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PubMed1998

Secular trends in preterm birth: a hospital-based cohort study.

CONTEXT: Canada and the United States have reported a recent increase in the incidence of preterm birth, but the reasons for this increase are unknown. OBJECTIVE: To assess secular trends in preterm birth and its potential determinants. DESIGN: Hospital-based cohort study. SETTING: Canadian tertiary care university teaching hospital, 1978-1996. PARTICIPANTS: A total of 65574 nonreferred live births and stillbirths. MAIN OUTCOME MEASURES: Changes in occurrence of preterm birth, before and after adjustment for changes in method of gestational age assessment, obstetric intervention, registration of births weighing less than 500 g, and sociodemographic, behavioral, and clinical determinants. RESULTS: A crude secular increase in preterm births was seen for births less than 37, 34, and 32 completed weeks using 3 alternative gestational age estimation methods. Based on an algorithm incorporating both menstrual and early ultrasound gestational age estimates, rates increased from 6.6% to 9.8% for births at less than 37 weeks' gestation, 1.7% to 2.3% at less than 34 weeks, and 1.0% to 1.2% at less than 32 weeks. Exclusion of births weighing less than 500 g and those with induction or preterm cesarean delivery without labor before each of the corresponding gestational age cutoffs eliminated the secular trends for births before 34 and 32 weeks and attenuated the trend for births before 37 weeks. Nearly half of the remaining trend for births before 37 weeks was accounted for by the increasing use of early ultrasound dating. The residual trend was eliminated after controlling for secular increases in unmarried status and the proportion of women aged 35 years or older. These factors, combined with a decrease in alcohol consumption and increases in histological chorioamnionitis and cocaine use, appear to have counteracted a reduction in preterm birth since the mid-1980s that otherwise would have been observed. CONCLUSIONS: This hospital's increase in preterm births since 1978 parallels increases reported in population-based national studies from the United States and Canada. This trend appears largely attributable to the increasing use of early ultrasound dating, preterm induction and preterm cesarean delivery without labor, and changes in sociodemographic and behavioral factors.

Canada↗
PubMed1983

Adult stature and age at menarche in Zapotec-speaking communities in the Valley of Oaxaca, Mexico, in a secular perspective.

Adult stature and the age at menarche among individuals from Zapotec-speaking communities in the Valley of Oaxaca in southern Mexico are considered in a secular perspective. Four sets of observations are utilized: 1) adult stature in males and females from five rural communities; 2) age at menarche in adult women and school girls from a single rural community; 3) earlier studies of adult stature in the Valley of Oaxaca; and 4) estimated stature from long bones excavated in various archaeological sites in the Valley of Oaxaca. There were no significant differences among the five communities for stature; hence, the data were pooled for analysis and comparison. Results of linear regression of stature and stature adjusted for the estimated effects of aging after 30 years of age on year of birth indicate negligible secular changes in either sex. Comparisons with statures from earlier surveys, the earliest dates to 1899, also indicate negligible changes. When adult women are grouped according to age, there are no differences in mean ages at menarche between the older and younger women. Mean age at menarche for the total adult sample is 14.53 +/- 0.08 years, which compares favorably with the probit estimate for school girls, 14.70 +/- 0.32 years. These results thus suggest virtually no secular change in adult size and maturity of the Zapotec-speaking population in the Valley of Oaxaca over the past 80 years. Differences in stature between contemporary populations and estimated statures from long bones from several archaeological sites in Oaxaca are small, and thus suggests little secular change over the past one to two-thousand years.

Adult↗
PubMed2004

Clinical perspectives on secular trends of intervertebral foramen diameters in an industrialized European society.

Low back pain origins have been a matter of great controversy. While spinal stenosis is now radiologically traceable, the alteration of intervertebral foramen is less clear. The aim of this study was to assess "secular trends"-alterations occurring from one generation to the next-in osseous intervertebral foramina of the major vertebral segments in an industrialized society, and to discuss their possible clinical implication. The macerated "maximum intervertebral foramen width" and "intervertebral foramen height" of all major vertebral levels in 71 non-pathologic Swiss adult skeletons from the nineteenth and early twentieth century, with known individual age and sex and similar geographic and socio-economic background, were measured by sliding caliper at validated landmarks. A secular trend of the increase in "maximum intervertebral foramen width" is found for most levels, with females showing a more prominent alteration. Additionally, the non-pathologic "maximum intervertebral foramen width" does not change with respect to individual age, nor is a significant side difference detectable. "Intervertebral foramen height," hereby defined as the difference of the dorsal vertebral body height minus pedicle height, demonstrates for most levels, and either sex, an insignificant negative secular trend. Neither stature nor skeletal robustness vary significantly through time within this particular sample. The results of this study, despite obvious inadequacies of methods used, exclude secular narrowing of the "maximum intervertebral foramen width" as the only cause of radiculopathy or spinal stenosis. Furthermore, we found a mild insignificant decrease of the clinically more relevant "intervertebral foramen height." Nevertheless, the detected short-time variability of the bony intervertebral foramen, independent of individual stature, skeletal robustness or age, argues for an enhanced focus on the understanding of clinically relevant changes of spinal morphology from generation to generation.

Adult↗
PubMed2006

Examining the evidence for recent secular changes in the timing of puberty in US children in light of increases in the prevalence of obesity.

This report reviews the available evidence from large population studies regarding a secular change in the timing and progress of puberty since 1960 in US children in light of concurrent increases in the prevalence of obesity. There probably was a secular decrease in the median age of onset and progression of genital development in Mexican-American boys and breast development Mexican-American girls in the 1980s and 1990s. The data are insufficient to do more than suggest corresponding trends in black boys and black girls, but there is no evidence of breast changes in white girls. Mean age of menarche decreased by approximately 3 months in US white girls and 5.5 months in US black girls between the late 1960s and approximately 1990. Evidence from a single study indicates the secular changes in age at menarche are consistent with the magnitude of secular change in obesity, although other evidence is equivocal.

Age Factors↗
PubMed2000

Growth and overweight of Navajo youth: secular changes from 1955 to 1997.

OBJECTIVE: To examine the growth status, prevalence of risk of overweight and of overweight, and secular changes in growth status in Navajo youth from 1955 to 1997. SUBJECTS: 526 (256 males, 270 females) Navajo children 6-12 y of age. MEASUREMENTS: Stature and mass were measured and the body mass index (BMI) was calculated. ANALYSIS: All three variables were plotted relative to age- and sex-specific US reference data and the prevalence rates for risk of overweight and of overweight were estimated using the BMI as the criterion. The cut-off for the risk of overweight was the age- and sex-specific 85th and 95th percentiles of NHANES I, while the cut-off for overweight was a BMI>/=95th percentiles. Age-specific sex differences were compared using independent samples t-tests. Secular changes for body size were estimated by comparing age- and sex-specific means for stature, mass, and the BMI in the present study and two previous studies in 1955 and 1989. RESULTS: No statistically significant differences were observed between sexes within age groups. In both sexes, mean age-specific stature appeared to be relatively stable around the 50th percentile of US reference values. Mean age-specific mass appeared to be relatively stable between the 50th and 90th percentiles of the reference values, while the mean BMI tended to fluctuate about the 85th percentile. Approximately 41% of the Navajo boys and girls 6-12 y of age had BMIs >/=85th percentiles of US reference data. Compared to corresponding data on Navajo youth in 1955 and 1989, the current sample was larger in mass and the BMI. The estimated rate of secular change in mass was about 1.5 kg/decade in younger boys and girls, and about 3 kg/decade in older boys and girls between 1955 and 1997. The estimated rate of secular change in the BMI was about 0.5-1.0 units/decade between 1955 and 1997, while that for stature was about 2 cm/decade between 1955 and 1997. CONCLUSIONS: The results are consistent with recent findings on the Navajo Health and Nutrition Survey that overweight is a serious public health concern across the lifespan in the Navajo, and that the problem begins in childhood. Furthermore, Navajo children appear to be heavier than about a decade ago. International Journal of Obesity (2000) 24, 211-218

Arizona↗
PubMed2005

Obesity in 70-year-old Swedes: secular changes over 30 years.

OBJECTIVE: Secular increases in obesity have been widely reported in middle-aged adults, but less is known about such trends among the elderly. The primary purpose of this paper is to document the most recent wave of the obesity epidemic in population-based samples of 70-y-old men and women from Göteborg. Additionally, we will investigate the influences of physical activity, smoking and education on these secular trends. POPULATIONS AND METHODS: Five population-based samples of 3702 70-y-olds (1669 men and 2033 women) in Göteborg, Sweden, born between 1901 and 1930, were examined in the Gerontological and Geriatric Population Studies (H70) between 1971 and 2000. Cohort differences in anthropometric measures were the main outcomes studied. Physical activity, smoking habits and education were assessed by comparable methods in all cohorts. Subsamples of the women in the latest two cohorts (birth years 1922 and 1930) were also part of the Prospective Population Study of Women in Göteborg. In these women, it was possible to examine body mass index (BMI) and waist-to-hip circumference ratio (WHR) longitudinally since 1968. RESULTS AND CONCLUSIONS: Significant upward trends were found for height, weight, BMI, waist circumference (WC), WHR, prevalence of overweight (BMI> or =25 kg/m(2)) and obesity (BMI> or =30 kg/m(2)) across cohorts in both sexes. In 2000, 20% of the 70-y-old men born in 1930 were obese, and the largest increment (almost doubling) had occurred between the early 1980s and the early 1990s. In 70-y-old women the prevalence of obesity was 24% in 2000, a 50% increase compared to the cohort born 8 y earlier. BMI increased over time in all physical activity, smoking and education groups, with the exception of never-smoking men. Although 70-y-old women in 2000 were heavier than cohorts examined 8 y previously, data from the women studied longitudinally revealed that these differences were already present in earlier adulthood. In conclusion, the elderly population is very much part of the obesity epidemic, although secular trends in BMI were detected slightly earlier in men than in women. The health implications of these secular trends should be focused on in future gerontological research.

Aged↗
PubMedDate not supplied

Secular trend in age at menarche for South Korean women born between 1920 and 1986: the Ansan Study.

BACKGROUND: There is strong evidence of a downward secular trend in age at menarche in Europe and the USA during the last century and in Japan and China during the past few decades. However, no study on this trend in age at menarche has been reported in South Korea. AIM: To measure the trend in age at menarche in South Korea during the past few decades and the association of height with this trend. SUBJECTS AND METHODS: A total of 1061 South Korean women born between 1920 and 1986 were randomly recruited from Ansan Cohort Study samples and separate school girl samples, and subjected to this analysis. The data on age at menarche were collected by the retrospective method. Height was measured at time studied and assumed to be relatively constant since age at menarche. Women were grouped with respect to decade of birth and mean age at menarche was determined. The secular trends in annual age at menarche and in height were analysed by the 3-year moving average. RESULTS: Mean menarcheal age decreased from 16.8 to 12.7 years during the past 67 years, corresponding to -0.64 years per decade. Height increased from 149.23 to 161.75 cm during the same period, showing an inverse relationship in the change of trend between height and mean age at menarche. CONCLUSION: Our data suggest that the downward secular trend in age at menarche may reflect the secular change in physical growth in South Korean women during the past 67 years.

Adolescent↗
PubMedDate not supplied

Secular growth changes in body height and weight in children and adolescents in Shandong, China between 1939 and 2000.

BACKGROUND: There is strong evidence of a positive secular trend in physical growth in most of the world during the last century. However, no studies on this trend have been reported in Shandong Province, China. AIM: The study assessed the secular trend in body height and weight in Shandong Province during the past few decades and the association of socio-economic status with the intensity of the trend. SUBJECTS AND METHODS: The results of height and weight in 7-18-year-old boys and girls obtained in nine subsequent surveys (1939, 1956, 1962, 1972, 1979, 1985, 1991, 1995, and 2000) were included in this analysis. The differences of mean values between surveys and the increments per decade were compared. Socio-economic indicators were collected and analysed. RESULTS: In 18-year-old groups, mean height increased from 164.9 to 172.6 cm for boys and from 155.9 to 160.6 cm for girls, corresponding to 1.75 and 1.07 cm per decade, respectively, and the increments of weight were 7.5 kg for boys and 0.3 kg for girls, corresponding to 1.70 and 0.07 kg per decade, respectively, between 1956 and 2000. The biggest changes of physical growth were in 13-year-old boys and 11-year-old girls. CONCLUSION: Positive secular trends occurred in 7-18-year-old children and adolescents in Shandong Province, China during 1939-2000, which may reflect the secular changes in socio-economic status.

Adolescent↗
PubMedDate not supplied

The growth of London schoolchildren 1904-1966: an analysis of secular trend and intra-county variation.

Height and weight were measured on 299,303 children involved in eleven London County Council Surveys dating from 1904 to 1966. This paper describes the historical background to these surveys, the secular trend towards increasing heights and weights and a decreasing age at menarche, and the variation of height and weight between parts of the county. All the surveys were cross-sectional, but that of 1966 included yearly velocity data on 13,806 children. Means for height and weight by age and sex were adjusted to the exact half year to allow comparison of all surveys. Menarcheal age was determined by probit analysis on status quo data in 1954, 1959 and 1966. Intra-county comparisons were based on the Divisional Index of the nine Area Health Divisions of the County. The results indicate an end to the positive secular trend for height and weight at about the same time as the previously reported end to a decreasing age of menarch in London girls. Intra-county comparisons indicated different rates of secular trend within different areas favouring those children who were the smallest and lighest in 1949. The end of the secular trend is thought to be due to genetic factors and intra-county changes to improve environmental conditions.

Adolescent↗
PubMedDate not supplied

Lack of linkage between height and weight and age at menarche during the secular shift in growth of Japanese children.

During the past century, Japanese children have shown a most dramatic secular trend toward earlier menarche and accelerated tempo of growth. In order to assess the inter-relationship between these dual secular trends, we analysed the data on height and weight measurements of Japanese children, collected by the Japanese Ministry of Education in the years from 1900 through 1986, with reference to various retrospective studies on the age of menarche among Japanese. Between 1950 and 1983, both the mean height and weight at menarche varied significantly but percentage of the mean height achieved at menarcheal age, as compared with the mature height, remained relatively stable at approximately 95%. The results indicate that the secular trend toward earlier menarche reflects largely, if not solely, the secular change in tempo of physical growth in Japanese children.

Adolescent↗
PubMed2003

Secular trends and senescence of blood pressure in a Japanese and Yugoslavian cohort of the seven countries study.

The aim of this study was to: (i) separately estimate the effects of secular trends and senescence from the blood pressure (BP) data of a cohort follow-up study, and (ii) compare cohort and population stroke mortality trends with systolic blood pressure (SBP) senescence (aging) and secular trends. The data for this work came from a Japanese (n = 508 men) and a Yugoslavian cohort (n = 552 men) of the Seven Countries Study. This report is restricted to one cohort of each country for reason of data availability. Our analysis showed that BP rose with age even after correcting for the secular trends. A significant difference in SBP rise with age was found between Yugoslavian and Japanese cohorts (0.8 vs 1.4 mmHg/year, p = 0.0001). The secular and aging trends in SBP were significantly associated with the cohort and population stroke mortality in both cohorts. In conclusion, our results suggest that BP change with age does not result exclusively from biological aging; other factors also participate in the process. The rate of BP rise with age differs in two ethnically different populations. Difference in arterial stiffness and/or dietary salt intake between these populations may account for this observation.

Adult↗
PubMed2005

A strong secular trend in serum gamma-glutamyltransferase from 1996 to 2003 among South Korean men.

Serum gamma-glutamyltransferase (GGT) concentration, within its normal range, has recently been proposed as a reliable marker of oxidative stress. Oxidative stress plays a central pathogenic role in many metabolic and/or cardiovascular diseases, incidences of which have recently increased in South Korea. Since serum GGT has strong associations with these diseases and their risk factors, the authors hypothesized a corresponding secular trend of increasing serum GGT levels in South Korea. Study subjects were 8,072 male workers at a large steel company who were aged 24-44 years at baseline and had received annual physical examinations from 1996 to 2003. The secular trend was a 0.1066-units/liter increase in ln(GGT) level per calendar year (a 180% increase during the 7-year follow-up period) (p < 0.01). Adjustment for body mass index, alcohol consumption, smoking, exercise, and cholesterol level as time-dependent covariates did not change the results. Although cholesterol is commonly used as a marker of epidemiologic transition, there was a less dramatic secular trend in ln(serum cholesterol) level, and it disappeared after adjustment for the secular trend in serum GGT. These findings suggest that serum GGT concentration can be used as a sensitive marker of epidemiologic transition, and they portend a continuing rise in incidences of metabolic and/or cardiovascular diseases in this population in the coming years.

Adult↗
PubMedDate not supplied

Secular trend in reported sperm counts.

Claims that there has been a recent secular decline in splerm counts have been disputed. Protaglonists on both sides of the discussion have based their arguments on data from a few large samples at different times and (mostly) in different places. It is not disputed that the differences between the mean counts in the various samples are statistically significant: what is a tissue is whether a secular decline is responsible. The present not adops a different approach to the problem: an attempt has been made to locate representative data on mean sperm counts of unselected men over the last 45 years. Twenty-nine such means are cited here. There can be no reasonable doubt that these reported mean sperm counts show a decline with time of publication, at least since 1960. It is not easy to see what artifact - other than a real secular trend - might responsible. Accordingly it is concluded that - at least in some places - it seems likely that a secular decline has occurred.

Fertility↗
PubMed2001

Sex matters: secular and geographical trends in sex differences in coronary heart disease mortality.

OBJECTIVE: To examine secular trends and geographical variations in sex differences in mortality from coronary heart disease and investigate how these relate to distributions in risk factors. DESIGN: National and international data were used to examine secular trends and geographical variations in sex differences in mortality from coronary heart disease and risk factors. SETTING: England and Wales, 1921-98; Australia, France, Japan, Sweden, and the United States, 1947-97; 50 countries, 1992-6. DATA SOURCES: Office for National Statistics, World Health Organization, and Food and Agriculture Organization of the United Nations. RESULTS: The 20th century epidemic of coronary heart disease affected only men in most industrialised countries and had a very rapid onset in England and Wales, which has been examined in detail. If this male only epidemic had not occurred there would have been 1.2 million fewer deaths from coronary heart disease in men in England and Wales over the past 50 years. Secular trends in mean per capita fat consumption show a similar pattern to secular trends in coronary heart disease mortality in men. Fat consumption is positively correlated with coronary heart disease mortality in men (r(s)=0.79; 95% confidence interval 0.70 to 0.86) and inversely associated with coronary heart disease mortality in women (-0.30; -0.49 to -0.08) over this time. Although sex ratios for mortality from coronary heart disease show a clear period effect, those for lung cancer show a cohort effect. Sex ratios for stroke mortality were constant and close to unity for the entire period. Geographical variations in the sex ratio for coronary heart disease were associated with mean per capita fat consumption (0.64; 0.44 to 0.78) but were not associated with the sex ratio for smoking. CONCLUSION: Sex differences are largely the result of environmental factors and hence not inevitable. Understanding the factors that determine sex differences has important implications for public health, particularly for countries and parts of countries where the death rates for coronary heart disease are currently increasing.

Adult↗
PubMedDate not supplied

[Secular height trend: a literature review].

This paper presents a literature review of secular height trends. The principal topics included were definition of the phenomenon, use of historical data sets on height as an alternative approach for monitoring economic changes, the main theoretical explanations of the phenomenon, the beginning of military anthropometry, and past and current use in measuring secular height trends in recruits and children. The most important results showed that the positive secular trend can be attributed to environmental influences, especially improvements in health, economic, and social conditions. The mean reported rates in height increases varied with age, socioeconomic status, and country, so one must exercise caution in drawing inferences. World War II slowed the trend in several countries, including Brazil, but the trend was stronger in the post-war period than in the beginning of the century. Finally, we observed that data from military anthropometry are the most common source for estimating secular height trends.

Anthropometry↗
PubMed1988

Small, yet steady secular gain in height and weight of school children in the city of Sendai in past 15 years.

Secular changes in height and weight of primary (6th year grade) and junior high (3rd year grade) school children in the city of Sendai during the period of 1973 to 1987 were analyzed in comparison with the counterpart changes in Miyagi prefecture and all Japan. The regression analysis revealed that there was a linear relationship between the year of examination and the measures of height and weight both in boys and girls of primary and junior high schools. The secular gain was very steady, but the annual gain was small, i.e., about one third to one sixth of the counterpart value in 1960-1964 when the secular gain was the largest. Such reduction in secular gain is apparently common throughout the country. Rohrer's and Quetlet's indices stayed essentially unchanged throughout the 15 year study period among the school children in Sendai, in Miyagi and in Japan.

Body Height↗
PubMed1999

Secular trends in sperm variables for groups of men in fertile and infertile couples.

OBJECTIVE: To assess possible secular trends in sperm variables in men according to previous or subsequent paternity. DESIGN: A comparison of secular trends in sperm variables 1975-1994 in men under investigation for infertility in groups according to previous and subsequent paternity, based on data from the Medical Birth Registry of Norway. SETTING: University hospital, Sperm laboratory and the Medical Birth Registry of Norway. MATERIAL: Samples were obtained from: 1108 men who had fathered at least one child before the analysis. 1786 men who had at least one child after the analysis, and 2286 men with no children registered. MAIN OUTCOME MEASURES: Sperm concentration, seminal fluid volume, total number of spermatozoa per ejaculate. RESULTS: Analyzed by year of evaluation, men with no child registered had a significant secular decrease of sperm concentration, total number of sperms per ejaculate and seminal volume. The group with subsequent children had significant secular decrease of sperm concentration and total sperm count per ejaculate, while no significant changes were found for the group with previous children. Analyzed by year of birth, a significant decrease of sperm concentration and total sperm count was found for the group without and for the group with subsequent children. CONCLUSION: The results are compatible with a cohort effect, exhibiting a trend of deteriorating sperm variables in consecutive birth cohorts.

Adult↗
PubMedDate not supplied

Body image and eating behaviors in Orthodox and Secular Jewish women.

OBJECTIVE: To explore the impact of religion on the development of disturbances in body image and eating behaviors. PARTICIPANTS: 78 Orthodox Jewish women were compared with 48 secular Jewish women. DESIGN: Participants completed the Body Shape Questionnaire (BSQ), the Eating Disorder Examination-Questionnaire Version (EDE-Q), and the Figure Rating Scale (FRS). RESULTS: Despite a similar body mass index of 22.2 +/- 2.8 SDs, the secular women scored significantly higher on the BSQ (P = .005) and the EDE-Q (P = .004) than the Orthodox women. The secular women also had greater eating disorder symptomatology: more laxative use (P = .02) and a trend toward more vomiting (P = .06) and diuretic use (P = .06), although not more binge eating. They were twice as likely to have a fear of becoming fat (P = .05) and were four times as likely to be influenced by their shape and weight (P = .001). Also, despite increased media exposure, the secular group chose an ideal body size on the FRS similar to that of the Orthodox group, suggesting that their greater body dissatisfaction on the BSQ was related, instead, to greater cultural pressure for thinness (P = .007) and more shame about appearance (P = .04). CONCLUSION: Our findings show that membership in a strict, insulated religious group such as Orthodox Judaism may protect women, to some extent, from developing body dissatisfaction and eating pathology.

Adolescent↗