Validity of a telephone-administered 24-hour dietary recall in telephone and non-telephone households in the rural Lower Mississippi Delta region.

OBJECTIVE: To determine if 24-hour dietary recall data are influenced by whether data are collected by telephone or face-to-face interviews in telephone and non-telephone households. DESIGN: Dual sampling frame of telephone and non-telephone households. In telephone households, participants completed a 24-hour dietary recall either by face-to-face interview or telephone interview. In non-telephone households, participants completed a 24-hour dietary recall either by face-to-face interview or by using a cellular telephone provided by a field interviewer. SUBJECTS/SETTING: Four hundred nine participants from the rural Delta region of Arkansas, Louisiana, and Mississippi. MAIN OUTCOME MEASURES: Mean energy and protein intakes. STATISTICAL ANALYSES PERFORMED: Comparison of telephone and non-telephone households, controlling for type of interview, and comparison of telephone and face-to-face interviews in each household type using unpaired t tests and linear regression, adjusting for gender, age, and body mass index. RESULTS: Mean differences between telephone and face-to-face interviews for telephone households were -171 kcal (P = 0.1) and -6.9 g protein (P = 0.2), and for non-telephone households -143 kcal (P = 0.6) and 0.4 g protein (P = 1.0). Mean differences between telephone and non-telephone households for telephone interviews were 0 kcal (P = 1.0) and -0.9 g protein (P = 0.9), and for face-to-face interviews 28 kcal (P = 0.9) and 6.4 g protein (P = 0.5). Findings persisted when adjusted for gender, age, and body mass index. No statistically significant differences were detected for mean energy or protein intake between telephone and face-to-face interviews or between telephone and non-telephone households. APPLICATIONS/CONCLUSIONS: These data provide support that telephone surveys adequately describe energy and protein intakes for a rural, low-income population.

Perceptions of community nutrition and health needs in the Lower Mississippi Delta: a key informant approach.

OBJECTIVE: Key informants' perceptions of nutrition and health needs in their southern rural communities were assessed prior to nutrition intervention planning. DESIGN: This cross-sectional survey used in-person interviews. SUBJECTS/SETTINGS: A sample of 490 individuals from 12 professional and lay roles in 8 community sectors in 36 counties in Arkansas, Louisiana, and Mississippi was chosen. STATISTICAL ANALYSES PERFORMED: Factor analysis was carried out on reported food, nutrition, and health problems and contributing factors. The General Linear Models procedure identified within- and between-subject effects for factors. Tukey's post hoc tests identified differences between sectors and states. Frequencies and weighted rankings were computed for health problems. RESULTS: Key informants rated individual-level factors (food choices, education, willingness to change, health behavior) as more important than community-level factors (food and health care access, resources) with regard to nutrition and health problems and contributors to problems. The number one health problem was hypertension. IMPLICATIONS: Key informants are knowledgeable about nutrition and health problems, contributing factors, and available resources. Individual factors were perceived as more important contributors to nutrition and health problems providing valuable information for planning nutrition interventions.

Estimation of body fat in Caucasian and African-American girls: total-body electrical conductivity methodology versus a four-component model.

BACKGROUND: Obesity has been increasing dramatically in recent years among children, particularly African-American girls. Total-body electrical conductivity (TOBEC) is a simple way to measure body fat with minimal risk. OBJECTIVE: This study compared the agreement between the percentage of fat mass (%FM) predicted using two TOBEC equations with %FM measured by a four-component model in 73 Caucasian and 41 African-American girls. DESIGN AND MEASUREMENTS: %FM predicted using the TOBEC equations was compared with %FM from the four-component model based on measurements of body density, body water and bone mineral content. RESULTS: Analyses by linear regression analysis and by the Bland and Altman methods comparison procedure showed that the equation using the square root of the TOBEC zero-order Fourier coefficient and the subject's height yielded more accurate and more reproducible %FM, regardless of race, than the TOBEC linear equation, which was based on the zero-, first- and second-order Fourier coefficients. The Bland and Altman comparison further revealed that the accuracy and limits of agreement of the TOBEC linear equation were related to body fatness among the Caucasian girls. The relationship, however, disappeared when prepubescent girls and a girl with low %FM were excluded from the analysis. CONCLUSIONS: The TOBEC square root equation with adjustment for body geometry and length is recommended for use in adolescent girls, as it yielded better agreement with the criterion method. However, further validation of the TOBEC instrumentation for estimating body fat in prepubescent children and children with low body fat is warranted.

Estimating body fat in African American and white adolescent girls: a comparison of skinfold-thickness equations with a 4-compartment criterion model.

BACKGROUND: Although skinfold-thickness equations are widely used to estimate body fat, their accuracy in a biracial population of female adolescents has not been established. OBJECTIVE: We undertook this study to determine the agreement between 8 widely used skinfold-thickness equations and a 4-compartment criterion model in predicting the percentage body fat of 72 white and 40 African American girls aged 13.0 +/- 1.9 y. DESIGN: The biceps, triceps, suprailiac, subscapular, thigh, calf, and abdominal skinfold thicknesses of the subjects were measured with skinfold calipers and the buttocks circumference with a metal tape. The percentage fat mass (%FM) predicted by using each skinfold-thickness equation was compared with the criterion value calculated by the 4-compartment model on the basis of measurements of body density, body water, and bone mineral content. RESULTS: When the racial groups were analyzed separately, the Bland-Altman analysis indicated that the quadratic equations agreed most closely with the 4-compartment model's measurement of %FM. Agreement of the other equations varied with body fatness. CONCLUSIONS: The quadratic equation of Slaughter et al is recommended for population studies in female adolescents because of its accuracy and simplicity. However, an individual %FM can be over- or underestimated by approximately 10% when this skinfold-thickness equation is used.

Serum concentrations of insulin, insulin-like growth factor-I and insulin-like growth factor binding proteins are different between white and African American girls.

OBJECTIVES: To determine whether serum insulin-like growth factor (IGF)-I and IGF binding protein (IGFBP) concentrations are different between African American and white girls. STUDY DESIGN: Serum glucose and hormone concentrations were measured in blood samples collected after a 12-hour fast from 79 white and 57 African American healthy girls between 9 and 17 years of age. Tanner stages of pubic hair development were evaluated by physical examination, and body composition by dual energy x-ray absorptiometry. RESULTS: The African American girls were older and sexually more mature and had higher fat mass, higher serum insulin and free IGF-I concentrations, higher serum free IGF-I to total IGF-I ratio, but lower serum IGFBP-1 concentrations than the white girls. After controlling for sexual maturation and fat mass, the serum concentrations of total IGF-I, bound IGF-I, and IGFBP-3 in the white girls became significantly higher than those in the African American girls. The higher concentrations of total IGF-I in the white girls were due to a proportional increase in the concentrations of bound IGF-I that coincided with a similar increase in serum IGFBP-3 concentrations. CONCLUSIONS: Higher serum insulin concentrations in the African American girls are associated with lower serum IGFBP-1 concentrations and increased bioavailability of free IGF-I, which may contribute to their accelerated growth compared with their white counterparts.

Detection of the chemical warfare agents bis-(2-chloroethyl)ethylamine (HN-1) and tris-(2-chloroethyl)amine (HN-3) in air.

This paper describes the method development and validation for detection of the chemical warfare agents HN-1 and HN-3 in air using C8 solid-phase extraction disks followed by liquid desorption and analysis by gas chromatography. The method is contrasted to the standard approach which uses solid sorbent tubes followed by thermal desorption and analysis by gas chromatography.

Calcium absorption and kinetics are similar in 7- and 8-year-old Mexican-American and Caucasian girls despite hormonal differences.

To assess the possibility of ethnic differences in mineral metabolism in prepubertal children, we compared measures of calcium metabolism in 7- and 8-y-old Mexican-American (MA) and non-Hispanic Caucasian (CAU) girls (n = 38) living in southeastern Texas. We found similar fractional calcium absorption, urinary calcium excretion, calcium kinetic values and total-body bone mineral content in the MA and CAU girls. In contrast, parathyroid hormone (PTH) concentrations were greater in MA girls (4.01 +/- 0.47 vs. 1. 96 +/- 0.50 pmol/L, P = 0.005) than in CAU girls. Serum 25-hydroxyvitamin D concentrations were lower in MA girls (68.9 +/- 7.7 vs. 109.4 +/- 8.4 nmol/L, P = 0.001) than in CAU girls, but 1, 25-dihydroxyvitamin D concentrations did not differ between groups. Seasonal variability was seen for 25-hydroxyvitamin D concentrations in girls of both ethnic groups, but values in all of the girls were >30 nmol/L (12 ng/mL). We conclude the following: 1) greater PTH levels in MA girls than CAU girls are present without evidence of vitamin D deficiency; and 2) differences in 25-hydroxyvitamin D and PTH concentrations between MA and CAU girls do not have a large effect on calcium absorption, excretion or bone calcium kinetics. These data do not provide evidence for adjusting dietary recommendations for mineral or vitamin D intake by MA girls.

Pubertal African-American girls expend less energy at rest and during physical activity than Caucasian girls.

Between 1963 and 1991, the most dramatic increases in the prevalence of overweight in the United States have been reported in African-American girls. Lower basal energy expenditure and lack of physical activity are believed to be risk factors for excessive weight gain. We hypothesized that energy expenditure at rest and during physical activity are lower in pubertal African-American girls than in Caucasian girls. Basal metabolic rate and sleeping energy expenditure of 40 Caucasian and 41 African-American pubertal girls (matched for age, physical characteristics, body fat, and energy intake) were measured by whole-room calorimetry, energy expended for physical activity by the doubly labeled water method, sexual maturity by physical examination, body composition by dual-energy x-ray absorptiometry, physical fitness by treadmill testing, and energy intake by 3-day food record. After adjusting for soft lean tissue mass, the basal energy expenditure (1333 +/- 132 vs. 1412 +/- 132 kcal/day, P = 0.01) and energy expended for physical activity (809 +/- 637 vs. 1271 +/- 162 kcal/day, P < 0.01) were significantly lower in the African-American girls than in the Caucasian girls. The differences remained the same after controlling for differences in sexual maturity and/or physical fitness. The lower energy expenditure of the pubertal African-American girls suggests that they are at a higher risk of becoming overweight than their Caucasian counterparts.

Cholesterol-lowering effect of soy protein in normocholesterolemic and hypercholesterolemic men.

Cardiovascular heart disease is a major health problem in the United States. Elevated blood cholesterol has been shown to significantly increase the risk of cardiovascular heart disease. The National Cholesterol Educational Program (NCEP) Step I diet, which restricts fat and cholesterol intakes, is usually recommended as the initial treatment to lower blood cholesterol. Soy protein has been shown to be hypocholesterolemic, particularly in hypercholesterolemic subjects. However, the hypocholesterolemic effect of soy protein in subjects with a blood total cholesterol concentration <5.17 mmol/L is not clear. To determine whether soy protein could enhance the hypocholesterolemic effect of the NCEP Step I diet, 13 normocholesterolemic and 13 hypercholesterolemic men aged 20-50 y were enrolled in a randomized, 2-part, crossover study. Subjects were fed either an NCEP Step I soy-protein diet or an NCEP Step I animal protein diet for 5 wk. After a washout period of 10-15 wk, the subjects were fed the alternate diet for 5 wk. The hypocholesterolemic effect of soy protein was found to be independent of age, body weight, pretreatment plasma lipid concentrations, and sequence of dietary treatment. Regardless of plasma lipid status, the soy-protein diet was associated with a statistically significant decrease in the plasma concentrations of LDL cholesterol (P = 0.029) as well as the in the ratio of plasma LDL cholesterol to HDL cholesterol (P = 0.005). Our results indicate that soy protein enhances the hypocholesterolemic effect of the NCEP Step I diet in both normocholesterolemic and hypercholesterolemic men.

Serum leptin concentrations in Caucasian and African-American girls.

Because African-American girls are heavier, taller, and mature earlier than Caucasian girls, we hypothesized that the serum leptin concentration differs between the two groups. Serum leptin concentrations were measured by immunoassay in 12-h fasted blood samples collected from 79 Caucasian and 57 African-American girls between 8 and 17 yr of age. Body composition was measured by dual-energy x-ray absorptiometry, sexual maturity by physical examination, and physical fitness by treadmill testing. Serum leptin concentrations were positively correlated (P < 0.01) with maturation, body fatness, and insulin and were higher (6.6 ng/mL, P < 0.01) in the African-American girls after adjusting for age. The difference remained significant (P < 0.01) but was reduced to 3.2 ng/mL after controlling for differences in maturation, fat mass, and physical fitness. The higher serum leptin levels might play an important role in the accelerated growth and sexual maturation of African-American girls.

Calcium and magnesium balance in 9-14-y-old children.

Few data are available regarding calcium and magnesium absorption and endogenous fecal excretion in children. We used a multitracer stable isotope technique to assess calcium and magnesium balance in 12 boys and 13 girls aged 9-14 y (mean weight: 42 kg) maintained on relatively high calcium intakes (mean: 1310 +/- 82 mg/d). There were no significant differences in absorption of calcium or magnesium from milk between boys and girls. Calcium retention (balance) correlated positively with calcidiol (25-hydroxyvitamin D) concentration (r = 0.48, P = 0.02) and serum alkaline phosphatase activity (r = 0.44, P = 0.03). There was no significant relation between magnesium balance and concentration. When data from this study were combined with our previously reported data, an increase in total calcium absorption was seen for pubertal (Tanner stages 2-4) but not prepubertal (Tanner stage 1) white children over the range of intakes from approximately 750 to 1350 mg/d. Despite intakes similar to the 1989 recommended dietary allowance for magnesium (mean intake: 6.4 +/- 1.2 mg.kg-1.d-1), 11 of the 25 subjects (6 girls and 5 boys) were in negative magnesium balance. We conclude that benefits from higher calcium intakes, < or = 1350 mg/d, were most apparent in pubertal children. In addiction, higher magnesium intakes should be considered for children.

Absorption of calcium, zinc, and iron from breast milk by five- to seven-month-old infants.

Data are scarce regarding mineral bioavailability from human milk in older infants who may also be receiving solid foods (beikost). We measured the absorption of Ca, Zn, and Fe in 14 healthy, nonanemic 5-7-mo-old breast-fed infants whose mothers milk was extrinsically labeled with stable isotopes (44Ca, 70Zn, and 58Fe) of these minerals. In addition, Ca and Zn stable isotopes (46Ca and 67Zn) were administered i.v., and a second isotope of Fe (57Fe) was given orally without food as a non-meal dose. Subjects were not receiving any artificial infant formula or cow's milk, but most (10/14) were receiving beikost. Ca and Zn absorption was calculated using the urinary excretion of the isotopes during the 24 h after dosing (Ca) or their urinary ratio 72 h after dosing (Zn). Fe absorption was calculated using the red blood cell incorporation at 14 d. Fe absorption averaged 20.7 +/- 14.8% from the 58Fe given with human milk (geometric mean, 14.8%) and 17.7 +/- 15.1% (geometric mean, 11.0%) from the 57Fe non-meal dose. Ca absorption averaged 61.3 +/- 22.7% and Zn absorption (n = 10) averaged 49.5 +/- 18.5%. Absorption of Fe (natural logarithm) from the non-meal Fe dose (57Fe) but not from the human milk (58Fe) was significantly negatively correlated to serum ferritin (r = -0.70, p = 0.007 versus r = -0.35, p = 0.24). At the intake levels in this study, total daily Fe, Ca, and Zn intakes from beikost were not significantly correlated to their fractional absorption from breast milk, but Fe intake from beikost was significantly negatively correlated to absorption of Fe from the non-meal dose (r = -0.61, p = 0.021). We conclude that minerals are well absorbed from human milk in older infants after the introduction of beikost to the diet.

Are basal metabolic rate prediction equations appropriate for female children and adolescents?

The basal metabolic rate (BMR), which accounts for 50-70% of total energy expenditure, is essential for estimation of patient and population energy needs. Numerous equations have been formulated for prediction of human BMR. Most equations in current use are based on measurements of Caucasians performed more than four decades ago. We evaluated 10 prediction equations commonly used for estimation of BMR in 76 Caucasian and 42 African-American girls between 8 and 17 yr of age against BMR measured by whole-body calorimetry. The majority of the prediction equations (9 of 10) overestimated BMR by 60 +/- 46 kcal/day (range, 15-176 kcal/day). This overestimation was found to be significantly greater (P < 0.05) for African-American (77 +/- 17 kcal/day) than for Caucasians (25 +/- 17 kcal/day) in six equations, controlling for age, weight, and sexual maturity. We conclude that ethnicity is an important factor in estimation of the BMR and that the current prediction equations are not appropriate for accurate estimation of the BMR of individual female children and adolescents.

Variables related to urinary calcium excretion in young girls.

The relations among dietary and calcium kinetic factors and 24-h urinary mineral excretion were evaluated in a group of 89 healthy girls (51 white and 38 black) aged 4.9-16.7 years. Nutrient intakes were calculated for each participant using a weighed intake of all food and beverage on the day of the 24-h urine collection study and two subsequent 24-h food records. A significant relation was noted between urinary calcium and sodium excretion (r = 0.55; p < 0.0001). No significant relations were found between urinary calcium and (a) calcium intake (r = 0.08), (b) protein intake (r = 0.14), or (c) phosphorus intake (r = 0.11). Urinary calcium was not significantly related to fractional calcium absorption (r = 0.03) or net calcium absorption (r = 0.11), but was significantly associated with the bone calcium deposition rate (r = 0.24; p < 0.03). Using a multiple regression model, both urinary sodium and the bone calcium deposition rate were independent predictors of urinary calcium excretion in this population (r = 0.57; p = 0.0001). A substantial number of the children in this population had urinary calcium excretion > 4 mg/kg/day (12%). The incidence of hypercalciuria differed between the racial groups and was markedly higher in the white than in the black children (17.6 vs. 5.3%). Over a range of usual calcium intakes, during the rapid-bone-growth period in childhood and early adolescence, urinary calcium appears relatively unaffected by calcium intake and is most strongly associated with urinary sodium levels.

Changes in calcium kinetics associated with menarche.

To evaluate the consequences of puberty on calcium (Ca) metabolism, we measured Ca kinetic parameters in 43 healthy girls 1-60 months post menarche. There was a close relationship between the logarithmic transform of the number of months post menarche and the bone Ca deposition rate (Vo +) (r = -0.90, P < 0.001). Using multiple regression analysis with the logarithmic transforms of chronological age and months post menarche as independent parameters, we found that the number of months post menarche was more significantly correlated with Vo + (t = -7.4, P < 0.0001) than with chronological age (t = -3.1, P = 0.003). A longitudinal study of 17 girls demonstrated a peak Vo + approximately 8 months before menarche, with a decrease in Vo + after menarche. These studies indicate that the peak time for bone Ca deposition is in the premenarcheal and perimenarcheal time period. The close correlation between Vo + and months post menarche demonstrates the importance of puberty in consideration of bone Ca metabolism in girls.

Absorption by 1-year-old children of an iron supplement given with cow's milk or juice.

A paucity of data are available on toddlers for the evaluation of optimal strategies of Fe supplementation. In this study, we used a two-tracer stable isotope technique to determine Fe absorption from a 5-mg dose of stable isotopically enriched (57Fe or 58Fe) ferrous sulfate given with cow's milk (CM) compared with the same dose given with apple juice. Ten children (age 13 +/- 1 mo, weight 10.8 +/- 1.1 kg) who had recently discontinued formula feeding and begun on CM were studied. Red blood cell (RBC) iron incorporation of the isotope was determined 14 d after dosing with 57Fe and 58Fe. Fe absorption was calculated based on the assumption that 90% of absorbed Fe is incorporated into RBC. Absorption of Fe was significantly greater (13.7 +/- 6.4%) when given with juice than with milk (5.7 +/- 4.0%), p < 0.01 by paired t tests. Fe absorption from the dose given with juice was significantly negatively correlated with serum ferritin (n = 9, r = -0.70, p < 0.05). These results indicate that 1) a small supplement of Fe is better absorbed when given with juice than with CM, and 2) a large variability in Fe absorption exists in healthy 1-y-old infants, which is related to their existing Fe stores.

Analysis of chemical weapons degradation products by capillary electrophoresis with UV detection.

CE with UV detection is investigated for the separation and detection of 27 chemical weapons (CW) degradation products. Both capillary zone electrophoresis (CZE) and micellar electrokinetic chromatography (MEKC) separation techniques are used with direct and indirect UV detection. Optimal buffer systems and instrumental conditions are established for a representative collection of chemical warfare degradation compounds. Anionic, cationic, zwitterionic, and neutral components are determined with either direct UV absorbance or indirect UV displacement. Sodium dodecyl sulfate is used as the micelle-forming surfactant, and phenylphosphonic acid is used as the background electrolyte in borate buffer solutions. This evaluation is designed to demonstrate the applicability of CE as an analytical method in CW detection.

Precise determination of the absorptive component of urinary calcium excretion using stable isotopes.

Some patients with hypercalciuria are thought to have enhanced enteric calcium absorption, with a major component of recent diet contributing to urinary calcium. This mechanism has been difficult to test with the usual calcium loading procedures. We employed dual stable calcium isotope tracers to quantitate the components of urinary calcium excretion in 38 healthy female children. The mean urinary calcium excretion in these girls was 2.4 mg/kg per day. The contribution of recent diet to this total was a mean of 0.2 mg/kg per day. The maximum dietary contribution to urinary calcium excretion was 0.86 mg/kg per day. Recent diet contributes a mean of 8% to total dietary calcium excretion. This novel method permits precise quantitation of the contributions of recent diet and tissue stores to urinary calcium excretion. In these healthy girls, the fraction of urinary calcium derived from diet is trivial.

Differences in calcium absorption and kinetics between black and white girls aged 5-16 years.

To assess racial differences in calcium (Ca) metabolism, we measured Ca absorption and kinetics in 89 girls (38 black and 51 white) aged 4.9-16.7 years using a dual-tracer stable isotope technique. We found significantly greater rates of fractional (0.44 +/- 0.13 vs. 0.25 +/- 0.08, p < 0.0001) and total calcium absorption (406 +/- 142 vs. 234 +/- 82 mg/day, p < 0.0003) in black than in white postmenarcheal girls. Fractional absorption of Ca was also greater in black than in white premenarcheal girls (0.39 +/- 0.14 vs. 0.30 +/- 0.10, p = 0.01). Fractional absorption of Ca was more closely correlated to Ca intake in white (r = -0.42, p = 0.002) than in black girls (r = -0.25, p = 0.14). Urinary Ca excretion was significantly lower in pre- but not postmenarcheal black girls than in white girls. Calcium kinetic values associated with bone calcium deposition were greater in black girls, indicating a greater rate of bone Ca deposition in both pre- and postmenarcheal black girls. These results suggest that the greater bone mass accumulated during childhood and adolescence in black than in white females is due, in part, to greater rates of Ca absorption in black girls.

Mineral metabolism in children with dermatomyositis.

OBJECTIVE: To measure calcium metabolism in 12 children with juvenile dermatomyositis (JDM). METHODS: We used dual-tracer stable isotope studies to measure calcium metabolism in 12 children with JDM and a group of 43 healthy children (Group HC) of similar ages. Five of the JDM subjects were receiving steroids (Group JDM-ST) and 7 were not (Group JDM-NS). RESULTS: The rate of calcium absorption in Group JDM-ST was lower than that in Group HC (19 +/- 10% vs 30 +/- 11%, p < 0.05). The lower rate of absorption was associated with a net loss of calcium each day (calculated calcium retention, Vbal, of -35 +/- 14 mg/day compared to +140 +/- 97 mg/day in Group HC, p < 0.01). Group JDM-NS showed slightly lower calcium absorption than Group HC and significantly lower Vbal (+33 +/- 70 mg/day, p < 0.01 vs Group HC) than Group HC. Group JDM-ST subjects also had decreased bone calcium deposition rates. CONCLUSION: Patients with JDM may be at risk for significant loss of bone mineral associated with decreased calcium absorption, especially in the acute phase of their disease when they are receiving steroid therapy.