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Biomedical subjects

D H Montgomery

Publications and source records attributed to D H Montgomery.

12 recordsLinked to original sources
PubMed1999

Distribution of and factors associated with serum homocysteine levels in children: Child and Adolescent Trial for Cardiovascular Health.

CONTEXT: Although evidence suggests that homocysteine is a risk factor for cardiovascular disease in adults, little information exists on homocysteine levels in children. OBJECTIVES: To describe the distribution of serum homocysteine concentrations among children and to examine the association between homocysteine levels and several characteristics, including serum levels of folic acid and vitamins B12 and B6. DESIGN: Cross-sectional analysis. SETTING: School-based cohort from California, Louisiana, Minnesota, and Texas. PARTICIPANTS: A total of 3524 US schoolchildren, aged 13 and 14 years, from the Child and Adolescent Trial for Cardiovascular Health (completed in 1994). Measurement was conducted in 1997. MAIN OUTCOME MEASURE: Nonfasting serum total homocysteine concentration. RESULTS: The distribution of homocysteine values ranged from 0.1 to 25.7 micromol/L (median, 4.9 micromol/L). Geometric mean homocysteine concentration was significantly higher in boys (5.22 micromol/L) than girls (4.84 micromol/L); blacks (5.51 micromol/L) than whites (4.96 micromol/L) or Hispanics (4.93 micromol/L); nonusers of multivitamins (5.09 micromol/L) than users (4.82 micromol/L); and smokers (5.19 micromol/L) than nonsmokers (5.00 micromol/ L). Serum homocysteine was significantly inversely correlated with serum levels of folic acid (r= -0.36; P = .001), vitamin B12 (r = -0.21; P = .001), and vitamin B6 (r = -0.18; P = .001). Serum homocysteine was not significantly associated with serum lipid levels or family history of cardiovascular disease and was only weakly related to body mass index and systolic blood pressure. After multivariate adjustment, homocysteine remained independently associated with sex, race, serum folic acid and vitamin B12 levels, and systolic blood pressure. CONCLUSIONS: The distribution of homocysteine levels in children is substantially lower than that observed for adults; however, a small percentage of children are still potentially at elevated risk for future cardiovascular disease. Serum folic acid may be an important determinant of homocysteine levels in children.

Adolescent↗
PubMed1996

Natural history of severe atheromatous disease of the thoracic aorta: a transesophageal echocardiographic study.

OBJECTIVES: This study sought to prospectively observe the morphologic and clinical natural history of severe atherosclerotic disease of the thoracic aorta as defined by transesophageal echocardiography. BACKGROUND: Atherosclerosis of the thoracic aorta has been shown to be highly associated with risk for embolic events in transesophageal studies, but the natural history of the disease under clinical conditions has not been reported. METHODS: During a 20-month period, 191 of 264 patients undergoing transesophageal echocardiography had adequate visualization of the aorta to allow atherosclerotic severity to be graded as follows: grade I = normal (44 patients); grade II = intimal thickening (52 patients); grade III = atheroma < 5 mm (62 patients); grade IV = atheroma > or = 5 mm (19 patients); grade V = mobile lesion (14 patients). All available patients with grades IV (8 patients) and V (10 patients) disease as well as a subgroup of 12 patients with grade III disease had follow-up transesophageal echocardiographic studies (mean [+/- SD] 11.7 +/- 0.9 months, range 6 to 22). RESULTS: Of 30 patients undergoing follow-up transesophageal echocardiographic studies, 20 (66%) had no change in atherosclerotic severity grade. Of the remaining 10 patients, atherosclerotic severity progressed one grade in 7 and decreased in 3 with resolved mobile lesions. Of 18 patients with grade IV or V disease of the aorta who underwent a follow-up study, 11 (61%) demonstrated formation of new mobile lesions. Of 10 patients with grade V disease on initial study who underwent follow-up study, 7 (70%) demonstrated resolution of a specific previously documented mobile lesion. However, seven patients (70%) with grade V disease also demonstrated development of a new mobile lesion. Of 33 patients with grade IV or V disease, 8 (24%) died during the study period, and 1 (3%) had a clinical embolic event. CONCLUSIONS: The presence of severe atherosclerotic disease of the thoracic aorta as defined by transesophageal echocardiography is associated with a high mortality rate. Although the morphologic natural history of the disease process itself is marked by stability over a 1-year period, individual lesion morphology is dynamic, with formation and resolution of mobile components occurring frequently over the same period. The dynamic nature of individual lesion morphology potentially enhances the possibility of developing a successful therapeutic strategy.

Aged↗
PubMed1994

Reducing the fat content of ground beef in a school foodservice setting.

OBJECTIVE: The objective was to develop and test the nutrient results of a two-step defatting procedure with ground beef in a school foodservice setting as part of the Eat Smart school lunch component of the Child and Adolescent Trial for Cardiovascular Health (CATCH). SETTING AND DESIGN: The procedure was tested in a school foodservice setting to determine the effect of cooking, draining, and subsequent rinsing with hot water on nutrient composition of ground beef. Samples of raw; cooked and drained; and cooked, drained, and rinsed ground beef were collected and chemically analyzed for total fat, saturated fatty acids, monounsaturated fatty acids, polyunsaturated fatty acids, cholesterol, iron, and niacin content. RESULTS: The results indicated that the total fat and the saturated, monounsaturated, and polyunsaturated fatty acids were significantly reduced 31% to 35% from cooking and draining (P < .005) and reduced by an additional 25% to 30% from rinsing (P < .0001). Cholesterol content was not affected. Iron content increased after the cooking and rinsing, although not significantly. Niacin content significantly decreased during rinsing by 28% (P < .005), but the mean value of the cooked, drained, and rinsed ground beef still met the criteria of the Food and Drug Administration for a good source of niacin. APPLICATION: The two-step defatting procedure developed for use in a school foodservice setting lowers the total fat and saturated fatty acid content of ground beef without substantially reducing its nutritional quality.

Animals↗
PubMed1994

CATCH: food service program process evaluation in a multicenter trial.

Process evaluation is an essential element of a multicenter trial in order to explain study outcomes and monitor intervention progress. This paper presents the process evaluation model for the Eat Smart School Nutrition Program, the food service intervention component of the Child and Adolescent Trial for Cardiovascular Health (CATCH), and describes the process evaluation strategies developed to assess this program. The paper details (1) measures of program implementation including training, support visits, and program promotion, (2) food service staff characteristics, and (3) measures of mediating variables including secular trends and school meal participation.

Adolescent↗
PubMed1992

Worksite nutrition education can lower total cholesterol levels and promote weight loss among police department employees.

Individuals who work in law enforcement careers are often subjected to stress that can result in health and emotional disorders. Many police departments have begun to offer wellness programs to support their employees. This pilot study designed and implemented a nutrition education component for an existing police department wellness program. Twenty-eight subjects completed the 12-month study that included nutrition counseling, seminars on nutrition and eating behaviors, and monitoring of weight and blood lipid levels. There was a significant group trend for decreased weight and lower total cholesterol levels. Results of the study led to the development of health policy standards for the Austin (Tex) Police Department. Wellness programs that involve registered dietitians can result in weight loss and lower cholesterol levels for employees in high-stress occupations as well as changes in departmental policy.

Cholesterol↗
PubMed1990

Dietary intakes of police department employees in a wellness program.

A 12-month nutrition program was developed and implemented as a project of the Wellness Department of the Austin Police Department (APD). Forty APD employees began the program; 24 completed the dietary portion of the study. A comparison of 7-day dietary intakes recorded before and after the program indicated a decrease in energy intake from a mean of 2,273 +/- 694 kcal/day to 1,379 +/- 364 kcal/day (p less than .001). Percentage of energy from protein increased from 16% to 21% (p less than .001), and energy from fat decreased from 42% to 36% (p less than .05). Percentages of energy from carbohydrate and alcohol were not significantly different from the beginning to the end of the study. Daily intakes of cholesterol decreased from 405 +/- 188 mg/day to 295 +/- 132 mg/day (p less than .05). Phosphorus and iron intakes decreased significantly (p less than .01 and p less than .001, respectively), while intakes of calcium remained constant. Mean consumption of thiamin, riboflavin, and niacin decreased significantly (p less than .01, p less than .05, and p less than .01, respectively). The changes in vitamin A and ascorbic acid intakes were not significant. Results indicated that a nutrition education program can effect positive changes toward better food choices. However, dietitians working with similar populations should stress eating patterns that include foods dense in micronutrients.

Adult↗
PubMed1979

Germinal vesicle configurations and patterns of polypeptide synthesis of procine oocytes from antral follicles of different size, as related to their competency for spontaneous maturation.

The cytogenetic configurations of germinal vesicle (gv) chromatin were analyzed for pools of porcine oocytes harvested from small (1.0-2.0 mm), medium (3.0-5.0 mm), and large (6.0-10.0 mm) antral follicles. Groups of oocytes from these follicular classes also were examined by high-resolution, two-dimensional, polyacrylamide gel electrophoresis to compare their patterns of polypeptide synthesis. The results show a high incidence of gross and cytogenetic degeneration among oocytes from small antral follicles as compared with those from medium or lage follicles. Pools of oocytes could be separated, on the basis of gross morphology and integrity of adherent granulosa cells, into two classes: "Type A" which appeared normal, and "type B" which appeared to be atretic. Among selected "type A" oocytes a particular chromatin configuration, termed "fibrous" characterizes the gv of oocytes from small follicles; whereas a different configuration, termed "diffuse," characterizes the gv of oocytes from large follicles. The patterns of polypeptide synthesis were markedly different for samples of "type A" oocytes of the three follicular classes; and the patterns for oocytes from medium and large follicles were more similar to each other than to patterns for oocytes from slall follicles. The incidences of maturational development beyond the gv stage in vitro were similar for "type A" oocytes from the three follicular classes (i.e., 66% to 82% maturation); although "type B" oocytes underwent maturation beyond the gv at a significantly reduced incidence (i.e., 20% to 29% maturation). "Type A" oocytes from large follicles completed maturation in vitro (i.e., underwent the first meiotic division) at a significantly higher incidence (55%) than did oocytes from small (11% to 20%) or medium (16%) follicles. Our findings are consistent with the hypotheses that a high proportion of oocytes from small antral follicles are atretic, and that a developmental program controls the molecular and cytogenetic changes occurring in porcine oocytes during follicular growth. These changes appear to be highly correlated with the acquisition of competency to complete maturation in vitro, and possibly also are required for normal fertilization and embryogenesis.

Animals↗
PubMedDate not supplied

Changes in the nutrient content of school lunches: results from the CATCH Eat Smart Food service Intervention.

BACKGROUND: The Child and Adolescent Trial for Cardiovascular Health (CATCH) tested the effectiveness of a multilevel intervention aimed at promoting a healthful school environment and positive eating and physical activity behaviors in children. The CATCH Eat Smart Program targeted the school food service staff and aimed to lower the total fat, saturated fat, and sodium content of school meals. METHODS: The Eat Smart intervention was conducted in 56 intervention schools over a 2(1/2)-year period.+Five consecutive days of school menu, recipe, and vendor product information were collected from intervention and control schools at three intervals, Fall 1991, Spring 1993, and Spring 1994, to assess the nutrient content of school menus as offered. RESULTS: There was a significantly greater mean reduction in the percentage of calories from total fat (adjusted mean difference -4.1%; P < 0.0001) and saturated fat (adjusted mean difference -1.3%; P = 0.003) in intervention compared with control schools from baseline to follow-up. Although the sodium content of school lunches increased in both conditions, the mean increase was significantly lower in intervention schools (adjusted mean difference -89 mg; P = 0.034). There were no statistically significant differences for total amounts of cholesterol, carbohydrate, protein, dietary fiber, total sugars, calcium, iron, vitamin A value, and vitamin C. Average total calories decreased significantly; however, the mean total calories (683 kcal) for intervention schools remained above one-third of the Recommended Dietary Allowances for this age group. CONCLUSIONS: The CATCH Eat Smart intervention successfully lowered the total fat and saturated fat content of school lunches as offered, while maintaining recommended amounts of calories and essential nutrients.

Adolescent↗
PubMedDate not supplied

Improving school breakfasts: effects of the CATCH Eat Smart Program on the nutrient content of school breakfasts.

BACKGROUND: This paper describes the impact of the Eat Smart School Nutrition Program, the food service component of the Child and Adolescent Trial for Cardiovascular Health (CATCH), on the percentage of calories from total fat and saturated fat and the sodium content of school breakfasts. METHODS: Fifty-nine of the 96 CATCH schools offered breakfast. We collected 5 consecutive days of school breakfast menu, recipe, and vendor product information at three periods to assess the nutrient content of the school menus as offered. RESULTS: At baseline (Fall 1991), intervention school breakfasts provided 28% of calories from total fat and control schools 30%. Decreases occurred over time in both groups, but no significant differences were attributable to the intervention (adjusted mean difference = -0.4; P = 0.77). Saturated fat exceeded the Eat Smart goal at baseline in all schools and by follow-up (Spring 1994), the reduction in mean percentage of calories from saturated fat was greater in intervention than in control schools (adjusted mean difference = -1.6%; P = 0.052). Sodium goals were not achieved. Mean calorie levels were maintained at or above Eat Smart goals throughout the study in both groups. Differences over time in other dietary variables (percentage of calories from protein and carbohydrate and mean levels of protein, carbohydrate, calcium, iron, vitamin A value, vitamin C, total sugars, and dietary fiber) were not statistically significant between groups. No significant reductions in student participation in the School Breakfast Program (SBP) occurred. CONCLUSIONS: The Eat Smart food service intervention improved school breakfast composition, but not significantly more so than in control schools. Fat and saturated fat in school breakfasts were lowered while maintaining calories, other essential nutrient levels, and student participation in the SBP. Secular trends and also the possibility that control schools were affected by the Eat Smart intervention may account for these findings.

Adolescent↗
PubMedDate not supplied

Changes in nutrient intakes of elementary school children following a school-based intervention: results from the CATCH Study.

BACKGROUND: Twenty-four-hour recalls were used to assess the change in nutrient intake among elementary-age school children exposed to the Child and Adolescent Trial for Cardiovascular Health (CATCH). The purpose of this paper is to compare changes in nutrient intakes between treatment groups, sexes, ethnic groups, and the four CATCH sites. METHODS: Twenty-four-hour recalls were administered to a subsample of the CATCH cohort at baseline in third grade and following the intervention in fifth grade (n = 1,182). Changes in nutrient levels for total energy, dietary cholesterol, and dietary fiber and changes in the proportion of energy from fat, protein, carbohydrate, and fatty acids were studied looking at differences by treatment group, sex, ethnicity, and site. Mixed-model analysis of variance was used to examine the change in nutrient intake, defined as intake at follow-up minus intake at baseline. RESULTS: Students in the intervention schools showed statistically significant differences in the changes in total energy and proportion of energy from total fat, saturated fat, protein, and monounsaturated fat compared with students in the control group. Students in the intervention group decreased their total fat intake from 32.7% of energy to 30.3% of energy and saturated fat from 12.8% of energy to 11.4% of energy. There were no significant differences in intervention effects by ethnic group, sex, or site. Differences in nutrient change between the school-only and the school-plus-family intervention groups were nonsignificant. CONCLUSION: The results show that a school-based intervention can positively influence children's intakes of total fat and saturated fat, suggesting that population-based approaches for reducing cardiovascular risk factors in children are feasible and effective. The results are also important in showing that the intervention was effective in Caucasian, African-American, and Hispanic students, in boys and girls, and across four regions of the United States.

Analysis of Variance↗