Biomedical subjects

K E Peterson

Publications and source records attributed to K E Peterson.

At least 19 recordsLinked to original sources

PubMed2001

Relation between consumption of sugar-sweetened drinks and childhood obesity: a prospective, observational analysis.

BACKGROUND: The rising prevalence of obesity in children has been linked in part to the consumption of sugar-sweetened drinks. Our aim was to examine this relation. METHODS: We enrolled 548 ethnically diverse schoolchildren (age 11.7 years, SD 0.8) from public schools in four Massachusetts communities, and studied them prospectively for 19 months from October, 1995, to May, 1997. We examined the association between baseline and change in consumption of sugar-sweetened drinks (the independent variables), and difference in measures of obesity, with linear and logistic regression analyses adjusted for potentially confounding variables and clustering of results within schools. FINDINGS: For each additional serving of sugar-sweetened drink consumed, both body mass index (BMI) (mean 0.24 kg/m2; 95% CI 0.10-0.39; p=0.03) and frequency of obesity (odds ratio 1.60; 95% CI 1.14-2.24; p=0.02) increased after adjustment for anthropometric, demographic, dietary, and lifestyle variables. Baseline consumption of sugar-sweetened drinks was also independently associated with change in BMI (mean 0.18 kg/m2 for each daily serving; 95% CI 0.09-0.27; p=0.02). INTERPRETATION: Consumption of sugar-sweetened drinks is associated with obesity in children.

Anthropometry↗

PubMed2001

Role of interleukin-4 (IL-4), IL-12, and gamma interferon in primary and vaccine-primed immune responses to Friend retrovirus infection.

The immunological resistance of a host to viral infections may be strongly influenced by cytokines such as interleukin-12 (IL-12) and gamma interferon (IFN-gamma), which promote T helper type 1 responses, and IL-4, which promotes T helper type 2 responses. We studied the role of these cytokines during primary and secondary immune responses against Friend retrovirus infections in mice. IL-4- and IL-12-deficient mice were comparable to wild-type B6 mice in the ability to control acute and persistent Friend virus infections. In contrast, more than one-third of the IFN-gamma-deficient mice were unable to maintain long-term control of Friend virus and developed gross splenomegaly with high virus loads. Immunization with a live attenuated vaccine virus prior to challenge protected all three types of cytokine-deficient mice from viremia and high levels of spleen virus despite the finding that the vaccinated IFN-gamma-deficient mice were unable to class switch from immunoglobulin M (IgM) to IgG virus-neutralizing antibodies. The results indicate that IFN-gamma plays an important role during primary immune responses against Friend virus but is dispensable during vaccine-primed secondary responses.

Animals↗

PubMed2001

Differences in cytokine and chemokine responses during neurological disease induced by polytropic murine retroviruses Map to separate regions of the viral envelope gene.

Infection of the central nervous system (CNS) by several viruses can lead to upregulation of proinflammatory cytokines and chemokines. In immunocompetent adults, these molecules induce prominent inflammatory infiltrates. However, with immunosuppressive retroviruses, such as human immunodeficiency virus (HIV), little CNS inflammation is observed yet proinflammatory cytokines and chemokines are still upregulated in some patients and may mediate pathogenesis. The present study examined expression of cytokines and chemokines in brain tissue of neonatal mice infected with virulent (Fr98) and avirulent (Fr54) polytropic murine retroviruses. While both viruses infect microglia and endothelia primarily in the white matter areas of the CNS, only Fr98 induces clinical CNS disease. The pathology consists of gliosis with minimal morphological changes and no inflammation, similar to HIV. In the present experiments, mice infected with Fr98 had increased cerebellar mRNA levels of proinflammatory cytokines tumor necrosis factor alpha (TNF-alpha), TNF-beta, and interleukin-1 alpha and chemokines macrophage inflammatory protein-1 alpha (MIP-1 alpha), MIP-1 beta, monocyte chemoattractant protein 1 (MCP-1), gamma-interferon-inducible protein 10 (IP-10), and RANTES compared to mice infected with Fr54 or mock-infected controls. The increased expression of these genes occurred prior to the development of clinical symptoms, suggesting that these cytokines and chemokines might be involved in induction of neuropathogenesis. Two separate regions of the Fr98 envelope gene are associated with neurovirulence. CNS disease associated with the N-terminal portion of the Fr98 env gene was preceded by upregulation of cytokines and chemokines. In contrast, disease associated with the central region of the Fr98 env gene showed no upregulation of cytokines or chemokines and thus did not require increased expression of these genes for disease induction.

Animals↗

PubMed2001

Head lice resistance: itching that just won't stop.

OBJECTIVE: To evaluate the reports of resistance and cross-resistance to pediculicides in the head louse (Pediculus capitis), as well as the mechanisms involved. DATA SOURCES: Literature identified through a MEDLINE search (1966-April 2000) and through other secondary literature databases and/or bibliographies of pertinent articles. DATA SYNTHESIS: Head lice infestation is a common, worldwide problem. The widespread use of insecticide treatments together with inadequate treatment methods has led to a concern regarding the potential development of resistant head lice. This literature review examines the reports of resistance of the head louse as well as the purported mechanisms involved. CONCLUSIONS: Current research suggests that head lice resistance exists, but little is known regarding the actual incidence of this resistance or whether this incidence is increasing. More research is needed to assess the status of this problem. Proposed mechanisms for head lice resistance include knock-down resistance, glutathione S-transferase-based resistance, and monooxygenase-based resistance.

Animals↗

PubMed2001

Effect of maternal lead burden on infant weight and weight gain at one month of age among breastfed infants.

INTRODUCTION: Transfer of lead from bone to the bloodstream increases during lactation. However, the effect of maternal lead burden on growth in breastfed newborns is still unknown. This study examined early postnatal growth in a cohort of healthy breastfed newborns in relation to maternal bone lead burden. METHODS: Lead levels were measured among 329 mother-infant pairs in umbilical cord blood at birth and in maternal and infant venous blood at 1 month postpartum. Maternal evaluations at 1 month postpartum included lead measures in blood and bone (measured in the tibia and the patella). Blood lead was determined by graphite furnace atomic absorption spectrophotometry. Bone lead was measured by (109)Cd Kx-radiograph fluorescence instrument. The primary endpoints were attained weight 1 month of age, and weight gain from birth to 1 month of age, which were analyzed in relation to lead biomarkers and relevant covariates by linear regression models. RESULTS: Infants studied had an average weight gain of 33.1 g/day (standard deviation [SD] = 11.6). Mean infant (at 1 month of age) and maternal blood lead levels were 5.6 microg/dL (SD = 3.0) and 9.7 microg/dL (SD = 4.1), respectively. Mean maternal bone lead levels were 10.1 microg of lead/g (SD = 10.3) and 15.29 microg of lead/g (SD = 15.2) of bone mineral for tibia and patella, respectively. Infant blood lead levels were inversely associated with weight gain, with an estimated decline of 15.1 g per microg/dL of blood lead. Children who were exclusively breastfed had significantly higher weight gains; however, this gain decreased significantly with increasing levels of patella lead. The multivariate regression analysis predicted a 3.6-g decrease in weight at 1 month of age per microg of lead per gram bone mineral increase in maternal patella lead levels. CONCLUSIONS: Maternal lead burden is negatively associated to infant attained weight at 1 month of age and to postnatal weight gain from birth to 1 month of age. Additional studies are needed to better understand this source of exposure and to develop interventions to minimize its impact.

Adult↗

PubMed2000

Circumstances of post-neonatal deaths in Ceara, Northeast Brazil: mothers' health care-seeking behaviors during their infants' fatal illness.

Promotion of oral rehydration therapy (ORT) for the treatment of diarrheal diseases and the WHO case management strategy for acute respiratory infections (ARI) have contributed to significant reductions in infant mortality, but these two conditions remain the leading causes of infant deaths in most developing countries. Identification of the factors contributing to these deaths may contribute to reduce infant mortality from preventable causes. To gain insight into the circumstances and maternal and health services factors that may contribute to infant deaths we used a verbal autopsy method to interview mothers of all infants who died during the previous 12 months (June 1995-May 1996) in 11 municipalities in the State of Ceara, Northeast Brazil. Our results revealed that one-third of the deaths occurred in a hospital and two-thirds at home. Almost all the infants who died at home, however, had been examined one or more times by a doctor, and 36% of them had been hospitalized during the disease episode that resulted in death. For most (85%) of these children the causes of death were diarrhea or acute respiratory infection, and it is likely that death could have been averted if appropriate treatment had been initiated promptly. Three major groups of factors that alone or in combination appeared to contribute to most deaths were delays in seeking medical care on behalf of the parents, medical interventions reported as ineffective by mothers and delays in providing medical care to children who arrived at the hospital too late in the day to be scheduled for consultation. Our findings suggest that government efforts to further reduce infant mortality in Ceara should focus on health education interventions that address quality of home care, recognition of signs of severity and danger and importance of seeking timely medical care: and on improving the quality of care provided at community health centers and hospitals. Measures likely to improve infants' chance of survival include: ensuring prompt access to medical consultation for young children brought to health centers or hospitals with potentially life-threatening symptoms related to infections, health education to mothers on the need for continued home care after discharge and to return to the medical care facility if the child does not recover, and that they have access to medicine prescribed by hospital physicians. Further benefits could be obtained by using community health workers, now integrated into the Family Medicine Program (PSF) health teams, to provide health education, supervise home care, refer mothers to health centers and facilitate their access to hospitals.

Attitude to Health↗

PubMed2000

Major histocompatibility complex class I gene controls the generation of gamma interferon-producing CD4(+) and CD8(+) T cells important for recovery from friend retrovirus-induced leukemia.

Recovery from leukemia induced by Friend virus complex (FV) requires strong CD4(+) helper, CD8(+) cytotoxic T-lymphocyte, and B-cell responses. The development of these immune responses is dependent on the major histocompatibility complex (MHC) (H-2) genotype of the mouse. In H-2(b/b) mice, which spontaneously recover from FV-induced erythroleukemia, neutralization of gamma interferon (IFN-gamma) in vivo inhibited recovery, which indicated that IFN-gamma was a necessary component of the immune response to FV. Furthermore, in H-2(b/b) mice, high numbers of IFN-gamma-producing cells were detected after FV infection, whereas in H-2(a/b) mice, which have a low-recovery phenotype, only low numbers of IFN-gamma-producing cells were detected. Similarly, H-2(bm14/b) mice, which cannot recover from FV infection due to a point mutation in one allele of the H-2D(b) gene, also had low numbers of IFN-gamma-producing T cells. Surprisingly, this effect was observed for both CD8(+) and CD4(+) T cells. These findings reveal a novel influence of MHC class I genes on CD4(+) T-cell responses to viral infection. Furthermore, the influence of MHC class I genotype on the generation of both IFN-gamma-producing CD4(+) and CD8(+) T cells helps explain the major impact of the H-2D gene on recovery from FV disease.

Animals↗

PubMed2000

Determinants of bone and blood lead concentrations in the early postpartum period.

OBJECTIVE: This study investigated determinants of bone and blood lead concentrations in 430 lactating Mexican women during the early postpartum period and the contribution of bone lead to blood lead. METHODS: Maternal venous lead was measured at delivery and postpartum, and bone lead concentrations, measured with in vivo K-x ray fluorescence, were measured post partum. Data on environmental exposure, demographic characteristics, and maternal factors related to exposure to lead were collected by questionnaire. Linear regression was used to examine the relations between bone and blood lead, demographics, and environmental exposure variables. RESULTS: Mean (SD) blood, tibial, and patellar lead concentrations were 9.5 (4.5) microg/dl, 10.2 (10.1) microg Pb/g bone mineral, and 15.2 (15.1) microg Pb/g bone mineral respectively. These values are considerably higher than values for women in the United States. Older age, the cumulative use of lead glazed pottery, and higher proportion of life spent in Mexico City were powerful predictors of higher bone lead concentrations. Use of lead glazed ceramics to cook food in the past week and increased patellar lead concentrations were significant predictors of increased blood lead. Patellar lead concentrations explained one third of the variance accounted for by the final blood lead model. Women in the 90th percentile for patella lead had an untransformed predicted mean blood lead concentration 3.6 microg/dl higher than those in the 10th percentile. CONCLUSIONS: This study identified the use of lead glazed ceramics as a major source of cumulative exposure to lead, as reflected by bone lead concentrations, as well as current exposure, reflected by blood lead, in Mexico. A higher proportion of life spent in Mexico City, a proxy for exposure to leaded gasoline emissions, was identified as the other major source of cumulative lead exposure. The influence of bone lead on blood lead coupled with the long half life of lead in bone has implications for other populations and suggests that bone stores may pose a threat to women of reproductive age long after exposure has declined.

Adult↗

PubMed2000

Association of diarrhoea and upper respiratory infections with weight and height gains in Bangladeshi children aged 5 to 11 years.

INTRODUCTION: The association between infection and growth delay is not well documented in school-age children in developing countries. We conducted a prospective cohort study to examine the association between infectious disease and weight and height gains among Bangladeshi children. METHODS: A one-year follow-up study was performed to elucidate the determinants and consequences of physical growth of children under five years of age. The study included 135 households randomly selected from four villages in the Matlab area. RESULTS: The most frequent infections were upper respiratory infections (mean = 4 episodes or 27 days per year) followed by non-dysenteric diarrhoea (mean = 2.3 episodes or 15 days per year) and dysentery (mean = 0.2 episodes or 2 days per year). The number of episodes and their duration decreased significantly with age. Over a 12-month period the mean weight gain was 1.3 kg and the mean increase in height was 2.9 cm. The total number of days when diarrhoea occurred was negatively associated with annual weight gain (regression coefficient beta = -7 g per day, P = 0.02), with adjustment for age, sex, energy and protein intake, and household land ownership. The incidence of diarrhoeal disease was significantly associated with weight gain in intermediate models but only marginally associated with it in the final multivariate model (P = 0.08). Neither the incidence nor the duration of upper respiratory infections was associated with weight gain. Height gain was not significantly associated with the duration or incidence of either category of illness. Diarrhoea was a significant correlate of retarded weight gain among children above preschool age, whereas upper respiratory infections were not. DISCUSSION: Diarrhoeal morbidity slowed growth in children well beyond the weaning age, suggesting that increased attention should be given to the study of the continuous impact of diarrhoea in children aged over 5 years. An understanding of the determinants of growth in school-age children in developing countries would maximize the health and developmental outcomes that are the target of international child survival strategies at younger ages.

Bangladesh↗

PubMed1999

B7.2 has opposing roles during the activation versus effector stages of experimental autoimmune thyroiditis.

APCs provide costimulatory and down-regulatory signals to Ag-activated T cells through interactions between B7.1 and B7.2 on APCs with either CD28 or CTL Ag-4 expressed on T cells. Recipients of mouse thyroglobulin (MTg)-primed spleen cells activated in the presence of anti-B7.2 had decreased experimental autoimmune thyroiditis (EAT) severity compared with recipients of cells cultured with control rat Ig or anti-B7.1. Blocking B7.2 during in vivo priming also suppressed the ability of MTg-primed spleen cells to transfer EAT, implicating a role for B7.2 for priming and in vitro activation of EAT effector cells. In contrast, administration of anti-B7.2 or anti-B7.2 Fab to recipients of MTg-activated spleen cells increased the severity of EAT compared with recipients receiving control Ig. Thyroids from anti-B7.2-treated recipients had increased expression of IL-4 mRNA compared with thyroids from rat Ig-treated controls. Both B7.1 and B7.2 molecules were expressed in the thyroids of mice with EAT, although B7.2 was more prevalent than B7.1. Administration of both anti-B7.1 and anti-B7.2 to recipient mice suppressed the development of EAT, while anti-B7.1 treatment alone had no effect on EAT severity. The suppression of EAT was not observed when anti-B7.1 and anti-B7.2 treatment was delayed until 7 days after cell transfer, suggesting a requirement for B7 in the initiation of EAT in recipient mice. These results suggest that costimulation is required during the effector phase of EAT and that B7.2 may have opposing roles in the activation versus effector stages of autoreactive T cells.

Abatacept↗

PubMed1999

Impact of a school-based interdisciplinary intervention on diet and physical activity among urban primary school children: eat well and keep moving.

OBJECTIVE: To evaluate the impact of a school-based interdisciplinary health behavior intervention on diet and physical activity among children in grades 4 and 5. DESIGN: A quasiexperimental field trial with 6 intervention and 8 matched control schools. Outcomes were assessed longitudinally using preintervention (fall 1995) and follow-up (spring 1997) student survey food frequency and activity measures and follow-up 24-hour recall measures of diet and activity. Change was also assessed using yearly repeated cross-sectional surveys of all grade 5 students from 1995 through 1997. PARTICIPANTS: Longitudinal data were collected from 479 students initially in grade 4 in Baltimore, Md, public schools; 91% were African American. Repeated 24-hour recall measures in 1997 were collected for a random subsample of 336 students. Cross-sectional survey data were collected from all grade 5 students in 1995,1996, and 1997 (n = 2103). INTERVENTION: The Eat Well and Keep Moving Program was taught by classroom teachers over 2 years in math, science, language arts, and social studies classes. Materials provided links to school food services and families and provided training and wellness programs for teachers and other staff members. Intervention materials focused on decreasing consumption of foods high in total and saturated fat and increasing fruit and vegetable intake, as well as reducing television viewing and increasing physical activity. MAIN OUTCOME MEASURES: Dietary intake and physical activity measured via repeated 24-hour recall were primary end points, with additional food frequency and activity measures. RESULTS: The 24-hour recall measures indicated that, after controlling for baseline covariates, the percentages of total energy from fat and saturated fat were reduced among students in intervention compared with control schools (-1.4%; 95% confidence interval [CI], -2.8 to -0.04; P = .04 and -0.60%; 95% CI, -1.2 to -0.01; P = .05). There was an increase in fruit and vegetable intake (0.36 servings/4184 kJ; 95% CI, 0.10-0.62; P=.01), in vitamin C intake (8.8 mg/4184 kJ; 95% CI, 2.0-16; P=.01), and in fiber consumption (0.7 g/4184 kJ; 95% CI, 0.0-1.4; P=.05). Television viewing was marginally reduced (-0.55 h/d; 95% CI, -1.04 to 0.04; P=.06). Analysis of longitudinal and repeated cross-sectional food frequency data indicated similar significant decreases in the percentages of total energy from fat and saturated fat. CONCLUSION: Evaluation of the Eat Well and Keep Moving Program indicates effectiveness in improving dietary intake of students and reducing television viewing.

Baltimore↗

PubMed1999

CD40L is necessary for the priming of effector cells for lymphocytic and granulomatous experimental autoimmune thyroiditis.

The interaction of CD40 on antigen presenting cells (APC) with CD40L on mouse thyroglobulin (MTg)-specific T cells may deliver an essential signal for the development of CD4(+) experimental autoimmune thyroiditis (EAT) effector cells and anti-MTg producing B cells. To determine the requirement for CD40-CD40L interactions in G-EAT, donor mice were injected with an anti-CD40L monoclonal antibody (mAb) on days -1, 0, and +1 relative to immunization with MTg and adjuvant. Recipients of spleen cells from MTg-primed donor mice injected with anti-CD40L did not develop EAT, while spleen cells from similarly immunized hamster Ig-treated donors transferred severe G-EAT. Although the decreased EAT severity was accompanied by increased IL-4 mRNA expression by CD4(+) T cells from anti-CD40L-treated donors, the increased IL-4 was not necessary for suppression of EAT, since anti-CD40L treatment prevented EAT in IL-4-deficient mice. Addition of MTg-primed B cells during in vitro activation of spleen cells from anti-CD40L-treated donors did not induce EAT in recipients, suggesting that anti-CD40L suppresses EAT by preventing the sensitization of EAT effector cells. Addition of anti-CD40L during in vitro activation of MTg-primed spleen cells or treatment of recipients with anti-CD40L had no effect on EAT severity, indicating that CD40-CD40L interactions are not required after EAT effector cells are primed to MTg.

Animals↗

PubMed1999

The relationship between social network characteristics and breast cancer screening practices among employed women.

This study examined the relationship between social network characteristics and breast cancer screening practices among employed women. We hypothesized that larger social networks, higher levels of support from networks, and stronger social influences to undergo screening would be positively associated with regular utilization of mammograms and clinical breast examinations. Data were collected from women aged 52 and over who were employed in 27 worksites (N = 1,045). Social network characteristics, breast cancer screening practices, and sociodemographic factors were assessed in a self-administered survey. Bivariate analyses revealed that social influences were significantly associated with regular screening; social support was only marginally associated with regular screening; and social network size was not at all associated. In multivariate analyses, only the perception that screening is normative among one's peers was predictive of regular screening. Provider recommendation was the single most potent predictor of regular screening. These findings provide support for the importance of social norms in motivating women to adhere to screening guidelines. In addition, they underscore the potent impact of provider recommendations on women's screening practices.

Aged↗

PubMed1999

Reproducibility and validity of a food frequency questionnaire among fourth to seventh grade inner-city school children: implications of age and day-to-day variation in dietary intake.

OBJECTIVE: To assess the reproducibility and validity of a semiquantitative food frequency questionnaire (FFQ) to classify children and adolescents in terms of daily servings of fruits and vegetables and intake of calories, protein, fat, carbohydrate, dietary fibre, vitamin C, phosphorous, calcium and iron. DESIGN: FFQs were collected in the autumn of 1993 and 1994. Four 24-hour diet recalls were collected during the same 1-year period and their mean was compared to the FFQ diet estimates. SETTING: Low income, inner-city state schools. SUBJECTS: A sample of 109 inner-city fourth to seventh grade students. RESULTS: The 1-year reproducibility of the FFQ, assessed with Spearman correlations, was lower among the fourth and fifth (range: r=-0.26 to 0.40) than the sixth and seventh grade students (range: r=0.18-0.47). After adjusting for day-to-day variation in dietary intake, for most nutrients and foods the correlations between the FFQ and the 24-hour recalls remained greater among the junior high school students (fourth to fifth grade range: r=0.0-0.42; sixth to seventh grade range: r=0.07-0.76). CONCLUSIONS: Inner-city sixth and seventh grade students demonstrated the ability to provide valid estimates of intake of calories, carbohydrate, calcium, phosphorous, iron and vitamin C over the past year. However, children in the fourth and fifth grades experienced some difficulty in completing the FFQ. Our results suggest that, before using this instrument with fourth and fifth grade children, investigators should assess whether study participants can think abstractly and are familiar with the concept of 'average intake'.

Child↗

PubMed1999

Association of maternal short stature with stunting in Mexican children: common genes vs common environment.

OBJECTIVE: To evaluate the association between stunting in children and maternal short stature, controlling for potential environmental confounders. DESIGN: 1988 Mexico National Nutrition Survey. SETTING: Mexico SUBJECTS: The final sample size was 4663 pairs of children (<5 y) and their mothers (12-49 y) from a total of 13 236 surveyed houses. MAIN OUTCOME MEASURES: Stunting (height-for-age Z-scores <-2). RESULTS: The prevalence of stunting in children was 19%, and 10% of the mothers exhibited short stature (<145 cm). In the crude analysis, mothers with short stature were significantly more likely to have stunted children (odds ratio (OR)=4.0; 95% confidence interval (CI)=3.2-4.8; P-value <0.001). In a multiple logistic regression model the OR for child stunting was reduced, but remained significant OR=2.0; 95% CI=1.6-2.6; P-value <0.001) after adjustment for region, urban/rural residence, socio-economic status, household size, child age and presence of infection in the past 14 d, and maternal age, body mass index (BMI), and educational level. Adjusted ORs varied between regions (Mexico City, OR=3.9; North Mexico, OR=3. 1; Central Mexico, OR=2.0; South Mexico, OR=1.6. Comparison of crude vs adjusted estimates pointed to regional differences in the proportion of association between maternal and child short statures explained by environmental determinants. CONCLUSIONS: Maternal stature, reflecting her potential height and early environment, appeared to contribute to child height independently of the shared risk factors that could affect stature. Nonetheless, we could explain much of the association between stunting in children and maternal short stature by environmental factors, and part of the residual variability may be due to unmeasured determinants. Regional differences pointed to a predominance of environmental factors in explaining child stunting in poorer regions.

Adult↗

PubMed1999

Association of obesity with physical activity, television programs and other forms of video viewing among children in Mexico city.

OBJECTIVE: To assess the association of physical activity, television program viewing and other forms of video viewing with the prevalence of obesity among school children. DESIGN: Cross-sectional study. SUBJECTS: 712 children, 9-16 y old, from a low- and a middle-income town in the Mexico City area. MEASUREMENTS: Children completed a self administered questionnaire to assess time spent in physical activity and television viewing, and diet. Height weight and triceps skinfolds were measured. The outcome variable was obesity, and the covariates were hours of television programs and other video viewing, physical activity, energy intake, percentage of energy from fat, town of location of school, age, gender and perception of mother's weight status. RESULTS: Among 461 children with complete information, 24% were classified as obese. Children reported an average of 4.1 +/- 2.2 h/d watching television (2.4 +/- 1.5 h/d for TV programs and 1.7 +/- 1.5 h/d for video cassette recorder (VCR) or videogames), and 1.8 +/- 1.3 h/d in moderate and vigorous physical activities. Odds ratios (OR) of obesity were 12% higher for each hour of television program viewing per day (OR = 1.12, 95% confidence interval (CI) 1.02,-1.22), and 10% lower for each hour of moderate/vigorous physical activity per day (OR = 0.90, 95% CI 0.83-0.98), controlling for age, gender, town and perception of mother's weight status. Children in the middle-income town had higher adjusted odds of obesity (OR = 2.58, 95% CI 1.47-4.54). CONCLUSION: Physical activity and television viewing, but not VCR/videogames use, were related to obesity prevalence in Mexican children 9-16 y old.

Adolescent↗

PubMed1999

Variations in infant mortality rates among municipalities in the state of Ceará, Northeast Brazil: an ecological analysis.

BACKGROUND: Infant mortality rates vary substantially among municipalities in the State of Ceará, from 14 to 193 per 1000 live births. Identification of the determinants of these differences can be of particular importance to infant health policy and programmes in Brazil where local governments play a pivotal role in providing primary health care. METHODS: Ecological study across 140 municipalities in the State of Ceará, Brazil. RESULTS: To determine the interrelationships between potential predictors of infant mortality, we classified 11 variables into proximate determinants (adequate weight gain and exclusively breastfeeding), health services variables (prenatal care up-to-date, participation in growth monitoring, immunization up-to-date, and decentralization of health services), and socioeconomic factors (female literacy rate, household income, adequate water supply, adequate sanitation, and per capita gross municipality product), and included the variables in each group simultaneously in linear regression models. In these analyses, only one of the proximate determinants (exclusively breastfeeding (inversely), R2 = 9.3) and one of the health services variables (prenatal care up-to-date (inversely), R2 = 22.8) remained significantly associated with infant mortality. In contrast, female literacy rate (inversely), household income (directly) and per capita GMP (inversely) were independently associated with the infant mortality rate (for the model including the three variables R2 = 25.2). Finally, we considered simultaneously the variables from each group, and selected a model that explained 41% of the variation in infant mortality rates between municipalities. The paradoxical direct association between household income and infant mortality was present only in models including female illiteracy rate, and suggests that among these municipalities, increases in income unaccompanied by improvements in female education may not substantially reduce infant mortality. The lack of independent associations between inadequate sanitation and infant mortality rates may be due to the uniformly poor level of this indicator across municipalities and provides no evidence against its critical role in child survival. CONCLUSIONS: These results suggest that promotion of exclusive breastfeeding and increased prenatal care utilization, as well as investments in female education would have substantial positive effects in further reducing infant mortality rates in the State of Ceará.

Brazil↗

PubMed1999

Relationship between health services, socioeconomic variables and inadequate weight gain among Brazilian children.

This ecological analysis assessed the relative contribution of behavioural, health services and socioeconomic variables to inadequate weight gain in infants (0-11 months) and children (12-23 months) in 140 municipalities in the State of Ceara, north-east Brazil. To assess the total effect of selected variables, we fitted three unique sets of multivariate linear regression models to the prevalence of inadequate weight gain in infants and in children. The final predictive models included variables from the three sets. Findings showed that participation in growth monitoring and urbanization were inversely and significantly associated with the prevalence of inadequate weight gain in infants, accounting for 38.3% of the variation. Female illiteracy rate, participation in growth monitoring and degree of urbanization were all positively associated with prevalence of inadequate weight gain in children. Together, these factors explained 25.6% of the variation. Our results suggest that efforts to reduce the average municipality-specific female illiteracy rate, in combination with participation in growth monitoring, may be effective in reducing municipality-level prevalence of inadequate weight gain in infants and children in Ceara.

Adolescent↗