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Biomedical subjects

D F Williamson

Publications and source records attributed to D F Williamson.

At least 109 records · Page 6Linked to original sources
PubMed1991

Is race associated with weight change in US adults after adjustment for income, education, and marital factors?

We examined the 10-y change in body mass index (BMI, in kg/m2) of black and white adults who entered the First National Health and Nutrition Examination Survey Epidemiologic Followup Study at ages 25-44 y. In women the mean change in BMI was greater for blacks than for whites despite multiple adjustments. However, the risk of major weight gain (MWG; BMI change greater than or equal to + 5) was nearly identical in black and white women. Womens' MWG was independently associated with low income [odds ratio (OR) = 1.7] and with becoming married (OR = 1.8). The risk of major weight loss (MWL; BMI change less than or equal to -2.5) was lower in black women than in white women (OR = 0.6). In men mean BMI change, MWG (BMI change greater than or equal to + 4) and MWL (BMI change greater than or equal to -2) were not associated with race, but there were effects associated with low income, low education, and marital changes. Black race does not increase the risk of weight gain; in women it may be associated with a reduced likelihood of weight loss.

Adult↗
PubMed1991

Race and weight change in US women: the roles of socioeconomic and marital status.

BACKGROUND: The prevalence of overweight among Black women in the US is higher than among White women, but the causes are unknown. METHODS: We examined the weight change for 514 Black and 2,770 White women who entered the first Health and Nutrtion Examination Survey (1971-75) at ages 25-44 years and were weighed again a decade later. We used multivariate analyses to estimate the weight-change effectgs associated with race, family income, education, and marital change. RESULTS: After multiple adjustments, Black race, education below college level, and becoming married during the follow-up interval were each independently associated with an increased mean weight change. Using multivariate logistic analyses, Black race was not independently associated with an increased risk of major weight gain (change greater than or equal to +13 kg), but it was associated with a reduced likelihood of major weight loss (change less than or equal to -7 kg) (odds ratio - 0.64 [95% CI -0.41, 0.97])]. Very low family income was independently associated with the likelihood of both major weight gain (OR - 1.71 [95% CI - 1.15, 2.55]) and major weight loss (OR - 1.86 [95% CI - 1.18, 2.95]). CONCLUSIONS: Amont US women, Black race is independently associated with a reduced likelihood of major weight loss, but not with major weight gain. Women at greatest risk of weight gain are those with education below college level, those entering marriage, and those with very low family income.

Adult↗
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↗
PubMed1990

Depression and the dynamics of smoking. A national perspective.

Data from multiple studies suggest that depression plays a role in cigarette smoking. To obtain a national perspective on the role of depression in the dynamics of smoking, we analyzed data from the first National Health and Nutrition Examination Survey and the National Health and Nutrition Examination Survey Epidemiologic Follow-up Study. We used the Center for Epidemiologic Studies Depression Scale to assess symptoms of depression and used the standard cutoff (score, greater than or equal to 16) for defining persons as depressed. The cross-sectional analysis of the first National Health and Nutrition Examination Survey showed that the prevalence of current smokers increased as the Center for Epidemiologic Studies Depression Scale score increased, whereas the quit ratio (former smokers/ever smokers) decreased as the Center for Epidemiologic Studies Depression Scale score increased. Among the cohort of smokers in the National Health and Nutrition Examination Survey Epidemiologic Follow-up Study, the estimated incidence of quitting after 9 years of follow-up was 9.9% for depressed smokers and 17.7% for nondepressed smokers. When we adjusted for amount smoked, sex, age, and educational attainment by means of a Cox proportional hazards model, we found that depressed smokers were 40% less likely to have quit compared with nondepressed smokers (relative risk, 0.6). These findings suggest that depression plays an important role in the dynamics of cigarette smoking in the United States.

Adult↗
PubMed1990

The effect of known risk factors on the excess mortality of black adults in the United States.

We compared the mortality rate ratios, before and after adjustment for different risk factors, of black vs white adults in the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study. For persons 35 to 54 years old, the rate ratio of mortality for blacks vs whites decreased from 2.3 (unadjusted) to 1.9 when adjusted simultaneously for six well-established risk factors (smoking, systolic blood pressure, cholesterol level, body-mass index, alcohol intake, and diabetes) and decreased from 1.9 to 1.4 when adjusted for the six risk factors plus family income. Thus, approximately 31% of the excess mortality can be accounted for by six well-established risk factors and a further 38% by family income. This leaves 31% unexplained. Broader social and health system changes and research targeted at the causes of the mortality gap, coupled with increased efforts aimed at modifiable risk factors, may all be needed for egalitarian goals in health to be realized.

Adult↗
PubMed1990

Identifying the malnourished within Peru: regional variation in the performance of a nutrition indicator.

Malnourished children may also have siblings at increased risk of poor health. Early identification of siblings at risk could lead to timely intervention to prevent the development of malnutrition or other potentially life-threatening events. In a nationwide survey conducted in Peru in 1984, stunting in an older sibling (defined as height/age less than or equal to 3.00 SD of the NCHS/CDC reference median) was evaluated as an indicator for stunting in a target sibling (next youngest) sibling) (n = 3284). The prevalence of stunting was much higher in target siblings who had an older sibling with stunting compared to those whose older sibling was not stunted, with prevalence ratios of 8.5 in Lima, 4.7 in urban areas, and 2.5 in rural areas. Screening indices (sensitivity, specificity, and predictive value positive) also showed marked variation across regions. The variation in this indicator's performance across regions demonstrates the importance of evaluating screening tools within the populations where they will be applied. Regional variations in the performance of malnutrition indicators should be anticipated because malnutrition is the result of a complex, multifactorial process.

Anthropometry↗
PubMed1990

A comparison of alcohol sales data with survey data on self-reported alcohol use in 21 states.

We used data from 21 states that participated in the 1985 Behavioral Risk Factor Surveillance System to compare state-specific per capita self-reported alcohol consumption and the prevalence of three drinking behaviors with state-specific per capita sales. The correlation coefficient for per capita sales and per capita self-reported consumption for the 21 states was 0.81. Per capita sales were also significantly correlated with the prevalence of self-reported heavier drinking, binge drinking, and drinking and driving; the corresponding correlation coefficients were 0.74, 0.59, and 0.51. These findings suggest that states with higher per capita sales of alcohol also have higher rates of self-reported consumption and drinking patterns suggestive of high-risk behavior.

Alcohol Drinking↗
PubMed1990

The contributions of income, education and changing marital status to weight change among US men.

The prevalence of overweight in men varies with socioeconomic and marital status. To explore the origin of these associations, we studied the effects of family income, education, and changing marital status on change in body mass index (BMI, kg/m2) over 10 years in a representative sample of US men. The subjects were 1552 white and black US men who entered the Health and Nutrition Examination Survey-I (in 1971-75) at ages 25-44 and were re-evaluated a decade later (in 1982-84). After adjusting for socio-demographic factors, baseline BMI, smoking and physical activity, the mean 10-year change in BMI was greater for men with 12 years of education (difference = 0.31 BMI units (95 percent CI 0.04-0.59) ) or with less than 12 years (difference 0.58 (0.22-0.94) ) compared with men who studied beyond 12th grade. Ten-year weight changes were also defined categorically as major weight gain (BMI change greater than or equal to +4 units) or major weight loss (BMI change less than or equal to -2 units). By multiple logistic regression analysis, the odds of experiencing major weight gain were independently associated with low family income (odds ratio (OR) = 1.8 (95 percent CI, 1.0-3.3) ) compared with favorable income, and with becoming married (OR = 3.3 (1.7-6.3) ) or remaining unmarried (OR = 2.1 (1.1-4.2) ) compared with men who were consistently married. The risk of major weight loss was independently associated with marriage ending (OR = 1.8 (1.0-3.3) ) or with remaining unmarried (OR = 2.5 (1.3-4.7) ). A US public health strategy for the prevention of men's weight gain should focus on men with little education or low family incomes and those who are unmarried. There may also be a benefit to preventive weight-gain counseling for men as they enter marriage.

Adult↗
PubMed1990

The 10-year incidence of overweight and major weight gain in US adults.

We estimated the 10-year incidence of major weight gain (a gain in body mass index of greater than or equal to 5 kg/m2 and overweight (a body mass index of greater than or equal to 27.8 for men and greater than or equal to 27.3 for women) in US adults using data from the First National Health and Nutrition Examination Survey Epidemiologic Follow-up Study. Persons aged 25 to 74 years at baseline were reweighed a decade after their initial examination (men, 3727; women, 6135). The incidence of major weight gain was twice as high in women and was highest in persons aged 25 to 34 years (men, 3.9%; women, 8.4%). Initially overweight women aged 25 to 44 years had the highest incidence of major weight gain of any subgroup (14.2%). For person not overweight at baseline (men, 2760; women, 4295), the incidence of becoming overweight was similar in both sexes and was highest in those aged 35 to 44 years (men, 16.3%; women, 13.5%). We conclude that obesity prevention should begin among adults in their early 20s and that special emphasis is needed for young women who are already overweight.

Adult↗
PubMed1990

Smoking and the risk of peptic ulcer disease among women in the United States.

Although multiple studies support a causal relationship between smoking and peptic ulcers in men, data for women are limited. Therefore, we used data from the First National Health and Nutrition Examination Survey Epidemiologic Follow-up Study, a nationally representative prospective study of US adults, to evaluate the impact of smoking on the incidence of peptic ulcers in women. The study cohort included 2851 women who had not been diagnosed as having a peptic ulcer prior to the baseline interview. Among these women, 140 (4.9%) developed peptic ulcer disease. During 12.5 years of follow-up, the estimated cumulative incidence of ulcers was 10.0% for current smokers, 6.4% for former smokers, and 5.4% for never smokers. After adjusting for age, education, regular aspirin use, coffee consumption, and use of alcohol, current smokers were 1.8 times more likely to develop ulcers than never smokers (95% confidence interval, 1.2 to 2.6); the risk of peptic ulcer increased as the amount smoked increased. During the time of this study, we estimate that approximately 20% of incident peptic ulcer cases among US women were attributable to cigarette smoking.

Adult↗
PubMed1989

The prevalence of high blood cholesterol levels among adults in the United States.

Using the National Cholesterol Education Program's Guidelines for the Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults and the most recent nationally representative serum total cholesterol and lipoprotein data for adults (ages 20 to 74 years) from the second National Health and Nutrition Examination Survey (1976 to 1980), it is estimated that 41% of adults should have lipoprotein analysis after an initial measurement of serum total cholesterol. Furthermore, it is estimated that 88% of those who need lipoprotein analysis, or 36% of all adults aged 20 to 74 years, are candidates for medical advice and intervention for high blood cholesterol levels. We estimate, based on 1986 population data, that approximately 40 million Americans between the ages of 20 and 59 years are candidates for medical advice and intervention. An additional 24 million Americans aged 60 years and older are candidates. Overall, we estimate that about 60 million Americans aged 20 years and older are candidates for medical advice and intervention for high levels of blood cholesterol, although a less intensive approach might be appropriate for elderly patients.

Adult↗
PubMed1989

The box plot: a simple visual method to interpret data.

Exploratory data analysis involves the use of statistical techniques to identify patterns that may be hidden in a group of numbers. One of these techniques is the "box plot," which is used to visually summarize and compare groups of data. The box plot uses the median, the approximate quartiles, and the lowest and highest data points to convey the level, spread, and symmetry of a distribution of data values. It can also be easily refined to identify outlier data values and can be easily constructed by hand. We apply box plots to tabular data from two recently published articles to show how readers can use box plots to improve the interpretation of data in complex tables. The box plot, like other visual methods, is more than a substitute for a table: It is a tool that can improve our reasoning about quantitative information. We recommend that the box plot be used more frequently.

Alcohol Drinking↗
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↗
PubMed1989

State-specific progress toward the 1990 objective for the nation for cigarette smoking prevalence.

We predicted the smoking prevalences for 1990 for each state in the US, assuming that the decline in each state from 1985-1990 would be the same as the decline in the US from 1965-1985. In 1985, only three states had smoking prevalences less than 25 percent. Based upon the observed decline in smoking in the US from 1965-1985 of 0.5 percent per year, we predict that only seven states will have smoking prevalences less than 25 percent by 1990. States need to consider current smoking prevalence and achievable rates of decline when setting objectives for 1990 and beyond.

Adult↗
PubMed1989

Dietary and weight control practices among persons with hypertension: findings from the 1986 Behavioral Risk Factor Surveys.

The National Heart, Lung, and Blood Institute has concluded that reducing sodium intake, controlling weight, and moderating alcohol consumption can help patients with hypertension control their blood pressure. To determine whether such patients have adopted recommended dietary practices, we analyzed data collected in 1986 from telephone surveys of adults in 26 states (no. = 34,395). The self-reported dietary practices that we evaluated were: use of table salt, alcohol consumption, and weight control practices. In comparison with persons who did not have hypertension (no. = 26,848), those with hypertension who were receiving pharmacological therapy ("treated hypertensives," no. = 5,025) were more likely to report limiting their use of table salt (odds ratio [OR] = 2.5) and were less likely to have their weight controlled (OR = 0.4). Although overweight persons with hypertension were more likely than persons with normal blood pressure to attempt to lose weight, most have not included exercise in their weight loss efforts. There was no difference between persons who do not have hypertension and treated patients with hypertension in their use of alcohol. Untreated persons with hypertension (no. = 2,378) were less likely to limit their use of table salt and less likely to moderate their use of alcohol than treated persons with hypertension but otherwise reported similar dietary practices. Dietetic practitioners may need to emphasize moderation of alcohol use and the use of physical activity to lose weight when counseling patients with hypertension.

Adult↗
PubMed1988

Alcohol and fatal injuries among US adults. Findings from the NHANES I Epidemiologic Follow-up Study.

Use of alcohol is an important risk factor for fatal injuries. However, little information on the relationship between self-reported alcohol use and subsequent risk of fatal injury is available. Therefore, we examined the relationship between the usual number of drinks consumed per occasion and the incidence of fatal injuries in a cohort of US adults. Using data on self-reported alcohol use obtained from 13,251 adults who were included in the National Health and Nutrition Examination Survey Epidemiologic Follow-up Study (mean length of follow-up, 9.3 years), we calculated the incidence of fatal injury according to the usual number of drinks consumed per occasion. After we adjusted for the effects of age, sex, race, and education, persons who consumed five or more drinks per occasion were nearly twice as likely to die from injuries (relative risk, 1.9; 95% confidence interval, 1.0 to 3.5) than persons who drank fewer than five drinks per occasion. A dose-response relationship was observed between the usual number of drinks consumed per occasion and risk of fatal injury, with persons who reported drinking nine or more drinks per occasion being 3.3 times more likely to die from injuries (95% confidence interval, 1.3 to 8.3). These data demonstrate the impact of alcohol use on mortality from injuries in the United States and suggest that self-reported alcohol consumption is an important indicator of risk for fatal injury.

Adult↗