Increased Toll-like receptor (TLR) mRNA expression in monocytes is a feature of metabolic syndrome in adolescents.

BACKGROUND: Metabolic syndrome (MetSyn) is diagnosed frequently in some but not all overweight adolescents. Chronic inflammation, as seen in obesity, is strongly associated with MetSyn. OBJECTIVES: The aim of this pilot study was to assess the correlation between activation of the innate immune system and MetSyn, independent of body mass index (BMI), in a young population. METHODS: We quantitatively measured both systemic pro-inflammatory cytokines and gene expression of Toll-like receptors (TLRs) and downstream cytokines in circulating monocytes obtained from nine adolescents with metabolic syndrome (Overwt-MetSyn) and eight BMI-matched controls (Overwt-Healthy). RESULTS: The Overwt-MetSyn group demonstrated a significant elevation in expression of TLR2, TLR4, tumour necrosis factor-a (TNF a) and interleukin-6 (IL6) in peripheral monocytes, and increased circulating levels of TNF a and IL6 when compared with the Overwt-Healthy group. TLR2 (r = 0.78, P < 0.001), TLR4 (r = 0.57, P < 0.01) and TNF a (r = 0.61, P < 0.01) gene expression positively correlated with serum levels of TNF a. CONCLUSIONS: Our study suggests that activation of the innate immune pathway via TLRs may be partially responsible for the increased systemic inflammation seen in adolescents with MetSyn.

Healthy lifestyle factors associated with reduced cardiometabolic risk.

Minimal data are available regarding the cumulative effects of healthy lifestyle behaviours on cardiometabolic risk. The objective of the present study was to examine a combination of healthy lifestyle behaviours associated with cardiometabolic risk reduction. The analysis was based on a cross-sectional study of 1454 participants from the population-based Lipid Research Clinic's Princeton Follow-up Study. The healthy lifestyle factors included fruit and vegetable intake ≥ 5 servings/d, meat intake ≤ 2 servings/d, never smoking, consuming 2-6 alcoholic drinks/week, television (TV) viewing time ≤ 2 h/d and moderate to vigorous physical activity ≥ 4 h/week. The combination of healthy lifestyle behaviours was strongly and negatively associated with the presence of cardiometabolic risk, as well as with a composite cardiometabolic risk score after adjustment for race, age, generation and sex. With each additional healthy lifestyle factor, cardiometabolic risk decreased by 31 % (OR 0·69; 95 % CI 0·61, 0·78). A higher healthy lifestyle score was associated with a lower prevalence of cardiometabolic risk (P for trend < 0·001). Compared with individuals having 0-1 healthy lifestyle behaviours, those with 5 or 6 healthy lifestyle behaviours had a 70 % lower prevalence of cardiometabolic risk (OR 0·30; 95 % CI 0·13, 0·67). Healthy lifestyle behaviours including sufficient fruit and vegetable intake, less meat intake, less TV viewing time, abstinence from smoking, modest alcohol intake and regular exercise are associated with reduced cardiometabolic risk.

Endothelin-1-induced proliferation of human endothelial cells depends on activation of K+ channels and Ca+ influx.

AIMS: Endothelin-1 (ET-1) promotes endothelial cell growth. Endothelial cell proliferation involves the activation of Ca2+-activated K+ channels. In this study, we investigated whether Ca2+-activated K+ channels with big conductance (BK(Ca)) contribute to endothelial cell proliferation induced by ET-1. METHODS: The patch-clamp technique was used to analyse BK(Ca) activity in endothelial cells derived from human umbilical cord veins (HUVEC). Endothelial proliferation was examined using cell counts and measuring [3H]-thymidine incorporation. Changes of intracellular Ca2+ levels were examined using fura-2 fluorescence imaging. RESULTS: Characteristic BK(Ca) were identified in cultured HUVEC. Continuous perfusion of HUVEC with 10 nmol L(-1) ET-1 caused a significant increase of BK(Ca) open-state probability (n = 14; P < 0.05; cell-attached patches). The ET(B)-receptor antagonist (BQ-788, 1 micromol L(-1)) blocked this effect. Stimulation with Et-1 (10 nmol L(-1)) significantly increased cell growth by 69% (n = 12; P < 0.05). In contrast, the combination of ET-1 (10 nmol L(-1)) and the highly specific BK(Ca) blocker iberiotoxin (IBX; 100 nmol L(-1)) did not cause a significant increase in endothelial cell growth. Ca2+ dependency of ET-1-induced proliferation was tested using the intracellular Ca2+-chelator BAPTA (10 micromol L(-1)). BAPTA abolished ET-1 induced proliferation (n = 12; P < 0.01). In addition, ET-1-induced HUVEC growth was significantly reduced, if cells were kept in a Ca2+-reduced solution (0.3 mmol L(-1)), or by the application of 2 aminoethoxdiphenyl borate (100 micromol L(-1)) which blocks hyperpolarization-induced Ca2+ entry (n = 12; P < 0.05). CONCLUSION: Activation of BK(Ca) by ET-1 requires ET(B)-receptor activation and induces a capacitative Ca2+ influx which plays an important role in ET-1-mediated endothelial cell proliferation.

[Long-term follow-up after direct PTCA in women with acute myocardial infarction]. / Langzeitbefunde der primären Angioplastie bei Frauen mit akutem Myokardinfarkt.

METHODS: Long-term follow-up of 204 consecutive and unselected women vs 577 men after direct PTCA for acute myocardial infarction. RESULTS: Women were older, had more significant comorbidity, and had a longer prehospital phase. Direct PTCA of the infarct artery was angiographically successful in 95% of women and in 94% of men. Total cumulative mortality during 4 years of follow-up was 12.5%, 14.5% 18%, and 23% in women, respectively, vs 9%, 10.5%, 12%, and 15%, respectively, in men (p=ns through year 3, p<0.05 thereafter). After multivariate analysis, gender was no independent risk factor of increased mortality. Major cardiac events and need for target vessel revascularization were unrelated to gender. CONCLUSIONS: There are no gender-specific differences in mortality after direct PTCA for acute myocardial infarction.

[Prevalence and significance of coronary collateral circulation in patients with acute myocardial infarct]. / Prävalenz und Bedeutung der koronaren Kollateralzirkulation bei Patienten mit akutem Myokardinfarkt.

UNLABELLED: Angiograms from consecutive and unselected patients with acute myocardial infarction were studied with respect to the prevalence as well as the significance of coronary collateral circulation to myocardium distal to the acute coronary occlusion. METHODS: Coronary angiograms were obtained from 700 consecutive and unselected patients with an acute transmural infarction within 3.7 +/- 3 hours (0.5-12) of symptom onset. No patient had undergone i.v. thrombolysis prior to angiography. Complete and acute vessel occlusion was found in 626/700 patients (89%). Coronary collaterals were detected and graded using Rentrop's classification. The grade of collateral circulation was related to the clinical course after 30 days and to the global and regional left ventricular wall motion. RESULTS: Collaterals were found in 334 patients (69%); 242 patients (38%) had collateral flow grade 2 or 3. Collaterals were demonstrated more frequently in women vs men and in patients with multivessel disease. The prevalence of collaterals was unrelated to age and the presence of diabetes mellitus. Patients who had angiography within 3 hours of symptom onset had collaterals detected less frequently than patients who had angiography beyond 6 hours (66% vs 75%, p < 0.05). No collaterals were found in 17/37 patients (47%) in cardiogenic shock and inferior MI but in only 30/164 patients (18%, p < 0.01) without shock. Global and regional left ventricular wall motion after 2 weeks was unrelated to the degree of coronary collateral circulation during acute myocardial infarction. CONCLUSION: Collateral circulation to myocardium distal to an acutely occluded coronary artery is detected in 2/3 patients during the acute infarct phase. The absence of collaterals is related to the early occurrence of cardiogenic shock in patients with inferior MI but not to the presence of diabetes mellitus. After direct angioplasty of the infarct vessel, the protective effects of coronary collaterals on chronic LV function remain uncertain.

Clinical performance of a specific algorithm to reconfirm self-terminating ventricular arrhythmias in current implantable cardioverter-defibrillators.

Inappropriate shock therapy is a frequent problem in patients with implantable cardioverter-defibrillators (ICDs), caused mostly by supraventricular rhythms. Self-terminating ventricular arrhythmias (STVAs), however, may also lead to inappropriate shock discharges even in ICDs with abortive shock capabilities. The aim of this study was to evaluate the clinical performance of a specific ventricular tachycardia/ventricular fibrillation (VT/VF) reconfirmation algorithm implemented in current ICD devices from Medtronic to prevent inappropriate shock discharges due to STVAs. A total of 161 STVA episodes were documented in 59 of 150 patients (39%) within a mean follow-up of 30 +/- 20 months and resulted in 25 inappropriate shock discharges in 15 of 150 patients (10%) despite activation of the reconfirmation algorithm. The first synchronization interval of the algorithm was met in 92% of STVA episodes with and even 38% of STVA episodes without shock delivery. A reduced incidence of inappropriate shocks due to STVAs was found with tachycardia/fibrillation detection intervals (TDI/FDI) programmed to shorter cycle lengths < or =280 ms or the use of the first 2 cycles after the end of charging to be considered for reconfirmation only. Thus, inappropriate shocks due to STVAs still occur in 10% of patients with ICDs despite activation of a specific VT/VF reconfirmation algorithm, and are mainly caused by meeting the first synchronization interval that therefore should be shortened in cycle length. Moreover, to reduce the likelihood of inappropriate shocks, the VF reconfirmation algorithm should be optimized by basing the synchronization intervals exclusively on the FDI with short cycle lengths or using the first 2 cycles for reconfirmation only.

Household television access: associations with screen time, reading, and homework among youth.

OBJECTIVE: We examined how household factors that mediate television access are associated with screen time (television, videos, movies, and computer and video games), reading, and homework. METHODS: We conducted a self-report survey among 1197 sixth and seventh graders in 10 middle schools in 4 Boston-area communities in 1995. To assess independent associations, SUDAAN linear regressions were calculated to control for respondent characteristics and household access and to account for clustered sampling in the school-based design. RESULTS: Total viewing (television, videos, movies, and computer and video games) averaged 3.35 plus minus 2.2 hours per day. In multivariate regressions, independent direct associations with total viewing were observed for the following categories: youth has a television in the bedroom: 0.64 hours per day (P <.001), never/seldom has family dinners: 0.55 hours (P <.01); no parental limits on television time: 0.48 hours (P <.01); and each additional television outside the youth's bedroom, 0.12 hours (P <.05). Similar results held when television/video/movie use was examined separately from computer/video game use. Youth reported an average of 1.6 plus minus 1.1 hours of reading and homework per day. Parental limits on television time were associated with 0.21 hours more reading per day (P <.01), whereas a television in the bedroom was associated with 0.18 hours less (P <.01). CONCLUSIONS: Reducing intrahousehold television access may enhance clinical, school, and community strategies to reduce youth television viewing and other screen time.

Differences in knowledge of hepatitis B among Vietnamese, African-American, Hispanic, and white adolescents in Worcester, Massachusetts.

OBJECTIVE: To assess the level of knowledge about hepatitis B of Vietnamese adolescents, a group at high risk for hepatitis B, and compare it to the knowledge of adolescents of other races and ethnicities. METHODS: A sample of 2816 adolescents was surveyed in 1993 in 2 middle schools and 2 high schools in Worcester, Massachusetts, using a self-administered multilingual questionnaire. RESULTS: Knowledge of hepatitis B was low overall. Vietnamese respondents were more likely than were other students to know that hepatitis B affects the liver (35.6% vs 22.6%). However, they were much less likely than were other students to correctly identify sex with an infected person as a risk factor for infection (13.7% vs 32. 8%). Independent predictors of this knowledge were: white race; older age; attending high school versus middle school; having been taught about hepatitis B in school; knowing the definition of hepatitis B; reporting better grades; having a family member with hepatitis B; and being more highly acculturated. CONCLUSIONS: Adolescent knowledge about risk of infection was low in this study. Attention should be directed at providing health education on hepatitis B to adolescents, particularly to Vietnamese. Health care providers, community health educators, and others engaged in the effort to control and eradicate hepatitis B should be sensitive to the unique educational and cultural needs of high-risk southeast Asian adolescent populations.

Reducing obesity via a school-based interdisciplinary intervention among youth: Planet Health.

OBJECTIVE: To evaluate the impact of a school-based health behavior intervention known as Planet Health on obesity among boys and girls in grades 6 to 8. DESIGN: Randomized, controlled field trial with 5 intervention and 5 control schools. Outcomes were assessed using preintervention (fall 1995) and follow-up measures (spring 1997), including prevalence, incidence, and remission of obesity. PARTICIPANTS: A group of 1295 ethnically diverse grade 6 and 7 students from public schools in 4 Massachusetts communities. INTERVENTION: Students participated in a school-based interdisciplinary intervention over 2 school years. Planet Health sessions were included within existing curricula using classroom teachers in 4 major subjects and physical education. Sessions focused on decreasing television viewing, decreasing consumption of high-fat foods, increasing fruit and vegetable intake, and increasing moderate and vigorous physical activity. MAIN OUTCOME MEASURES: Obesity was defined as a composite indicator based on both a body mass index and a triceps skinfold value greater than or equal to age- and sex-specific 85th percentiles. Because schools were randomized, rather than students, the generalized estimating equation method was used to adjust for individual-level covariates under cluster randomization. RESULTS: The prevalence of obesity among girls in intervention schools was reduced compared with controls, controlling for baseline obesity (odds ratio, 0.47; 95% confidence interval, 0.24-0.93; P = .03), with no differences found among boys. There was greater remission of obesity among intervention girls vs. control girls (odds ratio, 2.16; 95% confidence interval, 1.07-4.35; P = .04). The intervention reduced television hours among both girls and boys, and increased fruit and vegetable consumption and resulted in a smaller increment in total energy intake among girls. Reductions in television viewing predicted obesity change and mediated the intervention effect. Among girls, each hour of reduction in television viewing predicted reduced obesity prevalence (odds ratio, 0.85; 95% confidence interval, 0.75-0.97; P = .02). CONCLUSION: Planet Health decreased obesity among female students, indicating a promising school-based approach to reducing obesity among youth.

A remark on the high-conductance calcium-activated potassium channel in human endothelial cells.

The patch-clamp technique was used to examine the presence of large conductance calcium-activated potassium channels (BKCa) in human endothelial cells and to characterize their properties in terms of voltage dependence, ion conduction and blockade by iberiotoxin (IbTX). Experiments were performed using cell-attached and outside-out configurations on human umbilical vein endothelial cells (HUVEC). For the experiments HUVECs, which were passaged 6-19 times, were used. In early passages channel activities were absent suggesting the appearance of BKCa depending on cell culture time. The inverse logarithmic voltage sensitivity was 10.17 mV (median) for cell-attached recordings and 12.10 mV (median) for outside-out patches (membrane voltage range: 60-120 mV, symmetrical 140 mM K+ solutions). The I/V relationship was quasilinear in the range of 0-80 mV and exhibited a nonlinear behaviour under further depolarization suggesting some kind of saturation mechanism. Using a sigmoid function to fit the data, channel conductance was calculated as 172.9 pS (median) for cell-attached patches and as 262.1 pS (median) for outside-out patches. IbTX, known as one of the most selective blockers of BKCa was perfused to outside-out patches. In two out of three experiments there was complete block of the ion channel after 1 min.

Blockade of Ca2+-activated K+ channels inhibits proliferation of human endothelial cells induced by basic fibroblast growth factor.

Basic fibroblast growth factor (bFGF) exerts angiogenic and mitogenic properties in human tissue. Since changes in ion currents modulate essential Ca2+-dependent intracellular pathways in endothelial cells, we have investigated a possible contribution of Ca2+-activated K+ channels (BKCa) on bFGF-induced endothelial cell proliferation. The patch-clamp technique was used to identify BKCa and to study their modulation by bFGF in cultured endothelial cells of human umbilical cord veins (HUVEC). Cell counts of HUVEC were carried out on different days to analyze bFGF-induced cell proliferation and its influence by the specific BKCa blocker iberiotoxin (IBX). Using single-channel recordings, we found characteristic BKCa with a single-channel slope conductance of 170.3 +/- 2.1 pS (n = 7), half-maximal activation at internal pCa = 5.7 (n = 5; test potential: 80 mV), and dose-dependent block by IBX (25-100 nmol/l). In cell-attached patches bFGF (50 ng/ml) caused a significant increase in the open-state probability (NPo) after 6 min at test potentials of 80 and 100 mV (n = 28; p < 0.001), respectively, which lasted up to 30 min. After preincubation with pertussis toxin (100 ng/ml; 4 h) bFGF superfusion did not cause a significant increase in BKCa activity until 25 min had passed (n = 20; p < 0.01). Addition of 100 nmol/l IBX to the pipette solution caused a total block of BKCa within 2 min in cell-attached patches, whereas bFGF (50 ng/ml) was not able to activate BKCa. When incubated with IBX (25-100 nmol/l) every 2 days, bFGF-induced proliferation of HUVEC was significantly decreased by 50 (-41%) and 100 nmol/l (-50%) IBX (n = 5; p < 0.001) after 7 days. We conclude that activation of BKCa by bFGF may play an important role in bFGF-induced proliferation of human endothelial cells and thus might be important in the process of angiogenesis and vascular remodelling.

Patterns of smoking, risk factors for smoking, and smoking cessation among Vietnamese men in Massachusetts (United States).

OBJECTIVES: To measure the prevalence and patterns of, and risk factors for, smoking and other tobacco use among Vietnamese men in Massachusetts (United States). METHODS: Data were obtained via a telephone interview of 774 Vietnamese men in 1994. DESIGN: Cross-sectional survey administered via telephone in 1994. SETTING: Massachusetts, United States. SUBJECTS: Randomly selected Vietnamese men (n = 774). MAIN OUTCOME MEASURES: Present and past use of tobacco products, knowledge and attitudes regarding tobacco, and risk factors for tobacco use. Results were compared with data from the Massachusetts general population. RESULTS: Vietnamese men smoked at a rate 1.9 times that of the Massachusetts general men's rate (43% vs 24%). The smoking rate did not decrease with increasing length of residence in the United States. In a logistic regression, risk factors for current smoking were: age in the thirties; history of parental smoking; lower educational level; higher depression score; low level of exercise; lack of health insurance; and geographical origin from the south coast of Vietnam. Smoking cessation declined with increasing depression score. Most smokers (76%) had no plans to quit smoking. CONCLUSIONS: Vietnamese men smoke at much higher rates than the general population, and are much less likely to be planning cessation. High rates of depression and sociocultural barriers to smoking cessation must be addressed in efforts to reduce tobacco use among this high-risk population.

Modulation of Ca2+-activated K+ channels in human vascular cells by insulin and basic fibroblast growth factor.

Insulin and basic fibroblast growth factor (bFGF) play an important role in the pathogenesis of atherosclerosis and have been shown to have vasodilatory effects. Since modulation of vascular ion channels determines membrane potential and thereby influences essential Ca2+-dependent intracellular pathways, we have investigated the effect of insulin and bFGF on Ca2+-activated K+ channels (BKCa) in human umbilical vein endothelial cells (HUVEC) and smooth muscle cells. The latter were obtained from either atherosclerotic plaques (SMCP) or from media segments (SMCM) of human coronary arteries. Using the patch-clamp technique, insulin (100 microU/ml) caused a significant increase in BKCa open-state probability in SMCP and HUVEC, whereas no significant changes were observed in SMCM. Basic FGF (30 ng/ml) revealed a significant increase in BKCa activity in HUVEC and a significant decrease in the BKCa open-state probability in SMCP, but caused no changes in SMCM. Thus, growth factors modulate vascular BKCa in a cell-type specific manner, which may be of importance concerning vasoactive and atherogenic effects of growth factors.

Ca(2+)-activated K+ channels in human smooth muscle cells of coronary atherosclerotic plaques and coronary media segments.

The behavior of Ca(2+)-activated K+ channels of large conductance (BKCa) in smooth muscle cells, which were obtained from atherosclerotic plaque material (SMCP) and from media segments (SMCM) of human coronary arteries, were compared using the patch-clamp technique. Voltage-clamp protocols in cell-attached patches revealed the characteristic voltage-dependent activation of BKCa in both cell groups. Single-channel conduction as 216.4 +/- 16.7 pS (n = 6) in SMCP and 199.9 +/- 6.7 pS (n = 6) in SMCM in symmetrical 140 mM K+ solutions. Using outside-out patches, external perfusion with 500 microM tetraethylammonium ions caused a typical "flickery block" of the unitary current. The selective BKCa channel inhibitor iberiotoxin (50 nM) effectively blocked BKCa, channel activity. Comparing BKCa open-state probabilities (P0) at +80 mV in cell-attached patches, a highly significant difference between SMCP (P0 = 0.1438 +/- 0.1301; n = 15) and SMCM (P0 = 0.0093 +/- 0.0044; n = 15; Kruskal-Wallis test, p < 0.001) was found. In contrast to this finding, there was no significant difference in the open-state probability of BKCa, between SMCP (P0 = 0.542 +/- 0.0237; n = 9) and SMCM (P0 = 0.0472 +/- 0.0218; n = 10; p = n.s.) using inside-out patches. The results show an interesting difference in the behavior of large conductance Ca(2+)-activated K+ channel in SMCP compared to SMCM with a significantly higher channel activity in human smooth muscle cells obtained from coronary atherosclerotic plaque material. This finding may indicate an important functional role of BKCa channels in the development of atherosclerosis.

Differences in patterns of tobacco use in Vietnamese, African-American, Hispanic, and Caucasian adolescents in Worcester, Massachusetts.

Reduction of cigarette smoking among Southeast Asian men is a national health promotion objective for the year 2000. Early onset of cigarette smoking is known to be a risk factor for later nicotine addiction, yet little is known about tobacco patterns among Southeast Asian youths. Using questionnaire items from the Youth Risk Behavior Survey (YRBS) translated into Vietnamese and Spanish, this article reports such data on a school-based sample of Vietnamese adolescents in Worcester, Massachusetts, and compares smoking and other tobacco use among Caucasian, African-American, and Hispanic adolescents. A sample of 2,816 adolescents was surveyed in two public middle and two public high schools. Prevalence of cigarette smoking among Vietnamese boys (27.9%) was similar to that for Caucasian boys (28.3%) and was higher than that for Hispanic boys (19.7%) or African-American boys (18.9%). Vietnamese girls smoked rarely (3.7%). Vietnamese boys were less likely to smoke in middle school than were other students, and more likely to report smoking in high school than were non-Vietnamese. They were also significantly less likely than others to have smoked their first cigarette at age 12 years or younger (odds ratio (OR) = 0.2, 95 percent confidence interval (CI) = 0.1, 0.4). In multivariate analyses, older age, male gender, smoking by friends, and carrying of a weapon were independent risk factors for current cigarette smoking. Vietnamese subjects differed from others with respect to factors associated with smoking, perceived susceptibility to cancer, and belief in the importance of not smoking for preventing cancer. Among Vietnamese adolescents over age 16, increasing length of time in the United States was associated with decreasing smoking prevalence. The prevalence of smokeless tobacco use among Vietnamese boys (12.0%) was similar to that among other minority boys but was rare among Vietnamese girls. This study is the first to document the rates of tobacco use among Vietnamese adolescents, and the findings suggest that Vietnamese boys should be targeted in efforts to achieve the goal of reducing smoking among Southeast Asian men. Medical Subject Headings (MeSH): adolescent behavior, health surveys, smoking, health promotion, tobacco, smokeless, Asians, Asian Americans, Vietnam.

Assessing unmet need for services for pediatric undernutrition. HSPH MPH Student Research Team.

Evaluation and treatment of undernourished children in Massachusetts has been provided since 1984 by the seven outpatient Growth and Nutrition (GN) Clinics administered by the Massachusetts Department of Public Health (MDPH). This study explored the potential unmet need for nutritional services among low-income, multiethnic children ages birth to 36 months presenting to an inner-city pediatric emergency department (ED). During March 1992, staff obtained weight and stature on all children under 36 months of age brought to the ED. A structured interview questionnaire obtained data on demographic characteristics, birth history, and participation in means-tested federal benefit programs and MDPH GN Clinics. Among 252 children with complete anthropometric data, 22 (8.9%) had at least one anthropometric index (weight-for-age, height-for-age, weight-for-height) below the fifth percentile. Birthweights < 2500 g were reported by 18.5% of caregivers; 58% of children with height-for-age less than the fifth percentile and 63% of those with weight-for-age less than the fifth percentile were low birthweight (LBW) (Fisher's exact test, P < .002 and P < .006, respectively). Thirteen percent of families had no health insurance, and 77.1% received Medicaid. Among 22 children with anthropometry less than the fifth percentile, one half to three quarters participated in federally funded programs including Special Supplemental Food Program for Women, Infants, and Children (WIC), Aid to Families With Dependent Children (AFDC), and Food Stamps, but only 11% had been referred to the GN Clinics. These findings suggest that federal means-tested benefit programs and MDPH GN Clinic services were underused by groups at nutritional risk.(ABSTRACT TRUNCATED AT 250 WORDS)

High prevalence of overweight and short stature among Head Start children in Massachusetts.

The Head Start Program measures children's heights and weights to screen for growth problems such as obesity, wasting, and short stature. At present, little public health use is made of these data. In this paper, the authors present serial cross-sectional nutrition surveillance data from Massachusetts Head Start Programs. Nonrandom samples of local Head Start Programs provided annual screening data from 1988 to 1991 on an average of 2,664 children per year. Height and weight measurements were compared with National Center for Health Statistics (NCHS) reference populations. On average, 87 percent of the children were 36 to 59 months of age and 51 percent were white. From 7.3 to 8.8 percent of children were below the 5th percentile of height for age each year, and from 1.2 to 3.3 percent were underweight, with weight below the 5th percentile for height (P < 0.05 compared with NCHS population). In each year overweight (weight for height above the 95th percentile) was most prevalent, ranging from 9.6 percent to 13.3 percent (P < 0.05 compared with NCHS) and demonstrating a statistically significant upward trend over the 4 years of study (chi-square = 9.21, P < 0.01). The prevalence of overweight and short stature varied by race and ethnicity. A statistically significant upward trend in overweight was seen among Hispanic children (chi-square = 5.99, P < 0.05). Also, children who were 48 months of age or older were more likely than younger children to be overweight (P < 0.05). The prevalence of short stature did not vary significantly by year, sex, or age. The authors conclude that children attending Head Start Programs in Massachusetts are at risk for short stature and are at increasing risk of obesity. These risks vary by race and ethnicity. Further research is needed to determine the generalizability of these findings to other regions and to evaluate social and behavioral correlates of poor nutrition outcomes among Head Start children.

Diet measurement in Vietnamese youth: concurrent reliability of a self-administered food frequency questionnaire.

Dietary patterns of Asian Americans change with increasing acculturation, leading to increased consumption of Western foods including those high in fat. Strategies to preserve the healthy aspects of traditional diets need to be developed and dietary assessment methods evaluated. Little is known about reliability of brief dietary measures in the general population or among minority youth. The concurrent reliability of a brief food frequency questionnaire (FFQ) was determined among Vietnamese youth using diet reports. Students in a bilingual high school program were given a FFQ. Students then completed daily diet reports one day each week over seven weeks. The data from the FFQ were compared to the daily food reports. The reliability of the FFQ was highest for frequently eaten food types like rice (r = 0.626, P < 0.01), fruit (r = 0.513, P < 0.01), meat (r = 0.525, P < 0.01) and vegetables (r = 0.474, P < 0.01) and was lower for less commonly eaten types including fish/shellfish (r = 0.227, P = 0.20) and fried foods (r = 0.310, P = 0.07). These results suggest that a few simple FFQ items, particularly for indicator foods such as rice, are reliable for dietary assessment in this population.