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Biomedical subjects

M D Carroll

Publications and source records attributed to M D Carroll.

At least 19 recordsLinked to original sources
PubMed2000

Energy and fat intakes of children and adolescents in the united states: data from the national health and nutrition examination surveys.

BACKGROUND: Dietary factors related to body weight and chronic disease risk are of interest because of recent increases in the prevalence of overweight. OBJECTIVE: Secular trends in energy and fat intakes of youths aged 2-19 y were assessed. Current intakes were compared with recommendations. DESIGN: Dietary 24-h recall data from the third National Health and Nutrition Examination Survey (1988-1994) and earlier national surveys were examined. RESULTS: Mean energy intake changed little from the 1970s to 1988-1994 except for an increase among adolescent females. Over the same time period, the mean percentage of energy from total and saturated fat decreased, but remained above recommendations, with overall means of 33.5% of energy from fat and 12.2% of energy from saturated fat. In 1988-1994, approximately 1 in 4 youths met the recommendations for intakes of fat and saturated fat and 3 in 4 met the recommendation for cholesterol intake. Beverages contributed 20-24% of energy across all ages and soft drinks provided 8% of energy in adolescents. Except for adolescent girls, beverage energy contributions were generally higher among overweight than nonoverweight youths; soft drink energy contribution was higher among overweight youths than among nonoverweight youths for all groups. CONCLUSIONS: The lack of evidence of a general increase in energy intake among youths despite an increase in the prevalence of overweight suggests that physical inactivity is a major public health challenge in this age group. Efforts to increase physical activity and decrease nonnutritive sources of energy may be important approaches to counter the rise in overweight prevalence.

Adolescent↗
PubMed1998

Overweight and obesity in the United States: prevalence and trends, 1960-1994.

OBJECTIVE: To describe the prevalence of, and trends in, overweight and obesity in the US population using standardized international definitions. DESIGN: Successive cross-sectional nationally representative surveys, including the National Health Examination Survey (NHES I; 1960-62) and the National Health and Nutrition Examination Surveys (NHANES I: 1971-1974; NHANES II: 1976-1980; NHANES III: 1988-94). Body mass index (BMI:kg/m2) was calculated from measured weight and height. Overweight and obesity were defined as follows: Overweight (BMI > or = 25.0); pre-obese (BMI 25.0-29.9), class I obesity (BMI 30.0-34.9), class II obesity (BMI 35.0-39.9), and class III obesity (BMI > or = 40.0). RESULTS: For men and women aged 20-74 y, the age-adjusted prevalence of BMI 25.0-29.9 showed little or no increase over time (NHES I: 30.5%, NHANES I: 32.0%, NHANES II: 31.5% and NHANES III: 32.0%) but the prevalence of obesity (BMI > or = 30.0) showed a large increase between NHANES II and NHANES III (NHES I: 12.8%; NHANES I, 14.1%; NHANES II, 14.5% and NHANES III, 22.5%). Trends were generally similar for all age, gender and race-ethnic groups. The crude prevalence of overweight and obesity (BMI >> 25.0) for age > or = 20 y was 59.4% for men, 50.7% for women and 54.9% overall. The prevalence of class III obesity (BMI > or = 40.0) exceeded 10% for non-Hispanic black women aged 40-59 y. CONCLUSIONS: Between 1976-80 and 1988-94, the prevalence of obesity (BMI > or= 30.0) increased markedly in the US. These findings are in agreement with trends seen elsewhere in the world. Use of standardized definitions facilitates international comparisons.

Adult↗
PubMed1998

Blood folate and vitamin B12: United States, 1988-94.

OBJECTIVES: This report presents national estimates of serum and red blood cell (RBC) folate and serum vitamin B12 distributions for persons 4 years and over, by sociodemographic variables. METHODS: The third National Health and Nutrition Examination Survey (NHANES III) (1988-94), provides information on the health and nutritional status of the civilian noninstitutionalized U.S. population. The analytic sample included 23,378 participants with serum folate data, 23,082 with RBC folate data, and 11,851 with serum vitamin B12 data. RESULTS: The mean serum and RBC folate concentrations are 7.2 and 196 nanograms per milliliter (ng/mL), respectively, and the mean serum vitamin B12 concentration is 518 picograms per milliliter (pg/mL). Non-Hispanic white people have higher mean serum and RBC folate concentrations than non-Hispanic black or Mexican American people. Serum vitamin B12 concentrations are lowest for older adults, and non-Hispanic black people have higher serum B12 concentrations than non-Hispanic white individuals. Only approximately 3 percent of the population has a serum B12 concentration less than 200 pg/mL. CONCLUSIONS: Inadequate folate status may be more prevalent among non-Hispanic black and Mexican American people. Data also suggest a modest prevalence of low serum B12 concentrations. Future assessments of folate and vitamin B12 status will be important to evaluate the impact of a recently enacted fortification policy.

Adolescent↗
PubMed1997

Prevalence of iron deficiency in the United States.

OBJECTIVE: To determine the prevalence of iron deficiency and iron deficiency anemia in the US population. DESIGN: Nationally representative cross-sectional health examination survey that included venous blood measurements of iron status. MAIN OUTCOME MEASURES: Iron deficiency, defined as having an abnormal value for at least 2 of 3 laboratory tests of iron status (erythrocyte protoporphyrin, transferrin saturation, or serum ferritin); and iron deficiency anemia, defined as iron deficiency plus low hemoglobin. PARTICIPANTS: A total of 24,894 persons aged 1 year and older examined in the third National Health and Nutrition Examination Survey (1988-1994). RESULTS: Nine percent of toddlers aged 1 to 2 years and 9% to 11% of adolescent girls and women of childbearing age were iron deficient; of these, iron deficiency anemia was found in 3% and 2% to 5%, respectively. These prevalences correspond to approximately 700,000 toddlers and 7.8 million women with iron deficiency; of these, approximately 240,000 toddlers and 3.3 million women have iron deficiency anemia. Iron deficiency occurred in no more than 7% of older children or those older than 50 years, and in no more than 1% of teenage boys and young men. Among women of childbearing age, iron deficiency was more likely in those who are minority, low income, and multiparous. CONCLUSION: Iron deficiency and iron deficiency anemia are still relatively common in toddlers, adolescent girls, and women of childbearing age.

Adolescent↗
PubMed1997

Varying body mass index cutoff points to describe overweight prevalence among U.S. adults: NHANES III (1988 to 1994).

Body mass index (BMI; kg/m2) distributions are commonly reported in the scientific literature to describe weight for stature. These data are collected for various groups of subjects in local health and body composition studies, and comparisons with national distributions are often desirable. Tabular data for population prevalence estimates from the third National Health and Nutrition Examination Survey (NHANES III, 1988 to 1994) at selected gender- and age-specific BMI levels ranging from < 18.0 to > 45.0 are presented and compared with various examples of BMI criteria reported in the scientific literature. NHANES III was a statistically representative national probability sample of the civilian, noninstitutionalized population of the United States in which height and weight were measured as part of a more comprehensive health examination. The implications of varying population prevalence estimates based on varying BMI cutoff points are briefly discussed for selected examples including World Health Organization over-weight/obesity criteria and the U.S. Dietary Guidelines for Americans. The median BMI for U.S. adults aged 20 years and older is 25.5 kg/m2. Median stature and weight for men are 175.5 cm and 80.0 kg and for women are 161.6 cm and 65.6 kg, respectively. The percentage of the population with BMI < 19.0 is 1.6% for men, 5.7% for women; BMI > or = 19.0 to < 25.0 is 39.0% for men, 43.6% for women; BMI > or = 25.0 is 59.4% for men, 50.7% for women. An estimated 97.1 million adults have a BMI > or = 25.0. Additional prevalence estimates based on other BMI cutoff points and ages are presented.

Adult↗
PubMed1997

Apolipoprotein B and AI distributions in the United States, 1988-1991: results of the National Health and Nutrition Examination Survey III (NHANES III).

Serum apolipoproteins (apo) B and AI were measured in a probability sample of the noninstitutionalized US civilian population, ages > or = 4 years, which included non-Hispanic whites, non-Hispanic blacks, and Mexican-Americans. Apo B concentrations were the same in males and females, lower in black males than in other males, low in childhood (approximately 0.80 g/L) and increasing to approximately 1.2 g/L in adults, and higher in younger women on hormones. Apo AI was higher in females than males, higher in blacks than in others, remained constant from childhood to adulthood (approximately 1.35 g/L) in males, but increased with age (approximately 1.30 g/L to approximately 1.55 g/L) in females, and was higher in women taking hormones. These are the first national probability estimates of apo B and apo AI in the US and are referable to the WHO-IFCC First International Reference Materials for apo AI and B.

Adolescent↗
PubMed1995

Total energy intake of the US population: the third National Health and Nutrition Examination Survey, 1988-1991.

The third National Health and Nutrition Examination Survey (NHANES III) was conducted to assess the health and nutritional status of the US population. As part of the nutritional status assessment, reliable 24-h dietary recalls were collected for 14,801 examined persons. Mean (+/- SEM) energy intakes are reported for persons aged > or = 2 mo by age, sex, and race-ethnicity. Males had higher mean energy intakes than did females. Energy intakes peaked during late adolescence and young adulthood and declined thereafter. Energy intake patterns were similar among non-Hispanic whites, non-Hispanic blacks, and Mexican Americans. Underreporting was addressed by computing a ratio of energy intake (EI) to estimated basal metabolic rate (BMRest). This ratio (EI:BMRest) was 1.47 for adult males and 1.26 for nonpregnant adult females. Overweight adults had a lower mean EI:BMRest (1.09 in females and 1.28 in males). Underreporting in food consumption surveys remains problematic among females and overweight persons.

Adolescent↗
PubMed1995

Macronutrient intakes among adult Hispanics: a comparison of Mexican Americans, Cuban Americans, and mainland Puerto Ricans.

OBJECTIVES: The purpose of this study was to compare energy and macronutrient intakes between adult Mexican Americans, Cuban Americans, mainland Puerto Ricans, and non-Hispanics. METHODS: Age-specific mean intakes were estimated based on 24-hour recalls from the Hispanic Health and Nutrition Examination Survey (HHANES) (1982 to 1984) and the Second National Health and Nutrition Examination Survey (NHANES II) (1976 to 1980) and were compared with the use of t tests. RESULTS: Mexican Americans had higher total fat, saturated fat, and monounsaturated fat intakes than did Puerto Ricans and older Cuban Americans. Cuban Americans and Puerto Ricans had similar intakes, except for younger Cuban Americans, who had higher total and saturated fat and lower carbohydrate intakes. Cholesterol intakes among Mexican American men and 60- to 74-year-old women were higher than those among other Hispanic groups. Carbohydrate and protein intakes were higher among Hispanic groups compared with those among non-Hispanics while total fat intakes were generally lower. CONCLUSIONS: Since macronutrient intakes differ between Hispanic groups, dietary research, recommendations, and interventions should be targeted to each group individually. Older Puerto Rican and Cuban American adults met population guidelines for reducing chronic disease risk for more macronutrients than any other group.

Adult↗
PubMed1994

Measurement of apolipoproteins A-I and B during the National Health and Nutrition Examination Survey (NHANES) III.

We measured apolipoproteins (apo) A-I and B by rate immunonephelometry (rate INA) during Phase 1 of the National Health and Nutrition Examination Survey (NHANES) III. We also made the measurements by radial immunodiffusion (RID) in a 20% subset of the samples. Aliquots of this subset were also analyzed in the Northwest Lipid Research Laboratories by fixed-time INA calibrated to the World Health Organization (WHO)-International Federation of Clinical Chemistry (IFCC) First International Reference Materials for Apolipoproteins A-I and B. The CVs for the rate INA and RID measurements were: apoA-I, 4.5-7.7% and 2.5-7.6%, respectively; apoB, 2.3-5.3% and 2.3-6.4%, respectively. In NHANES III, rate INA values (x) can be transformed to WHO-IFCC Reference Material-based values (y) as follows: for apoA-I, y = 0.87x + 251.8 mg/L (r = 0.93, SEslope = 0.13, SEintercept = 17, n = 708); for apoB (mg/L), y = 1.068x + 112.8 mg/L (r = 0.98, SEslope = 0.08, SEintercept = 7, n = 646).

Apolipoprotein A-I↗
PubMed1993

Prevalence of high blood cholesterol among US adults. An update based on guidelines from the second report of the National Cholesterol Education Program Adult Treatment Panel.

OBJECTIVE: To estimate the current levels and trends in the proportion of US adults with high blood cholesterol based on guidelines from the second report of the National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP II). DESIGN: Nationally representative cross-sectional surveys. SETTING/PARTICIPANTS: Data for 7775 participants 20 years of age and older from phase 1 of the third National Health and Nutrition Examination Survey (NHANES III) (data collected from 1988 through 1991) and for 9797 participants 20 through 74 years of age from NHANES II (data collected from 1976 through 1980) were used. RESULTS: From the data collection period in NHANES II (1976 through 1980) to the period in NHANES III (1988 through 1991), the proportion of adults with high blood cholesterol levels (> or = 240 mg/dL [6.21 mmol bd) fell from 26% to 20%, while the proportion with desirable levels (< 200 mg/dL [5.17 mmol/L]) rose from 44% to 49%. Currently, using the ATP II guidelines and NHANES III data, 40% of all adults 20 years of age and older would require fasting lipoprotein analysis; and 29% of all adults would be candidates for dietary therapy (as compared with 36%, using NHANES II data). Based on 1990 population data, it is estimated that approximately 52 million Americans 20 years of age and older would be candidates for dietary therapy. Assuming that dietary intervention would reduce low-density lipoprotein (LDL) cholesterol levels by 10%, as many as 7% of all adult Americans (approximately 12.7 million) might be candidates for cholesterol-lowering drugs. This estimate reflects approximately 4 million adults with established coronary heart disease, of whom half are aged 65 years and older, and up to 8.7 million adults without established coronary heart disease, of whom up to 3.1 million are aged 65 years and older. CONCLUSIONS: Substantial progress has been made in reducing the prevalence of high blood cholesterol; yet a large proportion of all adults, approximately 29%, require dietary intervention for high blood cholesterol.

Adult↗
PubMed1993

Declining serum total cholesterol levels among US adults. The National Health and Nutrition Examination Surveys.

OBJECTIVE: To examine the secular trend in serum total cholesterol levels of the US adult population. DESIGN: Nationally representative cross-sectional surveys with both an in person interview and a medical examination that included the measurement of blood lipid levels. SETTING/PARTICIPANTS: Between 6000 and 13,000 adults aged 20 through 74 years examined in each of four separate national surveys during 1960 through 1962, 1971 through 1974, 1976 through 1980, and 1988 through 1991. RESULTS: Mean serum total cholesterol levels in US adults aged 20 through 74 years have consistently declined over the time period 1960 through 1991. More than half of the decline occurred during the time period 1976 through 1991. This decline occurred across the entire distribution of serum cholesterol levels and in all age-sex groups. High-density lipoprotein cholesterol and very low-density lipoprotein cholesterol levels have not changed, suggesting that the decline in total cholesterol levels is due to a decline in low-density lipoprotein cholesterol levels. CONCLUSIONS: These results document a continuing and substantial decline in serum cholesterol levels among US adults. They suggest that public health programs, designed to reduce cholesterol levels, are proving successful. The observed downward trend in serum cholesterol levels has coincided with a continuing decline in coronary heart disease mortality. These observations suggest that the Healthy People 2000 goal of reducing the mean serum cholesterol level of US adults to no more than 200 mg/dL (5.17 mmol/L) is attainable.

Adult↗
PubMed1993

Calcium intakes of Mexican Americans, Cubans, Puerto Ricans, non-Hispanic whites, and non-Hispanic blacks in the United States.

OBJECTIVE: To compare dietary calcium intakes from food in Mexican Americans, Cubans, Puerto Ricans, non-Hispanic whites, and non-Hispanic blacks aged 11 through 74 years. DESIGN: Population survey data from the Hispanic Health and Nutrition Examination Survey and the second National Health and Nutrition Examination Survey were used to calculate calcium intake from a single 24-hour recall. These data were compared by age and sex between the five population groups. Food sources of calcium in the three Hispanic groups were also examined using 24-hour recall data. SUBJECTS: The sample consisted of 11,773 non-Hispanic whites, 1,728 non-Hispanic blacks, 4,739 Mexican Americans, 1,076 Cubans, and 1,835 Puerto Ricans. MAIN OUTCOME MEASURES: Mean calcium intake, percentage intake of Recommended Dietary Allowance, and, for Hispanics, food sources of calcium. STATISTICAL ANALYSES: Means were compared within age and sex groups between the five population groups using a t test. RESULTS: Calcium intakes from food in the three Hispanic groups were similar to intakes of non-Hispanic whites and higher than intakes of non-Hispanic blacks. Although dairy foods were the main sources of calcium for Hispanics, corn tortillas were important calcium sources among Mexican Americans. Women consumed less calcium than the Recommended Dietary Allowance in all age and racial or ethnic groups. APPLICATIONS: When assessing calcium intakes of the three Hispanic groups, ethnic differences in food sources of calcium need to be considered. Efforts to increase calcium intake in Hispanics also need to account for ethnic differences.

Adolescent↗
PubMed1986

A data-based approach to diet questionnaire design and testing.

A self-administered diet history questionnaire has been developed for epidemiologic and clinical use. Both the food list and the nutrient values to be associated with it were developed using dietary data from 11,658 adult respondents to the Second National Health and Nutrition Examination Survey (NHANES II). Food items were selected on the basis of their contribution to total population intake of energy and each of 17 nutrients in the NHANES II data, and represent over 90% of each of those nutrients. Associated nutrient composition values were determined from the NHANES II database using frequency of consumption data in that survey. Portion sizes to be associated with each food item were derived from observed portion size distributions in NHANES II, based on three-dimensional models. The resulting food list and its corresponding brief data base, when used to calculate nutrients from a diet record, yielded correlations of r greater than 0.70 with the more detailed method. Field administration produced mean values comparable to national data.

Adult↗
PubMed1985

Nutrient sources in the American diet: quantitative data from the NHANES II survey. I. Vitamins and minerals.

Dietary data from 11,658 adult respondents in the second National Health and Nutrition Examination Survey were used to provide quantitative information regarding the contribution of specific foods to the total population intake of the following 10 nutrients: vitamin A, thiamine, riboflavin, niacin, vitamin C, iron, phosphorus, calcium, sodium, and potassium. Data are reported in the companion paper regarding the number of adults in the US population consuming each of 147 food items, representing all foods reported by these respondents. The percentage of total nutrient intake which each food provides is presented for the top 50 contributors of each of the nutrients listed above. Foods sometimes overlooked as important sources are found in some instances to be quantitatively important to population intake, such as spaghetti dishes as an independent source of carotenoids. These data should be useful to epidemiologists with a substantive interest in dietary etiologies or a methodological interest in the development of dietary assessment instruments. In addition, they may be useful to health care planners or nutrition educators.

Adult↗
PubMed1985

Nutrient sources in the American diet: quantitative data from the NHANES II survey. II. Macronutrients and fats.

Dietary data from 11,658 adult respondents in the second National Health and Nutrition Examination Survey were used to provide quantitative information regarding the contribution of specific foods to the total population intake of the following nutrients: calories, protein, carbohydrate, total fat, saturated fat, oleic acid, linoleic acid, and cholesterol. The percentage of total nutrient intake which each food provides is presented for the top 50 contributors of each of these nutrients, as well as the proportion of the population consuming them. These data may provide a basis for the selection of foods to be included in dietary assessment instruments. They may also be useful to health care planners or nutrition educators.

Adult↗