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Biomedical subjects

M K Serdula

Publications and source records attributed to M K Serdula.

At least 55 records · Page 3Linked to original sources
PubMed1992

Trends in anthropometric measurements among Mescalero Apache Indian preschool children. 1968 through 1988.

OBJECTIVE: To determine if there were trends in underweight, short stature, and obesity among 1- through 5-year-old Mescalero (NM) Apache Indian children from 1968 through 1988. DESIGN: Cross-sectional review of hospital clinic charts for five cohorts. SETTING: General pediatric outpatient clinic at the Mescalero Indian Health Service Hospital. PARTICIPANTS: Sixty-nine patients aged 1 through 5 years in 1968, 1973, 1978, 1983, or 1988 for whom weight and height were recorded during a well-child visit that occurred in the respective year. SELECTION PROCEDURES: Approximately half the charts were screened for eligibility through systematic sampling for all years except 1988; for 1988 all available charts were screened for eligibility for the study. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: We found trends of decreasing prevalence of both underweight (defined as weight-for-height below the fifth percentile) and short stature (defined as height-for-age below the fifth percentile) based on the Centers for Disease Control/World Health Organization growth reference. We found no secular trends in obesity (weight-for-height above the 95th percentile), although the prevalences throughout the 21-year period were as much as two to four times higher than expected when compared with the Centers for Disease Control/World Health Organization reference. There has been an upward shift in both weight-for-height and height-for-age distributions since 1968, indicating that Mescalero children today are, on average, heavier and taller. CONCLUSIONS: Underweight and short stature decreased among Mescalero preschool children from 1968 through 1988, suggesting nutritional improvements. However, given the current high prevalence of obesity, it is recommended that surveillance of nutritional status be continued and appropriate interventions be developed to treat and prevent obesity in this population.

Anthropometry↗
PubMed1992

Weight loss attempts in adults: goals, duration, and rate of weight loss.

OBJECTIVES: Although attempted weight loss is common, little is known about the goals and durations of weight loss attempts and the rates of achieved weight loss in the general population. METHODS: Data were collected by telephone in 1989 from adults aged 18 years and older in 39 states and the District of Columbia. Analyses were carried out separately for the 6758 men and 14,915 women who reported currently trying to lose weight. RESULTS: Approximately 25% of the men respondents and 40% of the women respondents reported that they were currently trying to lose weight. Among men, a higher percentage of Hispanics (31%) than of Whites (25%) or Blacks (23%) reported trying to lose weight. Among women, however, there were no ethnic differences in prevalence. The average man wanted to lose 30 pounds and to weigh 178 pounds; the average woman wanted to lose 31 pounds and to weigh 133 pounds. Black women wanted to lose an average of 8 pounds more than did White women, but Black women's goal weight was 10 pounds heavier. The average rate of achieved weight loss was 1.4 pounds per week for men and 1.1 pounds per week for women; these averages, however, may reflect only the experience of those most successful at losing weight. CONCLUSIONS: Attempted weight loss is a common behavior, regardless of age, gender, or ethnicity, and weight loss goals are substantial; however, obesity remains a major public health problem in the United States.

Adolescent↗
PubMed1991

Obesity among Mescalero preschool children. Association with maternal obesity and birth weight.

The prevalence of obesity among native American children ranks with the highest in the United States. However, little is known about associated risk factors for obesity among these children. We conducted a medical record review of 261 preschool children enrolled in the Mescalero Apache tribe to determine the prevalence of obesity and associated risk factors. The prevalence of obesity (weight for height greater than 95th percentile) in this population was 19.5%. The prevalence of obesity (body mass index greater than 95th percentile) in their mothers was 23%. Children with obese mothers were more than twice as likely to be obese than children of nonobese mothers. Children with a high birth weight were three times as likely to be obese as children of low or normal birth weight. The high prevalence of obesity may be due to both life-style and dietary patterns on the reservation. Family-based interventions are needed to prevent obesity and its long-term consequences in this population.

Birth Weight↗
PubMed1991

Weight loss and bulimic eating behavior: changing patterns within a population of young adult women.

A survey of 364 college freshman women was conducted to examine weight loss practices. Nearly 60% of women were currently on a diet to lose or to maintain weight. Since entering college 7 months earlier, 29% had used crash dieting or fasting as a means of weight control. Even though most had experimented with purging and diet pills in high school, most of these had discontinued these practices. Twenty percent had at some time used diet pills, but only 4% were currently users; 13% had at some time used purgatives (vomiting, laxatives, or diuretics), but only 5% were current users. Use of purgatives may indicate a more general pattern of addictive health behavior. Compared to women who had never used purgatives, current purgative users were 4.1 times more likely to smoke (44% vs 11%) and 2.7 times as likely to use drugs (33% vs 12%). Of the 51 women who had ever smoked, 37% listed weight control as a reason for it. Longitudinal investigations are needed to determine how weight loss practices track from adolescence into adulthood and to determine factors predisposing to the establishment of unhealthy weight loss practices, such as severely restrictive dieting, "yo-yo dieting" (weight cycling), and use of diet pills, purgatives, or tobacco.

Adolescent↗
PubMed1991

Correlates of breast-feeding in a low-income population of whites, blacks, and southeast Asians.

Infant feeding was examined in 492 children in a population-based survey conducted in a low-income, urban county of St Paul, Minn. Of 41 Southeast Asian infants who were foreign born, 93% (38) had been breast-fed compared with 10% (12) of Southeast Asian infants born in the United States (n = 116). Among non-Southeast Asian infants, 73% (173) of whites (n = 237), 63% (27) of blacks (n = 43) and 65% (36) of other ethnic groups (n = 55) had been breast-fed. Among the non-Southeast Asian infants, the initiation of breast-feeding was associated with higher parental education and with being married. Ethnic group, level of poverty, and participation in the Supplemental Food Program for Women, Infants, and Children during pregnancy did not appear to influence the initiation of breast-feeding. The findings indicate a higher incidence of breast-feeding than in previous surveys of low-income black and white women; however, this may reflect the higher educational level of the non-Southeast Asian study population. In contrast, the sharp decline in the incidence of breast-feeding among Southeast Asian infants who were born in the United States compared with those who were foreign born indicates the need for public health approaches to strengthen traditional breast-feeding practices.

Black or African American↗
PubMed1991

Breast-feeding among women attending women, infants, and children clinics in Georgia, 1987.

Breast-feeding is an important determinant of the health and nutritional status of children, particularly in lower socioeconomic populations. A major goal of the Georgia Special Supplemental Food Program for Women, Infants, and Children (WIC) is to increase the practice of breast-feeding among the women it serves. Breast-feeding practices were determined among a random sample of 404 women from a cohort of 2010 who attended WIC prenatal clinics in Georgia in 1986 and were expected to deliver in February 1987. Respondents were interviewed 6 months postpartum. Of these women, 24% initially breast-fed, but only 6% continued for 6 months or longer. The initiation of breast-feeding was associated with greater maternal education and with being married. The adjusted odds of breast-feeding for mothers who were married or living as married were 3.0 (95% confidence interval, 1.7 to 5.3) times greater than for mothers who were not married or living as married. Mothers with more than 12 years, 12 years, or 10 to 11 years of education were 5.2 (1.8 to 15.3), 2.7 (1.0 to 6.9), and 2.5 (0.9 to 6.9) times more likely, respectively, to breast-feed than mothers with 9 or fewer years of education. After adjustment was made for marital status and education, the remaining variables (ethnicity, parity, age, and employment status) did not influence the initiation of breast-feeding in this low-income population. The need for vigorous promotion of breast-feeding by the Georgia WIC program is emphasized by the low rate of initiation and short duration of breast-feeding in this low-income population.

Black or African American↗
PubMed1990

Macrosomia: influence of maternal overweight among a low-income population.

Macrosomia (birth weight greater than 4000 gm) is associated with a wide variety of adverse intrapartum and perinatal outcomes. To evaluate the effect of pregravid obesity on infant birth weight, we examined data from a low-income population of women (n = 127,879). The population was divided into five groups on the basis of pregravid body mass index (weight/height) designated by the National Health and Nutrition Examination Survey II reference population (less than 25th percentile, 25th to less than 75th percentile, 75th to less than 85th percentile, 85th to less than 95th percentile, and greater than or equal to 95th percentile). The prevalence of infant macrosomia ranged from 5% for the lowest group to 17% for the highest group. With the use of the second group (25th to less than 75th percentile) as a reference, odds ratios (adjusted for maternal age, smoking status, race, height, parity, gestational age, and infant sex) for macrosomia for the five sequential weight groups were 0.6, 1.0, 1.3, 1.6 and 2.2. We conclude that pregravid overweight had a significant independent effect on birth weight outcome.

Adolescent↗
PubMed1990

Methodological issues in nutrition surveillance: the CDC experience.

Nutrition surveillance systems serve to provide state- and locality-specific data that are useful for the management of public health nutrition programs. Current systems, such as the Pediatric and Pregnancy Nutrition Surveillance Systems coordinated by the Centers for Disease Control (CDC), collect program-based data focused on nutrition problems in infants, children, and pregnant women. These systems provide highly useful information, but also present significant methodological challenges relating to representativeness, quality control, and indicator sensitivity/specificity. As the importance of nutritional risk factors for chronic disease is increasingly recognized, the concept of nutrition surveillance must be expanded beyond maternal and child nutrition to include nutrition-related behaviors and risk factors in adolescents and adults. The Behavioral Risk Factor Surveillance System (BRFSS), coordinated by CDC, collects telephone survey data that include information on nutrition-related issues such as overweight, weight-loss practices, and cholesterol screening. In addition, a school-based surveillance system is being established by CDC in coordination with state education agencies to assess adolescent health behaviors, including nutrition. The operation of these nutrition surveillance systems presents significant methodological issues that must be considered in interpreting and using the data for public health purposes.

Adolescent↗
PubMed1989

Comparing the prevalence of smoking in pregnant and nonpregnant women, 1985 to 1986.

The 1990 health objectives for the nation state that pregnant women should be only half as likely to smoke as nonpregnant women. To assess progress toward meeting this objective, we used cross-sectional data from the 26 states in the Behavioral Risk Factor Surveillance System in 1985 and 1986. We compared the prevalence of self-reported smoking among pregnant (N = 836) and nonpregnant (N = 18,025) women aged 18 to 45 years. Overall, pregnant women were 70% as likely to be current smokers as nonpregnant women (prevalence ratio, 0.7; 95% confidence interval, 0.6 to 0.8), while blacks showed the largest pregnancy-associated reduction in the prevalence of smoking (prevalence ratio, 0.5; 95% confidence interval, 0.3 to 0.9). Most of the difference in smoking prevalence occurred not because pregnant women were less likely to have ever smoked, but because pregnant women were more likely to have quit smoking than nonpregnant women. However, unmarried pregnant white women were 40% more likely to smoke than their nonpregnant counterparts (prevalence ratio, 1.4; 95% confidence interval, 1.1 to 1.7). We conclude from this analysis that the 1990 health objective for smoking among pregnant women is unlikely to be achieved. Clinicians providing care to pregnant women need to pay increased attention to smoking cessation.

Adolescent↗
PubMed1989

Feeding practices and growth in Yemeni children.

A nutritional survey in the Tihama region of Yemen allowed an analysis of the relationship between infant feeding practices and the growth of children 3-23 months of age. The survey was conducted in 1979 on a representative sample of 364 preschool children 3-23 months of age. After adjustment for demographic and socioeconomic factors, breast feeding was found to be associated with higher weight-for-length and weight-for-age. The strongest beneficial effect of breast feeding on weight-for-length was seen at 3-6 months, a weaker effect at 7-12 months, and essentially no effect over 12 months of age. A higher weight-for-age was seen in breast-fed infants 3-6 months of age only. Introducing other foods was associated with higher weight-for-length only in children 13-23 months of age. Neither breast feeding nor introducing other foods was associated with length-for-age. Infant feeding practices appear to be associated with weight gain, but not linear growth in Yemeni infants.

Anthropometry↗
PubMed1987

Validity of clinic-based nutritional surveillance for prevalence estimation of undernutrition.

Few studies have been performed to assess the validity of clinic-based nutritional surveillance systems. We compared estimates of the prevalence of underweight (low weight-for-age) obtained from the clinic-based Swaziland surveillance system with estimates obtained from the 1983 National Nutrition Status Survey of Rural Swaziland. The age-adjusted prevalence of underweight among first-time clinic attenders (10.0%) was very similar to that estimated by the national survey (9.4%). However, the prevalence of underweight among children attending two or more times in a year was less than half that of first attenders (4.4%). The regional differences in the prevalence of underweight found in the national survey were not detected by the surveillance system. Surveillance data are useful in describing the nutritional status of children from clinics within the surveillance system. However, surveillance data, particularly from re-attenders, will not necessarily provide a valid estimate of nutritional status within the general population or of differences between regions.

Age Factors↗
PubMed1986

Evaluation of reactions to food additives: the aspartame experience.

Despite the widespread use of chemical food additives, few criteria exist to evaluate consumer reports of adverse reactions. We analyzed 231 consumer complaints associated with the food additive aspartame. We developed a methodologic approach to evaluate all complaints by adapting general criteria used to investigate adverse reactions to medications. Complaints were ranked according to the effects of cessation and rechallenge. Using this method, we found no clear symptom complex that suggests a widespread public health hazard associated with aspartame use; however, we identified some case reports in which the symptoms may be attributable to aspartame in commonly-consumed amounts. The systematic application of pre-defined review criteria, such as those described here, to monitor consumer complaints related to food additives will help identify products that warrant more focused clinical studies.

Adult↗
PubMed1986

Seasonal differences in breast-feeding in rural Egypt.

Two surveys in Upper and Lower rural Egypt allowed an analysis of the seasonality of infant feeding. The first, including 937 children, was conducted during the relatively cool season of low diarrhea incidence in January-April 1978; the second, including 976 children, took place during the hot season of high diarrhea incidence in August-September 1980. Of infants 6-11 mo old, the proportion exclusively breast-feeding was greater in the hot-season survey (40% vs 16% in Lower Egypt, p less than 0.01; 36% vs 22% in Upper Egypt, p less than 0.01). Of children 12-17 mo old, a higher proportion were completely weaned during the hot season in Lower Egypt only (28% vs 14%, p less than 0.01). This difference was explained by an increase in pregnancy rates during the hot season resulting in less breast-feeding. Seasonal variation must be considered in the interpretation of infant-feeding surveys.

Breast Feeding↗
PubMed1984

Serological response to rubella revaccination.

To document the serological response, 21 seronegative rubella vaccinees (hemagglutination inhibition [HI] titer less than 10) were revaccinated with RA 27/3 rubella vaccine. All demonstrated an anamnestic response. Although RA 27/3 vaccine was an effective booster, antibody boost was not maintained in some persons. Of 15 persons tested, 24 to 27 months after revaccination, six had a significant HI antibody drop (fourfold or greater); only one had lost all detectable HI antibody. Although all 21 study participants were initially HI seronegative by rubella HI testing, 16 (76.2%) possessed neutralization and/or enzyme-linked immunosorbent assay antibodies before revaccination. As more persons with vaccine-induced immunity join the adult population pool, more sensitive test methods may be needed to assess serological status accurately.

Antibodies, Viral↗
PubMed1984

Therapeutic abortions following rubella infection in pregnancy: the potential impact on the incidence of congenital rubella syndrome.

In 1977, a large rubella outbreak occurred in Hawaii. Because attack rates were high among women of childbearing age, we conducted extensive surveillance efforts to detect both pregnancies complicated by rubella and cases of congenital rubella syndrome (CRS). Initial surveillance included a survey of physicians and hospitals, review of fetal death and birth certificates, and cord blood screening for rubella-specific IgM of infants born following the epidemic. Two years after the outbreak, the medical community was again surveyed to identify affected children who were missed initially. No case of CRS was identified either shortly after the outbreak or in the ensuing two years. In addition, none of the 5,605 cord serum samples obtained was found to contain rubella-specific IgM antibody. Through active surveillance, we received 12 reports of rubella in pregnant women, of whom 11 elected to terminate their pregnancies. The extensive use of therapeutic abortion by exposed women may have prevented the birth of infants with CRS. Surveillance for rubella-related abortions is an important component in assessing the health impact of rubella in a community.

Abortion, Therapeutic↗