardians. As odds ratio of 1.14 was observed for each 5-year increase in maternal age. Obesity was less common for girls with more siblings; the odds for obesity decreased by 14% for each additional sibling in the household. In blacks, the prevalence of obesity was not related to parental employment or to parental education. In whites, the odds of obesity were higher for girls with no employed parent/guardian in the household and for girls with parents or guardians with lower levels of educational attainment. Examining the associations between sociodemographic factors and risk of childhood obesity provides important clues for understanding racial differences in obesity, a major risk factor for coronary heart disease.


Asunto(s)
Población Negra , Obesidad/etnología , Población Blanca , Negro o Afroamericano , Niño , Escolaridad , Empleo , Femenino , Humanos , Edad Materna , Oportunidad Relativa , Prevalencia , Factores Socioeconómicos , Estados Unidos/epidemiología
5.
J Pediatr ; 129(2): 208-13, 1996 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-8765617

RESUMEN

OBJECTIVE: To evaluate racial differences in blood pressure in girls aged 9 to 10 years in the National Heart, Lung, and Blood Institute Growth and Health Study (NGHS) and to evaluate the extent to which racial differences in blood pressure are explained by other factors, including sexual maturation and body size. METHODS: The NGHS enrolled 539 black and 616 white girls aged 9 years, and 674 black and 550 white girls aged 10 years. Racial differences in blood pressure were examined. Relationships of stage of sexual maturation, height, and skinfold thickness with systolic and diastolic blood pressure were evaluated by multiple regression analysis. RESULTS: The black girls had significantly higher systolic (102.0 +/- 8.90 vs 100.5 +/- 9.42 mm Hg, p <0.001) and diastolic (58.0 +/- 12.0 vs 56.5 +/- 12.51 mm Hg, p <0.01) blood pressures than the white girls. The black girls were also more advanced in sexual maturation and were taller (142.9 +/- 7.94 vs 139.6 +/- 7.05, p <0.001) and heavier (39.6 +/- 11.24 vs 35.3 +/- 8.73 kg, p <0.001) than the white girls. Both systolic and diastolic blood pressure were significantly correlated with level of maturation, height, weight, and sum of skinfolds. Stage of maturation was found to account for the difference in blood pressure between black girls and white girls. In a multiple regression analysis, controlling for height (for diastolic blood pressure) and for both height and sum of skinfolds (for systolic blood pressure) eliminated the effects of race and stage of maturation on blood pressure. CONCLUSION: Racial differences in blood pressure were observed for 9- and 10-year-old girls and are explained by the fact that black girls were more mature than white girls. The effect of sexual maturation on blood pressure appears to operate through height and body fat. The effect of obesity may be more important for systolic than for diastolic blood pressure. Continuation of racial differences in blood pressure may result in a higher prevalence of hypertension for black women.


Asunto(s)
Población Negra , Presión Sanguínea , Maduración Sexual , Población Blanca , Tejido Adiposo/anatomía & histología , Constitución Corporal , Estatura , Peso Corporal , Niño , Estudios de Cohortes , Diástole , Femenino , Humanos , Hipertensión/etiología , National Institutes of Health (U.S.) , Obesidad/fisiopatología , Pubertad , Análisis de Regresión , Grosor de los Pliegues Cutáneos , Sístole , Estados Unidos
6.
Ann Epidemiol ; 6(4): 266-75, 1996 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-8876836

RESUMEN

The purpose of this investigation was to determine whether measures of socioeconomic status (SES) are inversely associated with obesity in 9- to 10-year-old black and white girls and their parents. Subjects were participants in the Growth and Health Study (NGHS) of the National Heart, Lung, and Blood Institute. Extensive SES, anthropometric, and dietary data were collected at baseline on 2379 NGHS participants. The prevalence of obesity was examined in the NGHS girls and parents in relation to SES and selected environmental factors. Less obesity was observed at higher levels of household income and parental education in white girls but not in black girls. Among the mothers of the NGHS participants who were seen, lower prevalence of obesity was observed with higher levels of income and education for white mothers, but no consistent patterns were seen in black mothers. Univariate logistic models indicated that the prevalence of obesity was significantly and inversely associated with parental income and education and number of parents in the household in white girls whereas caloric intake and TV viewing were significantly and positively associated with obesity. Among black girls, only TV viewing was significantly and positively associated with the prevalence of obesity. Multivariate logistic regression models revealed that lower parental educational attainment, one-parent household, and increased caloric intake were significantly associated with the prevalence of obesity in white girls; for black girls, only increased hours of TV viewing were significant in these models. It is concluded that socioeconomic status, as measured by education and income, was related to the prevalence of obesity in girls, with racial variation in these associations. A lower prevalence of obesity was seen at higher levels of socioeconomic status in white girls, whereas no clear relationship was detected in black girls. These findings raise new questions regarding the correlates of obesity in black girls.


Asunto(s)
Población Negra , Obesidad/epidemiología , Clase Social , Población Blanca , Distribución de Chi-Cuadrado , Niño , Estudios de Cohortes , Intervalos de Confianza , Bases de Datos Factuales , Ingestión de Energía , Femenino , Humanos , Renta , Actividades Recreativas , Modelos Logísticos , Estudios Longitudinales , Madres/educación , Madres/estadística & datos numéricos , Obesidad/economía , Obesidad/etnología , Oportunidad Relativa , Prevalencia , Factores de Riesgo , Muestreo , Televisión/estadística & datos numéricos , Estados Unidos/epidemiología
7.
Am J Hypertens ; 9(3): 242-7, 1996 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-8695023

RESUMEN

The use of the onset of the fourth (K4) or fifth (K5) Korotkoff phase to determine diastolic blood pressure in children has been controversial; most recently, the Second Task Force recommended the use of K4 for children up to age 13 years and K5 for children age 13 and above. We performed a cross-sectional analysis of 1,155 nine-year old (53% white and 47% black) and 1,224 ten-year old girls (45% white and 55% black) in the National Heart, Lung, and Blood Institute Growth and Health Study (NGHS). The mean blood pressures for the first, fourth, and fifth Korotkoff phases were 100.1 (+/- 8.9) mm Hg, 66.6 (+/- 9.8) mm Hg, and 56.8 (+/- 11.8) mm Hg for nine-year-olds and 102.8 (+/- 9.0) mm Hg, 68.1 (+/- 10.1) mm Hg, and 58.1 (+/- 11.9) mm Hg for ten-year-olds. The mean difference between K4 and K5 was 9.9 (+/- 6.4) mm Hg. The correlation between K1 and K4 was 0.45, between K1 and K5 was 0.34, and between K4 and K5 was 0.84. Elevation of blood pressure was defined at or above the 95th percentile based on the NGHS distribution for K1, K4, or K5; the relative risk of having an elevated K1 was 10.1 if K4 was elevated and 5.9 if K5 was elevated. Of the 159 subjects potentially classified with elevated diastolic pressure, 95 subjects (60%) would be classified differently depending on whether K4 or K5 was used to define elevated diastolic blood pressure. The choice of the onset of the fourth or fifth Korotkoff phase for determining diastolic blood pressure in children may have important implications for which individuals are classified as having hypertension.


Asunto(s)
Presión Sanguínea/fisiología , Constitución Corporal , Hipertensión/clasificación , Determinación de la Presión Sanguínea , Niño , Estudios Transversales , Diástole , Femenino , Humanos , Hipertensión/diagnóstico , Hipertensión/fisiopatología , National Institutes of Health (U.S.) , Grupos Raciales , Factores de Riesgo , Instituciones Académicas , Estados Unidos
8.
Am J Public Health ; 85(12): 1698-702, 1995 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-7503349

RESUMEN

To determine the correlates of serum high-density lipoprotein cholesterol (HDL-C) in 9- and 10-year-old girls, data were examined from 624 Black girls and 773 White girls. Black girls had, on average, 3.6 mg/dL higher levels than White girls. Each 10-mm increase in sum of skinfolds was associated with a decrease of 1.4 mg/dL; each unit increase in the tricep/suprailiac skinfold ratio was associated with an increase of 2 mg/dL; and each 10% increase in polyunsaturated fat intake was associated with an increase of 3.4 mg/dL. The associations of sedentary activity and sexual maturation with HDL were mediated by differences in adiposity. Interventions to decrease adiposity may be important for the primary prevention of heart disease in women.


Asunto(s)
Población Negra , HDL-Colesterol/sangre , Obesidad/sangre , Obesidad/etnología , Población Blanca , Niño , Enfermedad Coronaria/etiología , Grasas de la Dieta/administración & dosificación , Ejercicio Físico , Ácidos Grasos Insaturados/administración & dosificación , Femenino , Humanos , Obesidad/complicaciones , Estudios Prospectivos , Pubertad , Factores de Riesgo , Grosor de los Pliegues Cutáneos , Estados Unidos
9.
Am Rev Respir Dis ; 146(6): 1419-25, 1992 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-1333737

RESUMEN

Indirect effects of cytomegalovirus (CMV) infections in lung transplant recipients (LTX) have not previously been described in detail. We compared spirometric results, development of chronic rejection, rates of respiratory superinfections, and mortality as long as 2 yr after transplantation, between 62 LTX who never developed CMV (CMV-) and 56 LTX with a history of CMV pulmonary infections (CMV+). Initial spirometric parameters were near identical for both groups, but determinations > or = 6 months after transplantation showed that expiratory flows of the CMV+ were significantly reduced. Actuarial prevalences of chronic allograft rejection (CR) at 2 yr were highest among CMV+ with biopsy-proved pneumonitis (74%) compared with 22% among CMV- (p < 0.038). Bacterial or fungal pneumonias developed in 58.9% of the CMV+, whereas the rate among CMV- was 38.7% (p < 0.05). Only 36% of LTX with CMV pneumonitis lived 2 yr compared with 70% survival for CMV- (p < 0.016). Ganciclovir treatment of CMV infections decreased rates of respiratory superinfections and improved survival of patients, but it did not appear to affect subsequent development of CR. We conclude that CMV pulmonary infections among LTX result in serious late sequelae and that current treatment is ineffectual for prevention of viral-associated CR in these patients.


Asunto(s)
Infecciones por Citomegalovirus/complicaciones , Trasplante de Pulmón , Infecciones del Sistema Respiratorio/complicaciones , Adulto , Infecciones por Citomegalovirus/etiología , Infecciones por Citomegalovirus/fisiopatología , Femenino , Rechazo de Injerto , Humanos , Masculino , Persona de Mediana Edad , Neumonía/etiología , Neumonía/microbiología , Complicaciones Posoperatorias , Pronóstico , Infecciones del Sistema Respiratorio/etiología , Espirometría
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