Biomedical subjects

Penny Gordon-Larsen

Publications and source records attributed to Penny Gordon-Larsen.

At least 19 recordsLinked to original sources

PubMed2026

Multi-omic characterization of the Hispanic/Latino blood lipidome reveals an additional locus and attenuated genetic prediction.

While lipids have been extensively investigated, genetic regulation of the circulating lipidome in diverse populations remains poorly understood. We conducted a lipidome-wide genome-wide association study (GWAS) of 830 lipid species in 2,287 Hispanic/Latino participants and performed predictive modeling across omics layers. We identified 7,593 genome-wide significant SNPs mapping to 208 genes. Conditional analysis disentangled the long-range linkage disequilibrium artifacts from the pleiotropic FADS1/2/3 cluster. Separately, we discovered an association at the GPLD1 locus for a circulating ceramide. Colocalization revealed shared genetic architecture with conventional lipids alongside distinct, species-specific pathways. Incorporating Native/Indigenous American expression quantitative trait loci (eQTLs) within a multi-omic framework uncovered 62 likely regulatory genes missed by European-centric gene expression models. Finally, genetically regulated predictive models demonstrated performance declining from transcriptomics to proteomics to lipidomics, reflecting increased distance from gene action along the molecular cascade. Our study provides a genetic landscape of lipid metabolism in a highly burdened population and highlights the challenges in predicting lipid abundance.

Hispanic/Latino population↗

PubMed2007

Differential associations of fast food and restaurant food consumption with 3-y change in body mass index: the Coronary Artery Risk Development in Young Adults Study.

BACKGROUND: Away-from-home food consumption has rapidly increased, though little is known about the independent associations of restaurant food and fast food intake with body mass index (BMI) and BMI change. OBJECTIVE: The aim was to compare the associations of restaurant food and fast food consumption with current and 3-y changes in BMI. DESIGN: Multivariate linear regression models, with control for demographic and lifestyle factors, were used to examine cross-sectional and longitudinal associations of away-from-home eating with BMI by using data from subjects of the Coronary Artery Risk Development in Young Adults Study (n = 3394) obtained at exam years 7 (1992-1993) and 10 (1995-1996). RESULTS: Forty percent of the sample increased their weekly consumption of restaurant or fast food, though mean (+/-SD) changes were -0.16 +/- 2.39 times/wk (P = 0.0001) and -0.56 +/- 3.04 times/wk (P < 0.0001), respectively. Cross-sectionally, fast food, but not restaurant food, consumption was positively associated with BMI. Similarly, higher consumption of fast food at year 7 was associated with a 0.16-unit higher BMI at year 10. After adjustment for baseline away-from-home eating, increased consumption of fast food only (beta: 0.20; 95% CI: 0.01, 0.39) and of both restaurant food and fast food (beta: 0.29; 95% CI: 0.06, 0.51) were positively associated with BMI change, though the estimates were not significantly different (P = 0.47). Increased consumption of restaurant food only was unrelated to BMI change (beta: -0.01; 95% CI: -0.21, 0.19), which differed significantly (P = 0.014) from the estimate for an increase in both restaurant food and fast food intake. CONCLUSIONS: We found differential effects of restaurant food and fast food intakes on BMI, although the observed differences were not always statistically significant. More research is needed to determine whether the differential effects are related to consumer characteristics or the food itself.

Adult↗

PubMed2006

China's transition: the effect of rapid urbanization on adult occupational physical activity.

China has recently undergone rapid social and economic change. Increases in urbanization have led to equally rapid shifts toward more sedentary occupations through the acquisition of new technology and transitions away from a mostly agricultural economy. Our purpose was to utilize a detailed measure of urbanicity comprising 10 dimensions of urban services and infrastructure to examine its effects on the occupational physical activity patterns of Chinese adults. Longitudinal data were from individuals aged 18-55 from the years 1991-1997 of the China Health and Nutrition Survey (N=4376 men and 4384 women). Logistic multilevel regression analyses indicated that men had 68% greater odds, and women had 51% greater odds, of light versus heavy occupational activity given the mean change in urbanization over the 6-year period. Further, simulations showed that light occupational activity increased linearly with increasing urbanization. After controlling for individual-level predictors, community-level urbanization explained 54% and 40% of the variance in occupational activity for men and women, respectively. This study provides empirical evidence of the reduction in intensity of occupational activity with modernization. It is likely that urbanization will continue unabated in China and this is liable to lead to further transitions in the labor market resulting in additional reductions in work-related activity. Because occupational activity remains the major source of energy expenditure for adults, unless alternative forms are widely adopted, the Chinese population is at risk of dramatic increases in the numbers of overweight and obese individuals.

Adolescent↗

PubMed2006

Self-reported health, perceived racial discrimination, and skin color in African Americans in the CARDIA study.

This study investigates the association between self-reported physical and mental health and both perceived racial discrimination and skin color in African American men and women. We used data from the longitudinal coronary artery risk development in young adults study (CARDIA) in African American men and women (n=1722) in the USA. We assessed self-reported mental and physical health status and depressive symptoms at the Year 15 (2000-2001) follow-up examination using the Medical Outcomes Study Short Form (SF-12) and the Center for Epidemiologic Studies Depression scale. Skin color was measured at the Year 7 examination (1992-1993). To assess racial discrimination, we used a summary score (range 0-21) for 7 questions on experiencing racial discrimination: at school, getting a job, getting housing, at work, at home, getting medical care, on the street or in a public setting. Self-reported racial discrimination was more common in men than in women (78.1% versus 73.0%, p<0.05) and in those with higher educational attainment, independent of gender. Discrimination was statistically significantly associated with worse physical and mental health in both men and women, before and after adjustment for age, education, income, and skin color. For example, mental health (0-100 scale) decreased an average of 0.29 units per unit increase in racial discrimination score in men; this became 0.32 units after adjustment. There was no association between self-reported physical and mental health and skin color. Further studies of the health consequences of discrimination will require investigation of both the upstream determinants of discrimination and the downstream mechanisms by which perceived discrimination affects health outcomes.

Adolescent↗

PubMed2006

Longitudinal trends in race/ethnic disparities in leading health indicators from adolescence to young adulthood.

OBJECTIVE: To use ethnically diverse, national data to examine longitudinal trends in race/ethnic disparities in 20 leading health indicators from Healthy People 2010 across multiple domains from adolescence to young adulthood. Much of what is known about health disparities is based on cross-sectional measures collected at a single time point. DESIGN, SETTING, AND PARTICIPANTS: Nationally representative data for more than 14 000 adolescents enrolled in wave I (1994-1995) or wave II (1996) of the National Longitudinal Study of Adolescent Health (Add Health) and followed up into adulthood (wave III; 2001-2002). We fit longitudinal regression models to assess and contrast the trend in health indicators among racial/ethnic groups of adolescents as they transition into adulthood. MAIN OUTCOME MEASURES: Diet, inactivity, obesity, tobacco use, substance use, binge drinking, violence, sexually transmitted diseases, mental health, and health care access. RESULTS: Diet, inactivity, obesity, health care access, substance use, and reproductive health worsened with age. Perceived health, mental health, and exposure to violence improved with age. On most health indicators, white and Asian subjects were at lowest and Native American subjects at highest risk. Although white subjects had more favorable health in adolescence, they experienced greatest declines by young adulthood. No single race/ethnic group consistently leads or falters in health across all indicators. CONCLUSIONS: Longitudinal data indicate that, for 15 of 20 indicators, health risk increased and access to health care decreased from the teen and adult years for most US race/ethnic groups. Relative rankings on a diverse range of health indicators (and patterns of change over time) vary by sex and race/ethnicity, causing disparities to fluctuate over time.

Adolescent↗

PubMed2006

Built and social environments associations with adolescent overweight and activity.

BACKGROUND: Little is known about the patterning of neighborhood characteristics, beyond the basic urban, rural, suburban trichotomy, and its impact on physical activity (PA) and overweight. METHODS: Nationally representative data (National Longitudinal Study of Adolescent Health, 1994-1995, n = 20,745) were collected. Weight, height, PA, and sedentary behavior were self-reported. Using diverse measures of the participants' residential neighborhoods (e.g., socioeconomic status, crime, road type, street connectivity, PA recreation facilities), cluster analyses identified homogeneous groups of adolescents sharing neighborhood characteristics. Poisson regression predicted relative risk (RR) of being physically active (five or more bouts/week of moderate to vigorous PA) and overweight (body mass index equal or greater than the 95th percentile, Centers for Disease Control and Prevention/National Center for Health Statistics growth curves). RESULTS: Six robust neighborhood patterns were identified: (1) rural working class; (2) exurban; (3) newer suburban; (4) upper-middle class, older suburban; (5) mixed-race urban; and (6) low-socioeconomic-status (SES) inner-city areas. Compared to adolescents living in newer suburbs, those in rural working-class (adjusted RR[ARR] = 1.38, 95% confidence interval [CI] = 1.13-1.69), exurban (ARR = 1.30, CI = 1.04-1.64), and mixed-race urban (ARR = 1.31, CI = 1.05-1.64) neighborhoods were more likely to be overweight, independent of individual SES, age, and race/ethnicity. Adolescents living in older suburban areas were more likely to be physically active than residents of newer suburbs (ARR = 1.11, CI = 1.04-1.18). Those living in low-SES inner-city neighborhoods were more likely to be active, though not significantly so, compared to mixed-race urban residents (ARR = 1.09, CI = 1.00-1.18). CONCLUSIONS: These findings demonstrate disadvantageous associations between specific rural and urban environments and behavior, illustrating important effects of the neighborhood on health and the inherent complexity of assessing residential landscapes across the United States. Simple classical urban-suburban-rural measures mask these important complexities.

Adolescent↗

PubMed2006

Body mass index gain, fast food, and physical activity: effects of shared environments over time.

OBJECTIVE: The magnitude of environmental vs. genetic effects on BMI, diet, and physical activity (PA) is widely debated. We followed a sibling cohort (where individuals shared households in childhood and adolescence) to young adulthood (when some continued sharing households and others lived apart) to examine the role of discordant environments in adult twins' divergent trends in BMI and health behaviors and to quantify the variation in BMI and behavior among all siblings that is attributable to environmental and additive genetic effects. RESEARCH METHODS AND PROCEDURES: In the National Longitudinal Study of Adolescent Health, siblings sharing households for > or =10 years as adolescents (mean age = 16.5 +/- 1.7 years; N = 5524) were followed into adulthood (mean = 22.4 +/- 1.8 years; N = 4368), self-reporting PA, sedentary behavior, and dietary characteristics. Adult BMI and adolescent z scores were derived from measured height and weight. RESULTS: Compared with those living together, twins living apart exhibited greater discordance in change in BMI, PA, and fast food intake from adolescence to adulthood. Adolescent household environments accounted for 8% to 10% of variation in adolescent fast food intake and sedentary behaviors and 50% of variation in adolescent overweight. Adolescent household effects on PA were substantially greater in young adulthood (accounting for 50% of variation) vs. adolescence. Young adult fast food intake was significantly affected by young adult household environment, accounting for 12% of variation. DISCUSSION: These findings highlight important environmental influences on BMI, PA, and fast food intake during the transition to adulthood. Household and physical environments play an important role in establishing long-term behavior patterns.

Adolescent↗

PubMed2006

Inequality in the built environment underlies key health disparities in physical activity and obesity.

CONTEXT: Environmental factors are suggested to play a major role in physical activity (PA) and other obesity-related behaviors, yet there is no national research on the relationship between disparity in access to recreational facilities and additional impact on PA and overweight patterns in US adolescents. OBJECTIVE: In a nationally representative cohort, we sought to assess the geographic and social distribution of PA facilities and how disparity in access might underlie population-level PA and overweight patterns. DESIGN, SETTING, AND PARTICIPANTS: Residential locations of US adolescents in wave I (1994-1995) of the National Longitudinal Study of Adolescent Health (N = 20745) were geocoded, and a 8.05-km buffer around each residence was drawn (N = 42857 census-block groups [19% of US block groups]). PA facilities, measured by national databases and satellite data, were linked with Geographic Information Systems technology to each respondent. Logistic-regression analyses tested the relationship of PA-related facilities with block-group socioeconomic status (SES) (at the community level) and the subsequent association of facilities with overweight and PA (at the individual level), controlling for population density. MAIN OUTCOME MEASURES: Outcome measures were overweight (BMI > or = 95th percentile of the Centers for Disease Control and Prevention/National Center for Health Statistics growth curves) and achievement of > or = 5 bouts per week of moderate-vigorous PA. RESULTS: Higher-SES block groups had a significantly greater relative odds of having 1 or more facilities. Low-SES and high-minority block groups were less likely to have facilities. Relative to zero facilities per block group, an increasing number of facilities was associated with decreased overweight and increased relative odds of achieving > or = 5 bouts per week of moderate-vigorous PA. CONCLUSIONS: Lower-SES and high-minority block groups had reduced access to facilities, which in turn was associated with decreased PA and increased overweight. Inequality in availability of PA facilities may contribute to ethnic and SES disparities in PA and overweight patterns.

Adolescent↗

PubMed2006

Physical activity and sedentary behavior patterns are associated with selected adolescent health risk behaviors.

OBJECTIVE: Little is known about how physical activity (PA), sedentary behavior, and various adolescent health risk behaviors are associated. The objective of this study was to examine relationships between PA and sedentary behavior patterns and an array of risk behaviors, including leading causes of adolescent morbidity/mortality. METHODS: Nationally representative self-reported data were collected (National Longitudinal Study of Adolescent Health; wave I: 1994-1995; II: 1996; N = 11957). Previously developed and validated cluster analyses identified 7 homogeneous groups of adolescents sharing PA and sedentary behaviors. Poisson regression predicted the relative risk of health risk behaviors, other weekly activities, and self-esteem across the 7 PA/sedentary behavior clusters controlling for demographics and socioeconomic status. Main outcome measures were adolescent risk behaviors (eg, truancy, cigarette smoking, sexual intercourse, delinquency), other weekly activities (eg, work, academic performance, sleep), self-esteem. RESULTS: Relative to high television (TV) and video viewers, adolescents in clusters characterized by skating and video gaming, high overall sports and sports participation with parents, using neighborhood recreation center, strict parental control of TV, reporting few activities overall, and being active in school were less likely to participate in a range of risky behaviors, ranging from an adjusted risk ratio (ARR) of 0.42 (outcome: illegal drug use, cluster: strict parental control of TV) to 0.88 (outcome: violence, cluster: sports with parents). Active teens were less likely to have low self-esteem (eg, adolescents engaging in sports with parents, ARR: 0.73) and more likely to have higher grades (eg, active in school, ARR: 1.20). CONCLUSIONS: Participation in a range of PA-related behaviors, particularly those characterized by high parental sports/exercise involvement, was associated with favorable adolescent risk profiles. Adolescents with high TV/video viewership were less likely to have positive risk behavior outcomes. Enhancing opportunities for PA and sport may have a beneficial effect on leading adolescent risk behaviors.

Absenteeism↗

PubMed2005

Environmental influences on food choice, physical activity and energy balance.

In this paper, the environment is defined as the macro- and community-level factors, including physical, legal and policy factors, that influence household and individual decisions. Thus, environment is conceived as the external context in which household and individual decisions are made. This paper reviews the literature on the ways the environment affects diet, physical activity, and obesity. Other key environmental factors discussed include economic, legal, and policy factors. Behind the major changes in diet and physical activity in the US and globally lie large shifts in food production, processing, and distribution systems as well as food shopping and eating options, resulting in the increase in availability of energy-dense foods. Similarly, the ways we move at home, work, leisure, and travel have shifted markedly, resulting in substantial reductions in energy expenditure. Many small area studies have linked environmental shifts with diet and activity changes. This paper begins with a review of environmental influences on diet and physical activity, and includes the discussion of two case studies on environmental influences on physical activity in a nationally representative sample of US adolescents. The case studies illustrate the important role of physical activity resources and the inequitable distribution of such activity-related facilities and resources, with high minority, low educated populations at strong disadvantage. Further, the research shows a significant association of such facilities with individual-level health behavior. The inequity in environmental supports for physical activity may underlie health disparities in the US population.

Diet↗

PubMed2005

Adolescent physical activity and sedentary behavior: patterning and long-term maintenance.

BACKGROUND: Little is known about physical activity (PA) and sedentary behavior patterning or its impact on long-term PA sustainability, particularly during the critical transition from adolescence to adulthood. METHODS: Nationally representative self-reported data were collected (National Longitudinal Study of Adolescent Health: Wave I, 1994-1995; Wave II, 1996; Wave III, 2001-2002). Cluster analyses identified homogeneous groups of adolescents with similar PA and sedentary behaviors. Logistic regression predicted odds of meeting national activity recommendations in adolescence and young adulthood. RESULTS: Seven clusters were characterized as follows: C1, high television (TV)/video, video gaming; C2, high skating, video gaming; C3, high sports participation with parents, high overall sports participation; C4, use of neighborhood recreation centers, high sports participation; C5, TV viewing limited by parents, moderate participation in school physical education (PE); C6, low parental TV control, reporting few activities overall; C7, active in school (team/individual sports, academic clubs, and PE). Odds of adolescents meeting PA recommendations were highest in C2 (odds ratio=13.1), C3 (5.8), C4 (4.2), and C7 (4.3) compared to C1. Independent of adolescent PA, absolute odds of meeting recommendations as young adults declined but were still relatively high in these clusters, indicating greater long-term PA sustainability. By young adulthood, however, overall PA declined dramatically in skaters/gamers (C2) and was notably low among those with TV viewing limited by parents (C5). CONCLUSIONS: While odds of meeting PA guidelines in adulthood declined in all clusters, the magnitude of this decline varied by cluster (declining most dramatically in skaters/gamers), providing insights into where to target effective intervention strategies that promote sustainable PA behaviors.

Adolescent↗

PubMed2005

Associations among active transportation, physical activity, and weight status in young adults.

OBJECTIVE: To describe prevalence of active, public, and car transit by overweight status and amount of leisure-time physical activity in a nationally representative cohort of ethnically diverse young adults. RESEARCH METHODS AND PROCEDURES: Questionnaire data on patterns of transportation were collected from U.S. adolescents enrolled in Wave III (2001) of the National Longitudinal Study of Adolescent Health (N = 10,771). Measured height and weight data were used to calculate BMI and classify adults by overweight status (BMI > or = 25). Self-reported physical activity data were used to classify adults into those who achieved > or = 5 bouts of weekly moderate-vigorous physical activity and those who did not. Results were stratified by overweight and physical activity status. RESULTS: The vast majority of young adults used car transit (work, 90.4%; school, 74.7%). A small proportion of young adults used active means of transportation to work (8.1%) and school (26.7%), and fewer used public transportation to work or school (<10%). The proportion of individuals using active transportation was higher among the nonoverweight traveling to work (9.2%) and school (29.7%) and among the more active traveling to work (15.2%) and school (37.0%) relative to the overweight and less active young adults. DISCUSSION: The vast majority of young adults of all racial/ethnic backgrounds, particularly blacks and Hispanics, did not use active transportation to school and/or work. Active transportation was more common among nonoverweight and more active young adults, of high socioeconomic status, particularly full-time students. Population-level efforts (and environmental supports) to increase non-leisure physical activity, particularly active transportation, are sorely needed as a means of supporting and promoting overall physical activity.

Adolescent↗

PubMed2005

The association between diet and height in the postinfancy period changes with age and socioeconomic status in Filipino youths.

Whether the determinants of linear growth can have independent effects beyond the critical infancy period has been questioned. This research uses uniquely suited data from >2000 youths from the Cebu Longitudinal Health and Nutrition Study in the Philippines to examine the association between diet and height in the postinfancy period. Anthropometric, diet, and other data were collected bimonthly from 0 to 2 y, and at the mean ages of 8, 11.5, 15.5, and 18.5 y. Generalized Estimating Equations were used to quantify the mean effects of diet diversity and energy intake on height across increments demarcated by the postinfancy data (2-8.5, 8.5-11.5, 11.5-15.5, and 15.5-18.5 y). We examined whether the effects differed by socioeconomic status (SES) and age. Effects with P < 0.05 were considered significant. Each additional unit of diet variety (range 0-8 U) was associated with a significant 0.33-cm increase in height in boys. Each additional 100 kcal (4186 kJ) was associated with significant increases in height of 0.05 cm in boys, and 0.02 cm in girls. Significant interactions (P < 0.15) with SES showed that each 100 kcal increase in energy intake was associated with a 0.08-cm increase in height at low SES with no difference at high SES. In both boys and girls, the effects of energy intake decreased with age, as shown by a significant age interaction (P < 0.15). The methods used incorporate the longitudinal nature of the data to offer a unique examination of the association between diet and height in the postinfancy period.

Adolescent↗

PubMed2005

Are adolescents who were breast-fed less likely to be overweight? Analyses of sibling pairs to reduce confounding.

BACKGROUND: Cohort analyses suggesting that breast-feeding protects against being overweight have been criticized for inadequately controlling for confounding associated with the self-selection of feeding practices. METHODS: Using nationally representative U.S. data from the National Longitudinal Study of Adolescent Health (1994-1996), we performed traditional cohort analyses (n = 11,998) using logistic regression to estimate the relation between breast-feeding and adolescent overweight (body mass index > or =85 percentile, based on year 2000 CDC growth charts), controlling for known potential confounders. Breast-feeding also was assessed in a subsample of 850 sibling pairs to account for unmeasured genetic and environmental factors. RESULTS: Among girls in the full cohort, the odds of being overweight declined among those who had been breast-fed at least 9 months; odds ratios ranged from 0.90 (95% confidence interval = 0.74-1.09) for <3 months of breast-feeding to 0.78 (0.64-0.96) for > or =9 months. A similar effect was seen in boys, although these trends were less consistent. In contrast, an analysis of sibling pairs provided no evidence of breast-feeding effects on weight within discordant trends. CONCLUSION: Cohort data indicate that odds of being overweight decrease as breast-feeding duration increases, at least among girls. However, sibling analyses suggest that this relationship may not be causal but rather attributable to unmeasured confounding related to mothers' choice to breast-feed, or to other childhood risk factors for overweight. Our results illustrate the utility of sibling analyses in understanding the true effect of early life exposures (such as breast-feeding) on health outcomes over time, independent of confounding factors that may not be satisfactorily controlled using traditional prospective cohort methods.

Adolescent↗

PubMed2004

Barriers to physical activity: qualitative data on caregiver-daughter perceptions and practices.

BACKGROUND: There is little research on household and physical environment barriers to physical activity, particularly in minority populations at high risk for obesity and inactivity. Few studies include data on caregiver and daughter dyads. Formative data were used to develop intervention strategies and pathways for the Girls Rule! obesity prevention intervention, in under-studied high-risk pre-adolescents. METHODS: Participants included 12 African-American girls (mean age 7.8 years) and their 11 primary female caregivers (mean age 41.8 years)--eight mother-daughter dyads and three grandmother-granddaughter dyads--for a total of 51 interviews across 23 participants interviewed from April to October 2000.A qualitative approach was used for 51 semistructured in-depth interviews with 11 dyads (female caregiver and girl), consisting of up to three interviews per respondent (mean=2.4 interviews per respondent). Interviews were transcribed, coded, and systematically analyzed between January 2002 and January 2003 to identify recurrent patterns and themes related to physical activity. RESULTS: Findings indicate clear preference of the girls for sedentary, rather than active, behaviors. Caregivers were unaware of the amount of TV viewed and found positive benefits of TV viewing, including safe supervision of their daughters. Barriers to physical activity include perceived lack of affordable and accessible recreation facilities and low caregiver motivation. Potential intervention strategies identified by respondents include walking for exercise and transportation and several low-cost, favored physical activities, such as hopscotch, jumping rope, and dance. CONCLUSIONS: These findings point toward several physical activity and obesity intervention strategies that can guide obesity prevention efforts.

Adult↗

PubMed2004

Longitudinal physical activity and sedentary behavior trends: adolescence to adulthood.

BACKGROUND: There is little national research on longitudinal patterns of physical activity and sedentary behavior in ethnically diverse teens as they transition to adulthood. METHODS: Longitudinal questionnaire data from U.S. adolescents enrolled in Wave I (1994-1995) and Wave III (2001) of the National Longitudinal Study of Adolescent Health (n =13,030) were analyzed in January 2004. Incidence, reversal, and maintenance of achieving five or more weekly bouts of moderate to vigorous physical activity (MVPA) and < or =14 hours of weekly TV and video viewing, computer/video game use (screen time) were assessed. Multinomial logistic regression models examined the likelihood of achieving five or more weekly sessions of MVPA week and < or =14 hours screen time per week as an adolescent and/or young adult, controlling for household income, parental education, age of adolescent, and seasonality. RESULTS: Of those achieving five or more weekly sessions of MVPA and < or =14 hours of weekly screen time as adolescents, few continued to achieve these favorable amounts of activity (4.4%) and screen time (37.0%) as adults. More failed to maintain these favorable amounts of activity (31.1%) and screen time (17.3%) into adulthood. Black versus white females were more likely to maintain less [corrected] favorable amounts of activity from adolescence to adulthood (odds ratio [OR]=3.09; 95% confidence interval [CI]=1.49-6.42), while black males (OR=1.50; CI=1.05-2.14) and females (OR=2.00; CI=1.40-2.87) were more likely than whites to maintain less (versus more) favorable screen time hours. CONCLUSIONS: The vast majority of adolescents do not achieve five or more bouts of moderate physical activity per week, and continue to fail to achieve this amount of activity into adulthood.

Adolescent↗

PubMed2004

Five-year obesity incidence in the transition period between adolescence and adulthood: the National Longitudinal Study of Adolescent Health.

BACKGROUND: No nationally representative longitudinal data have been analyzed to evaluate the incidence of obesity in the transition between adolescence and adulthood. OBJECTIVE: The objective was to examine dynamic patterns of change in obesity among white, black, Hispanic, and Asian US teens as they transitioned to young adulthood. DESIGN: We used nationally representative, longitudinally measured height and weight data collected from US adolescents enrolled in wave II (1996; ages 13-20 y) and wave III (2001; 19-26 y) of the National Longitudinal Study of Adolescent Health (n = 9795). Obesity incidence was defined on the basis of International Obesity Task Force (IOTF) cutoffs (wave II), which link childhood body mass index (BMI) centiles to adult cutoffs (BMI > or = 30; wave III), for comparability between adolescence and adulthood. In addition, the more commonly used cutoff of BMI > or = 95th percentile for age- and sex-specific cutoffs from the 2000 Centers for Disease Control and Prevention growth charts for adolescents (wave II) were compared with adult cutoffs (BMI > or = 30; wave III). RESULTS: On the basis of the IOTF cutoffs, obesity incidence over the 5-y study period was 12.7%; 9.4% of the population remained obese and 1.6% shifted from obese to nonobese. Obesity incidence was especially high in non-Hispanic black (18.4%) females relative to white females. The prevalence of obesity increased from 10.9% in wave II to 22.1% in wave III, and extreme obesity was 4.3% at wave III on the basis of a BMI > or = 40. CONCLUSIONS: During a 5-y transitional period between adolescence and young adulthood, the proportion of adolescents becoming and remaining obese into adulthood was very high. This upward trend is likely to continue. Effective preventive and treatment efforts are critically needed.

Adolescent↗

PubMed2004

"Does skinny mean healthy?" Perceived ideal, current, and healthy body sizes among African-American girls and their female caregivers.

OBJECTIVES: To qualitatively and quantitatively examine body image ideals and perceived weight-related health among African-American girls and their female caregivers to inform intervention development for Girls Rule!, an obesity prevention pilot program. DESIGN, SETTING, AND PARTICIPANTS: Formative study using qualitative data from semi-structured interviews and validated quantitative body image silhouette assessment among girls (N=47) and caregivers (N=44). The participants were a convenience sample of African-American church members from North Carolina. Differences were evaluated between perceived: 1) current and ideal body size; 2) current and unhealthy body size; and 3) ideal and unhealthy body size. RESULTS: Thirty-seven percent of the girls and 77% of the caregivers were overweight or obese. Three body image themes emerged from the qualitative interviews: 1) being fat is unhealthy; 2) caregivers are role models (positive and negative) for body image ideals; and 3) smaller body size is important for wearing fashionable clothing. A series of 9 body silhouettes were used to assess perceptions of both girls and caregivers. Overall, both girls (2.9 +/- 1.4) and caregivers (4.4 +/- 1.4) ideal body size was significantly (P<.01) smaller than their current body size (3.7 +/- 1.3 girls; 6.3 +/- 2.2 caregivers). Both girls (3.7 +/- 1.4) and caregivers (6.7 +/- 2.0) indicated that their current body sizes were statistically significantly (P<.05) smaller that what they considered to be unhealthy (7.9 +/- 1.4 girls; 7.9 +/- 1.2 caregivers). CONCLUSIONS: Results suggest that most of these African-American participants were not satisfied with their current body size and desired a smaller body. At the same time, both girls and caregivers failed to recognize the potential health consequences associated with their current body size. Critical issues for designing obesity prevention programs include positive role modeling within the family and addressing the association of body size with health risk.

Adult↗