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PubMed1987

Personality in the life course.

Using elements borrowed from psychology, sociology, and history, this article outlines a conceptual framework for the analysis of personality in the life course. It is proposed that the interactional framework toward which personality psychology aspires may be conceived of as a sequence of interactions of personality with age-graded roles and social transitions in historically changing environments. To the extent that one can (a) identify the age-graded role paths in the social structure, (b) select the age-relevant situations in which these roles are enacted, and (c) identify measures relevant to the culture pattern across these age-relevant situations, it should be possible to uncover the coherence of personality--ways of approaching and responding to the world--across time and in diverse situations. Each of these steps is delineated and then illustrated with a longitudinal study of explosive, undercontrolled children. This is not an effort to articulate a theory of personality development but to outline the parameters of social life--temporal and situational--to which personality research should attend.

Achievement↗

PubMed1997

Molecular ecology of Streptococcus thermophilus bacteriophage infections in a cheese factory.

A mozzarella cheese factory using an undefined, milk-derived Streptococcus thermophilus starter system was monitored longitudinally for 2 years to determine whether the diversity of the resident bacteriophage population arose from environmental sources or from genetic changes in the resident phage in the factory. The two hypotheses led to different predictions about the genetic diversity of the phages. With respect to host range, 12 distinct phage types were observed. With two exceptions, phages belonging to different lytic groups showed clearly distinct restriction patterns and multiple isolates of phages showing the same host range exhibited identical or highly related restriction patterns. Sequencing studies in a conserved region of the phage genome revealed no point mutations in multiple isolates of the same phage type, while up to 12% nucleotide sequence diversity was observed between the different phage types. This diversity is as large as that between the most different sequences from phages in our collection. These observations make unlikely a model that postulates a single phage invasion event and diversification of the phage during its residence in the factory. In the second stage of our factory study, a defined starter system was introduced that could not propagate the resident factory phage population. Within a week, three new phage types were observed in the factory while the resident phage population was decreased but not eliminated. Raw milk was the most likely source of these new phages, as phages with identical host ranges and restriction patterns were isolated from raw milk delivered to the factory during the intervention trial. Apparently, all of the genetic diversity observed in the S. thermophilus phages isolated during our survey was already created in their natural environment. A better understanding of the raw-milk ecology of S. thermophilus phages is thus essential for successful practical phage control.

Animals↗

PubMed2005

Fast-food intake and diet quality in black and white girls: the National Heart, Lung, and Blood Institute Growth and Health Study.

OBJECTIVE: To examine trends in fast-food consumption and its relationship to calorie, fat, and sodium intake in black and white adolescent girls. DESIGN: A longitudinal multicenter cohort study of the development of obesity and cardiovascular risk factors in black and white female adolescents. Data collection occurred annually using a validated 3-day food record and a food-patterns questionnaire. SUBJECTS AND SETTINGS: A biracial and socioeconomically diverse group of 2379 black and white girls recruited from 3 centers. MAIN OUTCOME MEASURE: Three-day food records and a food-patterns questionnaire were examined for intake of fast food and its association with nutrient intake. We compared patterns of exposure to fast food and its impact on intake of calories, fat, and sodium. RESULTS: Fast-food intake was positively associated with intake of energy and sodium as well as total fat and saturated fat as a percentage of calories. Fast-food intake increased with increasing age in both races. With increasing consumption of fast food, energy intake increased with an adjusted mean of 1837 kcal for the low fast-food frequency group vs 1966 kcal for the highest fast-food frequency group (P<.05). Total fat in the low fast-food frequency group was 34.3% as opposed to 35.8% in the highest fast-food frequency group (P<.05). Saturated fat went from 12.5% to 13% and sodium increased from 3085 mg to 3236 mg in the lowest vs the highest fast-food frequency group (P<.001). CONCLUSIONS: Dietary intake of fast food is a determinant of diet quality in adolescent girls. Efforts to reduce fast-food consumption may be useful in improving diet and risk for future cardiovascular disease.

Adolescent↗

PubMed2000

Detection of emerging resistance patterns within longitudinal surveillance systems: data sensitivity and microbial susceptibility. MYSTIC Advisory Board. Meropenem Yearly Susceptibility Test Information Collection.

Communicating information from antimicrobial resistance surveillance study data to microbiologists and physicians can be challenging. Large amounts of data, commonly reaching millions of MICs or zone diameter endpoints, must be analysed and condensed to easily-read tables or figures. Furthermore, data must not be prejudged relative to susceptibility categories, because of the diverse nature of interpretive criteria available internationally. An attempt must be made to present results of all surveillance studies in a mode that can be reinterpreted for immediate use in different geographical areas, or used to compare future data with relative ease and high accuracy. Such data displays require peer-reviewed journals to permit greater numbers of more complex tables to present results. The Meropenem Yearly Susceptibility Test Information Collection (MYSTIC) study is a year-on-year global surveillance programme in medical centres where meropenem is available for use. We have developed a presentation strategy that expands the long-term clinical value of MYSTIC results. In addition to statistical parameters, tables of cumulative percentages or numbers of strains inhibited at each tested antimicrobial concentration will be presented. Alternative figures (Finland-o-grams) could also be used, but these generally lack precise extractable rates and require more journal space. Regardless of study design, promotion of this presentation philosophy enhances any surveillance study's value to each reader or user and facilitates application to locally appropriate interpretations. The widespread use of these analysis and presentation principles as benchmarks by various resistance studies and networks is strongly encouraged, particularly by investigations across international boundaries.

Anti-Bacterial Agents↗

PubMed2006

Contrasting patterns of historical colonization in white oaks (Quercus spp.) in California and Europe.

Phylogeography allows the inference of evolutionary processes that have shaped the current distribution of genealogical lineages across a landscape. In this perspective, comparative phylogeographical analyses are useful in detecting common historical patterns by either comparing different species within the same area within a continent or by comparing similar species in different areas. Here, we analyse one taxon (the white oak, genus Quercus, subgenus Quercus, section Quercus) that is widespread worldwide, and we evaluate its phylogeographical pattern on two different continents: western North America and Western Europe. The goals of the present study are: (i) to compare the chloroplast genetic diversity found in one California oak species vs. that found in the extensively studied European oak species (in France and the Iberian Peninsula); (ii) to contrast the geographical structure of haplotypes between these two taxa and test for a phylogeographical structure for the California species. For this purpose, we used the same six maternally inherited chloroplast microsatellite markers and a similar sampling strategy. The haplotype diversity within site as well as the differentiation among sites was alike in both taxa, but the Californian species has higher allelic richness with a greater number of haplotypes (39 vs. 11 in the European white oak complex). Furthermore, in California these 39 haplotypes are distributed locally in patches while in the European oaks haplotypes are distributed into lineages partitioned longitudinally. These contrasted patterns could indicate that gene movement in California oak populations have been more stable in response to past climatic and geological events, in contrast to their European counterparts.

California↗

PubMedDate not supplied

Short- and long-term association between uric acid and a natural disaster.

OBJECTIVE: This paper analyzes the longitudinal relationship between serum uric acid level and a natural disaster. METHODS: The sample consists of factory workers who were participating in a longitudinal epidemiological study of coronary heart disease risk factors. Participants were seen in 1975 (baseline), 1980 (5 year follow-up), and 1987 (12 year follow-up). The 5 year (1980) follow-up examination was interrupted by a major earthquake and resumed 2 weeks after the quake. At this examination, participants seen after the quake had, on the average, significantly lower serum uric acid than those seen before the earthquake. In 1987 (7 years after the quake), participants were questioned whether or not (in their own perception) they were still suffering from damages due to the 1980 earthquake. RESULTS: At the examination in 1987, participants who reported suffering from damage due to the 1980 quake showed on the average significantly increased serum uric acid compared with participants who reported not suffering from damages due to the 1980 quake. The analyses of the data of 578 individuals who participated in all three examinations confirmed these findings and showed that they were independent from levels of uric acid measured prior to the disaster. CONCLUSIONS: The reason for this apparent different association with uric acid and acute and long-term exposure to the quake remains to be clarified but these findings are consistent with the existence of diverse patterns of physiologic response to different stressors.

Adaptation, Psychological↗

PubMed2001

HIV gp120 V(1)/V(2) and C(2)-V(3) domains glycoprotein compatibility is required for viral replication.

The envelope gene, especially the V(3) region, of HIV-1 has been shown to be a principal determinant of cell tropism, replication and cytopathogenicity of the virus. In addition, the V(1)/V(2) region of the envelope gene has been found to be an important factor in cell tropism. We examined the compatibility between the V(1)/V(2) and C(2)-V(3) domains of HIV-1 gp120 in different combinations on viral replication by using envelope recombinants between ME1 and ME46, two infectious molecular clones with diverse biologic activity longitudinally isolated from one seropositive subject. Our data demonstrate that a proper interaction between the regions of V(1)/V(2)and C(2) is essential for viral infection and hence replication. Sequence analysis and subsequent site directed mutagenesis study indicate that the pattern of potential envelope N-glycosylation in the V(1)/V(2) and C(2)-V(3) regions may be the determining factor in such interaction between these two regions. It is possible that improper N-glycosylation sites while not affecting virus assembly, can influence through steric hindrance the conformational change of the V(3) region that is required for the co-receptor attachment and hence the viral infectivity.

Binding Sites↗

PubMed2004

Defining subgroups of adolescents at risk for experimental and regular smoking.

If multiple etiologies of substance use are truly at work in the population, then further strides in the accurate prediction of smoking and the use of other substances will likely be built on diverse pattern-centered approaches that explore the presence of multiple population subgroups across various substance use stages. The present study aimed to identify population subgroups defined by individual risk factors or risk factor constellations that prospectively predict specific smoking stages. Using data from the National Longitudinal Study of Adolescent Health (Add Health), analyses were conducted on the sample that took part in the baseline and 1 year follow-up assessment between 1994 and 1996. Classification and regression tree procedures were used to investigate the structure of individual risk factors, or constellations of risk, that define population subgroups with high rates of both experimental and established smoking. For each level of smoking, a relatively simple model including two subgroups predicted over half of the smoking cases. Findings also indicated that the two group models identified higher rates of regular smokers compared to experimental smokers. Deviant behaviors and alcohol use without permission independently predicted movement to experimentation at follow-up. Progression to regular smoking from both a nonsmoking and experimental smoking status at baseline were each predicted by smoking friends. Additionally, baseline levels of experimental use predicted movement from experimental to regular smoking, while a relatively low grade point average predicted rapid progression from baseline nonuse to regular use at follow-up. By identifying first approximations of patterns, these analyses may lead to clues regarding the major multiple mechanisms at work for the progression of smoking among adolescents.

Adolescent↗

PubMed2001

(In)visible men. Emerging research on low-income, unmarried, and minority fathers.

The author aims to help make low-income, unmarried, and minority fathers more visible by reviewing the emerging literature base on this population and addressing important conceptual, methodological, and policy issues. Recent evidence is reviewed concerning patterns of fatherhood, factors that support or prohibit fathers' active involvement with their children, and the impact of paternal involvement on children's development. To move the field forward, advances are needed in methodology (increased use of father reports, multiple methods, and longitudinal studies), measurement (greater diversity and depth, multiple reporters), and theoretical and conceptual definitions (family systems perspectives, new and inclusive definitions of fatherhood). In particular, a multidisciplinary and contextualized perspective is an imperative aid to significantly increase understanding of the lives and impact of low-income, unmarried, and minority fathers.

Adult↗

PubMedDate not supplied

An immunoepidemiological approach to asthma: identification of in-vitro T-cell response patterns associated with different wheezing phenotypes in children.

BACKGROUND: Increasing evidence suggests that patterns of T-cell immunity to inhalant allergens in genetically diverse human populations are more heterogeneous than previously assumed, and that covert differences in expression patterns might underlie variations in airway disease phenotypes. We tested this proposition in a community sample of children. METHODS: We analysed data from 172 individuals who had been recruited antenatally to a longitudinal birth cohort study. Of the 194 birth cohort participants, data from the 147 probands (age range 8.6-13.5 years) who consented to blood collection were included along with data from 25 consenting siblings (mean age 11 years [range 7.4-17.4]). We ascertained clinical phenotypes related to asthma and allergy. We measured T-cell responses to allergens and mitogens, together with blood eosinophils and IgE/IgG antibodies, and assessed associations between these indices and clinical phenotypes. FINDINGS: Atopy was associated with allergen-specific T-helper (Th)2 responses dominated by interleukin 4, interleukin 5, interleukin 9, interleukin 13, whereas interleukin 10, tumour necrosis factor alpha, and interferon gamma responses were common to both atopics and non-atopics. The wheal size from skin prick with allergen was positively associated with in-vitro interleukin 5 and interferon gamma responses, and negatively associated with interleukin 10. Asthma, especially in atopics, was strongly associated with eosinophilia/interleukin 5, and bronchial hyper-responsiveness (BHR) was associated with eosinophilia plus polyclonal interferon gamma production. BHR in non-atopics was associated with elevated allergen-specific and polyclonal interleukin 10 production. INTERPRETATION: Parallel immunological and clinical profiling of children identified distinctive immune response patterns related to asthma and wheeze compared with BHR, in atopics non-atopics. Immunological hyper-responsiveness, including within the Th1 cytokine compartment, is identified as a hallmark of BHR. RELEVANCE TO PRACTICE: These findings highlight the heterogeneity of immune response patterns in asthmatic children, including those with seemingly homogeneous Th2-driven atopic asthma. Further elucidation of the covert relationships between wheezing phenotypes and underlying immunophenotypes in this age group will potentially lead to more effective treatments for what is an unexpectedly heterogeneous collection of disease subtypes.

Adolescent↗

PubMed2003

Two-year incidence of oral disadvantage, a measure of oral health-related quality of life.

UNLABELLED: Dental research has progressed from describing the burden of oral disease using traditional epidemiologic measures of incidence and prevalence, to measuring how oral disease, oral signs, and oral symptoms affect the daily activities and the overall quality of life of the individual. However, longitudinal evaluation of these associations remains rare. OBJECTIVES: To (i). describe the 2-year incidence and patterns of oral disadvantage; (ii). identify dimensions of oral health measures that are significant antecedents of oral disadvantage; and (iii). determine which oral health dimensions are the most strongly predictive of oral disadvantage. METHODS: The Florida Dental Care Study was a longitudinal study of oral health in diverse groups of persons who at baseline had at least one tooth and were 45 years or older. Incidence rates, odds ratios, and 95% confidence intervals were used to describe oral disadvantage and its relation to other measures of oral health. RESULTS: Nearly one-half of the participants experienced oral disadvantage at least once during 24 months of follow-up. The strongest antecedents associated with oral disadvantage were toothache pain and chewing difficulty. CONCLUSIONS: The incidence of oral disadvantage is substantial and consistent with the notion that oral health has a substantial impact on quality of life. Measures of oral pain and oral functional limitation were more strongly predictive of oral disadvantage than disease and tissue damage antecedents.

Aged↗

PubMedDate not supplied

Sequence diversity and linkage disequilibrium within the merozoite surface protein-1 (Msp-1) locus of Plasmodium falciparum: a longitudinal study in Brazil.

The merozoite surface protein-1 (MSP-1) is a major vaccine candidate for the asexual blood stage of malaria. We examined both the extent of sequence diversity in block 17, the 3' end of Msp-1 gene coding for a 19-kDa polypeptide (MSP-1(19)) putatively involved in red blood cell binding, and the patterns of linkage disequilibrium between polymorphic sites throughout the Msp-1 locus. The parasite population sample consisted of Plasmodium falciparum isolates collected between 1985 and 1998 in Rondĵnia, an area of hypoendemic malaria transmission in the southwestern Brazilian Amazon. Results were summarized as follows. (1) Seven block-17 sequence variants or haplotypes were found among 130 isolates, including two new haplotypes (novel combinations of previously reported amino acid replacements), here named Brazil-1 (E-TSR-F) and Brazil-2 (Q-TSR-F). (2) As previously shown for other Msp-1 polymorphisms, frequencies of block-17 haplotypes displayed significant temporal variation. (3) Extensive linkage disequilibrium was demonstrated between neighboring dimorphic sites within block 17, as well as between polymorphisms at the 5' and 3' ends of Msp-1 (map distance range: 3.83-4.99 kb). (4) The overall patterns of linkage disequilibrium within Msp-1 remained stable over a period of nearly one decade, and examples of possible 'epidemic' expansion of parasites carrying particular Msp-1 alleles were found in the 1980s and 1990s. These results are discussed in relation to the population biology of P. falciparum and the development of malaria vaccines based on MSP-1.

Alleles↗

PubMed1990

Longitudinal immunoblotting variations of auto-antibody reactivity of patients with systemic lupus erythematosus.

The purpose of this study was to examine longitudinally the different patterns of nuclear and cytoplasmic antigen recognition by sera from patients with SLE during clinical flare and remission using immunoblotting (IB) techniques. Serum samples (n = 150) were obtained from 35 SLE patients during a follow-up period averaging 4.7 years. Three patients (10 sera) were in complete remission: the IB pattern of these 3 patients remained unchanged; 32 SLE patients experienced one or more clinical flares: in 5 cases (20 sera) the IB analysis showed no detectable antibody. The following dominant IB patterns were seen in the remaining 27 active SLE patients: anti-Sm (n = 7), anti-Sm/RNP (n = 7), anti-SS-B and/or anti-Ro (n = 6), anti-histones (n = 5), anti-70 Kd (unidentified) (n = 2). No IB pattern was able to differentiate mild forms of SLE from severe cases. In 9 of 21 clinical flares, the serum IB pattern was not different from that of the patient's serum drawn during remission (3 severe and 6 mild flares). Diversity of the antibodies increased in 7 cases (5 severe, 2 mild flares); and a shift from one pattern to another was observed 5 times (2 severe, 3 mild flares). Twenty three subsequent remissions were studied: in 14 cases the IB profile was unmodified (5 severe, 9 mild SLE), and the diversity of the antibody narrowed in 4 cases (2 severe, 2 mild SLE). The IB pattern shifted from one pattern to another (2 severe, 4 mild SLE) in 5 instances.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed2002

Ethnic-immigrant differentials in health behaviors, morbidity, and cause-specific mortality in the United States: an analysis of two national data bases.

This study examines the extent to which various ethnic-immigrant and US-born groups differ in their risks of all-cause and cause-specific mortality, morbidity, and health behaviors. Using data from the National Longitudinal Mortality Study, 1979-1989, we estimated, for major US racial and ethnic groups, mortality risks of immigrants relative to those of the US-born. The Cox regression model was used to adjust mortality differentials by age, sex, marital status, rural/urban residence, education, and family income. Logistic regression was fitted to the National Health Interview Survey data to determine whether health status and behaviors vary among ethnic-immigrant groups and by length of US residence. Compared with US-born whites of equivalent socioeconomic and demographic background, foreign-born blacks, Hispanics, and Asians/Pacific Islanders (APIs), US-born APIs, US-born Hispanics, and foreign-born whites had, respectively, 48%, 45%, 43%, 32%, 26%, and 16% lower mortality risks. While American Indians did not differ significantly from US-born whites, US-born blacks had an 8% higher mortality risk. Black and Hispanic immigrants experienced, respectively, 52% and 26% lower mortality risks than their US-born counterparts. Considerable differentials were also found in mortality for cancer, cardiovascular, respiratory, infectious disease, and injury, and in morbidity and health behaviors, with API and Hispanic immigrants generally experiencing the lowest risks. Consistent with the acculturation hypothesis, immigrants' risks of smoking, obesity, hypertension, and chronic condition, although substantially lower than those for the US-born, increased with increasing length of US residence. Given the substantial nativity differences in health status and mortality, future waves of immigrants of diverse ethnic and cultural backgrounds will likely have a sizeable impact on the overall health, disease, and mortality patterns in the United States.

Adult↗

PubMed2005

A distinct preisthmic histogenetic domain is defined by overlap of Otx2 and Pax2 gene expression in the avian caudal midbrain.

Correlative in situ hybridization of Otx2, Pax2, Gbx2, and Fgf8 mRNA probes in adjacent serial sections through the chicken midbrain and isthmus at early to intermediate stages of development served to map in detail the area of overlap of Otx2 and Pax2 transcripts in the caudal midbrain. The neuronal populations developing within this preisthmic domain made up a caudal part of the midbrain reticular formation, the interfascicular nucleus, and the magnocellular (pre)isthmic nucleus, plus the corresponding part of the periaqueductal gray. The torus semicircularis-the inferior colliculus homolog-expressed Otx2 in its ventricular lining exclusively, but it never expressed Pax2. The parvicellular isthmic nucleus, although placed inside the midbrain lobe, never expressed Otx2, and its cells rapidly down-regulated an early transient Pax2 signal; this pattern is consistent with its reported isthmic origin and forward tangential translocation. This analysis reveals the existence of four distinct midbrain histogenetic domains along the longitudinal axis, at least for the alar plate. These presumably result from step-like isthmic organizer effects on Otx2-expressing midbrain neuroepithelium at different distances from a caudal FGF8 morphogen source (isthmic Fgf8-positive domain). The final phenotypes of these domains are histologically diverse and make up the griseum tectale (rostrally), the optic tectum, the torus semicircularis, and the presently characterized preisthmic domain (lying closest to the isthmic organizer). Available comparative data for reptiles and mammals suggest the general validity of this scheme.

Animals↗

PubMed2001

The development of waist circumference percentiles in British children aged 5.0-16.9 y.

OBJECTIVE: To develop waist circumference percentile curves for British children and to compare these curves with those from other countries. DESIGN: Cross-sectional study. SETTING: School-aged population. SUBJECTS: A representative sample of school children from the geographical regions of Great Britain, approximately in proportion to their age distribution. The sample population consisted of 8355 children (3585 males, 4770 females) with ages ranging between 5.0 and 16.9 y. INTERVENTIONS: Waist circumferences were measured with a flexible non-elastic tape and waist circumference percentiles were constructed and smoothed using the LMS method. MAIN OUTCOME MEASURES: Smoothed waist circumference percentile curves. RESULTS: Mean waist circumference increased with age in both boys and girls. For girls, curves began to plateau after the age of 13 y whereas, for boys, waist percentile curves continued to increase more sharply after this age. However, these curves mainly reflect the patterns of waist circumference in Caucasian children. CONCLUSIONS: These curves represent the first waist circumference percentiles for British children and could be used provisionally for both clinical and possibly epidemiological use, although they should be validated against equivalent longitudinal data. SPONSORSHIP: This project has been sponsored by UNL Diversity and Development Fund.

Abdomen↗

PubMed2005

Expression and ambivalence over expression of negative emotion:psychometric analysis in the Women's Health Initiative.

Inhibition of emotional expression has been associated with the incidence and progression of breast cancer and other chronic illnesses. Others have theorized that it may not be repression itself, but rather ambivalence over the expression of emotions that is the important health-related factor. The Women's Health Initiative (WHI), a long-term, national study focusing on disease prevention among postmenopausal women, is unique in its assessment of expression and ambivalence of negative emotion in a large study sample of multiethnic, older women. Psychological factors such as expression of negative emotion and ambivalence about expression of emotion are also determined by social patterning. The current study examined the psychometric properties of the instruments used to measure each construct and variation across race/ethnicity and age. The analysis suggests that the scales can be used with confidence in diverse ethnic and age groups. Examining ambivalence about expression of negative emotion in future longitudinal research will further elucidate its role in predicting disease incidence and recovery, both important in reducing the public health burden of chronic disease.

Aged↗

PubMed2001

A review of ethnicity, health and nutrition-related diseases in relation to migration in the United Kingdom.

OBJECTIVES: To identify lessons from and gaps in research on diet-disease links among former migrants in the United Kingdom (UK). RESULTS: Migrant status and self-identified ethnicity do not match so these terms mask differences in social, nutritional and health status within and between population groups. Some former migrants differ in causes of death from the general population, e.g.: fewer coronary heart disease deaths among Caribbean-born; fewer cancer deaths among Caribbean, South Asian- and East African-born adults. Irish- and Scottish-born have higher mortality from all causes. Experience of risk factors differ also, e.g.: higher prevalences of hypertension and diabetes in Caribbean- and South Asian-born adults than representative samples of the general population; obesity and raised waist-hip circumference ratios in South Asian, African-Caribbean and some Irish-born adults. Former migrants experience long-term disadvantage, associated with more self-defined illness and lower reported physical activity. Nutrient intake data from the few, recent, small-scale studies must be interpreted with caution due to methodological diversity. However, second generation offspring of former migrants appear to adopt British dietary patterns, increasing fat and reducing vegetable, fruit and pulse consumption compared with first generation migrants. CONCLUSIONS: There is insufficient evidence on why some former migrants but not others experience lower specific mortality than the general population. Dietary intake variations provide important clues particularly when examined by age and migration status. Majority ethnic and younger migrant groups could raise and sustain high fruit and vegetable intakes but lower proportions of fat, by adopting many dietary practices from older migrants. Objective measures of physical activity and longitudinal studies of diets among different ethnic groups are needed to explain diversity in health outcomes and provide for evidence-based action.

Africa↗