PubMed · 15654014
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Jean-Pierre Frat. 2005. Obesity in ICU patients: increase or decrease in mortality?. https://doi.org/10.1378/chest.127.1.414
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We propose an extension of the Harezlak and Heckman (J. Comput. Graph. Statist. 2001; 10(4): 713-729) test for detecting local extrema to the longitudinal data setting. We use penalized spline regression techniques (Statist. Sci. 1996; 11:89-102) to provide a computationally efficient method of testing for relatively large data sets. We estimate the p-values of our test, LongCriSP, with a smoothed bootstrap. Our simulation studies indicate that the test is generally conservative and has power exceeding 70 per cent at the alpha = 0.1 nominal level in most considered settings. Finally, we apply our testing procedure to the longitudinal measurements of body mass index of former prisoners of war in Vietnam and conclude that the mean population curve exhibits non-monotone behaviour.
OBJECTIVES: To estimate the prevalence and incidence of overweight among low-income, inner-city children aged 3 to 7 years and to determine predictors of changes in body mass index (BMI) (calculated as weight in kilograms divided by height in meters squared) percentile. DESIGN: Retrospective cohort study using administrative and medical records. SETTING: The Philadelphia Health Care Centers, 1996 through 2003. PARTICIPANTS: Three hundred eighty-six patients who had at least 2 well-child visits between the ages of 3 and 7 years, had at least 1 visit between September 2001 and 2003, and were between the ages of 5 and 7 years at the most recent visit. Mean follow-up time was 2.4 years. MAIN EXPOSURES: Age, sex, race/ethnicity, and BMI percentile at baseline. MAIN OUTCOME MEASURES: Prevalence and incidence of overweight and at risk of overweight and change in BMI percentile. RESULTS: Prevalence of overweight at the initial visit was 18%, with 16% at risk of overweight. At the last visit, the prevalence of overweight was 19%, with 15% at risk of overweight. Based on maximum BMI percentile, 29% were overweight at some point and an additional 19% were at risk of overweight at least once. Annualized incidence of overweight among those not overweight at baseline was 5% per year: 2% per year for normal-weight children and 14% per year for children in the at-risk category. The outcomes were not associated with sex, race/ethnicity, or age at first or last visit. Incident overweight was positively associated with BMI percentile at baseline. CONCLUSION: The early onset and frequent persistence of overweight demonstrated herein underline the need to prevent overweight among very young children.
Clarification of the role of diet in breast cancer pathogenesis is important in order to identify modifiable risk factors on which to focus prevention efforts. Excess weight and weight gain in adult life are related to higher risk of postmenopausal breast cancer, and weight loss after menopause is associated with substantially reduced risk. Even moderate alcohol consumption contributes considerably to excess breast cancer risk, which can likely be mitigated with adequate folate intake. Diet during early life may play a substantial role in later cancer risk, but data are limited. In addition, physical activity and the prevention of weight gain can improve survival after a breast cancer diagnosis.