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Biomedical subjects

Stephen R Daniels

Publications and source records attributed to Stephen R Daniels.

At least 19 recordsLinked to original sources
PubMed2007

Childhood overweight and cardiovascular disease risk factors: the National Heart, Lung, and Blood Institute Growth and Health Study.

OBJECTIVE: To estimate the prevalence and incidence of overweight in African-American and Caucasian girls, and to examine associations between adolescent overweight and cardiovascular disease (CVD) risk factors. STUDY DESIGN: In the National Heart, Lung and Blood Institute Growth and Health Study (NGHS), annual measurements were obtained from girls followed longitudinally between age 9 or 10 and 18 years; self-reported measures were obtained at age 21 to 23 years. A total of 1166 Caucasian girls and 1213 African-American girls participated in the study. Childhood overweight as defined by the Centers for Disease Control and Prevention (CDC) was the independent variable of primary interest. Measured outcomes included blood pressure and lipid levels. RESULTS: Rates of overweight increased through adolescence from 7% to 10% in the Caucasian girls and from 17% to 24% in the African-American girls. The incidence of overweight was greater at age 9 to 12 than in later adolescence. Girls who were overweight during childhood were 11 to 30 times more likely to be obese in young adulthood. Overweight was significantly associated with increased percent body fat, sum of skinfolds and waist circumference measurements, and unhealthful systolic and diastolic blood pressure, high-density lipoprotein cholesterol, and triglyceride levels. CONCLUSION: A relationship between CVD risk factors and CDC-defined overweight is present at age 9.

Adolescent↗
PubMed2006

Socioeconomic disparities in insulin resistance: results from the Princeton School District Study.

OBJECTIVES: The objectives of this study were to determine whether lower socioeconomic status (SES) is associated with changes in insulin resistance in adolescents over a 3-year period and explore moderators of this effect. METHODS: A total of 1167 healthy non-Hispanic black and white participants in the Princeton School District Study, a longitudinal study of fifth to 12th graders in a suburban Midwestern public school district were included in this study. Inclusion criteria were a) physical examination and fasting morning blood draw at baseline and 3 years later, b) younger than 20 years old at follow up, and c) information available on SES provided by a parent. The influence of SES on insulin resistance and change in insulin resistance over time was examined using general linear models adjusting for multiple covariates. Models also assessed if race or baseline weight status changed the SES-insulin resistance relationship and explored the role of perceived stress. RESULTS: Blacks and lower SES youth had higher body mass index z score and increased insulin resistance (p < .001). In multivariable models, lower parent education, but not household income, was associated with higher baseline insulin resistance (F = 7.84, p < .001) and worsening insulin resistance over time (F = 18.86, p < .001). Parent education's effect on change in insulin resistance was more pronounced for obese youth compared with nonobese (F interaction = 10.12, p < .001) even with adjustment for multiple covariates. Perceived stress did not alter these relationships. CONCLUSIONS: Lower parent education appears to be related to increased insulin resistance both cross-sectionally and over time in black and white adolescents. Worsening insulin resistance is especially problematic for obese adolescents from families with low parent education.

Adolescent↗
PubMed2006

Physical activity intervention studies: what we know and what we need to know: a scientific statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity); Council on Cardiovascular Disease in the Young; and the Interdisciplinary Working Group on Quality of Care and Outcomes Research.

In this review, our first purpose is to provide an overview of existing physical activity intervention research, focusing on subpopulations and intervention modalities. Our reviews within each area are not exhaustive or quantitative, as each area has been reviewed in more depth in numerous other reports. Instead, our goal is to provide a single document that provides a qualitative overview of intervention research that emphasizes selected topics of particular importance for improving the population-wide impact of interventions. Therefore, in synthesizing this vast literature, we begin with existing reviews of physical activity research in each area and incorporate in our discussions recent reports of well-designed individual physical activity intervention studies that expand the existing research base and/or target new areas of research. Our second purpose is to offer new ideas and recommendations to improve the state of the science within each area and, where possible, to propose ideas to help bridge the gaps between these existing categories of research.

Adolescent↗
PubMed2006

Cardiovascular risk reduction in high-risk pediatric patients: a scientific statement from the American Heart Association Expert Panel on Population and Prevention Science; the Councils on Cardiovascular Disease in the Young, Epidemiology and Prevention, Nutrition, Physical Activity and Metabolism, High Blood Pressure Research, Cardiovascular Nursing, and the Kidney in Heart Disease; and the Interdisciplinary Working Group on Quality of Care and Outcomes Research: endorsed by the American Academy of Pediatrics.

Although for most children the process of atherosclerosis is subclinical, dramatically accelerated atherosclerosis occurs in some pediatric disease states, with clinical coronary events occurring in childhood and very early adult life. As with most scientific statements about children and the future risk for cardiovascular disease, there are no randomized trials documenting the effects of risk reduction on hard clinical outcomes. A growing body of literature, however, identifies the importance of premature cardiovascular disease in the course of certain pediatric diagnoses and addresses the response to risk factor reduction. For this scientific statement, a panel of experts reviewed what is known about very premature cardiovascular disease in 8 high-risk pediatric diagnoses and, from the science base, developed practical recommendations for management of cardiovascular risk.

Arthritis, Rheumatoid↗
PubMed2006

Effects of sibutramine treatment in obese adolescents: a randomized trial.

BACKGROUND: Increased prevalence of adolescent obesity requires effective treatment options beyond behavior therapy. OBJECTIVE: To see whether sibutramine reduced weight more than placebo in obese adolescents who were receiving a behavior therapy program. DESIGN: 12-month, 3:1 randomized, double-blind trial conducted from July 2000 to February 2002. SETTING: 33 U.S. outpatient clinics. PARTICIPANTS: 498 participants 12 to 16 years of age with a body mass index (BMI) that was at least 2 units more than the U.S. weighted mean of the 95th percentile based on age and sex, to the upper limit of 44 kg/m2. INTERVENTIONS: Site-specific behavior therapy plus 10 mg of sibutramine or placebo. Blinded study medication dose was uptitrated to 15 mg or placebo at month 6 if initial BMI was not reduced by 10%. MEASUREMENTS: Body mass index, waist circumference, body weight, fasting lipid and glycemic variables, safety, and tolerability. RESULTS: Seventy-six percent of patients in the sibutramine group and 62% of patients in the placebo group completed the study. The estimated mean treatment group difference at month 12 (linear mixed-effects model) favored sibutramine for change from baseline in BMI (-2.9 kg/m2 [95% CI, -3.5 to -2.2 kg/m2]) and body weight (-8.4 kg [CI, -9.7 to -7.2 kg]) (P < 0.001 for both). The sibutramine group had greater improvements in triglyceride levels, high-density lipoprotein cholesterol levels, insulin levels, and insulin sensitivity (P < or = 0.001 for all). The rate of tachycardia was greater with sibutramine vs. placebo (12.5% vs. 6.2%; difference, 6.3 percentage points [CI, 1.0 to 11.7 percentage points]) but did not lead to increased withdrawal (2.4% vs. 1.5%; difference, 0.9 percentage point [CI, -1.7 to 3.5 percentage points]). LIMITATIONS: The 1-year study duration precluded assessment of long-term weight maintenance and putative health benefits and harms, and 24% and 38% of the sibutramine and placebo groups, respectively, did not complete follow-up. CONCLUSIONS: Sibutramine added to a behavior therapy program reduced BMI and body weight more than placebo and improved the profile of several metabolic risk factors in obese adolescents.

Adolescent↗
PubMed2006

Effect of blinded peer review on abstract acceptance.

CONTEXT: Peer review should evaluate the merit and quality of abstracts but may be biased by geographic location or institutional prestige. The effectiveness of blinded peer review at reducing bias is unknown. OBJECTIVE: To evaluate the effect of blinded review on the association between abstract characteristics and likelihood of abstract acceptance at a national research meeting. DESIGN AND SETTING: All abstracts submitted to the American Heart Association's annual Scientific Sessions research meeting from 2000-2004. Abstract review included the author's name and institution (open review) from 2000-2001, and this information was concealed (blinded review) from 2002-2004. Abstracts were categorized by country, primary language, institution prestige, author sex, and government and industry status. MAIN OUTCOME MEASURE: Likelihood of abstract acceptance during open and blinded review, by abstract characteristics. RESULTS: The mean number of abstracts submitted each year for evaluation was 13,455 and 28.5% were accepted. During open review, 40.8% of US and 22.6% of non-US abstracts were accepted (relative risk [RR], 1.81; 95% confidence interval [CI], 1.75-1.88), whereas during blinded review, 33.4% of US and 23.7% of non-US abstracts were accepted (RR, 1.41; 95% CI, 1.37-1.45; P<.001 for comparison between peer review periods). Among non-US abstracts, during open review, 31.1% from English- speaking countries and 20.9% from non-English-speaking countries were accepted (RR, 1.49; 95% CI, 1.39-1.59), whereas during blinded review, 28.8% and 22.8% of abstracts were accepted, respectively (RR, 1.26; 95% CI, 1.19-1.34; P<.001). Among abstracts from US academic institutions, during open review, 51.3% from highly prestigious and 32.6% from nonprestigious institutions were accepted (RR, 1.57; 95% CI, 1.48-1.67), whereas during blinded review, 38.8% and 29.0% of abstracts were accepted, respectively (RR, 1.34; 95% CI, 1.26-1.41; P<.001). CONCLUSIONS: This study provides evidence of bias in the open review of abstracts, favoring authors from the United States, English-speaking countries outside the United States, and prestigious academic institutions. Moreover, blinded review at least partially reduced reviewer bias.

Abstracting and Indexing↗
PubMed2006

Clinical stress testing in the pediatric age group: a statement from the American Heart Association Council on Cardiovascular Disease in the Young, Committee on Atherosclerosis, Hypertension, and Obesity in Youth.

This statement is an updated report of the American Heart Association's previous publications on exercise in children. In this statement, exercise laboratory requirements for environment, equipment, staffing, and procedures are presented. Indications and contraindications to stress testing are discussed, as are types of testing protocols and the use of pharmacological stress protocols. Current stress laboratory practices are reviewed on the basis of a survey of pediatric cardiology training programs.

Clinical Protocols↗
PubMed2006

Sleep in overweight adolescents: shorter sleep, poorer sleep quality, sleepiness, and sleep-disordered breathing.

OBJECTIVE: To document the sleep of overweight adolescents and to explore the degree to which weight-related sleep pathology might account for diminished psychosocial outcome. METHODS: Sixty children aged 10-16.9 from a weight-management clinic were compared to 22 healthy controls using comprehensive actigraphic, polysomnographic, and parent- and self-report questionnaire assessments. RESULTS: Overweight participants averaged more symptoms of sleep-disordered breathing, later sleep onset, shorter sleep time, and more disrupted sleep than controls. Although the groups did not differ in self-reported sleep habits, multiple concerns were reported by parents of overweight participants, including daytime sleepiness, parasomnias, and inadequate sleep. Group differences in academic grades and depressive symptoms were at least partially accounted for by short sleep and daytime sleepiness. CONCLUSIONS: Excessive weight is associated with an increased risk of sleep problems. There is a need for further research in this area and for clinicians who work with overweight children to evaluate their sleep.

Adolescent↗
PubMed2006

Fruit and vegetable intake: Few adolescent girls meet national guidelines.

OBJECTIVE: To examine longitudinal changes in daily fruit and vegetable consumption among black and white adolescent girls and calculate the percent of girls who met the Healthy People 2010 recommendations. METHODS: Girls (1186 black and 1126 white) who participated in the National Heart, Lung, and Blood Institute Growth Health Study (NGHS) were included if they had completed a 3-day food diary for at least one of six annual assessments visits, beginning at ages 11 or 12. Mixed models estimated the association of visit and race with (a) average daily consumption of fruits and vegetables and (b) the probability of meeting intake recommendations on one or more out of 3 days. RESULTS: For girls of both races, fruit and vegetable consumption increased with age; white girls showed a greater increase in fruit and nutrient-rich vegetable intake than black girls. Across visits, girls consumed considerably fewer than the recommended daily servings of fruits (1.0-1.5), vegetables (1.7-2.5), or nutrient-rich vegetables (0.25). Most girls (95%) failed to meet Healthy People 2010 recommendations. CONCLUSIONS: Public health efforts are needed to meet Healthy People 2010 objectives.

Adolescent↗
PubMed2006

Maternal infant-feeding style and children's adiposity at 5 years of age.

OBJECTIVES: To examine the relationship between maternal infant-feeding style and adiposity in childhood and to determine whether feeding style explains any of the association between maternal obesity and childhood adiposity. DESIGN: Prospective cohort study. SETTING: Cincinnati metropolitan area. PARTICIPANTS: A total of 313 preschool children; 80% were white and 20% were black. MAIN OUTCOME MEASURES: Seven factors describing maternal infant-feeding style derived from the Infant Feeding Questionnaire administered at age 3 years; maternal obesity, defined as a body mass index of 30 or higher before pregnancy; and adiposity at 5 years of age as assessed by dual-energy x-ray absorptiometry. RESULTS: The mean +/- SD fat mass was 4.55 +/- 1.64 kg. Seventeen percent of the mothers were obese before pregnancy. Children whose mothers had high concern about the infant overeating or becoming overweight (the highest tertile of the "overeating" factor) had 0.67 kg (95% confidence interval, 0.31-1.03 kg) higher fat mass than children whose mothers did not have high concern (the other 2 tertiles). None of the other 6 feeding factors were related to childhood adiposity. Children of obese mothers had 0.54 kg (95% confidence interval, 0.10-0.98 kg) higher fat mass than children of nonobese mothers. High concern about the infant overeating, which was more common in obese mothers, accounted for 15% of this 0.54-kg difference. CONCLUSION: High maternal concern about an infant overeating or becoming overweight was associated with higher adiposity at 5 years of age and explained some of the association between maternal obesity and child adiposity.

Adult↗
PubMed2006

Caffeine intake in eating disorders.

OBJECTIVE: The current study compares caffeine consumption in females with an eating disorder and females without an eating disorder. METHOD: Caffeine intake in three diagnostic groups (10 females with anorexia nervosa, 27 females with bulimia nervosa, and 42 females with binge eating disorder [BED]) was compared with caffeine intake in three comparison groups (n = 659 each). Data were obtained from a longitudinal study of Black and White girls. Three-day food records were examined for the years before the onset of the eating disorder, the onset year, and the years after the onset of the eating disorder. Data from the same years were used for the comparison groups. RESULTS: Caffeine intake increased over time between ages 9 and 19 years across all groups and this trend was not moderated by diagnostic status. For anorexia nervosa, relative to the non-eating disorder group, the proportional intake of caffeine from soda increased significantly before onset to onset to after onset and ingestion of chocolate-containing foods decreased sharply over time. CONCLUSION: Caffeine consumption in young girls with eating disorders differs from girls with no eating disorders only for anorexia nervosa, but not for bulimia nervosa or BED.

Adolescent↗
PubMed2006

Bariatric surgery in adolescents: an update.

Bariatric surgery, although not a cure for obesity, can help selected extremely obese adolescents achieve significant weight loss and improvement of obesity-related comorbidities, in conjunction with continued dietary and behavioral interventions. This article summarizes the current guidelines for selection of adolescent candidates for bariatric surgery and discusses the types of bariatric procedures presently available for this age group. Data on the complications and outcomes of bariatric surgery in this special population are reviewed.

Adolescent↗
PubMed2006

Correlates of beverage intake in adolescent girls: the National Heart, Lung, and Blood Institute Growth and Health Study.

OBJECTIVES: To examine longitudinal changes in consumption of 6 types of beverages (milk, diet and regular soda, fruit juice, fruit-flavored drinks, and coffee/tea) in girls and determine the relationship between beverage intake, body mass index (BMI), and nutrient intake. STUDY DESIGN: Three-day food diaries were included from black (1210) and white (1161) girls who participated in the National Heart, Lung, and Blood Institute Growth and Health Study. Diaries were recorded during annual visits beginning at ages 9 or 10 years until age 19 years. Mixed models estimated the association of (1) visit and race with average daily consumption of beverages and (2) beverage intake with BMI and average daily intake of total calories, sucrose, fructose, total sugars, and calcium. RESULTS: For girls of both races, milk consumption decreased and soda consumption increased with time. Changes in beverage intake with time varied by race for all beverages except fruit juice. For all beverage categories, consumption was associated with caloric intake. Of all beverages, increasing soda consumption predicted the greatest increase of BMI and the lowest increase in calcium intake. CONCLUSIONS: Public health efforts are needed to help adolescents gain access to and choose healthful beverages and decrease intake of beverages of minimal nutritional value.

Adolescent↗
PubMed2006

Lipid abnormalities are prevalent in youth with type 1 and type 2 diabetes: the SEARCH for Diabetes in Youth Study.

OBJECTIVE: Assessment of the prevalence of serum lipid abnormalities in US youth with type 1 or type 2 diabetes. STUDY DESIGN: The SEARCH for Diabetes in Youth Study was a cross-sectional, population-based study, conducted in six centers. Subjects were 2448 youth with diabetes who had a study examination. Outcome measures were fasting measures of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides, and non-HDL-C. Analysis was descriptive. RESULTS: The overall prevalence of high TC concentration (>240 mg/dL) was 5%; the overall prevalence of high LDL-C (>160 mg/dL) was 3%, and the overall prevalence of high triglyceride (>400 mg/dL) was 2%. About half of the participants (48%) had an LDL-C concentration above the optimal level of 100 mg/dL. Among youth ages 10+, the prevalence of abnormal lipids was higher in type 2 (n = 283) than in type 1 diabetes (n = 1963): 33% versus 19% had TC concentration >200 mg/dL; 24% versus 15% had LDL-C concentration >130 mg/dL; 29% versus 10% had triglyceride concentration >150 mg/dL; 44% versus 12% had HDL-C concentration <40 mg/dL. Only 1% of youth were receiving pharmacologic therapy for dyslipidemia. CONCLUSIONS: A substantial proportion of young patients with diabetes have abnormal serum lipids.

Adolescent↗
PubMed2006

Progression of left ventricular hypertrophy in children with early chronic kidney disease: 2-year follow-up study.

OBJECTIVE: To determine the prevalence and incidence of left ventricular hypertrophy (LVH) and LV geometry and identify variables associated with LV mass (LVM) growth and development of LVH in children and adolescents with chronic kidney disease (CKD). STUDY DESIGN: A 2-year longitudinal study of children with CKD (glomerular filtration rate [GFR] 15-89 mL/minute/1.73 m2). Thirty-one subjects had baseline and repeated echocardiography. RESULTS: Six (19%) of 31 children had LVH at baseline; the prevalence of LVH increased to 39% at 2-year follow-up. Eccentric LVH was the most common geometric pattern throughout the study. Among 25 children with initially normal LVM index, 8 (32%) developed new LVH. Children with incident LVH had significantly higher mean parathyroid hormone (iPTH), lower hemoglobin and calcium levels at baseline, and significantly larger increase in iPTH during a follow-up than children with normal LVM index. Stepwise regression analysis showed that lower initial LVM index and hemoglobin level and interval increase in iPTH and nighttime systolic blood pressure (SBP) load during a follow-up independently predicted interval increase in LVM index. CONCLUSIONS: LVH progresses in children during early stages of CKD. More aggressive control of anemia, BP, and hyperparathyroidism might be important in preventing the development of LVH in these patients.

Adolescent↗
PubMed2006

One-year outcomes of Roux-en-Y gastric bypass for morbidly obese adolescents: a multicenter study from the Pediatric Bariatric Study Group.

BACKGROUND/PURPOSE: Little is known about the metabolic outcomes of adolescent bariatric surgery. We report changes in weight, metabolic profile, and types of complications seen in a multicenter cohort. METHODS: One-year outcomes were included. For weight loss comparisons, a nonsurgical cohort (n = 12) was used. The primary outcome was weight change (n = 30) and secondary outcomes were metabolic variables (n = 24) and complications (n = 36). Data were analyzed using signed rank or paired t tests. RESULTS: Mean body mass index fell 37% (from 56.5 preoperatively to 35.8 kg/m2; P < .001) in surgical patients and 3% (from 47.2 to 46 kg/m2; P = NS) in nonsurgical patients. Surgical patients showed significant improvements in triglycerides (-65 mg/dL), total cholesterol (-28 mg/dL), fasting blood glucose (-12 mg/dL), and fasting insulin (-21 microM/mL]). Improvement in high-density lipoprotein cholesterol (-3.9 mg/dL) and low-density lipoprotein cholesterol (-8.8 mg/dL) was not statistically significant. Sixty-one percent of surgical patients had no complications. Of 15 patients with complications, 9 had minor complications with no long-term sequelae, 4 had at least 1 moderate complication with sequelae for at least 1 month and 2 had at least 1 severe medical complication with long-term consequences (including beriberi and death). There were no perioperative deaths or other severe surgical complications in this series. CONCLUSIONS: Postoperatively, adolescents lose significant weight and realize major metabolic improvements. The complication profile compares favorably to severely obese (body mass index >40 kg/m2) adults; however, small sample size precludes calculation of complication rates. Although there are considerable risks of bariatric surgery, early experience suggests that risks are offset by health benefits.

Adolescent↗
PubMed2006

Racial differences in correlates of misreporting of energy intake in adolescent females.

OBJECTIVE: To determine the extent of misreporting of energy intake (EI) and its anthropometric, demographic, and psychosocial correlates in a bi-racial cohort of young women. RESEARCH METHODS AND PROCEDURES: This was a cross-sectional study of 60 black and 60 white young women, 18 to 21 years old, enrolled in a longitudinal study. Total energy expenditure was assessed using doubly labeled water. Self-reported EI was obtained from 3-day food records. BMI was computed from height and weight. Fat mass was assessed by DXA. Multivariate analyses examined racial differences on the extent of misreporting and its effect on other potential correlates of misreporting. Race-specific step-wise linear regression analysis was performed to examine the effect of BMI, parental education, and drive for thinness on misreporting of EI. RESULTS: More white women tended to under-report EI than black women (22% vs. 13%, p = 0.07). In black women, under-reporting was significantly (p = 0.01) associated with drive for thinness score but was only marginally (p = 0.1) associated with BMI. Each point increase in drive for thinness score was associated with under-reporting by 40 kcal/d. In white women, under-reporting was significantly (p = 0.03) associated with higher parental education by 440 kcal/d and also only marginally (p = 0.09) with BMI. DISCUSSION: This tendency for under-reporting of EI limits the use of self-reported EI in studying energy balance in free-living subjects. Most black and almost all white women in their late teens significantly under-reported their EI, whereas under-reporting was not as evident among lean young black women.

Absorptiometry, Photon↗