Search PubMed⌕ Search

Biomedical subjects

L S Webber

Publications and source records attributed to L S Webber.

At least 55 records · Page 3Linked to original sources
PubMed1992

Relation of serum lipoprotein lipids and apolipoproteins to obesity in children: the Bogalusa Heart Study.

BACKGROUND: The relationship of serum lipoprotein lipids and apolipoproteins to obesity was studied in a biracial sample of 2,816 children of ages 5-17 in Bogalusa, Louisiana. METHODS: Two measures of obesity were used: fatness (subscapular skinfold thickness) and fat centrality (the ratio of subscapular to triceps skinfold thickness). Plasma insulin and glucose were included as metabolic markers related to obesity. RESULTS: The obesity associations were relatively strong with insulin (rs = 0.29, P less than 0.001, skinfold; rs = 0.15, P less than 0.001, skinfold ratio) and triglycerides (rs = 0.25, P less than 0.001, skinfold; rs = 0.19, P less than 0.001, skinfold ratio). The relationships of serum low-density lipoprotein cholesterol (LDL-C) (rs = 0.17, P less than 0.001, skinfold; rs = 0.13, P less than 0.001, skinfold ratio) and apolipoprotein (apo) B (rs = 0.16, P less than 0.001, skinfold; rs = 0.13, P less than 0.001, skinfold ratio) with the obesity measures were of lesser magnitude, but persisted after adjustment for insulin and triglycerides. The inverse association of obesity to serum high-density lipoprotein cholesterol (HDL-C) (rs = -0.13, P less than 0.001, both skinfold and skinfold ratio) and apo A-I (rs = -0.04, P = 0.03, skinfold; rs = -0.05, P = 0.004, skinfold ratio) was significant only before adjustment for insulin and serum triglycerides. Multiple linear regression of obesity measures showed that, like insulin, serum triglycerides had consistently higher standardized coefficients than LDL-C, HDL-C, apo B, and apo A-I. Apo A-I and apo B added only a small amount (less than 2%) of information to the relationship of serum lipoproteins with obesity measures. CONCLUSION: These results indicate that serum very-low-density lipoprotein (VLDL) levels are directly and independently related to obesity. The well-known inverse association between obesity and serum HDL-C is not independent, but secondary to the elevated VLDL or triglyceride levels associated with obesity. While associations of obesity and lipoprotein cholesterol are found, far fewer occur with apolipoproteins, especially Apo A-I. Interesting race and sex differences in the relationship of obesity to serum lipoproteins and apoproteins are noted, being greater among white children and more consistent in white males.

Adolescent↗
PubMed1992

Primary care physicians and children's blood cholesterol.

BACKGROUND. In a national survey sponsored by the National Heart, Lung, and Blood Institute, 62% of primary care physicians of children (under age 18 years) believed that high levels of low-density lipoprotein cholesterol in childhood had a great effect on subsequent heart disease risk. RESULTS. About 75% believed high blood pressure, smoking, and diabetes had similar effects. Although routine cholesterol screening in children under age 10 was infrequent, 72% of physicians screened high risk children. The age at which screening was done varied markedly; more pediatricians screened children younger than 5 years. The majority of physicians who saw children with high blood cholesterol instituted nondrug therapy, with pediatricians being most apt to do so. Low saturated fat diets were prescribed by 26% of these physicians and 9% of physicians prescribed increased polyunsaturated diets. Twelve percent of physicians treating hypercholesterolemic children used lipid-lowering drugs. Among those using drugs, 9% based drug use on total blood cholesterol measurements only. Factors that affected physician treatment of childhood hypercholesterolemia included physician specialty type, organization of practice (group or solo), and the age distribution of the pediatric patient population.

Age Factors↗
PubMed1992

Nutrient contribution of the school lunch program: implications for healthy people 2000.

Cardiovascular disease-related nutrients were quantified in a school lunch program over a 15-year period. Methods included 24-hour dietary recall, menu weights, and recipe analysis. School lunch was eaten by 93% of students. School lunches provided 23% of daily kilocalories and 24%, 29%, and 20% of daily fat, protein, and carbohydrate intake, respectively, saturated fat and cholesterol from school lunch were 27% and 24% of daily total. School lunch provided 7% of daily sucrose and 32% of daily sodium. Children not eating school lunch had significantly greater polyunsaturated (p less than .001), carbohydrate (p less than .05), and sucrose (p less than .001) intakes. Though the school lunch contributed less than one-third of daily total nutrients, intakes of diet components related to cardiovascular disease risk were excessive. Sixty percent to 80% of children exceed daily total fat, saturated fat, cholesterol, and sodium intakes over recommended levels. Schools can influence childhood cardiovascular disease risk by providing students healthier foods, with education to promote positive lifestyles.

Adolescent↗
PubMed1992

Body fatness and risk for elevated blood pressure, total cholesterol, and serum lipoprotein ratios in children and adolescents.

BACKGROUND: Recent studies have shown considerable variation in body fatness among children and adolescents defined as obese by a percentile rank for skinfold thickness. METHODS: We examined the relationship between percent body fat and risk for elevated blood pressure, serum total cholesterol, and serum lipoprotein ratios in a biracial sample of 3320 children and adolescents aged 5 to 18 years. Equations developed specifically for children using the sum of subscapular (S) and triceps (T) skinfolds were used to estimate percent fat. The S/T ratio provided an index of trunkal fat patterning. RESULTS: Significant overrepresentation (greater than 20%) of the uppermost quintile (UQ) for cardiovascular disease (CVD) risk factors was evident at or above 25% fat in males (32.2% to 37.3% in UQ) and at or above 30% fat in females (26.6% to 45.4% in UQ), even after adjusting for age, race, fasting status, and trunkal fat patterning. CONCLUSIONS: These data support the concept of body fatness standards in White and Black children and adolescents as significant predictors of CVD risk factors. Potential applications of these obesity standards include epidemiologic surveys, pediatric health screenings, and youth fitness tests.

Adolescent↗
PubMed1992

A food frequency questionnaire for adolescents: defining eating patterns.

A self-administered food frequency questionnaire (FFQ) was developed to indicate weekly consumption of 64 foods. Reliability, validity, and usefulness of the tool to define a protein eating pattern were determined. Adolescents (N = 1,108) completed the FFQ during the Bogalusa Heart Study. Two-hour and 2-week reliability measures demonstrated consistency of intake of specific foods. Frequency of foods obtained from seven consecutive 24-hour recalls was compared with frequency obtained from the FFQ. A mean 50% agreement for both frequency and quantity of food intake was observed. Geometric means showed differences in mean number of protein foods by age of adolescent but the only significant difference was for beef intake of 15-year-olds. White children reported more servings of beef, cheese, and vegetables with meat than did black children. Black children reported more servings of eggs, luncheon meat, pork, poultry, and total protein than did white children. Boys reported a greater frequency of total protein foods, specifically, eggs, milk, and poultry, than did girls. Significant correlations were noted between low-density-lipoprotein cholesterol and intake of eggs and luncheon meat. We were able to quantitate the reliability and validity of the FFQ and to use it to explore the association of specific eating patterns with cardiovascular disease risk.

Adolescent↗
PubMed1992

Nutrient adequacy of low fat intakes for children: the Bogalusa Heart Study.

Nutritional adequacy is important when diets and dietary alterations are recommended for children. Concern is expressed that low fat intakes may have deleterious effects on growth and development and may be deficient in total calories and essential nutrients. In a study of the effect of variation in percent fat in the diet, a sample of 871 ten-year-olds was stratified according to four different fat intakes: less than 30% of total kilocalories (kcal), 30% to 35% kcal, 35% to 40% kcal, and greater than 40% kcal. The race/sex distribution was similar within each fat intake group. Fourteen percent of the sample had fat intakes less than 30% of total calories. The amount of calories from breakfast, dinner, and snacks was higher in the children with fat intakes greater than 40% of total calories than those with lower fat intakes. The energy intake of all race/sex groups fell within the recommended range. The low fat intake group was eating 25% less calories than the high fat intake group (1800 kcal vs 2400 kcal). The percentage of calories from carbohydrate, specifically sugar, was greater in the low fat intake group compared with the high fat intake group. Percentage of calories from protein was approximately 13% for all groups. Fiber and starch were the same across all fat intakes.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗
PubMed1991

Tracking of serum lipids and lipoproteins from childhood to adulthood. The Bogalusa Heart Study.

Serum lipids (total cholesterol and triglycerides) and lipoprotein cholesterol fractions (low density lipoprotein (LDL) cholesterol, very low density lipoprotein (VLDL) cholesterol, and high density lipoprotein (HDL) cholesterol) have been measured approximately every 3 years on children and young adults since 1973-1974 in Bogalusa, Louisiana, a community of approximately 22,000 individuals, one-third of whom are black and two-thirds of whom are white. A total of 1,586 children were examined both at baseline (1973-1974) and at the most recent survey (1984-1986), providing 12 years of follow-up. The decreases in levels noted during puberty for total cholesterol and LDL cholesterol, primarily for boys, were followed by a rise until age 26 years. HDL cholesterol levels, particularly for white boys, continued to drop after age 14 years, yielding increasingly high LDL cholesterol/HDL cholesterol ratios. Tracking, as measured by both correlation coefficients and persistence at extreme quartiles, was evident for all of the lipids and lipoproteins. The 12-year correlation coefficients were greatest for LDL cholesterol and no trend in the magnitude of the correlation coefficients with age was noted. Tracking for HDL cholesterol was better after age 9 years, particularly for white males. Approximately 50% of those children who had total cholesterol levels or LDL cholesterol levels above the 75th percentile at baseline remained elevated 12 years later. For HDL cholesterol, a trend with age was noted for white boys: 42% of those aged 9-14 years in the lower most quartile persisted in this rank 12 years later. The best predictor of follow-up lipid or lipoprotein level was baseline level. The next best predictor was increase in weight as defined by weight/height, an index of obesity. That serum lipid and lipoprotein levels continue to track from childhood into young adulthood points to the necessity of measurement early in life and, where indicated, the introduction of preventive and interventional programs aimed at developing healthy lifestyles.

Adolescent↗
PubMed1991

Cardiovascular risk factors in Hispanic, white, and black children: the Brooks County and Bogalusa Heart studies.

Cardiovascular disease risk factors were studied in Hispanic children in Brooks County, Texas, and in white and black children in Bogalusa, Louisiana, in 1984-1985. The same protocols were used at both sites; examiners in Brooks County were trained by Bogalusa Heart Study staff. All blood samples were analyzed in a single laboratory standardized by the Centers for Disease Control. Hispanic children were about 4 cm shorter and were about the same weight as white and black children. Subscapular skinfolds were thickest in Hispanic children. Little difference was noted for blood pressure levels in the three ethnic groups. Total cholesterol levels were highest in black children, with a drop during puberty being noted in all of the ethnic groups. This drop with puberty appeared somewhat earlier in the Hispanic children. Lipoprotein levels for Hispanic children were, in general, similar to those noted for white children. Some of the Hispanic-black differences in lipid and lipoprotein levels could be explained by differences in body size. Because Hispanics are at increased risk for specific diseases, such as diabetes, increased study of this population is warranted. Intervention and education programs aimed at altering this risk must address the unique cultural heritage of this population.

Adolescent↗
PubMed1991

Race and gender differences in serum lipoproteins of children, adolescents, and young adults--emergence of an adverse lipoprotein pattern in white males: the Bogalusa Heart Study.

METHODS: Serum lipoprotein profiles in 4,231 individuals, ages 5-26 years, were studied cross-sectionally in a biracial community to describe the race- and gender-specific changes from adolescence into young adulthood. RESULTS: White children and adolescents of both genders showed significantly higher covariates--adjusted triglycerides (9-11 mg/dl) and very-low-density lipoprotein cholesterol (1-2 mg/dl)--and lower total cholesterol (3-14 mg/dl) and high-density lipoprotein cholesterol (6-10 mg/dl) levels than their black counterparts. These black-white differences persisted among young adults of both genders with the exception of total cholesterol levels (higher triglycerides: 23-32 mg/dl; higher very-low-density lipoprotein cholesterol: 5-7 mg/dl; lower high-density lipoprotein cholesterol: 9-11 mg/dl); in addition, white young adult males began to show higher levels of low-density lipoprotein cholesterol (14 mg/dl) than black young adult males. A consistent gender-related pattern emerged only among white young adults with males showing higher triglyceride levels (22 mg/dl), very-low-density lipoprotein cholesterol (5 mg/dl), and low-density lipoprotein cholesterol (10 mg/dl) and lower high-density lipoprotein cholesterol (10 mg/dl) than females. Lipoprotein changes from adolescence into young adulthood were more pronounced among white males than other race-gender groups, resulting in higher triglyceride, very-low-density lipoprotein cholesterol, and low-density lipoprotein cholesterol, a higher total cholesterol/high-density lipoprotein cholesterol ratio, and a lower high-density lipoprotein cholesterol in their young adulthood. According to the National Cholesterol Education Program criteria, a relatively higher proportion of young adult white males was classified as borderline-high (22.6%) or high (9.1%) for low-density lipoprotein cholesterol. Adiposity was the major contributor to the adverse lipoprotein pattern, especially among white males. Sexual maturation and age influenced the lipoprotein levels to a greater extent among white males. Cigarette smoking, alcohol intake, and oral contraceptive use began to emerge as minor but significant factors contributing to the lipoprotein levels in adolescents and young adults. CONCLUSION: These results underscore the desirability of early targeting for primary prevention.

Adolescent↗
PubMed1991

Studies of consistency of dietary intake during the first four years of life in a prospective analysis: Bogalusa Heart Study.

The consistency of intake levels for several dietary components over a 5-year period (age 6 months to 4 years) in a biracial infant-early childhood cohort has been demonstrated. Young children with high intakes of selected dietary components associated with risk of cardiovascular disease (e.g., total fat, saturated fat, dietary cholesterol) continue to have higher intakes as they mature than do their peers. Spearman rank correlation coefficients at a significant level are noted between ages 2 and 4 for the following nutrients: total protein (r = 0.65), animal protein (r = 0.46), total sugar (r = 0.39), sucrose (r = 0.37), starch (r = 0.33), total fat (r = 0.53), saturated fatty acid (SFA, r = 0.48), polyunsaturated fatty acid (PUFA, r = 0.43), and cholesterol (r = 0.49). At 2 years of age, some 47-65% of those in the upper tertile for total fat, SFA, and cholesterol intake remain in the upper tertile at age 4. Persistence of eating behaviors appears to begin as early as age 2, in part because of parental control over food patterns. These observations have implications for reduction of early cardiovascular risk factors in children and adoption of a more prudent dietary intake through consumer education.

Cholesterol, Dietary↗
PubMed1991

Racial (black-white) differences in serum lipoprotein (a) distribution and its relation to parental myocardial infarction in children. Bogalusa Heart Study.

BACKGROUND: The value of lipoprotein (a) [Lp(a)] in the prediction of coronary artery disease risk very early in life remains to be established in different racial groups. METHODS AND RESULTS: Serum Lp(a) distribution and its relation to parental histories of myocardial infarction were examined in 2,438 children (8-17 years old) from a biracial community. Parental myocardial infarction was used as a surrogate measure of future risk of disease in the offspring. Lp(a) levels averaged 1.7-fold higher in blacks than in whites (p less than 0.0001). A small but significant sex difference (females greater than males, p less than 0.05) was seen in both races. Race was the only independent variable that contributed appreciably (9%) to the variability of Lp(a) in serum. White children with parental myocardial infarction (n = 90) had increased levels of Lp(a) compared with those without parental myocardial infarction (22.4 versus 17.1 mg/dl, p less than 0.01). Furthermore, among white children, the prevalence of parental myocardial infarction was higher in those with Lp(a) levels of more than 25 mg/dl than in those with values of 25 mg/dl or less (9.5% versus 5.4%, p less than 0.01). In contrast, the relation of Lp(a) to parental myocardial infarction was not seen in black children. No associations were observed between parental myocardial infarction and serum levels of any of the lipids or lipoprotein cholesterol classes in children of either race. CONCLUSIONS: Serum Lp(a) levels may prove valuable in the assessment of coronary artery disease risk early in life among white populations. These findings also emphasize the need to evaluate the atherogenic potential of Lp(a) in different racial groups.

Adolescent↗
PubMed1991

Serum uric acid and its relation to cardiovascular disease risk factors in children and young adults from a biracial community: the Bogalusa Heart Study.

The distribution of serum uric acid and its relationship with cardiovascular risk variables have been studied in 3983 children and young adults, aged 5 to 26 years, drawn from a biracial (black and white) population. For two age groups, 5 to 11 years and 19 to 26 years, white subjects had significantly higher uric acid levels than black subjects, (4.02 mg/dl vs 3.57 mg/dl, p less than 0.0001, and 5.50 mg/dl vs 5.18 mg/dl, p less than 0.0001, respectively). Men in the 19 to 26 years age group had a significantly higher uric acid level than women (6.49 mg/dl vs 4.20 mg/dl, p less than 0.0001). White children and young adults were twice as likely to have levels above clinical limits than blacks, and males more likely to have hyperuricemia than females. Parents with a history of myocardial infarction were more likely to have children with hyperuricemia. Children and young adults with hyperuricemia had significantly higher plasma glucose (p less than 0.01) and insulin (p less than 0.001) levels, total cholesterol level (p less than 0.05), and serum triglyceride (p less than 0.0001), very-low-density lipoprotein cholesterol (p less than 0.01), low-density lipoprotein cholesterol (p less than 0.001), and total protein (p less than 0.0001) levels than subjects without hyperuricemia; high-density lipoprotein cholesterol level was significantly lower (p less than 0.0001) in subjects with hyperuricemia than in those without it.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Increasing impact of obesity on serum lipids and lipoproteins in young adults. The Bogalusa Heart Study.

Obesity is an important determinant of serum lipids and lipoproteins in adults. Since obesity begins early in life, the impact of obesity of serum lipid and lipoprotein levels was examined in 3311 children and young adults (ages 5 to 26 years) from a totally biracial community. Study subjects were grouped according to race, sex, and age categories (5 to 10 years, 11 to 16 years, 17 to 22 years, and 23 to 26 years), excluding females using oral contraceptives or who were pregnant. Overall, associations increase with age, being most prominently noted in white males. The strong positive relation of ponderosity to low-density lipoprotein cholesterol was indicated in the older age groups with correlation coefficients ranging from r = -.09 in the youngest black males to r = .47 in white males aged 17 to 22 years. A negative association was noted between ponderosity and high-density lipoprotein cholesterol with correlation coefficients ranging from r = .08 in black females aged 17 to 22 years to r = -.39 in the oldest white males. Similar results were seen using subscapular skin-fold thickness as a measure of central obesity. Overweight was defined as exceeding 20% above the National Health Anthropometric and Nutritional Examination Survey II survey 50th percentiles. The prevalence of overweight individuals increased with age, being most prominent in black females. The percent(s) of hypercholesterolemic cases, based on the National Cholesterol Education Program criteria, likewise increased with age. A marked proportion of older white males were classified as borderline high and high for low-density lipoprotein cholesterol. A regression model using subscapular skinfold to predict serum lipids and lipoproteins within each age group indicated a consistent increase in the adverse nature of the lipid profile. Intervention and education programs aimed at reducing obesity at younger ages are recommended to reduce serum lipid and lipoprotein levels developing in young adulthood.

Adolescent↗
PubMed1990

Measurement of apolipoprotein B as a screening test for identifying children with elevated levels of low-density lipoprotein cholesterol.

We compared the efficacy of two screening tests, measurement of apolipoprotein B (apo B) levels and measurement of serum total cholesterol levels, in detecting elevated low-density lipoprotein cholesterol (LDL-C) values in children. We studied 2850 children, aged 5 to 17 years, who had fasting lipid, lipoprotein, and apolipoprotein levels measured as part of the Bogalusa Heart Study. The test characteristics of apo B were superior to those of serum total cholesterol in screening children to detect elevated levels of LDL-C (greater than or equal to 95th percentile) and moderately elevated LDL-C levels (greater than or equal to 80th percentile). Unusually high or low values of high-density lipoprotein cholesterol are responsible for most of the misclassification that occurs when measurement of total cholesterol is used as a screening test for identifying children with elevated levels of LDL-C. This confounding effect of high-density lipoprotein cholesterol was eliminated when measurement of apo B levels was used as a screening test. Because the apo B test is more specific at a given sensitivity than the total cholesterol test, the apo B test can cost more and still be less expensive as a screening strategy. As the methods for determining apolipoprotein levels become standardized and readily available, the measurement of apolipoproteins could be developed into superior screening tests for the identification of patients with dyslipidemias.

Adolescent↗
PubMed1990

Combined low-dose medication and primary intervention over a 30-month period for sustained high blood pressure in childhood.

Studies of the pathobiologic consequences of high blood pressure in childhood, as well as those following blood pressure levels into young adulthood, indicate that early intervention in the natural history of essential hypertension is warranted. In an exploratory study of the concept, 95 children out of 1604 (aged 8 to 18 years), who persistently scored higher than the 90th percentile for blood pressure over a 4-month period, considering the race, sex, and height of the children, were studied. Five series of replicate measurements with 30 total observations were obtained. Children with evidence of secondary hypertension were excluded. The study children were randomly divided into treatment (n = 48) and high-comparison (n = 47) groups. Treatment consisted of low-dose combined drug therapy (propranolol and chlorthalidone) with an educational program directed towards hypertension and dietary and exercise modification. Monthly follow-up was continued for 30 months. Significant systolic (-3.59 mm Hg) and diastolic (-1.73 mm Hg) changes were noted up to 30 months (p less than 0.05) with minimal side effects. Furthermore, analyses suggested that the blood pressure change, at least in the first month, was mostly attributable to drug therapy. Moreover, the mechanism of blood pressure change appeared to be race-specific, with whites having pulse rate changes and blacks having significant weight changes, which were associated with blood pressure change. This trial shows further research is warranted to determine optimum approaches for early treatment of essential hypertension to prevent future hypertensive disease.

Adolescent↗