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Biomedical subjects

D R Jacobs

Publications and source records attributed to D R Jacobs.

At least 163 records · Page 9Linked to original sources
PubMed1992

Correlates of obesity in young black and white women: the CARDIA Study.

OBJECTIVES: Although differences in obesity between Blacks and Whites are well documented in adult women, less information is available on potential correlates of these differences, especially in young adults. METHODS: The association between behavioral and demographic factors and body size was assessed in 2801 Black and White women aged 18 to 30 years. RESULTS: Black women had significantly higher age-adjusted mean body mass index and subscapular skinfold thickness than did White women. Obesity had different associations with age and education across racial groups. A positive relationship between age and obesity was seen in Black women but not in White women, whereas a negative association between education and body size was noted only in White women. Potential contributing factors to the increased prevalence of obesity in Black women include a more sedentary lifestyle, higher energy intake, earlier menarche, and earlier age at first childbirth. CONCLUSIONS: The difference in obesity across race could not be explained completely by these factors, since within virtually all strata, Black women had higher body mass indexes. Further investigation is needed to develop interventional strategies to prevent or reduce excess levels of obesity in Black women.

Adolescent↗
PubMed1992

C-peptide response to meal challenge in nondiabetic and diabetic adults living in Wadena, Minnesota.

OBJECTIVE: The goal of the study was to provide cross-sectional descriptive data on the response of C-peptide to a vigorous meal stimulus in a population-based sample of nondiabetic adults compared with a population-based sample of adults with NIDDM. Available information is scanty, especially in subjects greater than 50 yr old. RESEARCH DESIGN AND METHODS: The group under study included 377 adults without previously known diabetes randomly chosen from the population of the city of Wadena, Minnesota, almost all of northern European background, and 88 adults with known diabetes. PCP was measured 90 min after ingestion of 480 ml liquid meal Ensure-Plus, which includes 95 g dextrose, 26 g protein, and 25 g fat. C-peptide also was measured in a 260-min urine collection after the meal challenge. Novo antibody M1221 was used for C-peptide assay throughout the study. Participants whose medical record indicated insulin-dependent diabetes with a history of acetone production were excluded from analyses. RESULTS: The distribution of UCP and PCP in this group of subjects appears very broad. Both the highest and lowest values for C-peptide were observed in individuals with diabetic glucose tolerance. The mean and median values in the nondiabetic group are higher than in previously published reports. After statistical adjustment for age, sex, BMI, and concomitant plasma glucose, participants with IGT produced significantly more C-peptide than the group with NGT (3.48 vs. 2.96 nM PCP, P less than 0.05). Participants with diabetic glucose tolerance and who were not taking insulin produced as much or more C-peptide than either the NGT or IGT groups, depending on the statistical model used for adjusting for plasma glucose. Diabetic participants who were taking insulin produced significantly lower amounts of C-peptide than any of the non-insulin-taking groups (approximately 30% of the C-peptide produced by the non-insulin-taking diabetic participants). A decline in PCP production with increasing years since diagnosis (5.7%/yr) was observed exclusively in the insulin-taking NIDDM participants. Effect modification by glucose tolerance classification was observed on the relationship between plasma glucose and PCP: PCP increased with increasing plasma glucose in NGT and IGT groups, but a nonsignificant negative relationship was exhibited in diabetic participants. CONCLUSIONS: The data suggest that two forms of NIDDM may exist, crudely distinguished by the clinical decision to use insulin to control blood glucose levels. The insulin-taking diabetic individuals may experience a greater likelihood of pancreatic failure, whereas non-insulin-taking diabetic individuals probably experience stable pancreatic function over the course of their disease. Longitudinal observation of the Wadena cohort will provide more insight into this possibility.

Adult↗
PubMed1992

Sex- and race-related differences in liver-associated serum chemistry tests in young adults in the CARDIA study.

Simultaneous multiple automated analyses of liver function can be performed quickly and cheaply, but their usefulness in mass screening is questionable. Reference intervals are frequently applied without regard to race and sex, despite the fact that reported values may vary considerably in relation to these factors. Serum analyte results for greater than 5000 black and white men and women in the CARDIA Study showed clinically and statistically significant differences by race and sex for values of aspartate aminotransferase, gamma-glutamyltransferase, alkaline phosphatase, total bilirubin, total protein, and albumin; these differences were not explained by differences in age, body mass, reported ethanol intake, smoking, or oral contraceptive use. Results for at least one of these six tests were out of range in 38% of the men and 19% of the women. Sex- and race-specific reference intervals are recommended to decrease the frequency of values reported as abnormal in otherwise healthy young adults.

Adult↗
PubMed1992

Symptom-limited graded treadmill exercise testing in young adults in the CARDIA study.

Symptom-limited, graded exercise treadmill testing was performed by 4,968 white and black adults, ages 18-30 yr, during the baseline examination for the CARDIA study. The mean estimated maximal exercise capacity by race/gender, expressed as metabolic units (METS), was: white men 13.8, black men 13.0, white women 11.1, and black women 9.4. Exercise test duration was higher in nonsmokers, positively related to physical activity score and pulmonary function (FEV1.ht-2), and inversely related to body mass index. Men had higher mean values than women for both test duration and a measure of submaximal performance, the workload 130 (WL130, the exercise test duration to a heart rate of 130 beats.min-1). Adjusted for age and education, white men had a longer mean test duration than black men (53 s longer, P less than 0.001), but nearly equal mean WL130. White women had higher mean values than black women for both test duration (114 s longer, P less than 0.001) and WL130 (36 s longer, P less than 0.001). Men had higher mean values than women for both outcome measures (P less than 0.001). Thus, in young adults significant gender and ethnic differences exist for exercise test performance, part of which can be explained by personal habits or traits.

Adolescent↗
PubMed1991

Anthropometric predictors of coronary heart disease and total mortality: findings from the US Railroad Study.

Prospective data from the US Railroad Study were used to investigate the relations of several anthropometric variables to coronary heart disease and all-cause mortality in males initially free of cardiovascular disease. Middle-aged men were examined in 1957-1960 and followed until 1977 or death. Anthropometric indicators of total body fat (body mass index and the sum of the subscapular and triceps skinfolds) and central body fat (the ratios chest circumference/biacromial (shoulder) diameter, and chest circumference/standing height) were significantly and directly associated with age-adjusted coronary heart disease mortality. When systolic blood pressure, serum cholesterol, cigarette smoking, and vital capacity were also taken into account, the ratio chest circumference/biacromial diameter remained significantly associated with coronary heart disease mortality. Total, central, and peripheral body fat had a "U"-shaped relation with all-cause mortality. Measures of the ratio of central to peripheral body fat were inconsistently related to mortality. These results indicate that certain anthropometric measurements, especially those that may indicate central adiposity, are positively related to the development of fatal coronary heart disease and quadratically related to all-causes death rates.

Adult↗
PubMed1991

Comparison of two methods of assessing physical activity in the Coronary Artery Risk Development in Young Adults (CARDIA) Study.

Physical activity was assessed by questionnaire among 4,956 young blacks and whites aged 18-30 years at the baseline examination (1985-1986) of the Coronary Artery Risk Development in Young Adults (CARDIA) study, a longitudinal study of cardiovascular risk factors. The Physical Activity Recall questionnaire categorized all activity during the previous week, while the Physical Activity History questionnaire quantified participation in 13 specific activities during the previous year. This report compares the two questionnaires with regard to their characterization of the activity levels of the sociodemographic subgroups of the study population and their associations with known physiologic correlates of physical activity. Both questionnaires resulted in the same physical activity patterns for sex (men greater than women) and age (younger greater than older) strata. However, the mean Physical Activity History score was higher in white women than in black women, while the Physical Activity Recall scores were nearly equal. The Physical Activity History score was directly related to educational status, and the Physical Activity Recall score was inversely related to educational status. The Physical Activity History score was generally more strongly associated with physiologic variables known to be related to physical activity (e.g., treadmill test duration). Based upon these findings, which may only be appropriate in this age group, it was concluded that the Physical Activity History score was the more valid measure of habitual physical activity in this study group of young adults.

Adolescent↗
PubMed1991

Differences in leisure-time physical activity levels between blacks and whites in population-based samples: the Minnesota Heart Survey.

Energy expenditure in leisure-time physical activity (LTPA) was measured using the Minnesota LTPA Questionnaire in 35- to 74-year-old black and white residents of Minneapolis-St. Paul, Minnesota. Estimates of the geometric mean LTPA energy expenditure were 129 and 204 kcal per day for black and white men (p less than .05) and 91 and 123 kcal per day for black and white women (p less than .05). The percentage of individuals expending 2000 kcal or more per week in LTPA was significantly lower in black men than white men (25 vs. 35%; p = .01) but was not different in black versus white women (18 vs. 17%). Although black men and women reported greater occupational physical activity than their white counterparts, LTPA and job activity were unrelated in all race and sex groups. In both races, LTPA energy expenditure declined with age. LTPA increased with level of formal education, and the largest LTPA difference between blacks and whites was observed in those who had a high-school diploma or less. Blacks had lower participation rates than whites in most of the individually assessed physical activities. Additional research is needed on the determinants and promoters of LTPA in population subgroups.

Black or African American↗
PubMed1991

Relationships between weight and caloric intake of men who stop smoking: the Multiple Risk Factor Intervention Trial.

Data from 6,569 middle-aged men in the Multiple Risk Factor Intervention Trial were analyzed to determine whether the weight change associated with smoking cessation resulted primarily from appetite or metabolic alterations. The appetite hypothesis attributes weight gain to an enhanced appetite and subsequent increase in caloric intake. The metabolic change hypothesis attributes weight gain to a metabolic alteration and subsequent decrease in basic caloric needs. Caloric intake and weight changes were tabulated for men who quit smoking and were compared to similar changes in men who continued smoking over 12 months. The difference between caloric intake changes in men quitting smoking versus men continuing smoking, controlled for weight change, was attributed to the metabolic change hypothesis. Men who quit smoking consumed 103 calories per day less (95% confidence interval = 29 to 177) than men who continued smoking with similar body weight changes. The decrease in caloric intake attributed to smoking cessation was proportional to the number of cigarettes smoked prior to cessation [corrected].

Adult↗
PubMed1991

Implications of obesity for cardiovascular disease in blacks: the CARDIA and ARIC studies.

To examine the relation of obesity to cardiovascular disease in blacks, we analyzed data from two population studies, including young and middle-aged adults. Obesity, defined by using the sum of subscapular and triceps skinfold measurements, was positively associated with atherogenic plasma lipids, systolic blood pressure, serum glucose and insulin, and prevalence of diabetes mellitus. The strength of these associations, for the most part, was similar in blacks and whites. However, with each unit increase in sum of skinfold thicknesses, plasma triglyceride concentrations in blacks appeared to increase only one-third to one-half as much as in whites. Prevalence of cardiovascular disease in 45- to 65-y-old blacks was associated with obesity; the odds ratio (95% confidence interval), adjusted for age and cigarette smoking, was 1.3 (0.9, 1.8) in both black men and black women. Additional analyses showed that abdominal adiposity conferred increased risk. These findings suggest that both blacks and whites should avoid excess adiposity.

Adolescent↗
PubMed1991

Meat consumption and its associations with other diet and health factors in young adults: the CARDIA study.

Using cross-sectional data from the longitudinal Coronary Artery Risk Development in Young Adults (CARDIA) study, we assessed associations between meat consumption and other dietary- and health-status indicators. Less than one percent of this sample (n = 32) ate no red meat or poultry, and another 1% (n = 47) ate red meat or poultry less than once per week. Individuals who ate red meat and poultry less than once per week were less likely to drink alcohol (P = 0.003); reported more physical activity (P less than or equal to 0.001); had lower [corrected] Keys scores (P less than or equal to 0.001); consumed diets higher in carbohydrates, starch, fiber, vitamins A and C, and calcium and lower in energy, fat, and protein (P less than or equal to 0.001); had smaller body sizes as indicated by the body mass index [calculated as wt(kg)/ht(m2)] (P = 0.01); and had lower concentrations of total serum cholesterol (P = 0.001), low-density-lipoprotein cholesterol (P = 0.001), and triglycerides (P = 0.015) compared with individuals who consumed meat more frequently.

Adult↗
PubMed1991

Relation of risk factor levels in young adulthood to parental history of disease. The CARDIA study.

BACKGROUND: The relation between self-reported parental disease and risk factor levels was examined in 2,637 black and 2,478 white men and women aged 18-30 years at the Coronary Artery Risk Development in Young Adults (CARDIA) Study baseline examination (1985-1986). METHODS AND RESULTS: The prevalence of parental disease (at least one parent) in white versus black participants was 44% and 56% for hypertension, 47% and 44% for obesity, 16% and 13% for myocardial infarction, 11% and 17% for diabetes, and 6% and 10% for stroke, respectively. Among these young adults, parental hypertension was associated with higher sex- and age-adjusted systolic and diastolic blood pressure levels. Parental myocardial infarction was associated with higher plasma cholesterol, higher blood pressure levels, and lower high density lipoprotein cholesterol levels in white participants. Parental diabetes was associated with higher fasting blood glucose and insulin levels in all race-sex groups and with higher triglycerides and lower high density lipoprotein cholesterol in black participants only. Parental history of obesity was related to less favorable age- and sex-adjusted lipid levels in white participants and higher blood pressure levels in black participants. Parental history of stroke was associated with higher systolic blood pressure levels in black participants. In general, these differences across family history were predicted only in part by obesity. The prevalence of more than one disease reported in parents occurred more frequently than would have been expected due to chance alone. CONCLUSIONS: These associations between parental disease and risk factors in their adult children probably reflects the impact of both environmental and genetic factors. Parental history may be a useful marker for high risk individuals.

Adult↗
PubMed1991

Etiology of drinking and driving among adolescents: implications for primary prevention.

A prospective study was conducted to investigate what factors are predictive of self-reported drinking and driving (DD) among adolescents. The study employs a theoretical framework taken from Problem Behavior Theory; environmental, personality, and behavioral factors are explored for their predictability of DD. A cohort of 1482 high school students completed a written survey in spring of 1986 and again in fall of 1986. The findings confirm that Problem Behavior Theory provides a useful theoretical framework with which to identify etiological factors predictive of DD among adolescents. Identified personality, perceived environmental, behavioral, and demographic factors accounted for approximately 50% of the reported variance in DD at baseline. The same factors accounted for approximately 40% percent of the variance in follow-up DD and were predictive both among the students who did not drink and drive at baseline (incidence cases), and among those students who did drink and drive at baseline (continuation versus discontinuation of the behavior). Based on these etiological data, we recommend that school-based, peer-led educational prevention programs be designed to reach young adolescents prior to the age at which a driver's license is obtained. We further recommend that the programs be broad-based and consider DD within the larger context of drinking and driving related behaviors and traffic safety in general.

Adolescent↗
PubMed1991

Pulmonary function and cardiovascular risk factor relationships in black and in white young men and women. The CARDIA Study.

Pulmonary function is known to be related inversely to incidence of coronary heart disease, congestive heart failure, chronic obstructive lung disease, lung cancer, and death from all causes. Reasons for some of these associations are poorly understood. Relationships between cardiovascular disease risk factors and pulmonary function were examined in 5,115 18- to 30-year-old black and white male and female participants in the study of Coronary Artery Risk Development in Young Adults (CARDIA). Forced expiratory volume in 1 s adjusted for height (FEV1/Ht2) was significantly lower in smokers than nonsmokers and in persons who reported shortness of breath; FEV1/Ht2 was correlated positively with a history of strenuous physical activity, duration of exercise on the treadmill, and high-density lipoprotein cholesterol. It was associated negatively with skinfold thicknesses, serum triglycerides, fasting serum insulin, and the Cook Medley scale of hostility. The association between pulmonary function and heart disease risk may reflect associations with physical fitness, vigor, fatness, and lipid profiles, as well as with cigarette smoking.

Adolescent↗