Prevalence and predictors of recommendations to lose weight in overweight and obese older adults in Georgia senior centers.

OBJECTIVE: To examine the prevalence and predictors of health care professional recommendations to lose weight in Older Americans Act Nutrition Program participants in Georgia senior centers who met professional and/or governmental organization criteria for weight loss recommendation. METHODS: Demographic, health, and weight loss recommendation information obtained from community-dwelling convenience sample (n=793; 2007-2008) of older adults via interviewer administered questionnaires. RESULTS: Approximately 70% of participants met weight loss criteria, but only 36% of them received advice to lose weight in the past year. Report of weight loss recommendation was 52.0% for those 'obese with risks' and 19.8% for those 'overweight with risks'. Recommendation to lose weight was significantly (p<0.05) associated with body mass index, waist circumference risk, younger age, self-reported disability, and urban residence. When controlled for other health and demographic factors, recommendation to lose weight was significantly associated with heart disease, but not other chronic conditions including diabetes, hypertension, or joint pain. CONCLUSION: Many older adults who may benefit from weight loss are not receiving advice to do so. Health care professionals need to be aware of this problem to assist community-dwelling older adults in better managing their health to help maintain independence and improve their quality of life.

Have regulatory efforts to reduce organophosphorus insecticide exposures been effective?

BACKGROUND: The Food Quality Protection Act (FQPA) was signed into law in 1996 to strengthen the regulation of pesticide tolerances in food. Organophosphorus (OP) insecticides were the first group of pesticides reviewed by the U.S. Environmental Protection Agency (EPA) under the new law. OBJECTIVE: Our goal was to determine whether urinary concentrations of dialkylphosphate (DAP) metabolites of OP pesticides declined between the National Health and Nutrition Examination Survey (NHANES) III and NHANES 1999-2004. METHODS: Using mass spectrometry-based methods, we analyzed urine samples from a nationally representative sample of 2,874 adults 20-59 years of age in NHANES 1999-2004 and samples from a non-nationally representative sample of 197 adult participants for NHANES III (1988-1994) for six common DAP metabolites of OP pesticides. RESULTS: Median urinary DAP concentrations decreased by more than half between NHANES III and NHANES 2003-2004. Reductions of about 50%-90% were also observed for 95th percentile concentrations of five of the six metabolites. Frequencies of detection (FODs) decreased in all six metabolites (< 50% reduction). On average, median and 95th percentile concentrations and FODs showed a larger decrease in diethylphosphate metabolites than dimethylphosphate metabolites. CONCLUSIONS: Human exposure to OP insecticides as assessed by urinary DAP concentrations has decreased since the implementation of the FQPA, although we cannot be certain that U.S. EPA actions in response to the FQPA directly caused the decrease in DAP concentrations.