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Biomedical subjects

T A Nicklas

Publications and source records attributed to T A Nicklas.

At least 37 records · Page 2Linked to original sources

Outcomes of a high school program to increase fruit and vegetable consumption: Gimme 5--a fresh nutrition concept for students.

This paper describes an intervention to increase high school students' fruit and vegetable consumption. Twelve schools were randomized to intervention or control conditions. The cohort (2,213 students; 56% females, 84% Caucasian) were followed from 9th to 12th grades. Interventions comprised a media campaign, classroom workshops, school meal modification, and parental support. Usual daily servings of fruit/vegetables increased 14% in the intervention compared to the control group (p > 0.001) the first three years. At follow-up, consumption within the control group also increased, resulting in no significant difference between groups. Intervention group knowledge scores and awareness indicators were significantly higher than those of the control group (p < 0.0001). Gimme 5 provided a first model to show that dietary habits of high school students can be influenced by positive media messages relative to that age group, increased exposure to a variety of tasty products, and minimal classroom activity.

Adolescent↗

School-based programs for health-risk reduction.

Based on implications from the pediatric studies of cardiovascular risk, it has become imperative that practical methods be developed to begin prevention of heart disease early in life. Schools provide an excellent setting for introducing comprehensive health education and promotion as a public health approach to the general population. A number of school-based health education programs have been developed (Heart Ahead/Heart Smart, CATCH, Gimme 5) for children in kindergarten through high school, in which education and environmental changes have been shown to be effective in promoting healthful behaviors. The effective implementation of health education depends to a large extent on the training and motivation of teachers, administrators, and food service staff. Training Institutes can be important for increasing personal awareness, disseminating information and materials, motivating health education efforts for teachers, food service staff and their students, and evaluating the health risk of school personnel.

Adolescent↗

Cardiovascular risk factors and behavior lifestyles of young women: implications from findings of the Bogalusa Heart Study.

The primary purposes of this article are to highlight important issues related to cardiovascular risk factors and behavior life-styles in young women and to examine racial (black-white) differences in risk factors that relate to cardiovascular disease. In childhood, some girls show cardiovascular risk factors of higher blood pressure levels, dyslipidemia, and obesity, all of which continue into young adulthood. Factors that contribute to abnormal risk factors are a high-saturated fat diet, excess energy intake related to inactivity, and cigarette smoking. Trends of obesity are documented; and young white girls are continuing to use tobacco, more so than boys and black girls. Although the onset of clinical cardiovascular disease is delayed in women, the stage is set in childhood for the development of early cardiovascular risk.

Adolescent↗

Marginal vitamin and mineral intakes of young adults: the Bogalusa Heart Study.

PURPOSE: To determine reported vitamin and mineral intakes, vitamin supplement use, and food consumption patterns of young adults. METHODS: Twenty-four-hour dietary recalls were collected from 1988-1991 on a cross-sectional sample of 504 young adults in Bogalusa, Louisiana, between the ages of 19 and 28 years (58% female; 70% white). Reported vitamin and mineral intake data were analyzed for race and gender differences. Descriptive and inferential statistics were calculated where appropriate. Food sources of selected vitamins and minerals were also examined. RESULTS: Reported intakes of vitamins A, B6, E, D, and C, folacin, magnesium, iron, zinc, and calcium were most likely to be inadequate compared with the Recommended dietary Allowances (RDA); with more females than males reported nutrient intakes less than two thirds of the RDA. Approximately 10% of the population reported taking a vitamin/mineral supplement over the 24-h survey period. Food source data indicated that breads and grains, milk, vegetables and soups, fruits, and beef were the primary contributors of the selected vitamins and minerals. CONCLUSIONS: Public health organizations and dietitians need to educate young adults on practical strategies for making wise food choices rich in nutrient content relative to energy value to ensure intakes that approach the RDAs.

Adolescent↗

Nutritional quality of a high carbohydrate diet as consumed by children: The Bogalusa Heart Study.

To study the nutritional adequacy of a high carbohydrate diet as consumed by children in a 24-h period, a sample of 568 10-y-old children was stratified into four levels of carbohydrate intake: < 45% of total energy (kJ), 45%-50% energy, 50%-55% energy, and >55% energy. Composition of the diet for those consuming >55% energy from carbohydrates was adequate in total energy, with 29% energy from fat, 11 % energy from saturated fatty acid, an average of 88 mg dietary cholesterol/4200 kJ and less than 10% energy from sucrose. Increased carbohydrate intake was attributed to an increased consumption of total sugars, starch and fiber. The percentage of children meeting two thirds or more of the Recommended Dietary Allowances for niacin and zinc was lower in the high carbohydrate intake group than in any of the low carbohydrate intake groups. Children with a high carbohydrate intake consumed more fruits, breads, grains, milk, desserts, candy and non-dairy beverages than those with a lower carbohydrate intake who consumed more meats. To meet current dietary recommendations for increased carbohydrate intake when meal patterns are designed, it is necessary to incorporate adequate amounts of foods from all of the food groups to maximize nutritional quality.

Cardiovascular Diseases↗

Dietary fiber intake of children and young adults: the Bogalusa Heart Study.

OBJECTIVE: To determine dietary fiber intake of children and young adults. DESIGN AND SETTING: Cross-sectional surveys of children and young adults in Bogalusa, La. SUBJECTS: Twenty-four-hour dietary recalls were collected from 1976 to 1988 on five cohorts of 10-year-olds (n = 1,254), two cohorts of 13-year-olds (n = 360), and young adults (n = 504) 19 to 28 years of age. STATISTICS: Dietary fiber intake data were analyzed for age, race, and gender differences and for secular trends. Descriptive and inferential statistics were calculated where appropriate. Dietary composition and food sources were examined for race-specific and gender-specific quartiles for dietary fiber intake adjusted per 1,000 kcal. RESULTS: Even after adjusting for energy intake, total dietary fiber intake remained unchanged from 1976 to 1988, averaging 12 g or 5 g/1,000 kcal. Blacks and males had higher total fiber intakes than whites and females at all ages. Consumption of vegetables and soups and breads and grains accounted for 53% (10-year-olds) to 70% (13-year-olds) of the total fiber consumed. When children were stratified into quartiles on the basis of fiber intake per 1,000 kcal, the percentage of energy from total fat and saturated fat was lower, and the percentage of energy from carbohydrate was higher, in children with higher fiber intakes per 1,000 kcal. APPLICATIONS: Dietary fiber intake of children has remained the same in the past 12 years and is comparable with the intake of young adults, which is well below the recommended level. Children with high fiber intakes (upper quartile) consumed less fat, particularly saturated fat, and more carbohydrate than children with low fiber intakes. Increasing consumption of whole-grain products, fruits, vegetables, and legumes (prepared with minimal added fat) will be necessary to reach the goal of optimal fiber intake and could result in an eating pattern that approaches the current recommendations for dietary fat and saturated fat.

Adolescent↗

Impact of meat consumption on nutritional quality and cardiovascular risk factors in young adults: the Bogalusa Heart Study.

OBJECTIVE: To document the contribution of meat consumption to the overall nutritional quality of the diet and assess its impact on cardiovascular risk factors in young adults. DESIGN AND SETTING: A cross-sectional survey of young adults in Bogalusa, La. SUBJECTS: We collected 24-hour dietary recalls from 504 19- to 28-year-olds from 1988 through 1991. STATISTICAL ANALYSES: We examined dietary composition by meat consumption quartiles. Analysis of variance and Newman-Keuls range tests were performed. RESULTS: Young adults consume an average of 6.5 oz meat daily; whites most often consumed beef and blacks most often consumed pork and poultry. Persons in the < 25th percentile for meat consumption consumed a diet closest to recommended levels--with 11% of energy from protein, 55% from carbohydrate, 32% from fat, 11% from saturated fatty acids, and 264 mg dietary cholesterol. In contrast, persons in the > 75th percentile for meat consumption consumed a diet with 18% of energy from protein, 40% from carbohydrate, 41% from fat, 13% from saturated fatty acids, and 372 mg dietary cholesterol. Intakes of heme iron and phosphorus were lower and calcium intake higher in persons in the < 25th percentile compared with those in the > 75th percentile for meat consumption. The percent of persons meeting two thirds of the Recommended Dietary Allowances for vitamin B-12, niacin, and zinc was greater in the > 75th percentile for meat consumption compared with the < 25th percentile for meat consumption. We noted no differences across meat consumption quartiles in blood lipids and lipoproteins, anthropometric measurements, and hemoglobin levels. APPLICATIONS/CONCLUSIONS: Consumption of moderate amounts of lean meat, along with healthier choices in other food groups, may be necessary to meet the current dietary recommendations.

Adult↗

Dietary studies of children: the Bogalusa Heart Study experience.

For more than 20 years the Bogalusa Heart Study has been collecting data on children's dietary intakes in a biracial community. The macronutrient contribution of children's diets is similar to that in diets of adolescents: 13% of energy from protein, 49% from carbohydrate, and 38% from fat. As children get older, mean intakes of vitamins and minerals per 1,000 kcal decrease. Ten-year-old children in 1987-1988 were 3 lb heavier than 10-year-olds in 1973-1974. Yet total energy intakes remained virtually the same from 1973 to 1988. The composition of macronutrients shifted over the 15-year period, with an increase in the percentage of energy from protein and carbohydrate and a decrease in the percentage of energy from total fat, particularly saturated fat. Dietary cholesterol intake also decreased as a result of a decrease in egg consumption. Although the diets of children changed positively from 1973 to 1988, more than 75% of children consumed more total fat, saturated fat, and cholesterol than the recommended amounts. School meals had a major impact on the diets of children. School breakfast and lunch, together, contributed approximately 50% of the day's total intake of energy, protein, cholesterol, carbohydrate, and sodium. About 40% of daily total fat intake came from school breakfast and lunch. The diets of children in the Bogalusa study are similar to those reported in national studies of children. What might be different, however, are the types of foods consumed and their contribution to intakes of specific nutrients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Dietary studies of children and young adults (1973-1988): the Bogalusa Heart Study.

The link between diet, the maintenance of health, and the development of chronic disease has become increasingly evident in recent years. The advice from national health organizations has become more focused, identifying dietary excesses of energy, total fat, saturated fatty acids, and dietary cholesterol as adversely affecting the health of Americans. In addition, eating habits formed during childhood have a potential lifelong effect on serum lipid levels, and thus, indirectly, on adult coronary heart disease risk. Therefore, an understanding of the diet and nutritional habits of children and young adults is critical to the planning of intervention strategies toward the natural course of coronary heart disease. For more than 20 years, the Bogalusa Heart Study has been collecting dietary data on subjects from infancy through adulthood. The dietary studies have described dietary patterns and nutrient intakes, relationships, and tracking of serum lipid and lipoprotein levels in a biracial, well defined population. These data have provided the rationale for the development of healthy eating habits early in life and ultimately the reduction of morbidity and mortality from cardiovascular disease.

Adolescent↗

Health ahead--the Heart Smart Family approach to prevention of cardiovascular disease.

The Heart Smart Family Health Promotion program is a unique approach to education and skills development aimed at improving the cardiovascular health of entire families. By including the entire family system, rather than singling out one individual for behavior change, social support and self-confidence are enhanced and the probability for maintenance of behavioral skills is increased. The Family Health Promotion program uses a format that minimizes lecture and maximizes awareness, skills development, problem-solving, and real-life application over a 12- to 16-week agenda. Behavioral counseling and contingency contracting provide opportunities for the practice and reinforcement of new behaviors. Initial evaluations of the program model developed with cardiovascular high-risk children and their parents indicated that parents significantly increased health knowledge, lowered blood pressure, became more physically active, and decreased their intake of total fat, saturated fat, and sodium. A clinically significant reduction in children's blood pressure also was observed. Children's weight (adjusted for height) remained stable. The Family Health Promotion program resulted in positive changes in cardiovascular risk factors and can be adapted to any clinical or health-promotion setting.

Cardiovascular Diseases↗

Dietary fiber intake of children: the Bogalusa Heart Study.

Age and secular trends in dietary fiber intake of children were examined using the 24-hour dietary recall method. Dietary fiber intake of five cohorts of 10-year-olds (n = 1254); two cohorts of 13-year-olds (n = 360); and children ages 10 (n = 767), 13 (n = 249), 15 (n = 108), and 17 (n = 89) years was examined from 1976 to 1988. Total dietary fiber intake remained unchanged from 1976 to 1988, even after adjusting for energy intake; averaging 12 or 5 g/100 calories (kcal). Black children had higher fiber intakes per 1000 kcal than white children from ages 10 to 17 years. Consumption of vegetables and/or soups and breads and/or cereals accounted for 53% (10 years) to 70% (13 years) of the total fiber consumed. When children were stratified into quartiles based on fiber intake per 1000 kcal, the percent of energy from total fat and saturated fat was lower, and the percent of energy from carbohydrates was higher in children with higher fiber intakes per 1000 kcal. Additional studies are needed to document dietary fiber intakes of children and their impact on overall diet composition and cardiovascular risk factors.

Adolescent↗

CATCH: food service program process evaluation in a multicenter trial.

Process evaluation is an essential element of a multicenter trial in order to explain study outcomes and monitor intervention progress. This paper presents the process evaluation model for the Eat Smart School Nutrition Program, the food service intervention component of the Child and Adolescent Trial for Cardiovascular Health (CATCH), and describes the process evaluation strategies developed to assess this program. The paper details (1) measures of program implementation including training, support visits, and program promotion, (2) food service staff characteristics, and (3) measures of mediating variables including secular trends and school meal participation.

Adolescent↗

Epidemiology of early primary hypertension and implications for prevention: the Bogalusa Heart Study.

Epidemiological studies of BPs in children and young adults over the past 20 years have contributed considerably to understanding the early onset of primary hypertension. Observations from autopsies and echocardiographic studies, together with long-term BP studies, of children clearly indicate that primary hypertension begins in early childhood. Although abnormal BP levels in children are much lower than the adult criteria used for clinical diagnosis of hypertension, essential hypertension is identifiable in early life. Complex haemodynamic and metabolic mechanisms related to essential hypertension are also being identified in childhood. The development of intervention programs in an attempt to prevent hypertension in its early phases suggests hypertensive cardiovascular disease is preventable. Environmental factors (improved dietary factors, altering electrolyte intake, prevention of obesity and increased activity levels) are critical elements to prevention. Children and young adults identified as high risk for hypertension need to be targeted for prevention of early cardiovascular renal disease. Also, as hypertension is so prevalent, attempts should be made to control environmental factors in the general public. Preventive programmes established by primary healthcare physicians, paediatricians and para-professionals can have a major impact on the reduction of hypertension and its complications of cardiovascular renal disease in the future.

Adolescent↗

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↗

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↗