Biomedical subjects

M K Serdula

Publications and source records attributed to M K Serdula.

At least 37 records · Page 2Linked to original sources

PubMed1996

The association between fruit and vegetable intake and chronic disease risk factors.

Understanding the associations between fruit and vegetable intake and other health behaviors is important for properly interpreting the rapidly growing number of studies that link low intakes of fruits and vegetables to the risk of cancer and cardiovascular disease. To examine the association between fruit and vegetable intake and behavioral risk factors for chronic diseases, we analyzed data from a population-based behavioral risk factor survey. Data were collected in 1990 from 21,892 adults in 16 states by a random-digit-dial telephone survey. Respondents answered questions about behaviors related to chronic disease risk, including their frequency of intake of fruits and vegetables, using a six-item questionnaire. Consumption of fruits and vegetables was lowest among those who also reported that they were sedentary, heavy smokers, heavy drinkers, or had never had their blood cholesterol checked. Because fruit and vegetable intake covaries with several other chronic disease risk factors, it is important to account for possible confounding between fruit and vegetable intake and other behaviors in etiologic studies of the risk of cancer and cardiovascular disease.

Adolescent↗

PubMed1996

Attempted weight loss during pregnancy.

OBJECTIVE: To assess the prevalence and correlates of weight loss during pregnancy. DESIGN: Cross-sectional telephone survey from 47 states and the District of Columbia. SUBJECTS: 1794 women who reported that they were pregnant at the time of the survey. MEASUREMENTS: Self-reported weight, height, disease and behaviors. RESULTS: A minority (3.7%; 95% CI, 2.6-4.9%) of women who reported being pregnant (n = 1794) also reported trying to lose weight. However, pregnant women who reported both drinking alcohol in the past month and currently smoking had the highest prevalence of attempted weight loss (12.7%), followed by women in their first trimester (9.4%), women with reported diabetes (9.0%) and women with very high BMIs (6.9%). After adjustment for survey design and other characteristics, women in their first trimester were four times more likely to attempt weight loss than those in the third trimester. CONCLUSION: These results suggest that weight loss attempts among women who report being pregnant are uncommon, but are more likely to occur in the first trimester and possibly among women who smoke and drink, have diabetes or are very overweight.

Alcohol Drinking↗

PubMed1995

Effects of question order on estimates of the prevalence of attempted weight loss.

Although numerous surveys have been conducted to estimate the prevalence of attempted weight loss, little information is available on the possible effects of question order on the prevalence estimates. The authors examined data collected from 231,852 respondents to surveys conducted in the District of Columbia and 20 states that participated in the Behavioral Risk Factor Surveillance System between 1985 and 1992. In surveys conducted from 1985 to 1988, respondents (n = 117,827) were first asked their body weight and then were asked if they were trying to lose weight; 48% of the women and 29% of the men reported that they were trying to lose weight. In 1989, 1991, and 1992 (no questions about weight control were asked in 1990), the order of the questions was reversed so that respondents (n = 114,025) were asked whether they were trying to lose weight before they were asked to report their weight; 41% of the women and 26% of the men reported that they were trying to lose weight. The authors conclude that survey respondents, especially women, may be more likely to report that they are trying to lose weight when questions about weight control practices immediately follow questions on current weight. This apparent effect of question order points to the need for caution in comparing prevalence estimates across surveys in which the questions are not asked in a similar order, even when the questions are worded identically.

Adult↗

PubMed1995

Gestational weight gain among average-weight and overweight women--what is excessive?

OBJECTIVE: Our purpose was to determine the association between increased gestational weight gain and birth weight outcomes for low-income women. STUDY DESIGN: A total of 53,541 single, live infants delivered from 1990 to 1991 to white, black, and Hispanic women in eight states were evaluated. Multiple logistic regression was used to calculate risk of low and high (> 4500 gm) birth weight, adjusting for selected factors. RESULTS: The association between gestational weight gain and birth weight varied by prepregnancy body mass index. Risk for low birth weight decreased with increasing weight gain for average-weight women. There was no reduction in risk for low birth weight, however, beyond weight gains of 30 to 34 pounds for overweight women and 15 to 19 pounds for very-overweight women. Risk for high birth weight, however, increased with increasing weight gain in all three groups. CONCLUSION: Very-overweight women (body mass index > 29 kg/m2) may benefit from an upper guideline of 25 pounds of weight gain to help reduce risk for high birth weight.

Adolescent↗

PubMed1995

A brief, telephone-administered food frequency questionnaire can be useful for surveillance of dietary fat intakes.

A 13-item questionnaire designed for quick telephone administration was evaluated for use in surveillance of fat intake in the United States. Study populations included 560 middle-aged and older adults from Beaver Dam, WI, 252 middle-aged and older women from Wisconsin, 73 young, low income Hispanic women from Chicago, IL, 52 older adults from Arizona and 135 younger adults from Augusta, GA. Correlations between fat scores and fat intakes measured by multiple food records or recalls or by more extensive food frequency questionnaires ranged from 0.33 to 0.60, similar to results from other published questionnaire validation studies. Correlations with percentage of energy from fat were lower (0.26 to 0.42), except for the Chicago population, for which there was no correlation (-0.02). There was no systematic variation in correlations among other subgroups defined by demographic and health-related characteristics, including race (black vs. white). Most, but not all, of the substantial differences in fat intakes among subgroups were identified by the questionnaire. The questionnaire will not capture small differences in intakes among groups and is inappropriate when the sample size is limited or for populations with diets substantially different from the typical U.S. diets, such as the Chicago population. However, with attention to its limitations, the questionnaire is useful for surveillance.

Adolescent↗

PubMed1995

The validity of self-reports of past body weights by U.S. adults.

Past weight or patterns of weight change may be more important to chronic disease risk than current weight. Self-reports, however, are often the only source of information about past body weight. To date, very few studies have examined factors affecting the validity of self-reported past body weight. We examined the validity of self-reported past body weights of 1,931 U.S. adults who were participants in the First National Health and Nutrition Examination Survey (1971-1975) and were interviewed again in the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study (1982-1984). We compared the body weight measured during the initial examination (1971-1975) with the recalled 1971-1975 body weight reported during the follow-up interview (1982-1984). Recalled past weight was strongly correlated with previously measured weight (r = 0.73 for men, and r = 0.74 for women). Men overestimated their past body weight, whereas women underestimated their past weight. Although 39% of men and 41% of women estimated their past weight within 5 pounds, approximately 17% of women and 10% of men underestimated their past weight more than 15 pounds. Accuracy of reporting was influenced by sex, race, current body mass index, and the amount of weight gained over the 10 years following the initial examination. These factors should be considered when using recalled weight in epidemiologic studies.

Adult↗

PubMed1995

Alcohol intake and subsequent mortality: findings from the NHANES I Follow-up Study.

OBJECTIVE: Because past research has focused primarily on populations of middle-aged men, the relationship between alcohol and mortality among women and the elderly has been less well substantiated METHOD: We examined the relationship between alcohol intake and mortality using data from the NHANES I Epidemiologic Follow-Up Study. Total mortality was examined for both sexes (N = 4,614 women, 3,573 men), but ischemic heart disease (IHD) mortality was examined only for men because the number of deaths was too small in women. Proportional hazards modeling was used to adjust for the baseline characteristics of age, race, education, body weight, smoking and physical activity. RESULTS: For men aged 40 to 64, the adjusted relative risks (RR) of death for drinking levels of .5 drinks/day, .5 to < 2 and > or = 2 (compared to the nondrinking reference group) were 0.8 (95% Confidence Interval: 0.6, 1.1), 0.9 (CI:0.6, 1.2) and 1.2 (CI: 0.9, 1.6); RRs of IHD mortality were 0.6 (CI: 0.4, 0.9), 0.5 (CI: 0.3, 0.9) and 0.7 (CI: 0.5, 1.2). For women aged 40 to 64, the RRs for death for the same exposure categories were 1.2 (CI: 0.9, 1.6), 0.9 (CI: 0.6, 1.4) and 1.9 (CI: 1.2, 3.0). Among both sexes 65 years and older, consumption of < 2 drinks/day was associated with about a 20% decrease in total mortality and IHD mortality (men only). However, this protective effect disappeared after exclusion of those with pre-existing disease. CONCLUSIONS: Our findings support a protective effect of moderate alcohol intake on IHD mortality in middle-aged men. Among both men and women, there was little evidence of a protective association between moderate alcohol intake and total mortality after excluding those with pre-existing disease.

Adult↗

PubMed1995

The association between alcohol use and health behaviors related to the risk of cardiovascular disease: the South Carolina Cardiovascular Disease Prevention Project.

OBJECTIVE: This study examines the relationship between alcohol use and health behaviors related to the risk of cardiovascular disease (CVD). In particular, we examined the relationship between alcohol use and leisure time physical activity, participation in community physical activity programs and behaviors used for weight loss. Numerous studies have found a "protective" effect of moderate alcohol consumption on the risk of CVD. However, most of these studies have not adequately controlled for potential confounding by health behaviors associated with alcohol use. METHOD: We used descriptive and logistic regression analyses to examine cross-sectional survey data from 2,072 participants in the South Carolina Cardiovascular Disease Prevention Project. RESULTS: After controlling for age, race, education and preexisting CVD, moderate and heavy drinkers who do not smoke were more likely than nondrinkers to report engaging in regular leisure time physical activity. The relationship between other health behaviors and alcohol consumption was less clear. Among men, moderate and heavy drinkers were no more likely than nondrinkers to participate in community physical activity programs; among women, moderate and heavy drinkers were more likely than nondrinkers to report this activity. Moderate drinkers were more likely than nondrinkers to report that they were attempting to lose weight, however this difference was not statistically significant. CONCLUSIONS: These data suggest that at least some of the apparent protective effect of moderate alcohol consumption found in other studies may be due to differences between nondrinkers and drinkers with respect to physical activity and other health practices.

Adolescent↗

PubMed1995

Fruit and vegetable intake among adults in 16 states: results of a brief telephone survey.

A brief food frequency questionnaire was used to assess daily fruit and vegetable consumption among 23,699 adults in 16 US states sampled in a random-digit dialing telephone survey. Men consumed fewer servings per day (3.3) than did women (3.7). Only 20% of the population consumed the recommended 5 or more daily servings. Intakes varied somewhat by state and were lower among the young and the less educated. Efforts are needed to improve fruit and vegetable consumption among all Americans, especially younger adults and those with lower levels of education.

Adolescent↗

PubMed1995

The association between leisure-time physical activity and dietary fat in American adults.

Relations between leisure-time physical activity and dietary fat were examined in a population-based probability sample of 29,672 adults in the 1990 Behavioral Risk Factor Surveillance System. Consumption of 13 high-fat food items and participation in physical activities were measured, and fat and activity scores were calculated. Dietary fat and physical activity were strongly and inversely associated. This association was independent of nine other demographic and behavioral risk factors. Etiologic researchers should consider that diet and physical activity can potentially confound each other, and creators of public health messages that target one behavior should consider including the other.

Adolescent↗

PubMed1994

A prospective study of alcohol intake and change in body weight among US adults.

Little is known about the role of alcohol in determining change in body weight. In this paper, the authors examine the relation between alcohol intake and body weight in 7,230 US adults aged 25-74 years who participated in the First National Health and Nutrition Examination Survey (1971-1975) and who were reweighed 10 years later (1982-1984). Both cross-sectional and prospective analyses were adjusted for age, race, height, education, health status, smoking status, diet status, physical activity, and total nonalcoholic caloric intake. At baseline, women who reported at least one drink per day weighed 2.3 kg less than nondrinkers (95% confidence interval (CI) -0.4 to -4.2). Little relation was observed between body weight and alcohol intake cross-sectionally among men. Prospectively, both men and women drinkers tended to gain less weight than did nondrinkers (p = 0.006 for trend in women, p = 0.11 for trend in men). Drinkers also had more stable weight over the 10-year follow-up period. Drinkers were less likely to have major weight gain or loss (gaining or losing > or = 10 kg) than were nondrinkers. Compared with nondrinkers, for those who consumed 1-6.9 drinks per week, women had an odds ratio (OR) = 0.7 (95% CI 0.5 to 0.9) for major weight gain and an OR = 0.7 (95% CI 0.5 to 1.1) for major weight loss, while men had an OR = 1.0 (95% CI 0.6 to 1.6) for major weight gain and an OR = 0.7 (95% CI 0.5 to 1.2) for major weight loss. For those who consumed > or = 2 drinks per day, women had an OR = 0.5 (95% CI 0.3 to 1.0) for major weight gain and an OR = 0.8 (95% CI 0.4 to 1.6) for major weight loss, while men had an OR = 0.9 (95% CI 0.5 to 1.6) for major weight gain and an OR = 1.0 (95% CI 0.6 to 1.7) for major weight loss. These data suggest that alcohol intake does not increase the risk of obesity.

Adult↗

PubMed1994

Weight control practices in adults: results of a multistate telephone survey.

In this study, data collected in 1989 in a random-digit dialing telephone survey of 60,590 adults in 38 states and the District of Columbia were analyzed. Approximately 38% of women and 24% of men reported that they were currently trying to lose weight. Methods reported were counting calories (24% of women, 14% of men), participating in organized weight loss programs (10%, 3%), taking special supplements (10%, 7%), taking diet pills (4%, 2%), and fasting for 24 hours or longer (5%, 5%). Among both sexes, only half of those trying to lose weight reported using the recommended method of caloric restriction combined with physical activity.

Adolescent↗

PubMed1994

A prospective study of childbearing and 10-year weight gain in US white women 25 to 45 years of age.

Although birth rates to US women aged 25 and older have increased markedly over the last two decades, accurate estimates of the long-term weight gain associated with childbearing are not available for older mothers in the general population. We examined the effect of childbearing on weight change in 2547 white women aged 25-45 years who were initially weighed in the First National Health and Nutrition Examination Survey (1971-75) and who were reweighed an average of 10 years later. Linear and logistic regression estimates were adjusted for duration of follow-up, age, body mass index, initial parity, education, smoking, drinking, employment status, marital status, illness, physical activity, and dieting to lose weight. Compared to parous women who did not give birth during the study period, the mean excess weight gain was 1.6 kg (95% Confidence Limits, +/- 2.3 kg) for nulliparous women, and was 1.7 kg (+/- 1.1 kg), 1.7 kg (+/- 2.0 kg), and 2.2 kg (+/- 4.3 kg), for women having one, two and three live births, respectively. Among women who were nulliparous at baseline, those that had their live births during the study period gained similar amounts of weight to that of women who began childbearing before the beginning of the study. The risk of gaining more than 13 kg was increased by 40%-60%, and the risk of becoming overweight was increased by 60%-110% in women having live births during the study. We conclude that the average weight gain associated with childbearing after the age of 25 is quite modest in US white women. However, for some women who give birth after the age of 25 the risks of major weight gain and becoming overweight are increased in association wtih childbearing.

Adult↗

PubMed1993

Weight control practices of U.S. adolescents and adults.

OBJECTIVE: To estimate the prevalence of various weight-loss practices in U.S. adolescents and adults. DESIGN: The Youth Risk Behavior Survey, a self-administered survey of a random sample of high school students in 1990 and the Behavioral Risk Factor Surveillance System, a random-digit dial survey in 1989. SETTING: Thirty-eight states and the District of Columbia. PARTICIPANTS: High school students (n = 11,467) and adults 18 years and older (n = 60,861). RESULTS: Among high school students, 44% of female students and 15% of male students reported that they were trying to lose weight. An additional 26% of female students and 15% of male students reported that they were trying to keep from gaining more weight. Students reported that they had used the following weight control methods in the 7 days preceding the survey: exercise (51% of female students and 30% of male students); skipping meals (49% and 18%, respectively); taking diet pills (4% and 2%, respectively); and vomiting (3% and 1%, respectively). Among adults, 38% of women and 24% of men reported that they were trying to lose weight, whereas 28% of each sex reported that they were trying to maintain their weight. CONCLUSIONS: Attempts to lose or maintain weight are very prevalent among both adolescents and adults, especially among females.

Adolescent↗

PubMed1993

Weight loss and subsequent death in a cohort of U.S. adults.

OBJECTIVE: Because we previously found that weight loss was associated with increased risk for death in all but very overweight men in a cohort of U.S. adults, we undertook a new analysis to determine whether inadequate control for preexisting illness or cigarette smoking contributed to this association. DESIGN: Cohort study. SETTING: The first National Health and Nutrition Examination Survey (NHANES I, 1971 to 1975) collected information on maximum lifetime weight and measured current weight on a probability sample of U.S. adults. The NHANES I Epidemiologic Follow-up Study determined the vital status of participants through 1987. PARTICIPANTS: Men (n = 2453) and women (n = 2739) who were 45 to 74 years old at the time of the NHANES I examination. RESULTS: The effect of excluding persons who died within the first 5 and first 8 years after baseline was examined to limit the influence of weight loss due to preexisting illness. For women, extension of the exclusionary period weakened the association between weight loss and increased risk for death from noncardiovascular disease. However, excluding death for as much as 8 years after baseline did not affect the strong association between weight loss and increased risk for death from cardiovascular disease among men and women with maximum body mass indexes between 26 and 29 (relative risks of up to 2.1 and 3.6 for men and women, respectively, after excluding deaths in the first 8 years). Results were not substantially altered by limiting the analysis to persons who never smoked. CONCLUSIONS: Preexisting illness may influence the association between weight loss and death principally through deaths from noncardiovascular disease. For some persons, weight loss is associated with an increased risk for death, even after excluding deaths occurring in the first 8 years.

Aged↗

PubMed1993

Recent trends in the identification and treatment of high blood cholesterol by physicians. Progress and missed opportunities.

OBJECTIVE: To investigate recent trends in the percentage and characteristics of patients being treated by a physician for high blood cholesterol (HBC) and to assess missed clinical opportunities to screen for HBC. DESIGN, SETTING, PARTICIPANTS: Telephone interviews of 154,735 adults in 37 states that participated in the Behavioral Risk Factor Surveillance System during 1988-1990 to assess trends in the percentage of patients treated for HBC by a physician. An opportunity was considered missed if a person did not report being screened for HBC despite seeing a physician for preventive care in the last 2 years. RESULTS: Between the first quarter of 1988 and the last quarter of 1990, the percentage of persons treated by a physician for HBC increased from 7.6% to 11.7% (P < .001). However, since an estimated 36% of US adults need treatment for HBC, fewer than one third of persons who need treatment are receiving it. Persons with two or more cardiac risk factors were more likely to be treated, while men, blacks, persons in lower socioeconomic groups, and persons between 20 and 34 years of age were less likely to be treated. Among the 126,571 persons who had seen a physician for preventive care within the last 2 years, missed opportunities to screen for HBC were most common among persons aged 20 through 34 years (59%) and among women who had seen obstetricians/gynecologists for preventive care (43%). CONCLUSIONS: Fewer than one third of persons who need treatment for HBC as estimated by data from the second National Health and Nutrition and Nutrition Examination Survey are receiving treatment. Better use of clinical opportunities to screen for HBC could substantially accelerate the progress in identifying persons, young adults in particular, who are likely to benefit from cholesterol reduction.

Adult↗

PubMed1993

Do obese children become obese adults? A review of the literature.

BACKGROUND: Obese children may be at increased risk of becoming obese adults. To examine the relationship between obesity in childhood and obesity in adulthood, we reviewed the epidemiologic literature published between 1970 and July 1992. Comparison between studies was complicated by differences in study design, definitions of obesity, and analytic methods used. Although the correlations between anthropometric measures of obesity in childhood and those in adulthood varied considerably among studies, the associations were consistently positive. RESULTS: About a third (26 to 41%) of obese preschool children were obese as adults, and about half (42 to 63%) of obese school-age children were obese as adults. For all studies and across all ages, the risk of adult obesity was at least twice as high for obese children as for nonobese children. The risk of adult obesity was greater for children who were at higher levels of obesity and for children who were obese at older ages. CONCLUSION: The wide range of estimates in this literature are, in part, due to differences in study designs, definitions of obesity, ages at which participants were measured, intervals between measurements, and population and cultural differences.

Adolescent↗

PubMed1992

Weight loss and mortality in a national cohort of adults, 1971-1987.

Although obesity is a risk factor for mortality, evidence that weight loss improves survival is limited. The relation between self-reported previous maximum weight, weight loss, and subsequent mortality was examined in 2,140 men and 2,550 women aged 45-74 years who participated in the First National Health and Nutrition Examination Survey (1971-1975) and survived the next 5 years. Vital status was determined through 1987. Among men and women whose maximum body mass index (weight (kg)/height (m)2) was between 26 and 29, risk of death increased with increasing weight loss, after adjustment for age, race, smoking, parity, preexisting illnesses, and maximum body mass index. Subjects who lost 15% or more of their maximum weight had over twice the mortality risk of those who lost less than 5%. At maximum body mass indices of 29 or higher, mortality risk increased with the amount of weight lost in women, but weight loss of 5% to < 15% appeared to lessen mortality risk in men. Generalization from these results is limited by the older age range of the sample and the inability to adequately distinguish voluntary from involuntary weight loss in this study. However, these findings suggest that prevention of severe overweight may be more generally effective than weight loss in reducing obesity-related mortality in the US population.

Aged↗