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Biomedical subjects

J H Himes

Publications and source records attributed to J H Himes.

At least 19 recordsLinked to original sources
PubMed2001

A randomized trial of a brief intervention to increase fruit and vegetable intake: a replication study among callers to the CIS.

BACKGROUND: Results are reported from a large randomized trial designed to increase fruit and vegetable consumption among callers to the National Cancer Institute's Cancer Information Service (CIS) (n = 1,717). METHODS: CIS callers assigned to the intervention group (n = 861) received a brief proactive educational intervention over the telephone at the end of usual service, with two follow-up mailouts. Key educational messages and print material derived from the NCI 5 A Day for Better Health program were provided to intervention participants. Participants were interviewed by telephone at 4 weeks (n = 1,307), 4 months (n = 1,180), and 12 months for follow-up (n = 1,016). RESULTS: Results obtained from a single-item measure of fruit and vegetable consumption indicate a significant intervention effect of 0.88 servings per day at 4 weeks follow-up (P < 0.001), 0.63 servings per day at 4 months follow-up (P < 0.001), and 0.43 servings per day at 12 months follow-up (P < 0.001). Using a 7-item food frequency measure, an intervention effect of 0.63 servings per day was obtained at 4 weeks follow-up (P < 0.001), compared with 0.39 servings per day at 4 months follow-up (P = 0.002) and 0.44 servings per day at 12 months follow-up (P = 0.002). A 24-h recall assessment included in the 4-month interviews also yielded a significant intervention effect of 0.67 servings per day (P = 0.015). The vast majority of callers (90%) endorsed the strategy of providing 5 A Day information proactively within the CIS. CONCLUSIONS: This brief educational intervention was associated with higher levels of self-reported fruit and vegetable intake at both short- and long-term follow-up. Additional research is recommended to test this or a similar intervention in diverse populations.

Adult↗
PubMed2000

Differences and trends in antioxidant dietary intake in smokers and non-smokers, 1980-1992: the Minnesota Heart Survey.

PURPOSE: Differences and secular trends in dietary antioxidant vitamin intake (vitamins E, C, and beta-carotene) in current non-smokers, light smokers, and heavy smokers were examined as part of the Minnesota Heart Survey. METHODS: Three cross-sectional surveys were conducted in adults ages 25-74 years in 1980-82 (N = 1682), 1985-87 (N = 2326), and 1990-92 (N = 2487). Dietary information was obtained from a 24-hour dietary recall. Smoking was assessed through self-report. Intakes were adjusted for age, energy intake, body mass index, education level, and exercise level (vitamins E, C and beta-carotene). RESULTS: Antioxidant vitamin intakes were significantly higher in non-smokers than in light (1-20 cig/day) and heavy smokers (>20 cig/day) when all three survey periods were combined. In men, mean vitamin E intake was 9.2 mg, 8.6 mg, and 7.8 mg for non-smokers, light smokers, and heavy smokers, respectively. Results were similar in men for beta-carotene (non-smokers 1408 microg, light smokers 1287 microg, and heavy smokers 1064 microg), and vitamin C (non-smokers 81 mg, light smokers 67 mg, and heavy smokers 56 mg). Women had results of similar magnitude and direction. From 1980-92, secular trends in men showed non-significant increases from 1980-82 to 1990-92 in beta-carotene (+6.1%), while decreases were observed in vitamins E (-1.1%) and C (-2.6%). In contrast, women had large decreases in all antioxidant vitamin intakes: vitamin E (-13%), vitamin C (-18.6%), and beta-carotene (-16.2%). CONCLUSIONS: Light and heavy smokers had a significantly lower overall mean dietary antioxidant vitamin intake than non-smokers. Over the decade, antioxidant dietary intake remained relatively stable in men and decreased in women in Minneapolis-St. Paul, despite improvements in access to antioxidant rich fruits and vegetables.

Adult↗
PubMed2000

Associations of periodontal disease with femoral bone mineral density and estrogen replacement therapy: cross-sectional evaluation of US adults from NHANES III.

The objectives of this study were to evaluate the possible association of periodontal disease with (1) femoral bone mineral density (BMD), and (2) estrogen replacement therapy in a large sample of US adults (N= 11,655). The mean clinical attachment loss (CAL) per person was the main outcome variable. Based on the total BMD of the proximal femur and using the WHO diagnostic criteria, subjects were classified as having osteoporosis, osteopenia, or normal BMD. After adjusting for confounders, females with high calculus scores and low BMD had significantly more CAL than females with normal BMD and similar calculus scores (p<0.0001). No association was observed among women with low and intermediate levels of calculus. The greater CAL present among women with low BMD was associated with gingival recession. Patterns of findings were similar but equivocal among men, of whom only 66 were osteoporotic. After adjustment for possible confounders, postmenopausal women who reported having used estrogen replacement therapy presented significantly less mean CAL than those who never used estrogen. These findings indicate that in the presence of high calculus scores, females with osteoporosis are at increased risk for attachment loss and that this risk may be attenuated by the use of estrogen replacement therapy.

Adult↗
PubMed2000

Estimation of body fat from anthropometry and bioelectrical impedance in Native American children.

OBJECTIVE: Obesity, as measured by body mass index, is highly prevalent in Native American children, yet there are no valid equations to estimate total body fatness for this population. This study was designed to develop equations to estimate percentage body fat from anthropometry and bioelectrical impedance as a critical part of Pathways, a multi-site study of primary prevention of obesity in Native American children. DESIGN: Percentage fat was estimated from deuterium oxide dilution in 98 Native American children (Pima/Maricopa, Tohono O'odham and White Mountain Apache tribes) between 8 and 11 y of age. The mean fat content (38.4%+/-8. 1%) was calculated assuming the water content of the fat-free body was 76%. Initial independent variables were height, weight, waist circumference, six skinfolds and whole-body resistance and reactance from bioelectrical impedance (BIA). RESULTS: Using all-possible-subsets regressions with the Mallows C (p) criterion, and with age and sex included in each regression model, waist circumference, calf and biceps skinfolds contributed least to the multiple regression analysis. The combination of weight, two skinfolds (any two out of the four best: triceps, suprailiac, subscapular and abdomen) and bioelectrical impedance variables provided excellent predictability. Equations without BIA variables yielded r2 almost as high as those with BIA variables. The recommended equation predicts percentage fat with a root mean square error=3.2% fat and an adjusted r2=0.840. CONCLUSION: The combination of anthropometry and BIA variables can be used to estimate total body fat in field studies of Native American children. The derived equation yields considerably higher percentage fat values than other skinfold equations in children.

Adipose Tissue↗
PubMed1999

1994-1996 U.S. singleton birth weight percentiles for gestational age by race, Hispanic origin, and gender.

OBJECTIVES: Establishing and comparing race, ethnic, and gender-specific birth weight percentiles for gestational age is requisite for investigating the determinants of variations in fetal growth. In this study, we calculate percentiles of birth weight for gestational age for the total 1994-1996 U.S. population and contrast these percentiles by racial/ethnic and gender groups. METHODS: Single live births to U.S. resident mothers were selected from the 1994-1996 U.S. Natality Files. After exclusions, 5,973,440 non-Hispanic Whites, 1,393,908 non-Hispanic African Americans, 1,683,333 Hispanics, 80,187 Native Americans, and 510,021 other racial/ethnic groups were used to calculate distribution percentiles of birth weight for each gestational age for which there were at least 50 cases to calculate the 50th percentile and 100 cases to calculate the 10th percentile. RESULTS: Fetal growth patterns among the four U.S. racial/ethnic groups varied markedly and, across the gestational age range, there was considerable oscillation in the relative ranking of any one group's birth weight percentile value in comparison to the others. Males had relatively higher birth weight percentile values than females. The proportion of infants with a birth weight value less than 1994-1996 U.S. population's 10th percentile value of birth weight for their corresponding gestational age was 7.87 for non-Hispanic Whites, 15.43 for non-Hispanic African Americans, 9.30 for Hispanics, and 8.81 for Native Americans. CONCLUSIONS: While the factors underlying trends and population subgroup differences in fetal growth are unclear, nutrition, smoking habits, health status, and maternal morbidity are possible precursors for part of the variations in patterns of fetal growth. As prenatal care has been touted as a means to reduce the risk of fetal growth restriction at term, assuring the availability and accessibility of comprehensive prenatal care services is viewed as an essential corollary in the effort to improve fetal growth patterns in the United States.

Black or African American↗
PubMed1999

Agreement among anthropometric indicators identifying the fattest adolescents.

Agreement was sought among six indicators used to classify youth as obese in 625 white youth, aged 12.0-18.0 y, who participated in the Third National Health and Nutrition Examination Survey. Indicators included body mass index (BMI), triceps and subscapular skinfolds, the sum of four skinfolds, waist circumference and percentage body fat determined by bioelectric impedance analysis (BIA). The fattest youth in each age and gender group were considered those > 80th centile for the indicator. Agreement was determined by kappa coefficients, which provide the chance-adjusted proportion of agreement in the upper quintiles to identify the same youth as the fattest. Kappas among indicators range from 0.57-0.85 for males and from 0.56-0.79 for females. Categorical agreement with the fattest youth by percentage body fat, changes considerably with age for most indicators, suggesting that relationships among indicators change during adolescence. Different indicators may identify different subpopulations as the fattest, arguing for caution in use and interpretation of results from different indicators, and in favour of standardized definitions for obesity in youth.

Adipose Tissue↗
PubMed1999

Prevalence of overweight and obesity in American Indian School children and adolescents in the Aberdeen area: a population study.

OBJECTIVES: This study estimated the prevalences of overweight and obesity in American Indian children and adolescents attending schools in the Aberdeen area Indian Health Service (including SD, ND, IA, NE). METHODS: Stature and weight were measured for 12559 children aged 5-17y and prevalences of overweight and obesity were determined relative to gender and age-specific national reference data for the body mass index (BMI). Those with BMI > 85th percentile were considered overweight and those with BMI > 95th percentile were considered obese. RESULTS: Age-adjusted prevalences of overweight were 39.1% and 38.0% for males and females, respectively, and corresponding age-adjusted prevalences for obesity were 22.0% and 18.0%, respectively. There were few regular changes in prevalences of overweight across ages for either gender, or for obesity in females. Prevalences of obesity in males increased systematically with age and exceed prevalences in females at many ages. CONCLUSIONS: Overweight and obesity based on elevated BMI are highly prevalent among American Indian youth. Even at the youngest school ages, overweight is more than twice as likely as national patterns and obesity is more than three times as prevalent. Primary prevention must begin very early among these children.

Adolescent↗
PubMed1999

Racial differences in birthweight for gestational age and infant mortality in extremely-low-risk US populations.

Using national data, we develop and contrast the birth-weight percentiles for gestational age by infants of extremely-low-risk (ELR) White and African-American women and examine racial differences in the proportion of small-for-gestational-age (SGA) births. We then scrutinise racial variations in infant mortality rates of the infants of ELR women. We further compare the infant mortality rates of infants at or below the 10th percentile of birthweight for gestational age of each race group to determine whether infants with similar restricted fetal growth have comparable risks of subsequent mortality. Single live births, 34-42 weeks' gestation, to White and African-American US-resident mothers were selected from the 1990-91 US Linked Live Birth--Infant Death File (n = 4,360,829). Extremely-low-risk mothers were defined as: married, aged 20-34 years, 13+ years of education, multiparae, with average parity for age, adequate prenatal care, vaginal delivery, and no reports of medical risk factors, tobacco use or alcohol use during pregnancy. Marked racial variation in birthweight percentiles by gestational age was evident. Compared with ELR White mothers, the risk of an SGA infant was 2.64 times greater for ELR African-American mothers and the risk of infant mortality was 1.61 times greater. For the ELR group, the infant mortality rates of African-American and White infants at or below the 10th percentile of birthweight for gestational age of their respective maternal race group were essentially identical after controlling for gestational age. In conclusion, race differences in fetal growth patterns remained after controlling for risk status. Efforts to remove racial disparities in infant mortality will need to develop aetiological pathways that can explain why African-Americans have relatively higher rates of preterm birth and higher infant mortality rates among term and non-SGA infants.

Adult↗
PubMed1999

Minimum time intervals for serial measurements of growth in recumbent length or stature of individual children.

A method is presented to estimate minimum time intervals for meaningful measurements of growth in recumbent length or stature on individual children. These intervals are based on the statistical features of growth, and consider the reliability of measurement, expected rates of growth, and variation in attained length or stature. Because of the assumptions used, the intervals should be considered as minima, except in some predictable cases. During the prepubescent period there are no differences in minimum intervals calculated for boys and girls. The intervals are shortest during the rapid growth attending infancy, and increase to 0.39 y (4.7 mo) at 8 y of age in boys and girls, and to 0.43 y (5.2 mo) at 10 y of age in boys. A reference curve of minimum intervals for length and stature during the prepubescent period is presented with an equation for more precise estimation of measurement intervals. To accommodate the pubescent growth spurt and its normal variation in timing, 0.5 y is recommended as the minimum interval during pubescence when the maturational timing of the child is unknown. These minimum measurement intervals should be appropriate for almost all individual children when growth in recumbent length or stature is measured serially.

Age Factors↗
PubMed1999

Design and statistical analysis for the Pathways study.

We report the design, rationale, and statistical procedures used in Pathways, a randomized, school-based intervention for the primary prevention of obesity in American Indian children. The intervention, which is now being implemented in 7 American Indian communities around the country, includes a health-promotion curriculum, a physical education program, a school meal program, and a family involvement component. Forty-one schools serving American Indian children were randomly assigned to be either intervention or control groups. The intervention will begin in the third grade and continue through the end of the fifth grade. Efficacy of intervention will be assessed by differences in mean percentage body fat, calculated by a prediction equation, between intervention and control schools at the end of the fifth grade. Power computations indicate that the study has power to detect a mean difference of 2.8% in body fat. Data analysis will use intention-to-treat concepts and the mixed linear model. The study will be completed in 2000.

Analysis of Variance↗
PubMed1999

Body composition assessment in American Indian children.

Although the high prevalence of obesity in American Indian children was documented in several surveys that used body mass index (BMI, in kg/m2) as the measure, there is limited information on more direct measurements of body adiposity in this population. The present study evaluated body composition in 81 boys (aged 11.2+/-0.6 y) and 75 girls (aged 11.0+/-0.4 y) attending public schools in 6 American Indian communities: White Mountain Apache, Pima, and Tohono O'Odham in Arizona; Oglala Lakota and Sicangu Lakota in South Dakota; and Navajo in New Mexico and Arizona. These communities were participating in the feasibility phase of Pathways, a multicenter intervention for the primary prevention of obesity. Body composition was estimated by using a combination of skinfold thickness and bioelectrical impedance measurements, with a prediction equation validated previously in this same population. The mean BMI was 20.4+/-4.2 for boys and 21.1+/-5.0 for girls. The sum of the triceps plus subscapular skinfold thicknesses averaged 28.6+/-7.0 mm in boys and 34.0+/-8.0 mm in girls. Mean percentage body fat was 35.6+/-6.9 in boys and 38.8+/-8.5 in girls. The results from this study confirmed the high prevalence of excess body fatness in school-age American Indian children and permitted the development of procedures, training, and quality control for measurement of the main outcome variable in the full-scale Pathways study.

Adipose Tissue↗
PubMed1998

Influence of diabetes during pregnancy on gestational age-specific newborn weight among US black and US white infants.

This study examined the impact of maternal diabetes on birth weight for gestational age patterns of all term black infants and white infants in the United States using data derived from the 1990-1991 US Live Birth File of the National Center for Health Statistics. Infants of both black mothers and white mothers exhibited the expected fetal overgrowth associated with maternal diabetes. However, the increase in birth weight was much greater in infants of black than white diabetic mothers in comparison with their nondiabetic counterparts, as measured by the discrepancy in birth weight between infants of diabetic and nondiabetic mothers at each gestational week, the incidence of large for gestational age, high birth weight, small for gestational age, and low birth weight. After adjustment for maternal hypertension, prenatal care use, and sociodemographic factors, the disparity in mean birth weight associated with diabetes was 211.67 g in black infants and 115.74 g in white infants. The adjusted odds ratios of birth weight > or = 4,000 g were 2.98 (95% confidence interval 2.89-3.12) for black infants and 1.83 (95% confidence interval 1.78-1.89) for white infants. Given the potential risks for mothers and infants consequent to maternal diabetes and fetal hyperinsulinemia, further investigation of the prevalence, characteristics, and outcomes of diabetes during pregnancy among black mothers and infants is warranted.

Adult↗
PubMed1998

School performance in adolescent Jamaican girls: associations with health, social and behavioural characteristics, and risk factors for dropout.

Health, nutrition and behavioural determinants of school achievement, attendance and dropout were examined in 452 girls aged 13-14 years, randomly selected from grade 8 in nine schools in inner-city Kingston, Jamaica. Girls who were anaemic, sexually active or aggressive had worse achievement levels. Better achievement levels were associated with possession of school materials and access to reading material outside of school. Poor attendance, early sexual activity, and not living with both parents predicted school dropout in the subsequent year. Strategies to reduce anaemia, to improve sex education and reduce the levels of aggression may benefit school performance.

Achievement↗
PubMed1997

Do children eat what they say? Validity of intended food choices among Native American school children.

OBJECTIVE: To examine the agreement between school children's intended food choices and observed food choices. DESIGN: Native American students in the second through fifth grade completed a questionnaire that asked them to select from 10 paired food choices for a given meal or snack. Three weeks later students chose among foods identical to those on the questionnaire as part of their usual school lunch or breakfast over three consecutive days; afternoon snacks were also offered. RESULTS: Agreement between students' intended food choices and observed food choices was examined across 10 food pairs. The composite kappa coefficient between intended and observed food choices was 0.09 (95% confidence interval 0.06, 0.012), including virtually no agreement above that expected by chance. There were no differences in agreement by sex or grade. CONCLUSIONS: Intended food choices were not significantly associated with observed food choices. It is unclear whether intended food choices reflect nutrition knowledge, socially desirable responses, food preferences, or some other dimension of eating behavior. Although responsive to school-based nutrition interventions, the interpretation of changes in intended food choices must be clarified in future research.

Child↗
PubMed1997

Covariations of eating behaviors with other health-related behaviors among adolescents.

PURPOSE: The study objectives are: (1) to examine and compare patterns of covariation of a wide range of health behaviors among adolescent boys and girls; (2) to determine whether eating behaviors are part of a larger construct of health-related behaviors and to identify the behaviors with which they share underlying similarities; and (3) to determine whether youth engaging in other health-compromising behaviors are at risk for unhealthy eating. METHODS: Data were analyzed from the Minnesota Adolescent Health Survey, a classroom-administered questionnaire, completed by 36,284 adolescents, in grades 7-12 from 1986-87. RESULTS: Among boys, factor analysis revealed five factors: (1) risk-taking behaviors, (2) school-related behaviors, (3) "quietly" disturbed behaviors (e.g., frequent dieting, self-induced vomiting, suicide attempts), (4) health-promoting behaviors; and (5) exercise. Eating behaviors loaded on the construct of health-promoting behaviors with brushing teeth and seat belt use. Among girls, four similar factors emerged; however, exercise loaded on the construct of health-promoting behaviors. Therefore, eating behaviors loaded with brushing teeth, seat belt use, and exercise among girls. Logistic regression analyses, controlling for sociodemographic and personal variables, revealed that boys and girls engaging in health-promoting behaviors were less likely to have unhealthy eating behaviors, while those engaging in quietly disturbed behaviors, risk-taking behaviors, and problematic school behaviors were more likely to have unhealthy eating behaviors. CONCLUSIONS: Eating behaviors appear to be part of a health-promoting behavioral construct and should not be viewed in isolation from other behaviors. Although eating behaviors do not appear to be part of the "problem behavior syndrome," youth engaging in a wide range of health-compromising behaviors are at risk for unhealthy eating; emphasizing the need to target high-risk youth with health promotion programs.

Adolescent↗
PubMed1997

A method to estimate prevalence of iron deficiency and iron deficiency anemia in adolescent Jamaican girls.

A method is presented to estimate a cutoff for hemoglobin concentration appropriate for estimating the prevalence of iron deficiency anemia in poor Jamaican girls 13-14 y of age. Iron deficiency was determined from a three-variable model of iron status (serum ferritin, erythrocyte protoporphyrin, and mean corpuscular volume). The most appropriate hemoglobin cutoff was considered the one that minimized misclassification of iron deficiency: that yielding the maximum kappa coefficient for correctly classifying iron deficiency between 100 and 120 g/L, at 1-g/L intervals. By using this method, a hemoglobin cutoff of 107 g/L was considered most appropriate. This cutoff and the other indicators were used to estimate prevalence of iron deficiency and iron deficiency anemia in the Jamaican girls: 7.6% and 4.3%, respectively. This approach should be appropriate for determining hemoglobin cutoffs for iron deficiency anemia in other populations.

Adolescent↗
PubMed1997

Bone mass and subsequent risk of hip fracture.

We examined prospectively the associations of bone density and bone dimensions with risk of hip fracture using data from the first National Health and Nutrition Examination Survey and its three follow-up studies. A cohort of 1,489 white women age 45 years or older who received detailed medical examinations in the baseline survey in 1971-1975 were subsequently contacted in 1982-1984, 1986, and 1987. Bone density and hand bone dimensions at several sites were measured at baseline. Fifty incident hip fractures were identified during the follow-up studies. Using Cox regression analyses, we found a relative risk of 11 for women with bone density below the 5th percentile, compared with those above the 75th percentile (95% confidence interval = 2.2-58). Women with smaller external bone dimensions also faced increased risk of hip fracture (relative risk = 4.6 for dimensions below the 5th percentile vs above the 75th percentile; 95% confidence interval = 1.5-14). On the other hand, internal bone dimensions were not associated materially with hip fracture.

Age Distribution↗