Biomedical subjects

George B Schreiber

Publications and source records attributed to George B Schreiber.

At least 19 recordsLinked to original sources

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

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

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

Convenience, the bane of our existence, and other barriers to donating.

BACKGROUND: To prevent donor loss and improve retention, it is important to understand the major deterrents to blood donation and to identify factors that can be effectively addressed by blood centers. STUDY DESIGN AND METHODS: A 30-item self-administered questionnaire was completed in 2003 by 1705 first-time and 2437 repeat US donors who had not donated in 2 to 3 years. Asian, Hispanic, black, and white first-time and repeat donors rated the importance of deterrents to donation in their decision to not return with a 1 to 5 scale. Categorical analysis of variance methods were used to compare the importance of deterrents between first-time and repeat donors of different race or ethnicity. RESULTS: Not having a convenient place to donate was most commonly cited as an important or very important reason for not returning by 32 to 42 percent of first-time and 26 to 43 percent of repeat respondents. Although bad treatment and poor staff skills were less of a barrier than convenience, they were more important for minority donors. Other factors such as physical side effects, foreign travel, or length of the process appeared less important. CONCLUSION: Inconvenience is a major barrier to donating, suggesting that mobile collections and increased hours of operation might help recapture lapsed donors. The finding that lapsed minority donors were more likely to give bad treatment and poor staff skills as important reasons to not donate is disconcerting in light of the changing donor demographics and increased efforts to recruit these donors.

Adult↗

PubMed2006

Factors influencing the decision to donate: racial and ethnic comparisons.

BACKGROUND: Understanding factors that encourage different racial and ethnic groups to donate is crucial for donor recruitment and retention. STUDY DESIGN AND METHODS: A 28-item self-administered questionnaire was completed in 2003 by 1862 Asian, 1479 black, 1641 Hispanic, and 2940 White US donors who had given whole blood within the past year. With a 1 to 5 scale, donors were asked to rate the importance of 17 factors in their last donation decision. Logistic regression was conducted to compare the odds of a factor being important or very important (score of 4 or 5) in one's decision to donate between race or ethnic groups, stratified by first-time and repeat status. RESULTS: More than 90 percent of each respondent group cited a desire, responsibility, or perceived duty to help others as an important or very important motivator. Being asked to donate at work was also an important motivator for all race and ethnic groups (56-70%). Getting the results of a health screen appealed to many (approx. 30% found it important or very important) and was most important to Black and Hispanic donors (odds ratios of 1.3-1.9 compared to White donors; p<0.003). CONCLUSION: Recruitment and retention programs should build on people's sense of social responsibility. Direct requests to donate are particularly effective motivators. Of a variety of incentives evaluated, offering more comprehensive health screens may motivate many donors, especially Black and Hispanic donors.

Adult↗

PubMed2005

Health services use in women with a history of bulimia nervosa or binge eating disorder.

OBJECTIVE: The current study examined health services use during the past 12 months in a sample of young women with a history of an adolescent eating disorder (bulimia nervosa [BN] or binge eating disorder [BED]). METHOD: A community sample of 1,582 young women (mean age = 21.5 years) was classified, based on a screening interview (and, for eating disorder diagnosis, confirmatory diagnostic interview), into one of three groups: BN or BED (n = 67), other psychiatric disorder (n = 443), and no adolescent psychiatric disorder (n = 1,072). RESULTS: A history of BN/BED in adolescence was associated with elevated health services use, but this was a general effect associated with having a psychiatric disorder, not an effect specific to the diagnosis of an eating disorder. Total service days, outpatient psychotherapy visits, and emergency department visits were elevated in the combined group of BN/BED and other psychiatric disorder participants relative to the healthy comparison group. The women with BN/BED did not differ significantly from the women with a non-eating-related psychiatric disorder in the use of these services. DISCUSSION: The similarity of health services use in young women with BN or BED and those with other psychiatric disorders underscores the clinical and economic impact of these eating disorders.

Adolescent↗

PubMed2005

Night eating syndrome in young adult women: prevalence and correlates.

OBJECTIVE: The current study examined the prevalence and clinical significance of night eating syndrome (NES) in a community cohort of Black and White women. METHOD: We assessed 682 Black and 659 White women for NES, eating disorders, and psychiatric symptomatology. RESULTS: The prevalence was 1.6% (22 of 1,341; Blacks [n = 20]; Whites [n = 2]). Comparisons between identified Black women and the remaining Black participants revealed no significant differences in obesity, psychiatric comorbidity, or self-reported psychiatric distress. Comorbidity with eating disorders as outlined in the 4th ed. of the Diagnostic and Statistical Manual of Mental Disorders (Washington, DC: American Psychiatric Association) was low (n = 1 [4.5%]). Black NES women were significantly less likely than Black non-NES women to be overweight and significantly more likely to have two or more children. DISCUSSION: NES was rare in this sample of young women. Low comorbidity of NES with other eating disorders suggests that NES may be distinct from the DSM-IV recognized eating disorders. Longitudinal data are needed to determine the long-term health implications of this behavioral pattern.

Adult↗

PubMed2005

Breakfast consumption by African-American and white adolescent girls correlates positively with calcium and fiber intake and negatively with body mass index.

OBJECTIVE: To describe age- and race-related differences in breakfast consumption and to examine the association of breakfast intake with dietary calcium and fiber and body mass index (BMI). DESIGN: Data from the National Heart, Lung, and Blood Institute Growth and Health Study, a 9-year, longitudinal biracial cohort study with annual 3-day food records. SUBJECTS/SETTING: The National Heart, Lung, and Blood Institute Growth and Health Study recruited 2,379 girls (1,166 white and 1,213 African American), aged 9 or 10 years at baseline for an observational study. Retention rates were very high at visits two through four (96%, 94%, and 91%), but declined to a low of 82% at visit seven, and increased to 89% at visit 10. MAIN OUTCOME MEASURES: Frequency of breakfast consumption, dietary calcium and fiber, and BMI. STATISTICAL ANALYSES: Generalized estimation equations methodology was used to examine differences in the frequency of breakfast eating by age and race. Generalized estimation equations analyses were also conducted to test whether breakfast consumption was predictive of intake of dietary calcium and fiber, and BMI, adjusting for potentially confounding effects of site, age, race, parental education, physical activity, and total energy intake. RESULTS: Frequency of breakfast eating declined with age, white girls reported more frequent breakfast consumption than African-American girls, and the racial difference decreased with increasing age. Days eating breakfast were associated with higher calcium and fiber intake in all models, regardless of adjustment variables. Days eating breakfast were predictive of lower BMI in models that adjusted for basic demographics (ie, site, age, and race), but the independent effect of breakfast was no longer significant after parental education, energy intake, and physical activity were added to the model. CONCLUSIONS: Dietetics professionals need to promote the importance of consuming breakfast to all children and adolescents, especially African-American girls.

Adolescent↗

PubMed2005

Self-reported symptoms of depression in late adolescence to early adulthood: a comparison of African-American and Caucasian females.

The prevalence of depressive symptoms from adolescence through young adulthood was examined in 1,146 African-American adolescent girls and 1,075 Caucasian adolescent girls who completed the Center for Epidemiological Studies of Depression scale. Caucasian girls' scores decreased over time, whereas scores for African-American girls were fairly consistent. Future studies are needed to examine age-specific risk factors in adolescent girls.

Adolescent↗

PubMed2005

Prevalence and comorbidity of major depressive disorder in young black and white women.

OBJECTIVE: This study reports the prevalence and comorbidity of depression in two large samples of black and white young adult women. METHOD: Clinical interviews of participants in a follow-up study of the National Heart, Lung, and Blood Institute Growth and Health Study (NGHS-Wave II; N=378) were contrasted with a subsample of the National Comorbidity Survey (NCS; N=3749) to examine the rates and comorbidity of lifetime major depressive disorder in black and white women using methodology described by . The sequencing of disorders was also examined to determine which disorder was primary. Comorbidity and sequencing were examined for alcohol and drug use disorder, panic disorder, specific phobia, social phobia, and post-traumatic stress disorder. RESULTS: Prevalence estimates for depression, alcohol use disorder, and drug use disorder were higher for white women than for black women in both NGHS-Wave II and NCS. Over half of depressed participants in both samples had at least one comorbid disorder and depression was associated with an increased probability of all the investigated disorders. Only one ethnic difference was found in comorbidity, indicating that black women were more likely to have comorbid panic disorder than white women were. Depression was primary to alcohol and substance use disorders, whereas it was secondary to specific phobia and PTSD. CONCLUSIONS: High rates of comorbidity were found for both black and white women, though few ethnic differences in comorbidity were found. Preventive and treatment interventions are needed to address multiple disorders in young adult women.

Adult↗

PubMed2005

Does adolescent depression predict obesity in black and white young adult women?

BACKGROUND: To examine whether adolescent depressive symptoms predict young adult body mass index (BMI) and obesity in black and white women. METHOD: Participants included 1554 black and white adolescent girls from the National Heart, Lung, and Blood Institute Growth and Health Study (NGHS) who completed the Center for Epidemiological Studies--Depression Scale (CES-D) at ages 16 and 18 years. RESULTS: Regression analyses showed that depressive symptoms at both ages 16 and 18 were associated with increased risk of obesity (BMI > or = 30) and elevated BMI in young adulthood (age 21) in both black and white girls. Black girls exhibited a significantly greater likelihood of obesity and higher BMI (i.e. a main effect of race), but the race x CES-D interaction was not significant in any analysis. CONCLUSIONS: Depressive symptoms in adolescence appear to be predictive of obesity and elevated BMI in early adulthood for both black and white girls, even when taking prior BMI into account, indicating that depressive symptoms confer risk for obesity above and beyond the known tracking of body weight. Obesity prevention studies might consider assessing depressive symptoms in adolescence in order to more fully capture important risk variables.

Adolescent↗

PubMed2005

An empirical study of the typology of bulimia nervosa and its spectrum variants.

BACKGROUND: There is an ongoing debate about the best way to classify eating disorders. This study examined potential subtypes of bulimia nervosa. METHOD: Latent class analysis (LCA) was used to identify subtypes of bulimic symptomatology, utilizing data from 234 respondents in a cohort of black and white young women ( n =2054). Participants were administered gated screening questions from the Eating Disorders Examination to determine DSM-IV diagnoses of eating disorders. RESULTS: A 3-class solution was judged best. Class 1, the "purger subtype" ( n =116), was characterized by vomiting, the use of fasting/diet pills, and relatively little bingeing. Class 2, the "binger subtype" ( n =97) comprised women who engaged in bingeing but minimal compensatory behaviors. Class 3, the "binge-purger subtype" ( n =21) had relatively high rates of all symptoms. Findings of differences between the three subtypes on validator variables and differences between the three subtypes compared to non-eating disorder groups suggest validity of the three bulimic subtypes identified in our analyses. Ethnicity and class membership were associated [chi 2 (3)=21.89, p <0.0001], reflecting a greater percentage of white women than black women in Class 1 and a greater percentage of black women than white women in Class 2. CONCLUSIONS: LCA revealed one subtype that was similar to bulimia nervosa and two subtypes of bulimic symptomatology that did not meet criteria for bulimia nervosa yet appear to be clinically significant. Further study of the psychological correlates, course, and treatment response of these classes would be of clinical interest.

Adolescent↗

PubMed2005

Correlates of persistent thinness in black and white young women.

OBJECTIVE: To examine health and psychosocial correlates of persistent thinness in black and white young adult women. RESEARCH METHODS AND PROCEDURES: 1,830 females (n = 988 black, n = 842 white) who participated in the National Heart, Lung, and Blood Institute Growth and Health Study were asked to indicate their current body size from a series of nine pictograms (1, emaciated to 9, obese). Persistent thinness was defined as having at least seven non-missing measurement points between ages 9 to 18 with a body size rating of <4 at all points. Generalized linear models were used to examine whether persistently thin women differed from comparison women on cardiovascular disease risk factors measured at age 18.5 and psychosocial variables measured at age 21.5. Prospective associations between psychological measures in childhood and persistent thinness through the course of adolescence were also examined. RESULTS: In the sample, 145 women (7.9%) met criteria for persistent thinness and 1,685 women (92.1%) were classified as not persistently thin. Persistently thin women had a later age of menarche, fewer weight concerns, and healthier eating attitudes, were less likely to have had a child, came from higher socioeconomic backgrounds, and had significantly lower blood pressure and higher high-density lipoprotein-cholesterol than comparison women. Differences were not found on measures of depression or health services use. Girls with higher self-esteem in childhood were more likely to remain persistently thin throughout adolescence. DISCUSSION: Persistently thin women seem to be healthier on several indicators relative to comparison women, and race did not moderate these differences.

Adolescent↗

PubMed2005

The impact of male-to-male sexual experience on risk profiles of blood donors.

BACKGROUND: Men who have had sex with men (MSM) since 1977 are permanently deferred from donating blood. Excluding only men who engaged in male-to-male sex within either the prior 12 months or 5 years has been proposed. Little is known about infectious disease risks of MSM who donate blood. STUDY DESIGN AND METHODS: Weighted analyses of data from an anonymous mail survey of blood donors were conducted to examine the characteristics of men reporting male-to-male sex during specified time periods. RESULTS: Of the 25,168 male respondents, 569 (2.4%) reported male-to-male sex, 280 (1.2%) since 1977. Compared to donors who did not report male-to-male sex, the prevalence of reactive screening test results was higher among donors who reported the practice within the past 5 years (< or =12 months odds ratio [OR] 5.3, 95% confidence interval [CI] 2.6-10.4; >12 months to 5 years, OR 7.1, 95% CI 1.2-41.7); however, no significant difference was found for donors who last practiced male-to-male sex more than 5 years ago (>5 years-after 1977, OR 1.4, 95% CI 0.7-2.6; 1977 or earlier, OR 1.6, 95% CI 0.7-3.7). The prevalence of unreported deferrable risks (UDRs) other than male-to-male sex was significantly higher for all donors who reported male-to-male sex with ORs ranging from 3.1 to 18.9 (p < or = 0.01). CONCLUSIONS: No evidence was found to support changing current policy to permit donations from men who practiced male-to-male sex within the past 5 years. For donors with a more remote history of male-to-male sex, the findings were equivocal. A better understanding of the association between male-to-male sex and other UDRs appears needed.

Blood Banks↗

PubMed2005

Development of the metabolic syndrome in black and white adolescent girls: a longitudinal assessment.

BACKGROUND: The metabolic syndrome, associated with increased risk of type 2 diabetes mellitus and cardiovascular disease, begins to develop during adolescence. OBJECTIVE: We sought to identify early predictors of the presence of the syndrome at the ages of 18 and 19 years in black and white girls. METHODS: Using longitudinal data on participants from 2 centers in the National Heart, Lung, and Blood Institute Growth and Health Study, a 10-year cohort study, we applied cutoffs from the Adult Treatment Panel III to document changes in the prevalence of abnormal syndrome elements and the syndrome in girls aged 9 and 10 years, when cases were rare, and those aged 18 and 19 years, when prevalence had reached 3%. Longitudinal regression models identified early predictors for the presence of the syndrome. RESULTS: Only 1 girl of each race had > or =3 factors at ages 9 and 10 (0.2%), but 20 black girls (3.5%) and 12 white girls (2.3%) had the syndrome 10 years later. Low high-density lipoprotein cholesterol was prevalent throughout the period in both black and white girls. The prevalence of other variables was low at enrollment but increased during follow-up, except for abnormal triglyceride levels in black girls, which remained low throughout follow-up. In multivariate models, early measures of waist circumference and triglyceride level were significant predictors for development of the syndrome. CONCLUSION: The strong association of central adiposity with the development of the metabolic syndrome suggests that early interventions aimed at managing preteen obesity could reduce risk of developing the syndrome.

Adolescent↗

PubMed2005

Impact of a two-city community cancer prevention intervention on African Americans.

We report the first multisite, multicomponent community intervention trial to focus on cancer prevention in African Americans. The project explored the potential of historically black medical schools to deliver health information to their local communities and used a community-based participatory research approach. The intervention consisted of culturally sensitive messages at appropriate educational levels delivered over an 18-month period and tested in predominantly black census tracts in Nashville, TN and Atlanta, GA. Chattanooga, TN and Decatur, GA served as comparison cities. Results were evaluated by pre- and postintervention random-digit dial telephone surveys. The intervention cities showed an increase in reported contact with or knowledge of the project. There was little or no effect on knowledge or attitudes in the intervention cities. Compared to Chattanooga, Nashville showed an increase in percentage of women receiving Pap smears. Compared to Decatur, Atlanta showed an increase in percentage of age-appropriate populations receiving digital rectal exams, colorectal cancer screenings and mammograms. The results of this community intervention trial demonstrated modest success and are encouraging for future efforts of longer duration.

Adult↗

PubMed2004

Measuring eating concerns in Black and White adolescent girls.

OBJECTIVE: Few instruments exist to measure eating concerns in adolescent girls from diverse ethnic backgrounds. METHODS: A Children's version of the Eating Disorder Inventory (EDI-C) has been under development for several years and was designed to be more appropriate for younger children with lower reading levels. However, little is known about the validity of this instrument. The current study reports on the factor structure of an early version of the EDI-C using nonclinical samples of 1,073 White and 1,155 Black girls (ages 11-12). RESULTS: Factor analysis resulted in an eight-factor solution for each group that included a weight concerns factor and an emotional distress factor. For Black girls only, the positively worded items from the Body Dissatisfaction subscale loaded on a separate factor. Four of five factors were similar to the original EDI subscales (Bulimia, Interpersonal Distrust, Maturity Fears, and Perfectionism), although the latter was unique to White girls. DISCUSSION: The factor structure was generally similar for Black and White girls, although the separate body satisfaction factor and lack of shared variance for the perfectionism factor for Black girls suggest that EDI data obtained from ethnic minority samples may need to be interpreted cautiously.

Adolescent↗

PubMed2004

Changes in weight and body image over time in women with eating disorders.

BACKGROUND: This study examined the changes in body image and weight in young women with an adolescent eating disorder, relative to women without an eating disorder (noED). METHOD: Three diagnostic groups, anorexia nervosa (AN; n = 10), bulimia nervosa (BN; n = 27), and binge eating disorder (BED; n = 42) and three comparison groups (noED; n = 659 each) were compared on body mass index (BMI) and self-reported current body size, ideal body size, and weight dissatisfaction. Dependent variables were examined 2 and 1 year before the onset, the onset year, and 1 and 2 years after the onset of the eating disorder in a model that was adjusted for ethnicity and BMI. RESULTS: BMI was lower in the AN group at all time points except 2 years before onset. AN girls evidenced a significantly stronger relation between BMI and current self-ratings and weight dissatisfaction than noED girls. BMI did not differ between the BN group and the noED group. Girls with BN reported larger current body sizes and greater weight dissatisfaction across all time points. The BED group had higher BMI than the noED group across time. BED girls reported greater current body size ratings and weight dissatisfaction than the noED girls. Girls with AN, BN, or BED did not differ from the noED girls on body ideal ratings. DISCUSSION: Body weight seems to influence perception of body size more so for girls with AN than for noED girls. No support was found for an accelerated weight gain over time for BN. Weight may increase over time for the BED group relative to the noED group, but larger studies are needed. Across all three groups, ideal body size appears to be unrelated to diagnostic status. Rather, the risk for developing an eating disorder appears to arise from size overestimation and related weight dissatisfaction.

Adolescent↗