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H S Kahn

Publications and source records attributed to H S Kahn.

54 records · Page 3Linked to original sources
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↗
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↗
PubMed1987

Vertex-corrected blood pressure in black girls. Relation to obesity, glucose, and cations.

Correlates of resting blood pressure (BP) were explored among 32 inner-city, black girls, ages 11.7 to 13.9 years, a sample drawn from the second and fourth quartiles of the BP distribution in an earlier school survey. Customary BP measurements in the seated position were corrected for the height of the arterial column extending from the BP cuff to the top (vertex) of each girl's head. This vertex correction procedure has previously been shown to eliminate the childhood association between mean arterial pressure and age. Vertex-corrected systolic BP was correlated individually (p less than 0.03) with serum fasting glucose, ionized calcium, sodium, and calculated osmolality. The BP association with serum glucose did not persist after an oral sucrose challenge. Vertex-corrected diastolic BP was correlated individually (p less than 0.02) with serum ionized calcium and four indices of obesity, the best correlated of which was the subscapular skinfold (r = 0.66, p = 0.0001). Vertex-corrected BPs generally provided stronger correlations than customary (uncorrected) BPs with the variables of interest. Correlations with seated BPs were generally stronger than those with supine BPs. By multiple regression analysis, seated vertex-corrected systolic BP was related directly to serum fasting glucose and ionized calcium and inversely to pulse rate (R2 = 0.53). Seated vertex-corrected diastolic BP was related directly to subscapular skinfold and calculated osmolality (R2 = 0.54). Vertex correction may facilitate clinical or epidemiological studies of early hypertension.

Adolescent↗
PubMed1986

Interpretation of children's blood pressure using a physiologic height correction.

In a cross-sectional survey of 1834 black, Atlanta schoolchildren we corrected the customary blood pressure (BP) observations for the height of the arterial column extending from the BP cuff to the top (vertex) of the subject's head. Each cuff-to-vertex height was converted to its pressure equivalent in mmHg; then this pressure was subtracted from the observed BP to compute vertex-corrected BP values. The vertex-corrected mean arterial pressure (VMAP) ranged from 22.3 to 83.2 mmHg, but there was no estimated linear association between VMAP and age. For males, mean VMAP was 49.4 mmHg for ages 6-13 and 46.0 mmHg for ages 14-17. For females, mean VMAP was 50.2 mmHg for ages 6-17. Since VMAP appears to be independent of age in most of childhood, its use may simplify the development of pediatric BP reference values. VMAP can also serve as a non-invasive approximation of cerebral perfusion pressure. Investigators of primary hypertension may wish to use VMAP for comparing average BP levels between childhood groups which differ by potentially etiologic characteristics.

Adolescent↗
PubMed1981

Acute biliary tract disease associated with echovirus 11 infection.

A patient hospitalized with the clinical diagnosis of acute cholecystitis had a normal cholangiogram and recovered without medical or surgical intervention. During the same week, two adults in an acquainted family had a similar syndrome at home. Echovirus 11 was cultured from the stool of all three patients, as well as from four other members of the same two families who had concurrent diarrheal illness. Serologic evidence confirmed acute echovirus 11 infection in the hospitalized patient. In the absence of evidence of a communitywide epidemic of cholecystitis, the coexistence of viral infection with biliary tract symptoms could represent an ongoing endemic situation. Recognition of this syndrome could make it possible to avoid unnecessary major surgical procedures.

Adult↗
PubMed1976

An association between the Dalkon Shield and complicated pregnancies among women hospitalized for intrauterine contraceptive device--related disorders.

A nationwide mail survey of virtually all physicians likely to be involved with intrauterine contraception resulted in 3,502 unduplicated reports of intrauterine contraceptive device (IUD)--related hospitalizations during the first six months of 1973. Dalkon Shield use was significantly more frequent among women hospitalized for a complicated pregnancy than those hospitalized for a non-pregnancy-related disorder. Although the observed association was not substantially altered by stratifications of the mail survey reports by the patient's age, race, or geographical region, the association did not apply to those women whose IUD's were explicitly reported to be of the nulliparous size. Interviews conducted with a probability sample of physicians who had not responded to the survey confirmed that the association between the Dalkon Shield and complicated pregnancy also existed in their experience. An association between the standard Dalkon Shield and complicated pregnancies might reflect an increased rate of pregnancy with this device, an increased rate of complications occurring after zygotic implantation, or perhaps both. Whatever the explanation, the observed association is sufficiently widespread to require further investigations.

Adolescent↗
PubMed1976

A proposal for a primary care registry.

A regional, voluntary, registry mechanism is proposed through which any citizen could indicate his intention of seeking primary health care from a physician, clinic, or institution that has also registered. By mutual agreement, the provider would recognize the registrant as a regular primary care patient. Providers would regularly receive lists of their registered primary care patients, including descriptive statistical summaries where appropriate. Such a registry would aid health care planners to promote a more equitable and efficient delivery system for primary care services.

Humans↗
PubMed1975

IUD-related hospitalizations. United States and Puerto Rico, 1973.

In a mail survey of physicians likely to be involved with intrauterine contraception in the United States and Puerto Rico, 49.2% of the physicians responded, describing 3,502 unduplicated reports of hospitalizations related to the use of intrauterine contraceptive devices (IUDs) during the first six months of 1973. We estimate from this response that approximately 7,900 IUD-related hospitalizations occurred during that period. Interviews with a probability sample of nonrespondents demonstrated that their IUD complication experience was not substantially different from that reported through the mail survey. Estimates of the number of IUDs worn in 1973 permit rate calculations of three to ten IUD-related hospitalizations per 1,000 woman-years of IUD use. The rate of hospitalizations attributable to the IUD is probably higher that that attributable to combination oral contraceptives.

Adolescent↗
PubMed1975

Mortality associated with use of IUDs.

Five deaths associated with the use of an intrauterine contraceptive device (IUD) were reported during the first half of 1973 through a nationwide mail survey of physicians whose practices were likely to be involved with intrauterine contraception. Four of the five reported deaths involved serious infections, and two of these four occurred in relation to a pregnancy. Use of an IUD prior to death ranged from seven months to 3 1/2 years. The mortality attributable to IUDs is estimated to be lower than that attributable to combination oral contraceptives.

Adolescent↗
PubMedDate not supplied

A review of the association between abdominal fat distribution, health outcome measures, and modifiable risk factors.

PURPOSE OF THE REVIEW. This review of the literature examines the relationship between abdominal fat distribution and specific health outcome measures, modifiable risk factors, the impact of intervention efforts, and the significance of measurement methods. SEARCH METHODS USED. The research material that was received was found through several on-line data bases, including MEDLINE and CINAHL, an examination of references from selected articles, a manual review of recent relevant journals, and interviews with several physicians and epidemiologists who are experts in this field of inquiry. Forty-three research articles were reviewed for the section on health risk outcomes and abdominal fat distribution. Twenty studies were reviewed in the section on modifiable variables associated with fat distribution. Finally, 10 studies which examined the effect of behavior change on fat distribution were included in this review. SUMMARY OF IMPORTANT FINDINGS. Recent research indicates that people whose body fat is deposited more in the central or abdominal area, especially the intra-abdominal area, than it is in the gluteofemoral area are at increased risk for cardiovascular disease. This risk is independent of, but exacerbated by, the degree of obesity. Several nonmodifiable factors such as age, gender, and menopause as well as some modifiable factors such as obesity, smoking, physical inactivity, and alcohol intake are positively associated with abdominal fat deposition. MAJOR CONCLUSIONS. Intervention results indicate that it is possible to decrease abdominal fat with total weight loss or smoking cessation.

Abdomen↗