Body mass index and the risk of asthma in adults.

Asthma and obesity are both chronic conditions and their prevalences have risen in affluent societies. A positive association between asthma and being overweight or obese has been reported in children and women, but associations in men are less clearly described. The objective of this study was to explore the association between body mass index (BMI) and asthma in men and women of diverse ethnic and socioeconomic background living in New York State, USA. In this study, we analyzed cross-sectional data on 5524 subjects aged 18 years and older who were interviewed by telephone in the 1996 and 1997 New York State Behavioral Risk Factor Surveillance System. Asthma (doctor-diagnosed), and weight and height were self-reported. BMI (kg/m2) was used as a measure of adiposity. Weighted logistic regression analysis, with stratification by gender and age, was used to examine the relationship between asthma prevalence and BMI, adjusting for race/ethnicity, education, health insurance, time since last physical examination, physical activity and smoking status. The results showed that the prevalence of asthma was 4.6% (CI: 3.6-5.5%) among men and 8.1% (CI: 7.1-9.1%) among women. In women, the prevalence of asthma was significantly increased in those with a BMI 25 kg/m2 or higher (BMI 25-27.5: OR = 1.76, 95% CI: 1.06-2.94; BMI 27.5-29.9: OR = 2.45, 95% CI: 1.41-4.25; BMI > or = 30: OR = 2.67, 95% CI: 1.66-4.29) when compared to the reference category (BMI: 22-24.9 kg/m2). In men, the prevalence of asthma was increased in the lowest weight category, BMI < 22 kg/m2 (OR = 3.05, 95% CI: 1.37-6.78) and in the highest category, BMI > or = 30 kg/m2 (OR = 2.92, 95% CI: 1.39-6.14). This U-shaped association persisted when restricting the analysis to men who had never smoked and was more pronounced for those between 18 and 49 years of age. In conclusion, this cross-sectional study showed that men and women differ significantly in the association between BMI and asthma prevalence only with respect to the lowest weight category. While women had a monotonic association, men showed a U-shaped relationship, indicating that both extremes of weight are associated with a higher prevalence of asthma.

Prostate cancer screening trends of New York State men at least 50 years of age, 1994 to 1997.

BACKGROUND: Despite the lack of consensus on prostate cancer screening recommendations, men are being screened at high rates in some states. Our objective was to examine the trends in prostate cancer screening awareness and practices from 1994 through 1997 and the relationship among screening practices and demographic characteristics, perceived risk, and family history of prostate cancer. METHODS: Data from the New York State Behavioral Risk Factor Surveillance System surveys and questionnaire modules on prostate cancer screening were used for this study, which excluded men younger than 50 years of age and men with a history of prostate cancer. The questionnaires were administered by random-digit-dialed monthly telephone surveys of the civilian, noninstitutionalized adult population in New York State. RESULTS: A total of 295, 336, 273, and 448 men, the vast majority of whom were white, met the study criteria for 1994, 1995, 1996, and 1997, respectively. Each year the percentage of men who reported having heard of the prostate specific antigen (PSA) test increased (test for trend, P < 0.001). Among those who had heard of the PSA test, the percentage who reported having had a PSA test increased steadily from 1994 to 1997. About 30% of the men in each year's study did not have an impression of their risk of getting prostate cancer. CONCLUSIONS: Given the increasing rate at which men are reporting being screened for prostate cancer and given their reported perceived risk levels, perhaps more needs to be done to educate men about screening implications and personal risk for prostate cancer.

Multistate surveillance for food-handling, preparation, and consumption behaviors associated with foodborne diseases: 1995 and 1996 BRFSS food-safety questions.

PROBLEM/CONDITION: In 1995, CDC, the Food and Drug Administration (FDA), and several state health departments collaboratively developed questions regarding food safety. This set of questions was used to collect data about food-handling, preparation, and consumption behaviors that have been associated with foodborne diseases in adults. These data will help characterize persons at high risk for foodborne illness and assist in developing food-safety education strategies for consumers and foodhandlers that are intended to reduce foodborne illness. REPORTING PERIOD COVERED: January 1995-December 1996. DESCRIPTION OF SYSTEM: Data were collected by using the 12 food-safety questions, which were administered with the 1995 Behavioral Risk Factor Surveillance Systems (BRFSS) in Colorado, Florida, Missouri, New York, and Tennessee, and the 1996 BRFSS in Indiana and New Jersey. In addition, data were collected in South Dakota from two of the standardized questions that deal with consumption of undercooked eggs and pink hamburgers. The BRFSS is a state-based system that surveys noninstitutionalized adults by telephone about their health behaviors and practices. RESULTS: This study included 19,356 completed questionnaires (2,461 in Colorado; 3,335 in Florida; 2,212 in Indiana; 1,572 in Missouri; 3,149 in New Jersey; 2,477 in New York; 2,110 in South Dakota; and 2,040 in Tennessee). During the previous 12 months, 50.2% of respondents reported eating undercooked eggs (95% confidence interval [CI] = 49.2-51.2); 23.8% reported eating home-canned vegetables (95% CI = 22.5-24.5); 19.7% reported eating pink hamburgers (95% CI = 18.9-20.5); 8.0% reported eating raw oysters (95% CI = 7.5-8.5); and 1.4% reported drinking raw milk (95% CI = 1.2-1.6). The prevalence of not washing hands with soap after handling raw meat or chicken and not washing a cutting board with soap or bleach after using it for cutting raw meat or chicken were 18.6% (95% CI = 17.8-19.4) and 19.5% (95% CI = 18.6-20.4), respectively. Less than half of respondents (45.4%, 95% CI = 44.2-46.6) reported seeing safe food-handling label information on raw meat products. In addition, among those persons who reported they remembered seeing the label information, 77.2% (95% CI = 76.0-78.4) remembered reading the label information, and 36.7% reported changing their meat and poultry preparation habits because of the labels (95% CI = 35.2-38.2). When population characteristics were considered in the analysis, all high-risk food-handling, preparation, and consumption behaviors were more prevalent in men than in women. Eating pink hamburgers during the previous 12 months was more commonly reported by whites (22.3%) than by blacks (6.5%). The prevalence of reported consumption of pink hamburgers during the previous. 12 months decreased with age (18-29 years: 21.8%, 30-59 years: 21.9%, and 60-99 years: 13.2%); increased with education (less than grade 12: 12.0%, high school graduate: 16.5%, and any college education: 24.0%); and increased with income (< $15,000: 11.8%, $15,000-$34,999: 17.6%, $35,000-$49,999: 22.0%, and > or = $50,000: 28.6%). INTERPRETATION: During 1995-1996, several high-risk food-handling, preparation, and consumption behaviors were common, and some were particular to specific population groups. Based on this analysis, interventions are needed to reduce the prevalence of these risky behaviors. All consumers and foodhandlers could benefit from food-safety education. ACTIONS TAKEN: Behavioral surveillance systems can provide data that identify persons or groups in which behaviors associated with foodborne diseases are more common and who are at higher risk for foodborne illness. State-specific data can assist in developing food-safety education programs and, if collected periodically, can be used to evaluate program effectiveness.

Association of being overweight with greater asthma symptoms in inner city black and Hispanic children.

OBJECTIVE: To determine whether the weight status of inner city black and Hispanic children with asthma differs from that of their peers and to assess whether overweight asthmatic children experience greater asthma symptoms. STUDY DESIGN: A cross-sectional study in an ambulatory chest clinic of an inner city medical center. METHODS: We studied black and Hispanic children aged 2 to 18 years (n = 209) with the single diagnosis of asthma. The peer control subjects consisted of a sample of black and Hispanic children aged 6 to 13 years (n = 1017), enrolled in the New York City schools. Asthma symptoms, the number of asthma medications prescribed, and peak expiratory flow rate (PEFR) measurements were used to classify asthma severity and relate to body mass index (BMI). Bivariate categorical analysis and chi 2 tests were performed to examine the relationship between high BMI and the individual measures of asthma severity. RESULTS: The prevalence of overweight was significantly higher in children with moderate to severe asthma than in their peers. The risk of overweight based on a BMI in the 85th percentile or greater was significantly associated with the following measures of asthma severity: (1) the number of school days missed per year; (2) a PEFR less than or equal to 60% of the predicted PEFR; and (3) the number of asthma medications prescribed. CONCLUSIONS: The prevalence of overweight was significantly higher in children with moderate to severe asthma than in their peers, and being overweight was associated with significantly more severe asthma symptoms. Further studies in overweight asthmatic children are needed, including the effect of weight loss on lung function and other markers of asthma severity.

Overweight school children in New York City: prevalence estimates and characteristics.

OBJECTIVES: To examine the prevalence of overweight and associated characteristics in a representative sample of children from schools in New York City (NYC). DESIGN: A cross-sectional survey with an in-person interview (including measurements of height and weight) and a household questionnaire. SUBJECTS: Second and fifth grade students from schools in NYC participated. A total of 1,396, including 692 second and 704 fifth grade, children were included in the analysis. MEASUREMENTS: Prevalence of overweight based on the body mass index (BMI) and the 85th or 95th percentile cutoff points from Cycles II and III of the National Health Examination Survey reference recently developed by the Centers for Disease Control and Prevention (CDC). The characteristics of overweight examined were: age, gender, socio-economic status, Hispanic origin, family structure, number of children in the household, meal preparation by children, food diversity and participation in the National School Lunch Program. RESULTS: Overweight based on the 85th percentile of BMI was 37.5% among second grade and 31.7% among fifth grade children. Based on the 95th percentile, overweight was 19.9% and 17.8%, respectively. Overweight was associated with Hispanic origin, fewer children in the household, family structure and meal preparation by children. CONCLUSIONS: Overweight is prevalent among elementary school children in NYC. Studies in diverse geographically defined areas with diverse populations, are necessary to design effective prevention efforts. Primary prevention efforts in NYC should target Hispanics and take into consideration individual behaviour and family characteristics.

Food consumption patterns of elementary schoolchildren in New York City.

OBJECTIVE: To examine food consumption patterns and related characteristics of schoolchildren. DESIGN: A representative survey involving a household questionnaire and child interview to conduct a nonquantitative 24-hour dietary recall. Indexes were developed to score the diets based on the Food Guide Pyramid and 5 A Day for Better Health recommendations. SUBJECTS/SETTING: Six hundred ninety-three 2nd-grade students and 704 5th-grade students from public and private schools in New York City. STATISTICAL ANALYSES PERFORMED: Weighted means and gender-adjusted analysis of covariance models were used to account for a complex survey design in calculating variance estimates. RESULTS: Compared with a maximum of 50, the mean Food Guide Pyramid index score was 29.2 for 2nd-grade students and 30.4 for 5th-grade students. The mean 5 A Day consumption score was 3.4 and 3.6 servings of fruits and vegetables daily for 2nd and 5th graders, respectively. Measures of food consumption were significantly related to socioeconomic status, race/ethnicity, skipping meals, and participating in school lunch for both grades, and with meal preparation for 5th graders. APPLICATIONS/CONCLUSIONS: The Food Guide Pyramid and 5 A Day recommendations provide guidelines for food selection beginning in childhood. Knowledge and skills training are needed to improve food consumption patterns as children consume foods away from home and as they take on greater responsibility for meal preparation and food selection.

Overweight schoolchildren in New York State: prevalence and characteristics.

OBJECTIVES: Childhood overweight is an increasing public health concern. This study was undertaken to determine the prevalence of overweight in elementary school children in New York State and to identify characteristics associated with child fatness. METHODS: Weight, height, triceps skinfold, midarm circumference, and a 24-hour dietary recall were taken on 1797 second- and fifth-grade students from 51 randomly selected schools in New York State outside of New York City. Parents completed a brief questionnaire. RESULTS: In comparison with 1974 and 1980 national reference data, up to twice the expected percentages of children had values above the 85th, 90th, and 95th percentiles for body mass index, triceps skinfold, and arm fat area. Regression analyses suggested that children who tended to be fatter were members of low socioeconomic status, two-parent (but not single-parent) households; those with few or no siblings; those who ate school lunch; and those who skipped breakfast. CONCLUSIONS: The findings suggest that overweight is a problem among many elementary school children in New York State and that sociodemographic characteristics may be useful for targeting preventive efforts.

Age, sex, educational attainment, and race/ethnicity in relation to consumption of specific foods contributing to the atherogenic potential of diet.

BACKGROUND: We examined which specific foods contributed to the atherogenic potential of diet in population segments defined by age, sex, educational attainment, and race/ethnicity. Data from the 1989 New York State Healthy Heart Program baseline survey were analyzed. METHODS: This telephone survey was conducted in eight communities (total population approximately 1.24 million people) in New York State. Response rate was 65.5% (N = 4,179); 3,606 subjects ages 20 to 64 years who reported their level of educational attainment with self-described ethnicity of white (N = 1,935), black (N = 1,035), or Hispanic (N = 636) were retained in the analysis. Diet was assessed using a 17-item food frequency questionnaire which focused on commonly eaten food high in saturated fat and cholesterol. Connor's cholesterol/saturated-fat index was used as a scale of the atherogenic potential of the diet. RESULTS: Eggs, whole milk, cheese, beef, and butter/margarine were the foods contributing most to the cholesterol/saturated-fat index score in all age-, sex-, and race/ethnicity-specific population segments examined, together contributing a total of 52 to 72% of the cholesterol/saturated-fat index score as measured by the 17-item diet questionnaire. CONCLUSIONS: The implication for public health campaigns directed at reducing the atherogenic potential of diet atherogenicity and for primary care practitioners seeking to influence the diet of patients with high blood cholesterol is that substitutions of less atherogenic food choices for these five foods would appear to be appropriate for most adults.

Development of the New York State Nutrition Surveillance Program.

New York State established a Nutrition Surveillance Program (NSP) in 1984. Precedents for the program included the Pediatric Nutrition Surveillance System of the Public Health Service's Centers for Disease Control and Prevention and periodic food and nutrition surveys conducted by the National Center for Health Statistics and the Human Nutrition Information Service, Department of Agriculture. The first phase of NSP was connected to a new program, the Supplemental Nutrition Assistance Program (SNAP), which established support for more than 1,000 emergency food programs across the State. SNAP also expanded the home delivered meal program for the frail elderly and the Special Supplemental Food Program for Women, Infants, and Children. NSP provided information on the extent of unmet nutrition needs that was used to establish funding requests and provided data describing the characteristics of SNAP participants that were used in developing new SNAP program components. The second phase of NSP began in 1988. It identified populations that were thought to be at nutrition risk and compiled information about the extent of unmet need, the characteristics of the population, and the status of current nutrition programs to meet the needs. As a result of this review, NSP added a nutrition component to the Dental Survey of School Children; conducted a dietary survey; developed an inventory of information sources in all State agencies; and established an annual work plan using department of health objectives. The third phase of NSP is the policy and planning phase, monitoring the Year 2000 Objectives and the Five-Year Plan of the New York State Food and Nutrition Policy Council.

Effect of pectin structure on protein utilization by growing rats.

The effect of pectins' molecular weight (MW) and degree of esterification (DE) on apparent digestibility (D), net protein utilization (NPU) and biological value (BV) of casein were tested. The pectins prepared differed in MW and DE respectively as follows: P-1 (180,000, 73%); P-2 (300,000, 28%); P-3 (60,000, 74%) and P-4 (75,000, 40%) and were fed as 10% of a purified diet containing 10% casein to growing male rats for 10 days. All preparations decreased D, with P-2 and P-4 showing milder effects than P-1 or P-3. Increased NPU was observed with pectins of low NW and/or DE, being significant only with P-4. Diets containing P-2, P-3 or P-4 had higher BV for casein than the pectin-free diet. Feeding these pectins in a protein-free diet did not cause a significant change in the rats' body N content. Thus, the increase in the BV of casein was attributed to improvements in the pattern of amino acids absorbed by rats fed pectins with low MW and/or low DE.