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PubMedDate not supplied

Tobacco smoking in India: prevalence, quit-rates and respiratory morbidity.

BACKGROUND: Population prevalence of tobacco smoking especially with reference to detailed habits such as the amount smoked, the smoking forms, quit-rates and relationship with demographic variables were studied at four different centres in India along with the study on epidemiology of asthma and chronic obstructive pulmonary disease. METHODS: The study population included adults of over 15 years of age selected with two-stage stratified random sample design. A specifically designed questionnaire was used for the study. RESULTS: There were 11496 (15.6%) ever smokers in the study sample of 73605 subjects. Among 37682 males, 10756 (28.5%) were ever smokers and among 35923 females, 740 (2.1%) were ever smokers. Bidi was the commonest form of smoking, more so in the rural areas. The mean number of cigarettes/bidis smoked per day was 14 (+/- 11.5) and the mean age of starting smoking was 20.5 (+/- 20.0) years. Increasing age, low socio-economic status and rural residence were important factors associated with smoking. Vigorous anti-tobacco measures under the tobacco control programmes yielded only a quit-rate of 10 percent. Nearly 14% of ever smokers had some respiratory symptoms. CONCLUSIONS: A substantial proportion of population in India has current or past smoking habit with higher prevalence among males than females. The quit-rates have been low in spite of the various anti-tobacco measures. There is a significant respiratory morbidity associated with smoking.

Adolescent↗
PubMed2006

Estimated risk of coronary heart disease in obese adult males in Northern Jordan.

OBJECTIVE: To examine the relationship between obesity, lipid profile and blood pressure, and to quantify the risk of coronary heart disease (CHD) for the next 10 years, using the Framingham risk scoring scheme among Jordanian adult males. METHODS: We conducted this study in Al-Sarieh, Jordan during the period March to May 2001. A total of 306 apparently healthy adult males, aged 30-50 years completed all the study procedures. We selected the participants using a multi-stage cluster sampling design. Dietary history and smoking habits were obtained using a pre-tested questionnaire and interview. Blood samples were obtained and examined for lipid profiles. We measured the blood pressures, as well as the weight and height to calculate the body mass index (BMI). The sample was categorized into 3 groups using the World Health Organization classifications for BMI. The risk of CHD was calculated using a scoring scale according to Framingham scheme. Analyses of data were carried out using the Chi-square test, and the Analysis of Variance. RESULTS: The mean age of the subjects was 39 years with a mean BMI of 28.2 kg/m2. The percentage of current smokers was 44.1%. The mean of serum total cholesterol, triglycerides, low density lipoprotein cholesterol and systolic blood pressure, increased significantly with increasing BMI categories, whereas the mean of high density lipoprotein cholesterol decreased with increasing BMI categories. Prevalence of medium and high risk of CHD significantly increased as BMI categories increases. CONCLUSION: The prevalence of estimated CHD risk for the next 10 years in moderate and high CHD categories increases as the BMI categories increases among Jordanian adult men in Al-Sarieh area.

Adult↗
PubMed2000

Measurement-specific quality-of-life satisfaction during the menopause in an Arabian Gulf country.

OBJECTIVE: The aim of this study was to use an instrument, the menopause-specific quality-of-life satisfaction questionnaire for the postmenopausal period, in the United Arab Emirates (UAE). DESIGN: A cross-sectional descriptive study was used to generate menopause symptoms experienced by Arabian Gulf women. Measurement-specific quality-of-life satisfaction questionnaires were used and face-to-face interviews were performed. SETTING: The study was based in primary health-care clinics in Al Ain City, Sharjah and Dubai Emirates, UAE. SUBJECTS: A multistage sampling design was used, and a representative sample of 450 UAE females aged 45 years and above were included during January-April 1999. RESULTS: Of the 450 women living in both urban and rural areas, 390 women agreed to participate (86.7%) and responded to the study. The mean age and standard deviation (SD) of the subjects was 56.5 +/- 6.6 years, and the median age of natural menopause in the present study was 48 years (mean +/- SD 48.4 +/- 3.8). The rate of consanguinous marriages in the sample was found to be 47.2%. The most common disease was found to be diabetes mellitus (10.3%), followed by osteoarthritis (7.7%), hypertension (7.2%) and asthma (6.2%), but the majority of subjects (68.7%) had no specific disease. Out of 29 possible symptoms, the mean number of symptoms was 7.57 (range 0-24). The most frequent symptom was 'aches in the back of the neck or head' at 46.4% followed by 'aches in the muscles/joints' at 34.6%. The least reported symptom was 'facial hair' at 15.9%. Increasing education resulted in more symptoms reported, and increasing parity resulted in fewer symptoms reported. In the present study, it was found that employed women experienced more symptoms and disorders. Of the total sample, 28.5% of the subjects reported no symptoms. In the four domains, 69% reported physical symptoms, 58.7% reported psychosocial symptoms, 40% reported vasomotor symptoms and 37.9% reported sexual symptoms. Spearman's rank correlation coefficient indicated that there is highly statistically significant concordance between the four domains (p < 0.01). CONCLUSION: The present study showed that menopause-related symptoms in UAE women are fewer and of less severity than in Western women. The postmenopausal women, despite a continued decline in estrogen levels, reported few symptoms as part of a normal life stage, suggesting that they were able to cope with stress.

Asthma↗
PubMed2006

Prevalence of prehypertension and hypertension in a Korean population: Korean National Health and Nutrition Survey 2001.

OBJECTIVE: The present study aimed to determine the prevalence of prehypertension and hypertension, and their association with the risk factors in a Korean population. DESIGN: The Korean Nation Health and Nutrition Survey 2001, a cross-sectional survey, was a nationally representative survey in which a stratified multistage sampling design was used. METHODS: Data from a comprehensive questionnaire, together with a physical examination and blood sample, were obtained from 6074 Korean adults (2620 men and 3454 women) aged > or = 20 years, and analysed. RESULTS: The estimated age-adjusted prevalence of hypertension and prehypertension was 22.9% (26.9% in men, 20.5% in women) and 31.6% (41.9% in men, 25.9% in women), respectively, in the Korean population according to Joint National Committee 7 criteria. Multivariate analysis revealed that age, gender, body mass index, fasting plasma glucose, total-cholesterol and alcohol consumption were significantly associated with hypertension. Overall, only 30.2% of the hypertensive individuals had been previously diagnosed. Furthermore, 22.9% of the hypertensive individuals were being treated with antihypertensive medication, but only 10.7% had their blood pressure adequately controlled. The rates of awareness, treatment and control were higher for the women than for the men, and these rates increased with age. CONCLUSION: Hypertension and prehypertension are common in Korea, and more than one-half of the hypertensive patients have not been diagnosed. These results place great emphasis on the urgent need for a public health program to improve the detection, prevention and treatment of hypertension and prehypertension.

Adult↗
PubMed2003

[The impact of the study design and the sampling procedure on the assessment of mental health services].

In this paper the impact of the study design and the sampling procedure on the assessment of the costs of schizophrenia treatment will be analyzed. The study sample consists of 307 patients with the diagnosis of schizophrenia (ICD 10F20) with the age between 18 and 65 years. Study participants were recruited consecutively in inpatient and outpatient treatment settings and in accommodation facilities according to the proportions of patients treated in these settings in Leipzig which have been assessed before. Treatment costs have been assessed by means of the German version of the Client Sociodemographic and Service Receipt Inventory at five follow-ups at six-months intervals. For the whole study period significant differences of the mean service costs due to the recruitment setting have been found. The mean yearly costs amounted to 44.669 DM for participants recruited in sheltered accommodation, 27.975 DM for participants in inpatient treatment and 5691 DM for patients in outpatient facilities. A random-effect regression model confirmed significant effects of the recruitment setting over all five follow-ups. Additionally, the variance of costs over time indicates that cost assessment by means of cross sectional data involves the danger of errors due to random dispersion.

Activities of Daily Living↗
PubMed2003

Efficiency of two-phase designs for prevalence estimation.

BACKGROUND: Unbiased estimation of the prevalence of diseases and other conditions is important but can be expensive, especially for conditions which do not necessarily lead to contact with health services. A two-phase population survey may seem an attractive option when there is a relatively cheap, although fallible, test for disease status available: the test is used in the first phase of the survey but in the second, only a subsample are classified by the relatively expensive, gold standard. Previously the cost efficiency of such studies compared with simple, one-phase random sample designs was investigated empirically and some questions remain unclear. METHODS: A simple formula for the maximum reduction in cost or standard error that can be achieved by two-phase sampling compared with simple random sampling is derived mathematically. A formula for the minimum reduction is also given and the influence of prevalence on efficiency explained. RESULTS: The main result shows that the sensitivity and specificity of the first stage test set an absolute limit on the efficiency of two-phase designs; in particular, two-phase sampling can never be justified on efficiency grounds alone if the test is not accurate enough.

Cost-Benefit Analysis↗
PubMed2002

Smoking patterns of household members and visitors in homes with children in the United States.

BACKGROUND: Environmental tobacco smoke (ETS), also called passive smoking, has been shown to have adverse effects on the health of children. OBJECTIVE: To determine the prevalence and pattern of ETS exposure in US homes with children younger than 18 years. DESIGN: We analyzed data from the 1994 National Health Interview Survey and Year 2000 Objectives supplement. A multistage sample design was used to represent the civilian, noninstitutionalized population of the United States. MAIN OUTCOME MEASURES: Frequency of smoking by household residents and visitors in homes with children. RESULTS: Thirty-five percent of children in the United States-21 million children-live in homes where residents or visitors smoke in the home on a regular basis (> or =1 d/wk). From the household perspective, regular smoking by residents and visitors occurs in 36% of homes in which children reside. In 92% of homes with children where residents smoke at home, they do so every day of the week. Sixteen percent of nonsmoking respondents with children report that other residents or visitors smoke in the home. In 6% of the homes where no residents smoke, there is nevertheless regular smoking by visitors. In multivariate regression analysis, the prevalence of regular smoking in homes with children varies by age of youngest child, race/ethnicity, number of parents in the home, parental educational level, income, and region of the country. CONCLUSIONS: Many children live in homes with ETS. Most respondents who smoke report that smoking occurs in the home every day. Visitors are an additional source of ETS in homes, including some homes where residents do not smoke. Clinicians who take care of children can advise parents, whether or not they smoke, on how to limit their children's ETS exposure.

Child↗
PubMed2005

Seat position and the risk of serious thoracoabdominal injury in lateral motor vehicle crashes.

CONTEXT: Previous studies have suggested that motor vehicle occupants seated on the near-side of a lateral impact have a higher proportion of thoracoabdominal injuries. However, due to limitations in previous studies, the true association between seat position, side of lateral impact, and thoracoabdominal injury is unclear. OBJECTIVE: To assess the relationship between seat position (i.e., near-side, middle-seat, and far-side, regardless of row), side of lateral motor vehicle crash (MVC), and serious thoracoabdominal injury after adjusting for important crash factors. DESIGN: National population-based cohort of adult subjects involved in MVCs and included in the National Automotive Sampling System Crashworthiness Data System database (NASS CDS) from 1995 to 2003. PATIENTS: Occupants aged > or =16 years involved in MVCs where the highest external deformation of the vehicle was located on the right or left side (i.e., lateral). MAIN OUTCOME MEASURE: Serious thoracic or abdominal injury, defined as an Abbreviated Injury Scale (AIS) > or =3 in the thoracic or abdominal body region. RESULTS: Fifteen thousand, one hundred and sixty persons involved in primary lateral MVCs were represented in the NASS CDS database during the 9-year period. There were 1867 (2%) persons with serious thoracic injuries and 507 persons (0.5%) with serious abdominal injuries. In multivariable logistic regression models that adjusted for important crash factors and the NASS CDS sampling design, seat position was a strong effect modifier of the association between side of lateral impact and serious thoracic (p<0.0001) and abdominal (p=0.0009) injury, with the risk of serious thoracic and abdominal injury highest for occupants seated on the near-side of the crash. The mean probability of injury was higher for near-side and middle-seat occupants compared to far-side occupants, and the probability of thoracic injury was approximately four times higher than that of abdominal injury for all seat positions. CONCLUSIONS: There is a strong, synergistic relationship between seat position and side of lateral MVC in assessing risk of serious thoracic and abdominal injury among adult occupants. The probability of serious thoracoabdominal injury increases with increasing proximity of seat position to side of the crash and the risk of thoracic injury is higher than abdominal injury for all seat positions.

Abdominal Injuries↗
PubMed1984

Nonrandom sampling in human genetics: familial correlations.

In the context of human genetics, sampling is often nonrandom in that pedigrees are frequently selected by virtue of their having at least one affected individual. For quantitative traits, it may be that the proband is selected because of a phenotypic value above some predetermined cut-point; this will also be true for diseases defined by a cut-point above which individuals are said to be affected (e.g. diabetes, hypertension, and obesity). Relatively little attention has been given to the implications of these forms of nonrandom sampling. In this paper, we show that the biases introduced by such sampling are sufficient to lead to erroneous model specification and biased parameter estimates in path analysis. Existing methodologies used to correct for such sampling (e.g., elimination of proband or regression techniques) also result in similar bias in estimation and model fitting. Thus, it is possible to make inferences which do not reflect underlying biology, but are artifacts of the sampling design. As a consequence, method-of-moment estimators are developed for means, variances, and correlations under such sampling. Simulation results are used to demonstrate the superiority of this method over alternate strategies.

Biometry↗
PubMed1993

Depression and the experience of chronic back pain: a study of related variables and age differences.

OBJECTIVE: To document the prevalence of depression and examine the relationship between depression and selected pain-related variables associated with chronic back pain among elderly and nonelderly samples. DESIGN: Survey with mailed questionnaire. SETTING: Patients seeking treatment at a spine diagnostic and treatment center. PATIENTS: Consecutive sample of elderly subjects (n = 69). Nonelderly subjects (n = 59) were randomly selected to achieve a sample size comparable to the elderly. Evaluation of depressed mood was determined by Beck Depression Inventory. MAIN OUTCOME MEASURES: Multidimensional Pain Inventory, Pain Disability Index, Pain Duration, Work-Related Disability, Medication Use, and Pain Severity. RESULTS: A high prevalence of dysphoria was found in both age groups. No significant differences were found between age and depressed mood. The only significant association between depressed mood and age occurred with pain duration, with the elderly experiencing fewer total hours per day in pain. Combining age groups, multivariate analysis of variance revealed that dysphoric chronic pain patients reported more antidepressant use, greater pain intensity, greater interference due to pain, and less life control than the nondepressed patients. Interference in activities demonstrated the strongest relationship with depressed mood in both age groups. CONCLUSIONS: There is a high prevalence of dysphoria in both the elderly and nonelderly with chronic back pain. The relationships between pain-related constructs and depressed mood in chronic back pain patients are similar in the elderly and nonelderly. The impact of the pain experience on the individual's activities, functioning, and feelings of life control should be considered in theoretical and clinical explanations of the association between pain and depression.

Adult↗
PubMed2000

Population pharmacokinetics of clomipramine, desmethylclomipramine, and hydroxylated metabolites in patients with depression receiving chronic treatment: model evaluation.

Because metabolites play a major role in the clinical response to clomipramine, the objective of the current study was to develop a population model and evaluate its performance to describe the pharmacokinetic profiles of clomipramine (C) and its active metabolites desmethylclomipramine (DC), 8-hydroxy-clomipramine (OHC) and 8-hydroxy-desmethylclomipramine (OHDC). A first sample of 14 patients served for development of a 2-molecule C and DC model, which was shown to provide reasonable estimates of AUC-based clearances, as well as precise estimation of interindividual variability. Simulated data, generated to mimic a semi-rich sampling design and chronic treatment with clomipramine, indicated that clearance estimation was feasible under routine treatment conditions. A second sample of 30 patients, recruited prospectively and followed for a median 4-week period, was used to extend the 2-molecule model to a 4-molecule model. Goodness-of-fit assessment revealed that model-predicted concentrations were reasonably close to observed concentrations for a majority of patients. Interindividual variability was 50% to 60% for hydroxylation and desmethylation clearances, and residual variability was 30%. The proposed model incorporates much of what is known about the metabolism of clomipramine and may valuably integrate the influence of genetic and environmental factors on each metabolic pathway.

Adult↗
PubMed2006

Disease mapping in veterinary epidemiology: a Bayesian geostatistical approach.

Model-based geostatistics and Bayesian approaches are useful in the context of veterinary epidemiology when point data have been collected by appropriate study design. We take advantage of an example of Epidemiological Surveillance on urban settings where a two-stage sampling design with first stage transects is applied to study the risk of dog parasite infection in the city of Naples, 2004-2005. We specified Bayesian Gaussian spatial exponential models and Bayesian kriging were performed to predict the continuous risk surface of parasite infection on the study region. We compared the results with those obtained by the application of hierarchical Bayesian models on areal data (proportion of positive specimens by transect). The models results were consistent with each other and the Bayesian geostatistical approach proved to be more accurate in identifying areas at risk of zoonotic parasitic diseases. In general, larger risk areas were identified at the city border where wild dogs mixed with domestic dogs and human or urban barriers were less present.

Animal Diseases↗
PubMed2003

Sampling correction in pedigree analysis.

Usually, a pedigree is sampled and included in the sample that is analyzed after following a predefined non-random sampling design comprising several specific procedures. To obtain a pedigree analysis result free from the bias caused by the sampling procedures, a correction is applied to the pedigree likelihood. The sampling procedures usually considered are: the pedigree ascertainment, determining whether a population unit is to be sampled; the intrafamilial pedigree extension, determining what part of the pedigree is to be sampled; and selective censoring of the sampled pedigree, determining whether it should be included in the sample to be analyzed. The probability of pedigree ascertainment is determined by the total set of potential probands in the true pedigree from which the sampled pedigree is obtained and we indicate how the necessary information on this set can be collected. If insufficient information on this set is observed, it is impossible to correct the pedigree likelihood adequately. Here we show that, if only the structure of this set is known, then an ascertainment-model-based pedigree likelihood can be obtained by conditioning on this structure. An ascertainment-model-free (AMF) pedigree likelihood can be correctly constructed by conditioning on all the data in this set, i.e. on both its structure and its phenotypic content. However, if this set has missing data, the AMF likelihood becomes undefined, which limits the utility of this AMF approach originally proposed by Ewens and Shute (1986). We also consider the sampling correction necessary when the pedigrees included in the sample analyzed have been subjected to censoring. The forms of likelihood correction developed here provide asymptotically unbiased estimators of the genetic model only if the formulated model is correct, which means that it must correctly allow for the most important features of the true inheritance of the trait studied. Otherwise, if no special case of the formulated general model is close to the true inheritance model, then the forms of likelihood correction proposed here result in biases, the magnitude and direction of which depend on both the true model and the general analysis model that should subsume it.

Journal Article↗
PubMed2002

Methodological rigor with internet samples: new ways to reach underrepresented populations.

We present several rigorous methods for sampling difficult-to-reach and empirically underrepresented populations via the Internet. The methodology's representativeness was tested by comparing the demographics of a small sample of 82 lesbian and bisexual females with a much larger Gallup Organization sample of the general population (n > 1,000) obtained via random digit dialing. Compared to the latter poll, the rigorous sampling designs developed for the Internet were found to be significantly more robust and equally representative of the U.S. general population. The Gallup Organization reached a sample more representative of the age distribution of the United States. The Internet sample reached a sample more representative of the population, with less education, lower incomes, and a broad spectrum of ethnic diversity. The samples were equally effective in representing the distribution of the population with rural and urban residence.

Adolescent↗
PubMedDate not supplied

Weighted likelihood, pseudo-likelihood and maximum likelihood methods for logistic regression analysis of two-stage data.

General approaches to the fitting of binary response models to data collected in two-stage and other stratified sampling designs include weighted likelihood, pseudo-likelihood and full maximum likelihood. In previous work the authors developed the large sample theory and methodology for fitting of logistic regression models to two-stage case-control data using full maximum likelihood. The present paper describes computational algorithms that permit efficient estimation of regression coefficients using weighted, pseudo- and full maximum likelihood. It also presents results of a simulation study involving continuous covariables where maximum likelihood clearly outperformed the other two methods and discusses the analysis of data from three bona fide case-control studies that illustrate some important relationships among the three methods. A concluding section discusses the application of two-stage methods to case-control studies with validation subsampling for control of measurement error.

Adult↗
PubMed2005

Premature death of adult adoptees: analyses of a case-cohort sample.

Genetic and environmental influence on risk of premature death in adulthood was investigated by estimating the associations in total and cause-specific mortality of adult Danish adoptees and their biological and adoptive parents. Among all 14,425 non-familial adoptions formally granted in Denmark during the period 1924 through 1947, we selected the study population according to a case-cohort sampling design. As the case-control design, the case-cohort design has the advantage of economic data collection and little loss in statistical efficiency, but the case-cohort sample has the additional advantages that rate ratio estimates may be obtained, and re-use of the cohort sample in future studies of other outcomes is possible. Analyses were performed using Kalbfleisch and Lawless's estimator for hazard ratio, and robust estimation for variances. In the main analyses the sample was restricted to birth years of the adoptees 1924 and after, and age of transfer to the adoptive parents before 7 years, and age at death was restricted to 16 to 70 years. The results showed a higher mortality among adoptees, whose biological parents died in the age range of 16 to 70 years; this was significant for deaths from natural causes, vascular causes and all causes. No influence was seen from early death of adoptive parents, regardless of cause of death.

Adolescent↗
PubMed2006

The Paul Coverdell National Acute Stroke Registry: initial results from four prototypes.

BACKGROUND: This paper summarizes the experiences of the Paul Coverdell National Acute Stroke Registry first four prototype registries in Georgia (GA), Massachusetts (MA), Michigan (MI), and Ohio (OH), and includes information on their sampling design, case ascertainment, and data collection methods, as well as some key findings. METHODS: Using a combination of different sampling methods, each prototype obtained a representative statewide sample of hospitals. Acute stroke admissions were identified through prospective (MA, MI) or retrospective (GA, OH) methods. A common set of case definitions and data elements were used by each registry. Weighted site-specific frequencies and 95% confidence intervals were generated for each outcome. A summary estimate, representing a weighted average of the four site-specific estimates, was also calculated. RESULTS: Of the total 6867 admissions, 1487 (21.6%) were from the GA registry, 1206 (17.6%) from MA, 2566 (37.4%) from MI, and 1608 (23.4%) from the OH prototype. Just less than 60% of admissions were ischemic strokes (site-specific estimates ranged from 52% to 70%), with transient ischemic attack (18.5%) and intracerebral hemorrhage (8.8%) making up most of the remainder. Twenty-one percent of patients admitted were younger than 60 years of age, and 55.3% were women. The proportion of black subjects varied from 7.1% (MI) to 30.6% (GA). Twenty-three percent of admissions arrived at the emergency department within 3 hours of onset. Overall 4.5% of ischemic stroke admissions were treated with recombinant tissue plasminogen activator; site-specific treatment rates were 3.0% (GA), 3.2% (OH), 3.4% (MI), and 8.5% (MA). Only a small minority of treated patients (range, 10.8% [OH] to 19.6% [MI]) received recombinant tissue plasminogen activator within the recommended 1 hour door-to-needle time. A minority of eligible subjects were screened for dysphagia (45.4%), underwent lipid testing (33.6%), or received smoking-cessation counseling (21.4%). In contrast, compliance with antithrombotic treatments at discharge was high (91.5%). CONCLUSIONS: A minority of acute stroke patients are treated according to established guidelines. Quality improvement interventions, targeted primarily at the healthcare systems level, are needed to improve acute stroke care in the United States.

Acute Disease↗
PubMed2006

Potentially protective factors associated with healthful body mass index in adolescents with obese and nonobese parents: a secondary data analysis of the third national health and nutrition examination survey, 1988-1994.

OBJECTIVE: To identify factors potentially protective against obesity in 12- to 16-year-olds with one or two obese parents, and those with no obese parents. DESIGN: A secondary analysis of the Third National Health and Nutrition Examination Survey, 1988-1994. SUBJECTS/SETTING: A nationally representative sample of healthful weight, at-risk, or overweight adolescents with measured heights and weights (n=1,890). Subsamples with any obese parent (body mass index > or =30) and no obese parents (both with body mass index <25) were analyzed. STATISTICAL ANALYSES PERFORMED: Bivariate analyses examined the association of predictor variables (demographics, nutrient intake, and physical activity) on the outcome. Logistic regressions examined the likelihood of being healthful weight. SUDAAN software (release 7.5, 1997, Research Triangle Institute, Research Triangle Park, NC) was used to account for the sample design. RESULTS: Overall, 71% of subjects had a healthful weight, 29% were at risk or overweight. Factors associated with healthful weight included having two nonobese parents (odds ratio [OR]=5.4), only father obese (OR=4.9), only mother obese (OR=3.3), higher reading scores (OR=1.02), lower water consumption (OR=1.8), more exercise programs (OR=2.8), and higher energy intake (OR=2.0). For adolescents with any obese parent, factors potentially protective against obesity included being female (OR=2.2), higher household education (OR=1.1), lower water consumption (OR=2.0), and eating breakfast some days (OR=3.1) or everyday (OR=4.0). For adolescents with no obese parents, potentially protective factors included older age (OR=1.2), not having asthma (OR=2.6), more exercise programs (OR=6.1), and higher energy intake (OR=2.9). All P<.05. CONCLUSIONS: Interventions targeted at adolescents who are at risk because they have parents with obesity should employ a family approach focused on regular breakfast consumption.

Adolescent↗