Biomedical subjects

L S Webber

Publications and source records attributed to L S Webber.

At least 37 records · Page 2Linked to original sources

PubMed1995

The emergence of clinically abnormal levels of cardiovascular disease risk factor variables among young adults: the Bogalusa Heart Study.

BACKGROUND: The Bogalusa Heart Study, a long-term epidemiologic investigation of the early natural history of atherosclerosis, was conducted for the first time in 1973-1974 on children from birth through the age of 14 in a biracial (black-white) population. METHODS: The emergence of clinically recognizable abnormalities (obesity, hypertension, and hyperlipidemia) was studied in 1,928 young adults, ages 19-32 years, examined in the 1988-1991 survey. RESULTS: The occurrence of morbid levels of cardiovascular disease risk factors varied by race and gender. The prevalence of severe overweight, body mass index > or = 31.1 kg/m2 for males and > or = 32.3 kg/m2 for females, was much higher for black women (20.1% than for white women (8.7%), black men (14.0%), or white men (11.7%). The frequency of hypertension [systolic blood pressure (BP) > or = 140 mm Hg, diastolic BP > or = 90 mm Hg, or treatment for high BP] was greatest for black women (13.9%) versus black men (10.1%), white men (6.2%), or white women (5.0%). Approximately 9.5% of the men and 6% of the women had elevated LDL cholesterol ( > or = 160 mg/dl), while elevated triglycerides ( > or = 250 mg/dl ranged from 0% in black females to 7.4% in white males. Dyslipoproteinemia related to HDL cholesterol ( < or = 35 mg/dl) was more marked among white men (16%) compared with other groups (approximately 4%). Correlations for risk factors in a subgroup of 1,587 individuals initially surveyed as children in 1973-1974 were examined as an indication of tracking over a 15-year period. Highly significant correlations were seen for obesity, blood pressure, and LDL cholesterol. CONCLUSION: Early identification of adverse levels of cardiovascular disease risk factors defined by clinical experience should help to predict and prevent future cardiovascular disease morbidity and mortality.

Adult↗

PubMed1995

Statistical design of the Child and Adolescent Trial for Cardiovascular Health (CATCH): implications of cluster randomization.

This paper describes some statistical considerations for the Child and Adolescent Trial for Cardiovascular Health (CATCH), a large-scale community health trial sponsored by the National Heart, Lung, and Blood Institute. The trial involves randomization of entire schools rather than individual students to the experimental arms. The paper discussed the implications of this form of randomization for the design and analysis of the trial. The power calculations and analysis plan for the trial are presented in detail. The handling of outmigrating and immigrating students is also discussed.

Adolescent↗

PubMed1995

Obesity studies in Bogalusa.

Obesity is a determinant of cardiovascular risk factors in childhood, adolescence, and adulthood. Since the inception of the Bogalusa Heart Study, various anthropometric measures of body size and mass have been obtained. Attention is given to identifying the distribution for various obesity measures, secular trends in obesity, clustering of obesity with other risk factors, and obesity during childhood as a predictor of risk factors during young adulthood. Race, gender, and age differences offer clues to etiology of future clinical disease and cardiovascular risk. Innovative programs are needed to alter the secular trend over the past 20 years toward increased obesity. General wellness must include a reduction in obesity.

Adolescent↗

PubMed1995

Alcohol consumption among adolescents and young adults: the Bogalusa Heart Study, 1981 to 1991.

This report describes the alcohol consumption of adolescents and young adults who participated in the Bogalusa Heart Study, 1981 to 1991. Data were collected in three cross-sectional surveys of school-age children (11 to 19 years) and three surveys of young adults (18 to 32 years). White males had the highest proportion of drinkers and Black females had the lowest. By the end of the decade, adult White and Black male drinkers were about equal. Most individuals drank once or twice a week, but daily drinkers had the highest weekly alcohol intake. An association between alcohol and high-density lipoprotein cholesterol was found only in the latest survey and probably reflects the aging of the cohort.

Adolescent↗

PubMed1995

Relationship of change in body mass to blood pressure among children in Korea and black and white children in the United States.

Body mass is a major factor in determining blood pressure levels in children. We compared associations of body mass with blood pressure in 121 white and 91 black children in Bogalusa, Louisiana with that of 370 children in Kangwha, Korea. All children were seven years old at entry into the study and were followed for three years. Korean children were shorter (p < 0.001) thinner (p <0.0001), and had a lower body mass index (p < 0.01) than white or black children. At age seven, systolic blood pressure levels were 2 approximately 5 mm Hg lower, but at age 10, they were 2 approximately 5 mm Hg higher in Korean than white or black children. The increases in blood pressure levels from age seven to ten years were much greater in Korean than black or white children, while changes in height, weight, and body mass index were generally less. Change in blood pressure level was positively associated with change in body mass index for systolic (but not diastolic) levels; however, the association was no stronger for Korean than for U.S. children, except for Korean males vs Bogalusa black males. Cross-cultural studies of other factors, such as diet and physical activity, may explain these differences.

Analysis of Variance↗

PubMed1994

Design of process evaluation within the Child and Adolescent Trial for Cardiovascular Health (CATCH).

Process evaluation complements outcome evaluation by providing data to describe how a program was implemented, how well the activities delivered fit the original design, to whom services were delivered, the extent to which the target population was reached, and factors external to the program that may compete with the program effects. The process evaluation system used in the Child and Adolescent Trial for Cardiovascular Health (CATCH) is presented in this paper. The conceptual model underlying the CATCH process evaluation system is described, and process measures and data collection protocols are reviewed. Functions of process evaluation data in the trial include: (1) describing the implementation of the program, (2) quality control and monitoring, and (3) explaining program effects. The importance of incorporating process evaluation into final outcome analyses and assessments of program impact is emphasized.

Adolescent↗

PubMed1993

Lipid and lipoprotein distributions in children by ethnic group, gender, and geographic location--preliminary findings of the Child and Adolescent Trial for Cardiovascular Health (CATCH).

BACKGROUND: The Child and Adolescent Trial for Cardiovascular Health is a school-based study designed to test the effectiveness of dietary, physical activity, and educational interventions for reducing cardiovascular disease risk and teaching healthful behaviors to children. METHODS: As part of a pilot phase in 1989, lipid, lipoprotein, and anthropometric measures were taken in black (n = 90), Hispanic (n = 68), and white (n = 265) 8- to 10-year-old schoolchildren in California, Louisiana, Minnesota, and Texas. RESULTS: There were no significant differences in mean lipoprotein cholesterol values between fasting and nonfasting children. Therefore data from fasting and nonfasting children were pooled. Males and females within the same ethnic groups had similar mean levels of total cholesterol, low-density lipoprotein cholesterol, and very low-density lipoprotein cholesterol. However, levels of high-density lipoprotein cholesterol were higher among white and black males than among females from the same ethnic groups. Black males had higher total cholesterol than white males and higher high-density lipoprotein cholesterol than white males and Hispanic males. Similarly, black females had higher high-density lipoprotein cholesterol than white and Hispanic females. In all children combined high-density lipoprotein cholesterol was inversely correlated and low-density lipoprotein cholesterol was positively correlated with subscapular and tricep skinfold thickness, weight, and body mass index. There were significant differences in mean lipoprotein cholesterol levels between geographic sites. Total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol were highest in children from California followed by children from Texas, Minnesota, and Louisiana. CONCLUSION: Our results suggest that body fatness total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol differ in children by gender, ethnicity, and geographic location.

Analysis of Variance↗

PubMed1993

Normative distribution of complete blood count from early childhood through adolescence: the Bogalusa Heart Study.

BACKGROUND: Noting the distribution of blood values in a biracial southern community according to age, sex, and race variations will help in understanding the normative developmental changes in early life and provides background information. METHODS: Complete blood counts were obtained from 3,018 free-living children ages 5-17 years from a well-defined black-white community as part of a cardiovascular risk factor screening. RESULTS: For children ages 5-17 years, hemoglobin levels, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, and red blood count increased (P < 0.01) with age. Levels of platelet count and white blood count decreased (P < 0.0005) with age. Compared with females, males between ages 12 and 17 years have (P < 0.05) 0.4 x 10(12)/liter higher red blood count, 1 g/dl higher hemoglobin, 2% higher hematocrit, 0.2 g/dl higher mean corpuscular hemoglobin concentration, 0.5 x 10(9)/liter lower white blood count, 1.4 fl lower mean corpuscular volume, 0.3 pg lower mean corpuscular hemoglobin, and 14 x 10(9)/liter lower platelet count. Compared with blacks, whites have (P < 0.05) 0.5 10(9)/liter higher white blood count, 0.05 10(12)/liter higher red blood count, 0.7 g/dl higher hemoglobin, 1.7% higher hematocrit, 2.4 fl higher mean corpuscular volume, 1 pg higher mean corpuscular hemoglobin, and 0.5 g/dl higher mean corpuscular hemoglobin concentration. A positive association was noted among blood count variables and hemoglobin with blood pressure similar to that in adults. CONCLUSION: Blood values differ by age, sex, and race. These differences change at maturation and should be considered when defining normal and "abnormal" blood values.

Adolescent↗

PubMed1993

Breakfast consumption affects adequacy of total daily intake in children.

Breakfast consumption patterns were assessed for 467 10-year-old children (59% white, 50% girls), who were interviewed in 1984-1985 or in 1987-1988. Consumption patterns were then related to mean daily nutrient intake patterns. More whites (56%) and more girls (46%) ate breakfast at home, whereas more blacks (58%) and more boys (49%) ate breakfast at school. Results indicated that 16% of all children skipped breakfast; the highest percentage was in black girls (24%). Breakfast consumption made a significant contribution to the child's mean daily nutrient intake. The average total energy intake was significantly lower for children who did not consume breakfast (mean = 1,821 kcal) and for children who consumed breakfast at home (mean = 2,098 kcal) compared with children who consumed breakfast at school (mean = 2,326 kcal). A similar pattern was noted for macronutrient contribution. Percentage of total energy from fat was lower in children who did not eat breakfast (34%) compared with those who did (37% to 39%), yet percentage of energy from carbohydrate was higher (53%) in children who did not eat breakfast. Children who skipped breakfast did not make up the differences in dietary intakes at other meals. A higher percentage of children who did not consume breakfast compared with those who ate breakfast did not meet two thirds of the Recommended Dietary Allowance for vitamins and minerals. These data confirm the importance of breakfast to overall dietary quality and adequacy in school-age children.

Black or African American↗

PubMed1993

Secular trends in dietary intakes and cardiovascular risk factors of 10-y-old children: the Bogalusa Heart Study (1973-1988).

Dietary intakes of 10-y-old children were examined in six cross-sectional surveys to observe secular trends in energy, macronutrient, cholesterol, sodium, and fatty acid intakes. Total energy intake remained unchanged from 1973 to 1988; however, when expressed as energy/kg body wt, intake decreased from 275.1 kJ (65.5 kcal) in 1973 to 254.9 kJ (60.7 kcal) in 1988 because children's weight increased. Linear trends over this time period were also noted for total fat (negative), saturated fatty acid (negative), polyunsaturated fatty acid (positive), dietary cholesterol (negative), and sodium intake (positive). There was a significant increase in percent energy from protein and carbohydrate and a significant decrease in percent energy from fat, primarily saturated and monounsaturated fatty acids. An apparent increase over time is noted in the percent of children meeting dietary recommendations for total fat, saturated fatty acid, and cholesterol. Yet, few children meet the prudent diet recommendations.

Black People↗

PubMed1993

Ambulatory blood pressure measurements in children and young adults selected by high and low casual blood pressure levels and parental history of hypertension: the Bogalusa Heart Study.

Ambulatory blood pressure measurements were obtained in 57 children and young adults selected by prior high or low casual blood pressure levels and parental history of hypertension. Considerable variation in blood pressure levels occurred over 24 hours, with generally higher levels occurring in those so selected. Parental history had a small influence on higher levels, although statistical significance was not shown. Persons with higher blood pressure levels did not reach levels as low during sleep, especially with regard to the systolic measurement, and a greater variability was noted in those selected for higher levels. Although differentiation of persons with high and low blood pressure levels can be obtained by noting average levels persisting above a cut point, for example, 140/85, in growing children an arbitrary 90th percentile based on age, height, and weight may be more appropriate. Ambulatory monitoring showed that young persons, selected by casual measurements as having high blood pressure, have a greater percentage of high levels persisting over a 24-hour period, comprising a greater blood pressure load. These observations also showed that even two series of casual measurements may misclassify a person as having hypertension. Ambulatory blood pressure monitoring will enhance understanding of the early natural history of hypertension and allow improved prevention of the disease.

Adolescent↗

PubMed1993

Fort Polk Heart Smart Program. Part I: Background design and significance.

This paper introduces three cardiovascular health evaluation and promotion projects targeting military families at Fort Polk, Louisiana. These studies examine dietary behavior and life-styles including tobacco and alcohol use of military wives, physical activity, cardiovascular disease risk factors of military personnel and their families, and other behavioral profiles with the goal of developing a healthy lifestyle modification program for families. Relevant biomedical background and rationale considerations are developed to support the current research. In addition, conclusions drawn from these studies indicate the opportunity for future health promotion programs at other military installations. The studies will provide the background for a manual of operations to conduct health promotions for families on a military base. Further, the model provides the opportunity for a social support mechanism for families during times of stress and military operations.

Cardiovascular Diseases↗

PubMed1993

Fort Polk Heart Smart Program. Part II: Cardiovascular risk factor assessment.

In order to identify potential abnormalities, a cardiovascular risk-factor screening was developed as part of the Fort Polk Heart Smart Program. Serum lipids and lipoproteins, blood pressure, and selected anthropometric indices were measured on 703 individuals. Overweight was more a problem for females, with over 40% having a body mass index greater than 27. The percentage of subjects exceeding National Cholesterol Education Program guidelines increased with age. Some 30% of white men 30-39 years old and 60% of white men above 40 years old had elevated total cholesterol. These observations provide the basis for a health promotion program for young military families.

Adolescent↗

PubMed1993

Fort Polk Heart Smart Program. Part III: Assessment of dietary intake of military wives.

Dietary intake of military wives and factors that influence nutrition of military families were examined in 186 military wives--67% white, 18% black, 11% Hispanic, and 4% other. The ages ranged from 19 to 45 years (mean = 28.7 years). The observations show that 1.7 meals per day were shared by all family members. Due to differences in energy intake and RDAs by age, dietary intakes were assessed in two age groups: 19-24 years (N = 51) and 25-45 years (N = 135). For both age groups, total energy intakes were lower than the RDAs, and the dietary composition was 52% carbohydrate (CHO), 14% protein, and 34% fat. Military wives 25-45 years old consumed more CHO in the form of sugar compared to the younger wives, who consumed more CHO in the form of starch. Some families require food stamps and are in the WIC program. There were no age differences in the type of protein or fat consumed, averaging 66% animal protein and 12% saturated fat. Dietary cholesterol intake was 229 mg for wives 19-24 and 243 mg for older wives and, based on approximately 1,900 kcal, dietary cholesterol exceeded 100 mg/1,000 kcal in both age groups. Sodium intake averaged 3.2 g. Forty-five percent of the military wives did not meet two-thirds of the RDA for vitamins D, E, B-6, iron, folic acid, zinc, and magnesium. Less than 20% met two-thirds of the RDA for riboflavin, vitamin A, thiamin, iodine, selenium, and calcium.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1993

Fort Polk Heart Smart Program. Part IV: Lifestyles of military personnel and their families.

Lifestyles are major determinants in development of heart disease. Tobacco and alcohol use, physical activity, and hostility, a component of type A, were assessed in a sample of active military men and their wives at Fort Polk, Louisiana. Findings included: (1) a greater frequency of cigarette smoking at Fort Polk compared to national surveys; (2) a higher frequency of alcohol consumption in ages 30-39, and more blacks reported alcohol use than other race groups; (3) a greater frequency of alcohol use at Fort Polk compared to a worldwide military survey; (4) no consistent differences in lipid or blood pressure levels for high and low activity groups of wives; and (5) wives' hostility scores were low, and were not correlated with other cardiovascular risk factors. The implication of lifestyle descriptions is the need for intervention and health promotion, not only for military personnel, but also for their families. The significance of health promotion programs is the eventual reduction of health care costs and the well-being of families and fitness of military personnel.

Adolescent↗

PubMed1993

Serum lipids and lipoprotein profiles of military personnel and their families: Fort Polk Heart Smart Program.

Serum lipid and lipoprotein distributions and their correlates were examined in white, black, and Hispanic Army personnel and their families (N = 589) as part of the Fort Polk Heart Smart Program. In general, blacks tended to have higher HDL-C and lower triglycerides and VLDL-C than whites and Hispanics, whereas Hispanics tended to manifest higher triglycerides, VLDL-C, and LDL-C than whites. Unlike black and Hispanic men, white men tended to have lower HDL-C than white women. In contrast to white men, both black and Hispanic men displayed elevated LDL-C compared with black and Hispanic women. A considerable proportion of individuals tended to manifest adverse lipoprotein patterns according to National Cholesterol Education Program guidelines for children and adults. Cigarette smoking and alcohol use were the major contributors to the variance of lipoproteins in men, whereas overweight and oral contraceptive use remained the major factors in this regard for women. These results indicate that early targeting of military personnel and their family members for primary prevention is highly desirable.

Adolescent↗

PubMed1992

Atherosclerosis of the aorta and coronary arteries and cardiovascular risk factors in persons aged 6 to 30 years and studied at necropsy (The Bogalusa Heart Study).

Race and sex differences in aorta and coronary atherosclerotic lesions were studied in 150 persons aged 6 to 30 years. The intimal surface involvement with aorta fatty streaks was extensive, 0 to 71%, and greater in blacks than in whites (32 vs 20%, p less than 0.001). Coronary artery fatty streaks were more extensive in male than in female subjects (range 0 to 22%). Fibrous plaque lesions were present but not extensive in either the aorta (0 to 12%) or the coronary artery (0 to 24%) specimens. Lesions were more prevalent in male than in female persons, particularly white male subjects. The relation of fatty streaks to fibrous plaques was greater in the coronary vessels than in the aorta. In male subjects, aorta fatty streaks were strongly related to antemortem levels of total cholesterol, low-density lipoprotein cholesterol and ponderal index in white male subjects. Coronary artery fatty streaks in white male persons were significantly associated with serum triglycerides, very low density lipoprotein cholesterol, systolic and diastolic blood pressure and ponderal index. These results link antemortem risk factors to the development of atherosclerotic lesions and emphasize the need for preventive cardiology in early life.

Adolescent↗

PubMed1992

The Heart Smart cardiovascular school health promotion: behavior correlates of risk factor change.

BACKGROUND: A growing awareness of health promotion and positive lifestyle change, coupled with the knowledge that cardiovascular risk has its origins in childhood, has led to the development of health promotion programs in the elementary school. While most school-based programs target specific behaviors or enlist singular intervention modalities, the Heart Smart cardiovascular school health promotion targeted the total school environment with a multidisciplinary approach to prompt the school's varied institutions to implement changes in curriculum, school lunch, and physical education. METHODS: Components of the Heart Smart environmental intervention included: (a) a school lunch program providing cardiovascular healthful food choices, reduced in fat by 30% and in sodium and sugar by 50%; (b) a physical education program promoting personal fitness and aerobic conditioning; and (c) cardiovascular risk factor screening, measuring fasting lipids and lipoproteins, anthropometrics, and blood pressure. Changes in cardiovascular risk factor status, school lunch selections, and exercise performance were compared. RESULTS: Screening participants showed greater improvement in health knowledge than nonparticipants. School lunch choices were successfully altered, and children whose lunch choices were cardiovascular healthful evidenced the greatest cholesterol reduction. Improvements in run/walk performance were related in predicted directions to the overall cardiovascular risk profile. Increases in high-density lipoprotein cholesterol were observed at intervention schools. CONCLUSION: Observations indicate a relationship between behavior change and physiologic changes achieved in a total school health promotion to reduce cardiovascular risk.

Anthropometry↗