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Biomedical subjects

I A Prior

Publications and source records attributed to I A Prior.

At least 37 records · Page 2Linked to original sources
PubMed1985

Mortality among New Zealand Maori and non-Maori Mormons.

Mortality rates for New Zealand Maori and non-Maori Mormons in the period 1970-77 have been compared with those for non-Mormons in the census year 1976 to measure the impact of the Mormon lifestyle on differences in mortality between Maoris and non-Maoris. Maori mortality was much lower among Mormons than non-Mormons suggesting that environmental, rather than genetic factors, play a predominant role in the relatively high overall Maori mortality. However the prevalence of smoking among Maori Mormons was not much lower than for the general Maori population. Reasons for the relative mortality advantage of Maori Mormons were therefore not clear, although attitudes to health and health services utilization, and the influence of strong social support networks, might be involved. Paradoxically, non-Maori Mormon mortality rates were similar to those for non-Mormons. A combination of factors appeared to contribute to this finding including the fact that 26% of non-Maori Mormons were of Pacific Island origin, non-Maori Mormons were of lower socioeconomic status than other non-Maoris, and part Maoris probably constitute a high, but unknown, proportion of Mormons classified as non-Maoris.

Adolescent↗
PubMed1985

Longitudinal analysis of the relationship between blood pressure and migration: the Tokelau Island Migrant Study.

The Pacific atoll population of Tokelau has been followed since 1968 to assess the health consequences of migration to a western society. The blood pressure of a cohort of 532 adults who were still living in Tokelau in 1976 (nonmigrants) are compared with those of a cohort of 280 adults who had migrated to New Zealand (migrants). Significant differences between migrants and nonmigrants were detected in the rates of change of both systolic and diastolic pressures in men, and in the rates of change of diastolic pressures in women. The age-, body mass, and blood pressure-corrected rates of change were greater in migrants than in nonmigrants, and greater in men than in women. Blood pressures tend to rise 1 mmHg/year faster among male migrants than among male nonmigrants, and about 0.4 mmHg/year faster among female migrants than among female nonmigrants. These findings have clear implications for the health of migrants.

Adolescent↗
PubMed1983

Elevation of systolic and diastolic blood pressure associated with migration: the Tokelau island migrant study.

Cross-sectional univariate and multivariate analyses estimated differences between the blood pressure of adult Tokelauan migrants to New Zealand and non-migrants still living on three Polynesian atolls. Response rates were 97 and 99% in the two locations. Among males, the difference between migrants and non-migrants after adjustment for significant covariates was 7.2 mmHg systolic pressure (p less than 0.001) and 8.1 mmHg diastolic pressure (p less than 0.001). Among females, adjusted systolic pressure was not significantly higher in migrants compared to non-migrants (1.8 mmHg, p = 0.065) and diastolic pressure was only 3.0 mmHg higher (p less than 0.001). Body mass is significantly correlated with blood pressure in this study group; nonetheless, differences in body mass explain only a small proportion of the observed migrant/non-migrant differential in blood pressure. Estimates of blood pressure differences preceding migration are also reported. These indicate that blood pressure was neither consistently nor significantly higher among those who subsequently migrated. This report provides compelling evidence linking Westernization and the development of chronic disease.

Adolescent↗
PubMed1983

Relationship between blood pressure and modernity among Ponapeans.

In the Micronesian island of Ponape blood pressures were found in 1947 and again in 1953 to be very low and to show no difference between age groups. As part of the US Trust Territory of the Pacific from 1945, the island had begun to change in the direction of modernity, the changes being most dramatic in the capital town of Kolonia, but no part of the island being unaffected. After a generation of modernization, a cross-sectional study was done to assess the impact of changing way of life on blood pressure. Communities were sampled at three levels of impact of modernization: the capital town of Kolonia, an intermediate area, and a remote area. No differences in salt intake were found for the three areas; but the population in the most modern area was younger and heavier. No consistent ecological differences were found in blood pressure level. Since there is considerable variation in modernity within each area, a Guttman-type scale of individual modernity was developed. No trends of variation of blood pressure with modernization were found to be consistent for both sexes and all areas. However, among males in the most modern area both systolic and diastolic pressures increased consistently with increasing modernity, controlling for age. For diastolic pressures, significant increases were found for all males, Kolonia males, and intermediate area males. When body mass as well as age were controlled, the strength of the trends decreased. But among Kolonia males the increase of diastolic pressure with increasing modernity remained highly significant; that of systolic pressure, marginally significant.

Adult↗
PubMed1983

Observations on rheumatic disease in Polynesia and the Philippines.

Two different types of study of rheumatic disease in the southwest Pacific are outlined. The Philippines study of a rural developing population is primarily oriented to intervention rather than causation, but before intervention can be effectively planned, information on the frequency and causes of rheumatic complaints is necessary. The Tokelauan investigation is a comprehensive prospective study of the total population with full medical examination of each subject allowing hypotheses to be tested concerning genetic and environmental variables.

Adolescent↗
PubMed1982

Ageing in the South Pacific. Physical changes with urbanization.

The process of ageing, the place the elderly hold in the South Pacific societies and the care they receive as they move from adult independence to geriatric dependence varies considerably in different Pacific Polynesian populations. This provides unusual opportunity to examine the physical changes of ageing in people of the same broad genetic make-up exposed to environmental changes brought about by urbanization. Epidemiological surveys carried out since 1962 among New Zealand Maoris, Tongans, Cook Island Maoris in Rarotonga and Pukapuka, and Tokelauans living in Tokelau and following migration to New Zealand, provide the main data base for this presentation. The pattern of blood pressure, body weight, serum lipids and clinical disorders show considerable variation which relate most closely to the adoption of westernized life-style and moving into an urban environment. Analysis of the ECG pattern, in Pukapukans, in whom blood pressure shows only a minor increase with age, compared with age and sex-matched subjects studied in Newcastle, England provide insights into the ageing heart. An examination of mortality based on risk factors at entry shows an inverse relationship of serum cholesterol to total mortality in New Zealand Maori men and women, in Tokelau men but not women. Increasing systolic blood pressure was related to mortality in New Zealand Maori men, Tokalau men and Caucasian women, but not in the other race sex groups. The pattern of ageing and risk factors must clearly be examined in individual populations because while death is the end the pathways vary.

Adult↗
PubMed1982

Kava, alcohol and tobacco consumption among Tongans with urbanization.

The prevalence of kava (Piper methysticum), alcohol and tobacco consumption in Nuku'alofa (urban) and Foa (rural) are described. Current kava consumption was males 48% and females 1%. Prevalence was significantly higher among rural males. Current alcohol consumption was almost exclusive to the urban population and predominantly male, but only 2 (1%) rural males were current alcohol consumers. 169 (84.0%) of the rural males were irregularly or had ceased consuming alcohol. Tobacco consumption also showed a significant male predominance. There was a significantly higher total tobacco consumption in the urban population. Concordance of the three habits was evident among males with 27 concordant positive (expected = 5.98) and 46 concordant negative (expected = 6.60). It appears that kava, a traditional Pacific beverage may have lost ground to alcohol as urban Tongans adopt a more cosmopolitan life style. Kava, if proved relatively harmless, may be promoted as a less unhealthy alternative to tobacco and alcohol.

Adult↗
PubMed1982

Age-associated change in QRS axis: intrinsic or extrinsic ageing?

Human ageing is most usefully conceptualised as an interaction between intrinsic and extrinsic processes. Comparison of age-associated trends in populations living under different environmental conditions provides a method of recognising the effects of extrinsic influences. This paper compares the age-associated trend in mean frontal plane QRS axis in the male adult population of Pukapuka with the trend observed in an age-matched sample from a British population. The Pukapukans show no rise in mean blood pressure with age and have other features placing them at low risk of coronary heart disease. Although the British population showed the shift to the left in mean QRS axis characteristic of economically advanced populations there was no change in mean QRS axis with age among the Pukapukans. The conclusion is drawn that the shift with age in QRS axis observed in advanced populations is extrinsic in origin but is not necessarily a manifestation of coronary heart disease.

Adult↗
PubMed1981

Cholesterol, coconuts, and diet on Polynesian atolls: a natural experiment: the Pukapuka and Tokelau island studies.

Two populations of Polynesians living on atolls near the equator provide an opportunity to investigate the relative effects of saturated fat and dietary cholesterol in determining serum cholesterol levels. The habitual diets of the toll dwellers from both Pukapuka and Tokelau are high in saturated fat but low in dietary cholesterol and sucrose. Coconut is the chief source of energy for both groups. Tokelauans obtain a much higher percentage of energy from coconut than the Pukapukans, 63% compared with 34%, so their intake of saturated fat is higher. The serum cholesterol levels are 35 to 40 mg higher in Tokelauans than in Pukapukans. These major differences in serum cholesterol levels are considered to be due to the higher saturated fat intake of the Tokelauans. Analysis of a variety of food samples, and human fat biopsies show a high lauric (12:0) and myristic (14:0) content. Vascular disease is uncommon in both populations and there is no evidence of the high saturated fat intake having a harmful effect in these populations.

Adipose Tissue↗
PubMed1980

The Tokelau island migrant study: prevalence and incidence of diabetes mellitus.

Tokelauans show an increased prevalence and incidence of diabetes mellitus after migration to the modern industrial society of New Zealand (NZ). In females the prevalence rose from 6.1 percent before migration to 10.8 percent afterwards, while in males a nonsignificant rise from 2.3 percent to 4.4 percent was observed. Migrants who had been in New Zealand for longer periods had higher incidence than other migrants. Time since arrival in New Zealand was a significant predictor of diabetes, but time spent in an intermediate environment, Samona, on the way to New Zealand was not. Increase in body weight and adiposity occurred in the migrants. Adiposity was associated with an increased risk of diabetes, but nonspecific weight increase was not. Diabetic females had experienced 15 percent more births than nondiabetic females. Changed energy balance related to diet and work patterns may be related to the increased incidence of diabetes in migrants, in a population predisposed by high serum uric acid concentrations, obesity and high fertility.

Adolescent↗
PubMed1980

Death in the South Pacific.

The pattern of mortality and the influence of blood pressure, serum cholesterol, and body mass on mortality is examined in 1980 adults in four contrasting South Pacific populations. Three of the populations are Polynesian: Pakapuka, an isolated coral atoll, Rarotonga, a less isolated volcanic island, and the New Zealand Maoris, and they are compared with a New Zealand caucasian sample. The baseline examinations were performed in 1963-64 and the cardiovascular risk factors and associated disease were found to be more prevalent in Polynesians with increasing westernisation. The dead or alive status was ascertained in 1974 for 99 percent of the subjects. The age standardised 10-11 year death rates also increased with increasing westernisation from 11.7 percent in Pukapukan men to 26.7 percent in Maori men. The Mantel-Haenszel method of analysis of survivorship data demonstrated a significant inverse relationship between baseline serum cholesterol and mortality in the New Zealand Maoris. Cox's proportional hazards regression model was used to examine the population differences in mortality and it was found that the variables studied do not explain these differences. This study demonstrates the adverse effect of esternisation on the health of Polynesians and suggests that the relationsip between risk factors and mortality differs between populations.

Adult↗
PubMed1980

Cholesterol and mortality in New Zealand Maoris.

The relation between serum cholesterol concentration and mortality was studied prospectively over 11 years in 630 New Zealand Maoris aged 25-74. Serum cholesterol concentration was measured at initial examination in 1962-3 in 94% of the subjects and whether each was dead or alive was determined in 1974. The causes of death were divided into three categories: cancer, cardiovascular disease, and "other." The Mantel-Haenszel method of analysis of survivorship data showed a significant inverse relation between serum cholesterol concentration and overall mortality in men (x 2/2 = 11.6; p = 0.003) and women (x 2/2 = 7.6; p = 0.02) with odds ratios of 2.3 and 1.9 respectively. Similar significant inverse relations were found for cancer and "other" causes of death. These relations remained significant when baseline age, systolic blood pressure, and the Quetelt index were controlled in Cox's proportional hazards regression model. The results of this study provide evidence for a potentially deleterious effect of low serum cholesterol concentration. Hence, further research is needed before indiscriminate efforts are made to lower serum cholesterol concentrations in New Zealand Maoris.

Adult↗
PubMed1979

The Tokelau Island migrant study: alcohol consumption in two environments.

The prevalence of alcohol consumption, the choice of beverages and the quantity of drinks used by a Polynesian society are described, both in the Tokelau atolls and among Tokelauan migrants in New Zealand. Current drinking was uncommon but increasing among women. Among men, it was more common, but both prevalence and quantity were modest compared with national alcohol consumption in New Zealand. Description of alcohol consumption in such migrant populations may provide a basis for encouraging continuing prudence regarding alcohol and ready acceptance and provision for the non-drinker of alcohol.

Adolescent↗