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Biomedical subjects

Julie A Marshall

Publications and source records attributed to Julie A Marshall.

15 recordsLinked to original sources
PubMed2006

Coaching process outcomes of a family visit nutrition and physical activity intervention.

The purpose of this article is to report the process outcomes of a coaching methodology used in a study designed to increase fruit and vegetable consumption and physical activity in families. Eighty-eight families with second graders were recruited from a rural, biethnic community in Colorado and randomized to intervention and delayed intervention conditions. This article reports on the 27 families in the delayed intervention group. Families received up to 10 home visits over 10 months from a family advisor and completed activities to improve their dietary and physical activity behaviors. Coaching conversations took place during each home visit. Coaching process outcomes were evaluated by analysis of visit documentation, participant survey, and qualitative interviews. Results indicated that coaching, in conjunction with family activities, engaged families in the process of change and facilitated movement toward the achievement of their weekly nutrition or physical activity goals. Coaching methodology may be particularly useful for participatory research.

Colorado↗
PubMed2006

Genetic and physiologic correlates of longitudinal immunoreactive trypsinogen decline in infants with cystic fibrosis identified through newborn screening.

OBJECTIVES: To characterize the time course and physiologic significance of decline in serum immunoreactive trypsinogen (IRT) levels in infants with cystic fibrosis (CF) by mode of diagnosis and genotype, and to examine IRT heritability. STUDY DESIGN: We studied longitudinal IRT measurements in 317 children with CF. We developed statistical models to describe IRT decline. Pancreatic disease severity (Mild or Severe) was assigned using CF genotype and was confirmed in 47 infants through fat malabsorption studies. RESULTS: Infants with severe disease exhibited IRT decline with non-detectable levels typically seen by 5 years of age. Infants with mild disease exhibited a decline in the first 2 years, asymptomatically approaching a level greater than published norms. IRT and fecal fat were inversely correlated. IRT values in infants with meconium ileus (MI) were significantly lower than newborn-screened infants at birth. The high proportion of shared variation in predicted IRT values among sibling pairs with severe disease suggests that IRT is heritable. CONCLUSIONS: IRT declines characteristically in infants with CF. Lower IRT values in newborns with MI suggest increased pancreatic injury. Furthermore, IRT is heritable among patients with severe disease suggesting genetic modifiers of early CF pancreatic injury. This study demonstrates heritability of a statistically modeled quantitative phenotype.

Biomarkers↗
PubMed2005

The C161-->T polymorphism in peroxisome proliferator-activated receptor gamma, but not P12A, is associated with insulin resistance in Hispanic and non-Hispanic white women: evidence for another functional variant in peroxisome proliferator-activated receptor gamma.

The P12A variant in the peroxisome proliferator-activated receptor gamma (PPARgamma) gene has been intensely studied for association with obesity-related or type-2 diabetes-related traits; however, the results have been somewhat inconsistent in different populations. We genotyped a large cohort of Hispanic and non-Hispanic white individuals from the San Luis Valley Diabetes Study for P12A and another common variant, C161-->T, in the PPARgamma gene to determine if these sites were associated with fasting glucose, insulin, free fatty acid levels, insulin sensitivity, or body fat. There were no statistically significant frequency differences at these two sites between Hispanic and non-Hispanic individuals. No significant association with the metabolic phenotypes was observed for either of the polymorphisms in men; however, in women, significant associations were shown between the C161-->T variant and fasting insulin (P=.008) and the homeostasis model assessment of insulin resistance (HOMA IR; P=.007). After adjusting for age, smoking, fat mass, and skin reflectance, linear regression showed that C161-->T explained 1.5% of the variation in both fasting insulin (P=.031) and HOMA IR (P=.028) whereas P12A contributed only 0.04% (fasting insulin, P=.268) and 0.02% (HOMA IR, P=.418) to the total trait variation. In the San Luis Valley Diabetes Study female patients, C161-->T appears to be a better predictor of fasting insulin levels and insulin resistance than P12A although the effect of this variant is small. These results support the hypothesis that C161-->T is in linkage disequilibrium with unidentified functional variation in PPARgamma or in a linked gene. This could explain some of the inconsistencies in the P12A association studies as the allele frequency and level of linkage disequilibrium of another functional polymorphism in the region could vary in different populations.

Colorado↗
PubMed2005

Physical activity in older, rural, Hispanic, and non-Hispanic white adults.

PURPOSE: Understanding variations in physical activity patterns is important for planning health interventions. This study describes age-related change in physical activity in 903 rural Hispanic and non-Hispanic white (NHW) adults age 55-80. METHODS: The Physical Activity History assessed 13 categories of productive and recreational activity during the past year with up to four assessments per participant from 1987 to 1998. RESULTS: The most common activities were walking and home maintenance/gardening. Productive and recreational physical activity levels were lower in women than men (P < 0.0001), and within each gender group Hispanics had lower levels of both activity types than NHW (P values less than 0.05). In men, productive activity steadily declined with age in NHW and Hispanics. Recreational activity increased slightly until age 63, then decreased after age 70. In women, productive activity initially stayed stable then decreased in NHW after age 63, and in Hispanics it decreased at younger ages before stabilizing after age 70. Recreational activity levels decreased steadily with age in all women, with a steeper rate of decline in NHW than Hispanics. In both ethnic groups, activity levels were lower in diabetics than nondiabetics, except for recreational activity in women where levels did not differ by diabetes status. CONCLUSIONS: The most common activities were similar to other studies of older adults, both recreational and productive activities contributed to total activity, and physical activity decreased in all gender-ethnic subgroups with age. Hispanic women reported the lowest activity levels. Interventions to maintain or increase recreational activity may need to target women at an earlier age than men.

Aged↗
PubMed2004

Genetic variation in fatty acid-binding protein-4 and peroxisome proliferator-activated receptor gamma interactively influence insulin sensitivity and body composition in males.

Obesity and type 2 diabetes are closely related, multifactorial metabolic conditions characterized by alterations in energy metabolism and glucose homeostasis, respectively. Peroxisome proliferator-activated receptor gamma (PPARgamma) is a ligand-dependent transcription factor that regulates genes involved in lipid and glucose homeostasis, including the adipocyte-specific fatty acid-binding protein (FABP4). In turn, FABP4 binds fatty acids and transports them to the nucleus where the FABP4/fatty acid complex activates PPARgamma in a positive feedback loop. In this study, we tested the hypothesis that the polymorphisms, FABP4-376 and PPARgamma Pro12Ala, interactively influence insulin sensitivity and body composition in nondiabetic, Hispanic and non-Hispanic white males (n = 314) participating in the San Luis Valley Diabetes Study (SLVDS). Although the individual sites were not statistically significantly associated with any of the outcomes, we found statistically significant interaction terms in 2-way analysis of covariance (ANCOVA) models for homeostasis model assessment of insulin resistance (HOMA-IR) (P =.014) and lean mass (P =.019). While the PPARgamma Pro12Ala site was the only statistically significant predictor of fat mass in the 2-way model (P =.012), the FABP4 and PPARgamma main effect terms individually became stronger when considered in one model compared with the analysis of each polymorphism separately. These findings provide evidence that FABP4 and PPARgamma work together to influence a biologic pathway affecting insulin sensitivity and body composition, illustrating the importance of investigating the joint effect of genes in determining susceptibility for complex disease.

Adult↗
PubMed2004

Genetic variation in uncoupling protein 3 is associated with dietary intake and body composition in females.

The uncoupling proteins (UCPs) are a family of mitochondrial transport proteins that promote proton leakage across the inner mitochondrial membrane, uncoupling oxidative phosphorylation from adenosine triphosphate (ATP) production and releasing energy as heat. Variation in these genes may disrupt biochemical pathways influencing thermogenesis, energy metabolism, and fuel substrate partitioning and oxidation, which may in turn predispose to obesity. We genotyped polymorphisms in UCP2 and UCP3 in a sample of nondiabetic participants (n = 722) of the San Luis Valley Diabetes Study (SLVDS) and found female-specific associations between UCP3 polymorphisms and measures of dietary intake and body composition. The UCP3-5 variant was statistically significantly associated with total caloric intake (P =.012), fat intake (P =.011), fat mass (P =.004), and lean mass (P =.013), with the C allele corresponding to higher dietary intake and lower fat mass and lean mass. The UCP3p-55 and the UCP3-3 polymorphisms, which were in high linkage disequilibrium (D' = 0.9776), showed similar patterns of association with total caloric intake (P =.031 and P =.042, respectively) and lean mass (P =.035 and P =.059, respectively), with the rare alleles corresponding to higher total intake and lean mass. No statistically significant associations were detected between the outcome variables and polymorphisms in UCP2. Two-way analysis of covariance (ANCOVA), used to evaluate the multi-locus effects and interactions between UCP3-5 and UCP3p-55, showed association with the main effect terms, but no evidence for statistically significant interaction between UCP3-5 and UCP3p-55 in regard to dietary intake. The UCP3-5 polymorphism was the only statistically significant genetic predictor of fat mass. The lean mass model showed no statistically significant association with either UCP3 variant. These results support a role for UCP3 in fuel substrate management and energy metabolism, which may influence body weight regulation.

Alleles↗
PubMed2003

Association of a woman's own birth weight with her subsequent risk for pregnancy-induced hypertension.

Studies have linked low birth weight to elevated risk for adult hypertension and insulin resistance. However, the relation between birth weight and later risk for pregnancy-induced hypertension (PIH), a disorder associated with insulin resistance and predictive of chronic hypertension, has not been well studied. This case-control study used linked hospital discharge and vital record data from New York State. Subjects were healthy women born in New York State who completed a first pregnancy there between 1994 and 1998. Records from each woman's own birth (1970-1985) were linked to those from her first pregnancy. Cases were 2,180 women diagnosed with PIH. Controls were the 22,955 remaining women with no record of PIH. Birth weight showed a U-shaped relation to risk for PIH, with the highest risks associated with very low and very high birth weights. Relative to women born at 3.5-4.0 kg, odds ratios adjusted for gestational age were 2.1 (95% confidence interval (CI): 1.1, 3.9) and 1.6 (95% CI: 1.1, 2.4), respectively, for women with birth weights less than 1.5 kg and greater than 4.5 kg. Adjustment for other perinatal factors reduced the association with high birth weight to 1.1 (95% CI: 0.7, 1.7) but strengthened that with lower birth weights, leaving a strong, inverse relation between birth weight and PIH risk (p for trend < 0.0001). These findings support a possible role for early life factors, particularly fetal growth, in the etiology of PIH.

Adolescent↗
PubMed2003

Variation in the FABP2 promoter alters transcriptional activity and is associated with body composition and plasma lipid levels.

The fatty acid-binding proteins (FABPs) are cytoplasmic proteins involved in intracellular fatty acid transport and metabolism. FABP2, the intestinal-type FABP, is expressed exclusively in enterocytes in the small intestine. In previous studies of an Ala54Thr substitution in FABP2, the Thr-allele showed association with increased lipid oxidation, elevated plasma lipids, and impaired insulin sensitivity. We screened roughly 1 kb 5' of the FABP2 initiation codon and identified three insertion/deletion polymorphisms and four single nucleotide polymorphisms (SNPs). Three of the SNPs were in complete linkage disequilibrium with the three insertion/deletion polymorphisms, defining exactly two haplotypes (FABP2p-ID). We tested the hypothesis that this variation alters gene expression by transfecting Caco-2 cells with pGL3-Basic constructs containing opposite FABP2p-ID haplotypes. Luciferase assays showed a statistically significant two-fold increase in gene expression of the pGL3-insertion construct over the pGL3-deletion construct (P<0.001; n=5). We also tested for association between three FABP2 variants and measurements of body composition, plasma lipids, and insulin sensitivity in non-diabetic control subjects from the San Luis Valley Diabetes Study (n=714). The only informative variant, FABP2p-ID, was statistically significantly associated with body mass index (P=0.042) and marginally associated with fat mass (P=0.084), cholesterol (P=0.066), and HOMA IR (a derived measure of insulin resistance; P=0.062) in the entire cohort. Similar associations were seen only in non-Hispanics when the analysis was stratified by ethnicity. Within the non-Hispanic subgroup, the effects of FABP2p-ID on plasma lipids were sex-specific. These results suggest that genetic variation in the 5' region of FABP2 affects transcriptional activity, presumably leading to alterations in body composition and lipid processing.

Analysis of Variance↗
PubMed2003

Validation of a food frequency questionnaire in preschool children.

BACKGROUND: Support for the validity of food frequency questionnaires (FFQ) in preschool children using parental report is limited. METHODS: We obtained dietary information for 68 children age 1-3 years using three or four 24-hour recalls and a FFQ regarding the child's diet covering one year from families in Denver, CO from 1997 to 1999. FFQs were completed by the parents, and recalls were collected via interviews with the parents and alternate caregivers, where applicable. Nutrient biomarkers were measured in the plasma of 38 of the children. All nutrients were adjusted for energy intake using residuals, and log-transformed where necessary. RESULTS: Correlations (Pearson r) between the FFQ and the average of the recalls were 0.33 for protein, 0.41 for carbohydrate, 0.39 for fat, 0.42 for vitamin C, 0.27 for alpha-tocopherol, and 0.08 for total energy intake. We found no substantial changes in these correlations after stratification by whether or not meals and snacks were provided by caregivers other than the parents. The highest correlations (Spearman r) with biological measures were 0.51 between plasma ascorbic acid and FFQ vitamin C, and 0.48 between plasma and FFQ alpha-tocopherol. CONCLUSIONS: The FFQ shows mostly good agreements with multiple 24-hour recalls and biomarkers in preschool children. In addition, the validity of the FFQ using parental report does not appear to be compromised when there are meal providers in addition to the parents.

Biomarkers↗
PubMed2002

Active site mapping and substrate channeling in the sterol methyltransferase pathway.

Sterol methyltransferase (SMT) from Saccharomyces cerevisiae was purified from Escherichia coli BL21(DE3) and labeled with the mechanism-based irreversible inhibitor [3-3H]26,27-dehydrozymosterol (26,27-DHZ). A 5-kDa tryptic digest peptide fragment containing six acidic residues at positions Glu-64, Asp-65, Glu-68, Asp-79, Glu-82, and Glu-98 was determined to contain the substrate analog covalently attached to Glu-68 by Edman sequencing and radioanalysis using C18 reverse phase high performance liquid chromatography. Site-directed mutagenesis of the six acidic residues to leucine followed by activity assay of the purified mutants confirmed Glu-68 as the only residue to participate in affinity labeling. Equilibration studies indicated that zymosterol and 26,27-DHZ were bound to native and the E68L mutant with similar affinity, whereas S-adenosylmethionine was bound only to the native SMT, K(d) of about 2 microm. Analysis of the incubation products of the wild-type and six leucine mutants by GC-MS demonstrated that zymosterol was converted to fecosterol, 26,27-DHZ was converted to 26-homo-cholesta-8(9),23(24)E,26(26')-trienol as well as 26-homocholesta-8(9),26(26')-3beta,24beta-dienol, and in the case of D79L and E82L mutants, zymosterol was also converted to a new product, 24-methylzymosta-8,25(27)-dienol. The structures of the methylenecyclopropane ring-opened olefins were determined unambiguously by a combination of (1)H and (13)C NMR techniques. A K(m) of 15 microm, K(cat) of 8 x 10(-4) s(-1), and partition ratio of 0.03 was established for 26,27-DHZ, suggesting that the methylenecyclopropane can serve as a lead structure for a new class of antifungal agents. Taken together, partitioning that leads to loss of enzyme function is the result of 26,27-DHZ catalysis forming a highly reactive cationic intermediate that interacts with the enzyme in a region normally not occupied by the zymosterol high energy intermediate as a consequence of less than perfect control. Alternatively, the gain in enzyme function resulting from the production of a delta(25(27))-olefin originates with the leucine substitution directing substrate channeling along different reaction channels in a similar region at the active site.

Amino Acid Sequence↗
PubMed2002

Association of a woman's own birth weight with subsequent risk for gestational diabetes.

CONTEXT: Several studies have reported links between reduced fetal growth and subsequent risk for type 2 diabetes among older adults, but the association between indices of fetal growth and gestational diabetes mellitus (GDM), a major complication of pregnancy and a strong predictor of type 2 diabetes, remains little explored. OBJECTIVE: To test the hypothesis that a woman's own fetal growth is inversely related to her later risk for GDM. DESIGN AND SETTING: Case-control study of linked hospital discharge and vital record data from the New York State Department of Health. POPULATION: Healthy women who completed their first pregnancies in New York State between 1994 and 1998 and who were also born in New York State. Records from each woman's first pregnancy were linked to those from her own birth (1970-1985). Cases were 440 women with a record of GDM. Controls were 22 955 remaining women with no indication of GDM. MAIN OUTCOME MEASURE: A woman's own birth weight, alone and adjusted for gestational age. RESULTS: Birth weight showed a U-shaped relationship to a woman's risk of GDM in her first pregnancy, with the highest risks associated with low and high birth weights. Odds ratios (ORs) adjusted for gestational age were 2.16 (95% confidence interval [CI], 1.04-4.50) for birth weight of less than 2000 g and 1.53 (95% CI, 1.03-2.27) for a birth weight of 4000 g or more. Adjustment for potential confounding factors, particularly prepregnancy body mass index and maternal diabetes, increased the OR for low birth weight to 4.23 (95% CI, 1.55-11.51), but reduced the OR for high birth weight to 0.92 (95% CI, 0.54-1.57), leaving a strong inverse dose-response relationship between birth weight and risk of GDM (adjusted P for trend <.001). CONCLUSIONS: In this large population-based study, a woman's own birth weight was strongly and inversely related to her risk of GDM, suggesting that early life factors may be important in the etiology of this disorder.

Adolescent↗
PubMed2002

Home and eating environments are associated with saturated fat intake in children in rural West Virginia.

OBJECTIVE: To describe sociodemographic, environmental, and knowledge factors in relation to self-reported, energy-adjusted saturated fat consumption among children in rural West Virginia. PARTICIPANTS: Three hundred twenty-five 5th graders who participated in the Coronary Artery Risk Detection in Appalachian Communities Project conducted in 3 rural counties in West Virginia in 1998-1999. METHODS: A cross-sectional survey based on self-reported information collected using a food frequency questionnaire, a nutrition knowledge questionnaire, and a family composition questionnaire. STATISTICAL ANALYSES: Descriptive statistics and multiple linear regression analysis. RESULTS: The mean percentage of energy from total fat was 31.8% +/- 4.9 and from saturated fat was 11.8% +/- 2.3. Energy-adjusted saturated fat intake was significantly higher among children with higher frequencies of breakfast and late-night snacks prepared away from home, and in households with single mothers. Variables associated with higher energy-adjusted saturated fat intake with marginal statistical significance (P=.05-.10) included attendance at schools with a higher percentage of students receiving free or reduced-price lunch, usual breakfast location other than home or school, and less knowledge about low-fat, low-sodium foods. Frequent late-night snacks prepared away from home and living with single mothers remained as significant correlates of energy-adjusted saturated fat intake independent of other hypothesized determinants. CONCLUSION: Efforts to reduce saturated fat intake among children in rural areas should focus on food prepared away from home. Nutrition-related behaviors of single mothers should be explored further.

Child↗
PubMedDate not supplied

Adapting and implementing a long-term nutrition and physical activity curriculum to a rural, low-income, biethnic community.

This study adapted an urban-based school nutrition program for delivery in a rural community. Specific aims were to adapt the curriculum; expand it to include physical activity; determine effectiveness on students' attitudes, knowledge, and self-efficacy; and assess teachers' impressions. Three cohorts were established: 173 students taught by a resource teacher, 170 students taught by classroom teachers, and 187 students who did not receive the curriculum. Pre- and posttest surveys measured outcomes, and classroom teachers were observed and interviewed. The curriculum was shown to be effective in enhancing student outcomes for both the resource teacher and classroom teacher cohorts. Teachers reported that lessons needed to be simplified and that children enjoyed them. Findings support the transferability of an urban-based nutrition curriculum to a rural community and the need for students to receive health education annually.

Child↗
PubMedDate not supplied

Using ethnography to improve intervention design.

PURPOSE: The purpose of this research was to use a three-phase ethnographic approach to examine the range of factors that affect people's decisions about physical activity and diet. DESIGN: We used open-ended data collection strategies, analyzed inductively, to inform, the development of a family intervention. SETTING: The study was conducted in a small low-income town in Colorado. SUBJECTS: Families with young children were selected to include social, economic, and ethnic diversity. Twenty-nine of 31 invited families participated (94%). MEASURES: The measures consisted of 21 open-ended interviews in the first phase; 12 semistructured interviews in the second phase, and six home visits in the third phase. The Atlas.ti program25 was used for data analysis. RESULTS: Significant barriers to regular exercise and good dietary habits were grouped as social/structural (e.g., working parents, costs of exercise) and cultural (e.g., perception that fast food is normal). Behavioral facilitators include disease in the family and community opportunities for exercise. Results revealed family values and dynamics that other methods would have missed. CONCLUSIONS: These data suggest that families are embedded in a multicomponent "web" of factors that influence diet and physical activity. It is feasible and desirable to use ethnographic methods to discern the interactions of these factors that make each household unique. These results argue for dynamic intervention designs that operate from a broad contextual perspective.

Adult↗