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Biomedical subjects

R C Ellison

Publications and source records attributed to R C Ellison.

At least 19 recordsLinked to original sources
PubMed1992

Inverse association of dietary calcium with systolic blood pressure in young children.

OBJECTIVE: To investigate the association of dietary calcium with blood pressure in young children. DESIGN: Cohort. SETTING: General community. SUBJECTS: Eighty-nine boys and girls, aged 3 to 6 years, from The Framingham Children's Study. MEASUREMENTS: During the first year of the study, we derived nutrient data from multiple food diaries (a mean of 9.6 days of recording for each subject). At the beginning of the second year of the study, we obtained anthropometric data and up to five blood pressure readings (mean, 4.5) on each child at a single sitting. RESULTS: The range of subjects' average daily calcium intake was 4.9 to 19.6 mmol per 4200 kJ, with a mean of 12.8 mmol per 4200 kJ. Subjects' average systolic blood pressure ranged from 73 to 129 mm Hg, with a mean of 95.9 mm Hg; for diastolic blood pressure, the range was 37 to 78 mm Hg, mean 54.6 mm Hg. Multiple linear regression analysis, adjusted for the effects of sex, height, body mass index, and heart rate, showed that for each increment of 2.5 mmol of dietary calcium per 4200 kJ per day, systolic blood pressure was 2.27 mm Hg lower (95% confidence interval, 0.63 to 3.91 mm Hg; P = .008). We found no such association for diastolic blood pressure. CONCLUSION: Dietary calcium is inversely related to systolic blood pressure in young children.

Blood Pressure↗
PubMed1992

Impact of within-person variability on identifying children with hypercholesterolemia: Framingham Children's Study.

BACKGROUND AND OBJECTIVE: The National Cholesterol Education Program guidelines recommending that children be screened to detect abnormal levels of blood lipids depend on accurate assignment to risk categories. Our objective was to assess the impact of within-person variability of blood lipids on such risk classification. DESIGN AND SUBJECTS: We measured total cholesterol (TC) and high-density lipoprotein-cholesterol (HDL-C) at three successive weekly visits in 24 children aged 6 to 9 years. MAIN OUTCOME MEASURES: Using within-person variance estimates, we constructed 95% confidence intervals to evaluate how well one, two, and three lipid measurements per child allowed assignment of risk as recommended by the National Cholesterol Education Program. RESULTS: The mean, overall, and within-person standard deviations were 145.7, 24.5, and 9.2 mg/dl, respectively, for TC, and 42.8, 10.1, and 4.6 mg/dl, respectively, for HDL-C. One TC measurement allowed confident assignment to the "acceptable" (less than 170 mg/dl) category only if less than 154.9 mg/dl, and to the "high" (greater than or equal to 200 mg/dl) category only if greater than 215.1 mg/dl. The average of two TC values allowed assignment to these categories if less than 159.3 or greater than 210.7 mg/dl, respectively. For the average of three TC values, these ranges were less than 161.3 and greater than 208.7 mg/dl, respectively. With one TC measurement, no value allowed assignment to the "borderline" (170 to 199 mg/dl) category. The average of two TC values allowed assignment to the "borderline" category if between 180.7 and 189.3 mg/dl. Using the average of three values enlarged this range by 4 mg/dl. For HDL-C, multiple measurements improved risk assignment in a similar fashion. CONCLUSION: The magnitude of within-person variability of TC and HDL-C limits the ability to classify children into risk categories recommended by the National Cholesterol Education Program.

Child↗
PubMed1992

Effects of alterations in fatty acid intake on the blood pressure of adolescents: the Exeter-Andover Project.

To judge the effect on blood pressure, the ratio of polyunsaturated to saturated fatty acids (P:S) of foods served to students at two boarding high schools was modified alternately at each school for one school year. The average P:S of the diet of males increased from 0.53 to 0.93 during the intervention whereas among females it increased from 0.64 to 0.98. Comparison of repeated systolic and diastolic blood pressure measurements near the end of the school year did not demonstrate a beneficial effect of the dietary fat changes on the blood pressure of these normotensive adolescents. Compared with the blood pressure patterns during control years, the dietary intervention resulted in slightly higher systolic (+0.88 mm Hg; 95% CI -0.66, +2.42) and diastolic (+1.23 mm Hg; 95% CI = +0.04, +2.42) blood pressure readings among males. Among females the intervention resulted in slightly lower systolic (-0.54 mm Hg; 95% CI = -1.95, +0.88) and diastolic (-0.80 mm Hg (95% CI -2.18, +0.58) blood pressure readings.

Adolescent↗
PubMed1992

Parent-child relationships in nutrient intake: the Framingham Children's Study.

Nutrient intake affects many of the identified risk factors for coronary heart disease (CHD). Although CHD risk factors have been shown to aggregate within families, less is known about the familial aggregation of nutrient intake. We analyzed diet records for an average of 9 d per subject on 87 mothers, 83 fathers, and 91 children aged 3-5 y. A statistically significant but modest correlation (r less than 0.50) was found between parents' and children's intakes for most nutrients. The intake of nutrients was more strongly related between mothers and children than between fathers and children, and there was a stronger association with children's values for parents consuming more meals at home. The results of this study confirm that parents' eating habits have an impact on the nutrient intake of their preschool children; the study furnishes indirect support for dietary-intervention programs targeting families for the primary prevention of CHD.

Adult↗
PubMed1991

Factors encouraging cohort maintenance in a longitudinal study.

Maintenance of the cohort is one of the primary challenges of a longitudinal study. At the end of 3 years of follow up in the Framingham Children's Study, a longitudinal study of young children and their parents, 100 of the original 106 families (94.3%) have remained in the study. A questionnaire was administered to identify factors contributing to the high rate of follow up to this point in the study. The attitudes of the staff, feedback to the subjects, the staff's handling of questions and problems, and association with the Framingham Heart Study emerged as the most important factors influencing continued participation in the study. In addition, 99% of the subjects stated that they believed the medical research to be important. We conclude that the quality of the communication with study participants and the subjects' perceived importance of the research have been the key factors in maintaining the cohort in this longitudinal epidemiologic study.

Attitude of Health Personnel↗
PubMed1991

Influence of parents' physical activity levels on activity levels of young children.

To determine the relationship between activity levels of parents and those of their young children, we monitored physical activity with a mechanical device, the Caltrac accelerometer, in one hundred 4- to 7-year-old children and in 99 of their mothers and 92 of their fathers. During 1 year in the Framingham Children's Study, data were obtained for an average of more than 10 hours per day for 8.6 +/- 1.8 days for the children, for 8.3 +/- 2.1 days for their mothers, and for 7.7 +/- 2.3 days for their fathers. Children of active mothers (average Caltrac accelerometer counts per hour greater than the median) were 2.0 times as likely to be active as children of inactive mothers (95% confidence interval = 0.9, 4.5); the relative odds ratio of being active for the children of active fathers was 3.5 (95% confidence interval = 1.5, 8.3). When both parents were active, the children were 5.8 times as likely to be active (95% confidence interval = 1.9, 17.4) as children of two inactive parents. Possible mechanisms for the relationship between parents' and child's activity levels include the parents' serving as role models, sharing of activities by family members, enhancement and support by active parents of their child's participation in physical activity, and genetically transmitted factors that predispose the child to increased levels of physical activity.

Child↗
PubMed1990

School-based cardiovascular health promotion: the child and adolescent trial for cardiovascular health (CATCH).

The Child and Adolescent Trial for Cardiovascular Health (CATCH) is a multisite intervention research study that builds on significant progress made in school health education research in the 1980s. The study has three phases: Phase I deals with study design, intervention, and measurement development, Phase II involves the main trial in 96 schools in four states, and Phase III focuses on analysis. The intervention program targets third-fifth grade students and focuses on multiple cardiovascular health behaviors, including eating habits, physical activity, and cigarette smoking. Classroom curricula, school environmental change, and family involvement programs are developed for each grade level and behavioral focus. This paper describes Phase II of CATCH with a rationale for cardiovascular health promotion with youth. The process of change that appears to be necessary for school-based health promotion and that will be tested in CATCH are presented as a framework to guide these efforts.

Adolescent↗
PubMed1990

Use of fat-modified food products to change dietary fat intake of young people.

Food purchasing and preparation practices were modified in two boarding high schools to increase the polyunsaturated-to-saturated fat ratio (P/S) of the diet of students by changing food products rather than attempting to change eating behaviors. During years when fat-modified products were served, the P/S of males increased by 75 percent, versus a decrease of 6 percent during control years. For females, P/S increased by 53 percent during intervention years, versus an increase of 6 percent during control years.

Adolescent↗
PubMed1990

Cheers!

Explore the source record for details and available documents.

Alcohol Drinking↗
PubMed1989

Effects on blood pressure of a decrease in sodium use in institutional food preparation: the Exeter-Andover Project.

To judge the effect on blood pressure, sodium intake of students at two boarding high schools was reduced by 15-20% through changes in food purchasing and in preparation practices in the schools' kitchens. Students were not asked to change their usual eating habits. Each school served alternately as the control or intervention school for one school year. Blood pressure was monitored among 341 subjects during control years and 309 subjects during intervention years. Analysis of blood pressure differences between early in the school year and near the end of the school year, with adjustment for sex and initial blood pressure, showed the effect of the dietary intervention to be -1.7 mmHg for systolic (95% CI = -0.6, -2.9, p = 0.003) and -1.5 mmHg for diastolic pressure (95% CI = -0.6, -2.5, p = 0.002). Such modest and easily attainable changes in sodium intake, if maintained, could have a significant effect on the future risk of essential hypertension among young people.

Adolescent↗
PubMed1989

The environmental component: changing school food service to promote cardiovascular health.

An environmental program directed at the food service departments of two boarding high schools has been tested in a concurrently controlled longitudinal investigation in which the intervention was applied to each school in alternate years. It has been demonstrated that changes in food purchasing and preparation practices can markedly decrease sodium and modify the fat composition of foods, and that such practices result in significant changes in the nutrient intake of students. Even without an educational component for students, who maintained their usual dietary practices, the changes by food service workers led to 15-20% less sodium intake, 20% less saturated fat intake, and an increase in the P/S ratio from 0.46 to 0.84 among students. The change in sodium intake over a school year resulted in lower blood pressure among students receiving the intervention. Adjusting for sex and baseline blood pressure, the estimated effect of the intervention on systolic pressure was -1.7 mmHg (95% C.I. -0.6, -2.9; p = 0.003); for diastolic pressure, it was -1.5 mmHg (95% C.I. -0.6, -2.5; p = 0.002). Such modifications by school food service workers are well accepted and produce very palatable foods. The widespread dissemination of such practices could favorably affect cardiovascular risk factors of students everywhere.

Adolescent↗
PubMed1989

Physician attitudes toward cost containment. The missing piece of the puzzle.

A survey of 720 physicians practicing in central and western Massachusetts was undertaken to examine their attitudes toward cost-containment measures. The majority of physicians felt that major techniques (58%), major procedures (57%), inappropriate ordering of diagnostic tests (48%), and malpractice concerns (47%) were very important contributors to increasing health care costs. Physician age, practice affiliation, and specialty area were related to the perceived importance of these factors. In addition, while there was a uniform lack of prior training in cost-containment measures, 48% of all physicians felt that courses in cost-containment techniques would be worthwhile. These results suggest a variety of concerns and issues that need to be considered when attempting to modify the cost-containment attitudes and practices of physicians.

Age Factors↗
PubMed1988

Lack of association between skin tags and colon polyps in a primary care setting.

Cutaneous skin tags (acrochordons) have recently been proposed as markers for adenomatous polyps of the colon among symptomatic patients referred for colonoscopy. To ascertain the utility of skin tags as a predictor of colonic polyps in a primary care setting, 492 patients, with a mean age of 58 +/- 13.3 years (241 with signs or symptoms and 251 for screening), were evaluated for the presence of skin tags and then examined using a 60-cm fiberoptic sigmoidoscope by an examiner "blinded" to the skin findings. Among patients with skin tags, 23 (10.2%) of 226 had polyps, whereas among patients without skin tags, 20 (7.5%) of 266 had polyps. The predictive value of the presence of a skin tag was 10.2%. Contrary to studies done in more selected populations with a higher prevalence of adenomatous polyps, the results using a 60-cm flexible sigmoidoscope in a primary care population suggest that cutaneous skin tags are not a marker for adenomatous polyps of the colon.

Adolescent↗