Cardiovascular Health Trajectories From Childhood Through Middle Age and Their Association With Subclinical Atherosclerosis.

Importance: Cross-sectional measures of cardiovascular health (CVH) have been associated with cardiovascular disease in older age, but little is known about longitudinal trajectories in CVH and their association with subclinical atherosclerosis in middle age. Objectives: To model long-term patterns in CVH starting in childhood and to assess their association with subclinical atherosclerosis in middle age. Design, Setting, and Participants: This cohort study used data from 5 prospective cardiovascular cohort studies from the United States and Finland from 1973 to 2015. A total of 9388 participants aged 8 to 55 years had at least 3 examinations and were eligible for this study. Statistical analysis was performed from December 1, 2015, to June 1, 2019. Exposures: Clinical CVH factors (body mass index, total cholesterol level, blood pressure, and glucose level) were classified as ideal, intermediate, or poor, and were summed as a clinical CVH score. Group-based latent class modeling identified trajectories in this score over time. Main Outcomes and Measures: Carotid intima-media thickness (cIMT) was measured for participants in 3 cohorts, and high cIMT was defined as a value at or above the 90th percentile. The association between CVH trajectory and cIMT was modeled using both linear and logistic regression adjusted for demographics, baseline health behaviors, and baseline (or proximal) CVH score. Results: Among 9388 participants (5146 [55%] female; 6228 [66%] white; baseline mean [SD] age, 17.5 [7.5] years), 5 distinct trajectory groups were identified: high-late decline (1518 participants [16%]), high-moderate decline (2403 [26%]), high-early decline (3066 [32%]), intermediate-late decline (1475 [16%]), and intermediate-early decline (926 [10%]). The high-late decline group had significantly lower adjusted cIMT vs other trajectory groups (high-late decline: 0.64 mm [95% CI, 0.63-0.65 mm] vs intermediate-early decline: 0.72 mm [95% CI, 0.69-0.75 mm] when adjusted for demographics and baseline smoking, diet, and physical activity; P < .01). The intermediate-early declining group had higher odds of high cIMT (odds ratio, 2.4; 95% CI, 1.3-4.5) compared with the high-late decline group, even after adjustment for baseline or proximal CVH score. Conclusions and Relevance: In this study, CVH declined from childhood into adulthood. Promoting and preserving ideal CVH from early life onward may be associated with reduced CVD risk later in life.

Occupationally Tailored, Web-Based, Nutrition and Physical Activity Program for Firefighters: Cluster Randomized Trial and Weight Outcome.

OBJECTIVE: The aim of this study was to determine the efficacy of an occupationally tailored, web-based health and wellness program, The First Twenty® (TF20), for weight change among volunteer firefighters. METHODS: The impact of TF20 on firefighters' 6-month weight change was tested in a cluster, randomized controlled trial, using a crossover design of firefighters in 10 departments. TF20 has web-based nutrition, physical activity, and behavioral health components. RESULTS: An adjusted treatment-induced weight loss from 1.7 to 2.8 lb was observed for all participants and 2.3 to 3.1 lb among overweight and obese participants. An average weight gain was observed among firefighters in the control condition and weight loss for those in the treatment condition. CONCLUSIONS: TF20 supports firefighters' weight loss. Firefighters need wellness interventions to improve nutrition and physical activity given their high prevalence of obesity.

Proportion of Orofacial Clefts Attributable to Recognized Risk Factors.

OBJECTIVE: Estimate the population attributable fraction (PAF) for a set of recognized risk factors for orofacial clefts. DESIGN: We used data from the National Birth Defects Prevention Study. For recognized risk factors for which data were available, we estimated crude population attributable fractions (cPAFs) to account for potential confounding, average-adjusted population attributable fractions (aaPAFs). We assessed 11 modifiable and 3 nonmodifiable parental/maternal risk factors. The aaPAF for individual risk factors and the total aaPAF for the set of risk factors were calculated using a method described by Eide and Geffler. SETTING: Population-based case-control study in 10 US states. PARTICIPANTS: Two thousand seven hundred seventy-nine cases with isolated cleft lip with or without cleft palate (CL±P), 1310 cases with isolated cleft palate (CP), and 11 692 controls with estimated dates of delivery between October 1, 1997, and December 31, 2011. MAIN OUTCOME MEASURES: Crude population attributable fraction and aaPAF. RESULTS: The proportion of CL±P and CP cases attributable to the full set of examined risk factors was 50% and 43%, respectively. The modifiable factor with the largest aaPAF was smoking during the month before pregnancy or the first month of pregnancy (4.0% for CL±P and 3.4% for CP). Among nonmodifiable factors, the factor with the largest aaPAF for CL±P was male sex (27%) and for CP it was female sex (16%). CONCLUSIONS: Our results may inform research and prevention efforts. A large proportion of orofacial cleft risk is attributable to nonmodifiable factors; it is important to better understand the mechanisms involved for these factors.

Adenovirus 36 antibody detection: Improving the standard serum neutralization assay.

Adenovirus 36 (AdV36) causes weight gain in animal models, including non-human primates. In humans, AdV36-neutralizing antibodies are associated with adiposity; however, longitudinal studies in large populations are needed to clarify AdV36's contribution. The current gold standard for detection of AdV36-specific antibody is the serum neutralization assay (SNA), which requires long incubation times and highly trained personnel. The standard SNA was modified using an immunocytochemical (ICC) approach, which allows for a more rapid and objective assessment of AdV36 antibodies. Using the ICC assay, virus-infected cells were detected as early as day 1 (D1) and by D5 were detected in 100% of microtiter wells versus 20.3% of wells detected by observing the cytopathic effect. Further, human sera tested with the ICC assay at D5 had a sensitivity and specificity of 80.0% and 95.7%, respectively, when compared to the standard SNA read at D11. Thus, the ICC assay decreased assay incubation time, provided a more objective and easily interpreted assessment, and had a high degree of sensitivity and specificity in determining serological status. The more rapid and objective ICC method will make large population studies feasible, improve comparability among laboratories, and contribute to understanding the role of AdV36 in obesity.

An examination of the benefits of health promotion programs for the national fire service.

BACKGROUND: Firefighters suffer from high prevalence of obesity, substandard fitness, and cardiovascular-related deaths. There have been a limited number of firefighter health promotion programs that have been developed and empirically-tested for this important occupational group. We evaluated the health of firefighters from departments with well-developed health promotion programs and compared them with those from departments not having such programs using a large national sample of career fire departments that varied in size and mission. We measured a broad array of important individual firefighter health outcomes (e.g., body composition, physical activity, and general and behavioral health) consistent with national fire service goals and addressed significant statistical limitations unaccounted for in previous studies. METHODS: Using the approach of purposive sampling of heterogeneous instances, we selected and conducted a national evaluation of 10 departments already implementing wellness and fitness programs (Wellness Approach; WA) with 10 departments that did not (Standard). Participants were 1,002 male firefighters (WA n = 522; Standard n = 480) who underwent assessments including body composition, fitness, and general/behavioral health (e.g., injury, depressive symptoms). RESULTS: Firefighters in WA departments were healthier than their Standard department counterparts. For example, they were less likely to be obese (adjusted [A]OR = 0.58; 95% CI = 0.41-0.82), more likely to meet endurance capacity standards for firefighting (AOR = 5.19; 95% CI = 2.49-10.83) and have higher estimated VO2max (40.7 ± 0.6 vs. 37.5 ± 1.3 for firefighters in Standard departments; p = 0.001). In addition, WA firefighter were substantially less likely to smoke (AOR = 0.30; 95% CI = 0.17-0.54) or ever have been diagnosed with an anxiety disorder (AOR = 0.27; 95% CI = 0.14-0.52) and they expressed higher job satisfaction across several domains. However, WA firefighters were somewhat more likely to have reported an injury to Workers' Compensation (AOR = 1.74; 95% CI = 1.05-2.90). It was notable that both groups evidenced high prevalence of smokeless tobacco use and binge drinking. CONCLUSIONS: Firefighters in departments selected based on having strong wellness programs (WA) were healthier along a number of dimensions important to firefighter wellness and operational readiness. However, several health areas require greater attention including problematic alcohol consumption and smokeless tobacco use, suggesting that more emphasis on these behavioral health issues is needed in the fire service.

Long-term physical activity outcomes of home-based lifestyle interventions among breast and prostate cancer survivors.

PURPOSE: Few studies have investigated long-term effects of physical activity (PA) interventions. The goal of this study was to evaluate whether or not increased levels of moderate to vigorous physical activity (MVPA) were maintained by cancer survivors 1 year after receipt of two home-based interventions. METHODS: The FRESH START trial randomized 543 breast and prostate cancer survivors to 1-of-2 mailed print diet and exercise interventions: sequentially-tailored vs. standardized (attention control). Each arm received eight mailings over a 1-year period, with follow-up at 1 and 2 years. This analysis focuses solely on the 400 participants who had suboptimal levels of MVPA at baseline (measured by the 7-Day Physical Activity Recall) and who completed the 2-year study. RESULTS: Median minutes of MVPA at baseline, 1-year and 2-year follow-up in the tailored intervention arm were as follows: 0, 90, and 60 min/week, respectively. The corresponding values in the attention control group were 0, 30, and 30 min/week. Significant improvements in MVPA from baseline to 2-year follow-up were observed in both study arms (p < 0.01). While significant between-arm differences were observed at 1-year follow-up (p < 0.01), there was only the suggestion of a trend (p = 0.08) at 2-year follow-up. CONCLUSIONS: This study provides evidence that mailed-print exercise interventions result in significant and sustainable improvements in MVPA among newly diagnosed cancer survivors that are observed well after the intervention is complete. While tailored interventions, as compared to standardized materials, appear to produce superior improvements in MVPA initially, these differences diminish over time.

Exercise among breast and prostate cancer survivors--what are their barriers?

INTRODUCTION: Despite proven benefits of regular physical activity, estimates indicate that few cancer survivors meet physical activity guidelines. The purpose of this paper is to identify and compare exercise barriers among cancer survivors, both cross-sectionally and longitudinally as they undergo home-based behavioral interventions. METHODS: Data on a sample of 452 breast and prostate cancer survivors who completed the FRESH START trial were analyzed collectively, as well as separately by cancer type. RESULTS: More total barriers (3.5 vs. 2.4; p < 0.01) were reported among breast cancer survivors compared with prostate cancer survivors. Commonly reported baseline exercise barriers among both groups were "too busy" (breast, 52% and prostate, 45%) and "no willpower" (breast, 51% and prostate, 44%). At baseline, breast cancer survivors who reported "no willpower" also reported 18.7 fewer minutes of physical activity compared with those not reporting this barrier (p < 0.01). Among prostate cancer survivors, this difference was 39.5 min (p < 0.01). Change in barriers was not associated with change in minutes of physical activity from baseline to post-intervention in either cancer survivor group. CONCLUSIONS: This is the largest study evaluating barriers and physical activity over time among cancer survivors. There are similarities and differences that both need to be taken into consideration when promoting physical activity among subgroups of survivors. IMPLICATIONS FOR CANCER SURVIVORS: Knowledge concerning barriers associated with reported physical activity may be helpful in designing optimally targeted physical activity interventions among breast and prostate cancer survivors.

A review of body size and breast cancer risk in Hispanic and African American women.

Obesity is an epidemic in the United States, especially among Hispanics and African Americans. Studies of obesity and breast cancer risk have been conducted primarily in non-Hispanic whites. There have been few studies of the association between body mass index (BMI) or weight gain and the risk of breast cancer in minorities, and the results have been inconsistent. Because most studies are conducted primarily in non-Hispanic whites, the etiology of breast cancer in minorities is not well understood. The authors of the current report reviewed the literature on the association between obesity, weight, and weight gain and breast cancer in minorities using a combination of the Medical Subject Heading (MeSH) terms "obesity," "body mass index," "weight," "weight gain," "Hispanic," and "African American." Only publications in English and with both risk estimates and 95% confidence intervals were considered. Forty-five studies of body size and breast cancer risk in non-Hispanic whites were identified. After an exhaustive search of the literature, only 3 studies of body size and breast cancer were conducted in Hispanic women were identified, and only 8 such studies in African American women were identified. The results were inconsistent in both race/ethnicity groups, with studies reporting positive, inverse, and null results. Thus, as obesity rates among Hispanics and African Americans continue to rise, there is an urgent need to identify the roles that both obesity and adult weight gain play in the development of breast cancer in these minorities. Additional studies are needed to provide more understanding of the etiology of this disease and to explain some of the disparities in incidence and mortality.

Modifiable barriers to cervical cancer screening adherence among working women in Mexico.

AIMS: To determine predictors of adherence to cervical cancer screening guidelines among women working in Monterrey, Mexico. Cases (n = 94) were sexually active female store clerks working in Monterrey, Mexico, aged 18-64, who were not adherent to Official Mexican Standard cervical cancer screening guidelines; controls (n = 135) were adherent to guidelines. The outcome of interest was adherence to cervical cancer screening services according to national screening guidelines. METHODS: Multivariate logistic regression analyzed knowledge factors and perceptions associated with adherence. RESULTS: Having no or inaccurate knowledge of screening guidelines (odds ratio [OR] 11.1, 95% confidence interval [95% CI] 4.3-28.5) and no knowledge of Pap examination utility (OR 6.8, 95% CI 1.0-46.4) were associated with screening guideline nonadherence. Perceptions of fear/embarrassment (OR 16.2, 95% CI 5.1-51.5) and lower levels of spousal/partner acceptance (OR 5.8, 95% CI 1.3-25.3) of the Pap examination were associated with screening guideline nonadherence. Results were adjusted for age at initiation of sexual activity, civil status, level of education, use of family planning/birth control, and income. CONCLUSIONS: Identification of knowledge factors and perceptions that predict screening guideline adherence can inform population-specific recommendations to increase screening and reduce cervical cancer morbidity and mortality among employed Mexican women.

Profiling lipoxygenase metabolism in specific steps of colorectal tumorigenesis.

Lipoxygenases (LOX) are key enzymes for the oxidative metabolism of polyunsaturated fatty acids into biologically active products. Clinical data on comparative levels of various LOX products in tumorigenesis are lacking. Therefore, we examined the profiles of several LOX products (5-LOX, 12-LOX, 15-LOX-1, and 15-LOX-2) by liquid chromatography/tandem mass spectrometry in the major steps of colorectal tumorigenesis (normal, polyp, and cancer) in a clinical study of 125 subjects (49 with normal colon, 36 with colorectal polyps, and 40 with colorectal cancer) who underwent prospective colorectal biopsies to control for various potential confounding factors (e.g., diet, medications). Mean 13-hydroxyoctadecadienoic acid (13-HODE) levels were significantly higher in normal colon [mean, 36.11 ng/mg protein; 95% confidence interval (95% CI), 31.56-40.67] than in paired colorectal cancer mucosa (mean, 27.01 ng/mg protein; 95% CI, 22.00-32.02; P = 0.0002), and in normal colon (mean, 37.15 ng/mg protein; 95% CI, 31.95-42.34) than in paired colorectal polyp mucosa (mean, 28.07 ng/mg protein; 95% CI, 23.66-32.48; P < 0.001). Mean 13-HODE levels, however, were similar between the left (mean, 37.15 ng/mg protein; 95% CI, 31.95-42.35) and the right normal colon (mean, 32.46 ng/mg protein; 95% CI, 27.95-36.98; P = 0.09). No significant differences with regard to 12- or 15-hydroxyeicosatetraenoic acid or leukotriene B(4) levels were detected between normal, polyp, and cancer mucosae. 15-LOX-1 inhibited interleukin-1beta expression. This study establishes that reduced 13-HODE levels are a specific alteration in the LOX product profile associated with human colorectal tumorigenesis.

Antioxidant genes, diabetes and dietary antioxidants in association with risk of pancreatic cancer.

To test the hypothesis that polymorphic variants of antioxidant genes modify the risk of pancreatic cancer, we examined seven single-nucleotide polymorphisms (SNPs) of genes coding for superoxide dismutase (SOD) 2, glutathione S-transferase alpha 4 (GSTA4), catalase and glutathione peroxidase in 575 patients with pancreatic adenocarcinoma and 648 healthy controls in a case-control study. Information on risk factors was collected by personal interview and dietary information was collected by a self-administered food frequency questionnaire. Genotypes were determined using the Taqman method. Adjusted odds ratio (AOR) and 95% confidence interval (CI) were estimated by unconditional logistic regression. No significant main effect of genotype was observed. A borderline significant interaction between diabetes and SOD2 Ex2+24T>C CT/TT genotype was observed (P(interaction) = 0.051); the AORs (95% CI) were 0.98 (0.73-1.32) for non-diabetics carrying the CT/TT genotype, 1.73 (0.94-3.18) for diabetics carrying the CC genotype and 3.49 (2.22-5.49) for diabetics carrying the CT/TT genotype compared with non-diabetics carrying the CC genotype. Moreover, the SOD2 -1221G>A AA genotype carriers had a significantly increased risk for pancreatic cancer among those with a low dietary vitamin E intake but decreased risk among those with a high vitamin E intake (P(interaction) = 0.002). There was a non-significant interaction between diabetes and GSTA4 Ex5-64G>A genotypes (P(interaction) = 0.078). No significant interaction between genotype with cigarette smoking or vitamin C intake was observed. These data suggest that genetic variations in antioxidant defenses modify the risk of pancreatic cancer in diabetics or individuals with a low dietary vitamin E intake.

A path analysis to identify the psychosocial factors influencing physical activity and bone health in middle-school girls.

BACKGROUND: The purpose of this study was to identify pathways used by psychosocial factors to influence physical activity and bone health in middle-school girls. METHODS: Baseline data from the Incorporating More Physical Activity and Calcium in Teens (IMPACT) study collected in 2001 to 2003 were used. IMPACT was a 1 1/2 years nutrition and physical activity intervention study designed to improve bone density in 717 middle-school girls in Texas. Structural Equations Modeling was used to examine the interrelationships and identify the direct and indirect pathways used by various psychosocial and environmental factors to influence physical activity and bone health. RESULTS: Results show that physical activity self-efficacy and social support (friend, family engagement, and encouragement in physical activity) had a significant direct and indirect influence on physical activity with participation in sports teams as the mediator. Participation in sports teams had a direct effect on both physical activity (beta = 0.20, P < .05) and bone health and (beta = 0.13, P < .05). CONCLUSION: The current study identified several direct and indirect pathways that psychosocial factors use to influence physical activity and bone health among adolescent girls. These findings are critical for the development of effective interventions for promoting bone health in this population.

Nutrient intake, physical activity, and CVD risk factors in children: Project HeartBeat!

BACKGROUND: Associations among dietary intake, physical activity, and cardiovascular disease (CVD) risk factors are inconsistent among male and female youth, possibly from lack of adjustment for pubertal status. The purpose of this report is to describe the associations of CVD risk factors among youth, adjusted for sexual maturation. METHODS: Data analyzed in 2007 from a sumsample of 556 children aged 8, 11, and 14 years in Project HeartBeat!, 1991-1993, provide cross-sectional patterns of CVD risk factors by age and gender, adjusting for sexual maturation, within dietary fat and physical activity categories. RESULTS: Girls consuming moderate- to high-fat diets were significantly less physically active than those consuming low-fat diets. Boys and girls consuming high-fat diets had higher saturated fat and cholesterol intakes than children in low-fat categories. Boys had no significant differences in physical activity, blood pressure, waist circumference, or plasma cholesterol levels across fat categories. Girls' plasma cholesterol levels showed no significant differences across fat categories. Dietary intake did not differ across moderate-to-vigorous physical activity (MVPA) categories within gender. There were no differences in BMI by fat or MVPA categories for either gender. Girls' waist circumference differed significantly by fat category, and systolic blood pressure differed significantly across fat and MVPA categories. Boys' fifth-phase diastolic blood pressure was significantly different across MVPA categories. CONCLUSIONS: Girls consuming atherogenic diets were significantly less physically active than those with low fat intakes, whereas boys consuming high-fat diets did not show differences in physical activity measures. With the prevalence of overweight rising among youth, the impact of atherogenic diets and sedentary lifestyles on CVD risk factors is of concern to public health professionals.

Body mass index and risk, age of onset, and survival in patients with pancreatic cancer.

CONTEXT: Obesity has been implicated as a risk factor for pancreatic cancer. OBJECTIVE: To demonstrate the association of excess body weight across an age cohort and the risk, age of onset, and overall survival of patients with pancreatic cancer. DESIGN, SETTING, AND PARTICIPANTS: A case-control study of 841 patients with pancreatic adenocarcinoma and 754 healthy individuals frequency matched by age, race, and sex. The study was conducted at a university cancer center in the United States from 2004 to 2008. Height and body weight histories were collected by personal interview starting at ages 14 to 19 years and over 10-year intervals progressing to the year prior to recruitment in the study. MAIN OUTCOME MEASURES: The associations between patients' body mass index (BMI) and risk of pancreatic cancer, age at onset, and overall survival were examined by unconditional logistic regression, linear regression, and Cox proportional hazard regression models, respectively. RESULTS: Individuals who were overweight (a BMI of 25-29.9) from the ages of 14 to 39 years (highest odds ratio [OR], 1.67; 95% confidence interval [CI], 1.20-2.34) or obese (a BMI > or = 30) from the ages of 20 to 49 years (highest OR, 2.58; 95% CI, 1.70-3.90) had an associated increased risk of pancreatic cancer, independent of diabetes status. The association was stronger in men (adjusted OR, 1.80; 95% CI, 1.45-2.23) by mean BMI from the ages of 14 to 59 years than in women (adjusted OR, 1.32; 95% CI, 1.02-1.70) and in ever smokers (adjusted OR, 1.75; 95% CI, 1.37-2.22) than in never smokers (adjusted OR, 1.46; 95% CI, 1.16-1.84). The population-attributable risk percentage of pancreatic cancer based on the mean BMI from the ages of 14 to 59 years was 10.3% for never smokers and 21.3% for ever smokers. Individuals who were overweight or obese from the ages of 20 to 49 years had an earlier onset of pancreatic cancer by 2 to 6 years (median age of onset was 64 years for patients with normal weight, 61 years for overweight patients [P = .02], and 59 years for obese patients [P < .001]). Compared with those with normal body weight and after adjusting for all clinical factors, individuals who were overweight or obese from the ages of 30 to 79 years or in the year prior to recruitment had reduced overall survival of pancreatic cancer regardless of disease stage and tumor resection status (overweight patients: hazard ratio, 1.26 [95% CI, 0.94-1.69], P = .04; obese patients: hazard ratio, 1.86 [95% CI, 1.35-2.56], P < .001). CONCLUSIONS: Overweight or obesity during early adulthood was associated with a greater risk of pancreatic cancer and a younger age of disease onset. Obesity at an older age was associated with a lower overall survival in patients with pancreatic cancer.

Personality as a predictor of dietary quality in spouses during midlife.

The authors evaluated the NEO Personality Inventory-Revised (NEO-PI-R) as a predictor of dietary quality in 850 married couples, focusing on associations among each participant's personality as a predictor of their own dietary quality and their spouses' dietary quality. Diet was based on a modified version of the US Department of Agriculture Healthy Eating Index. Openness was associated with self-ratings of dietary quality for wives (r = .28) and husbands (r = .27). Wives' levels of the characteristic openness were also related to their spouses' ratings of dietary quality (r = .22). The primary facets of openness accounting for the domain-level findings were O2-aesthetics and O4-actions. The remaining personality domains (neuroticism, extraversion, agreeableness, and conscientiousness) were not associated with self or spousal ratings of dietary quality (rs = .08-.09). Openness was associated with healthy eating habits--findings that may affect disease prevention during, midlife.

Heritage retention and bean intake correlates to dietary fiber intakes in Hispanic mothers--Qué Sabrosa Vida.

OBJECTIVE: To determine the correlation between fruit/vegetable and bean stage of change and heritage retention with fiber intake in Hispanic mothers. DESIGN: Cross-sectional study design used baseline survey data from the Qué Sabrosa Vida nutrition intervention developed by the University of Texas School of Public Health, Human Nutrition Center (Houston, TX). Participants were recruited and data gathered from telephone surveys using random digit dial methodology ensuring proportional representation of demographic subgroups. SUBJECTS: Hispanic mothers (N=293) responded to the baseline survey in El Paso, TX. ANALYSES: Using SPSS version 11.0 (SPSS Inc, Chicago, IL), descriptive statistics, chi2 , correlations, and analyses of variance were used to determine the relationship of variables to fiber intake. Potential confounding variables included were grain stage of change, age, education level, and marital status. RESULTS: Mean fiber intake for mothers was 21.9 g/day and mean age was 35.8 years. Chi2 of fruit/vegetable stage was P =.784. Chi 2 of bean stage, heritage retention score, age, and education to fiber intake were significant, P =.008, P =.004, P =.005, and P =.001, respectively. Bean stage, heritage retention score, age, and education level were significantly correlated. One-way analysis of variance of bean stage, heritage retention score, age, and education level by fiber intake were significant, P =.006, P =.001, P =.004, and P =.002, respectively. CONCLUSIONS: Older Hispanic mothers in the action/maintenance bean stage with strong heritage retention score had greater fiber intakes than younger mothers in pre-action bean stage with weak heritage retention score. As education level increased fiber intake decreased. Encouragement of bean consumption and heritage retention may increase fiber intake in this Hispanic mother population.

Dietary carotenoids and genetic instability modify bladder cancer risk.

In vitro and in vivo studies have shown that carotenoid supplementation is associated with decreased DNA damage, but the role of dietary carotenoids in cancer risk remains controversial because epidemiologic studies have yielded conflicting results. Limited data exist regarding the role of dietary carotenoids in the context of constitutional genetic instability in cancer risk. This case-control study estimated dietary carotenoid intake [microg/(kJ . d)] from a FFQ for 423 patients with bladder cancer and 467 healthy controls, and quantified baseline and benzo[a]pyrene diol epoxide (BPDE)- and gamma-radiation-induced DNA damage in the peripheral blood lymphocytes using the comet assay. Overall, intake of total carotenoids was lower (P < 0.01) for bladder cancer cases (mean +/- SD: 1273.4 +/- 688.9) compared with healthy controls (1501.3 +/- 791.5). When categorized into quartiles, there was an inverse association between increasing levels of carotenoid intake and bladder cancer risk with greatest protective effect [odds ratio (OR) = 0.56, 95% CI, 0.37-0.85] in the quartile with the highest level of intake. Baseline and mutagen-induced DNA damage was significantly higher in cases than in controls; when analyzed jointly with carotenoid intake, high DNA damage and low carotenoid intake were associated with the highest risk. For example, with high baseline DNA damage and low total carotenoid intake, the OR was 3.08 (95% CI, 1.64-5.77); with high baseline DNA damage and high total carotenoid intake, the risk was somewhat attenuated (OR = 2.49, 95% CI, 1.28-4.84). The risk was decreased further for low baseline DNA damage and low total carotenoid intake (OR = 2.18; 95% CI, 1.13-4.22). This study provides evidence of a preventive role for carotenoids in bladder cancer, and these data may have important implications for cancer prevention, especially for individuals susceptible to DNA damage.

Patterns of change in hostility from college to midlife in the UNC Alumni Heart Study predict high-risk status.

OBJECTIVE: To examine hostility measured in college and patterns of change in hostility from college to midlife as predictors of high health-related risk later in midlife. METHODS: Logistic regression models were used to test hostility/risk associations. RESULTS: College hostility predicted being a current smoker, consuming more than two drinks of alcohol, low social support, achieving less than expected in career and in relationships, risk for depression, and appraisal of life changing for the worse in terms of family events at midlife. Change in hostility did not predict smoking and drinking; however, it did significantly predict social isolation, lower income (only for women), obesity, avoidance of exercise, high-fat diet, and negative changes in economic life, work life, and physical health events-all risk indicators measured during the next decade. Appraisals of social support, lowered expectations, risk for depression, and reports of family life changing for the worse were predicted at both time periods. When change in hostility was modeled with college hostility, all risk indicators were significantly predicted by college hostility. CONCLUSIONS: High hostility in college and change in hostility from college to midlife predicts a full range of health risk indicators. When compared with the average population decline in hostility, gains in hostility at midlife are related to increased risk while declines in hostility are related to reduced risk. Higher midlife hostility is associated with increased odds of being in the higher risk group. Future research should focus on developing interventions to reduce hostility.

Healthy Growth: project description and baseline findings.

OBJECTIVES: The purpose of the study was to describe the physical activity, blood pressure, and body fat patterns of sixth-grade, African-American girls (N = 82), who participated in the Healthy Growth Study. The purpose of the primary study questions was to determine which sets of variables best predict blood pressure, physical activity, and body fat. DESIGN AND METHODS: This paper is a cross sectional analysis of the first assessment of a 5-year longitudinal project. Standard procedures were used to assess height, weight, skinfolds, blood pressure, physical activity, predictors of physical activity, maturation, dietary intake, fitness level, and health behaviors. RESULTS: The average age of the subjects was 12.3 years; almost two-thirds of the girls had reached menarche. Fifty-two percent of the 13-year-olds had body mass index (BMI) values greater than the 85th percentile for their age and sex compared to 32% of the 12-year-olds. None of the variables were significantly related to diastolic or systolic blood pressure. Physical activity was significantly and negatively related to total percent of calories from fat and to breast stages and positively related to waist/thigh ratio. Body mass index (BMI) was significantly and positively related to breast stages. CONCLUSIONS: Important developmental differences between 12- and 1 3-year-olds were evident. Body mass index (BMI) was mainly dependent on physical maturity. No relationship was found between BMI and blood pressure. The relationship between physical activity and waist/thigh ratio merits further study. The importance of BMI and physical inactivity as potential indicators of cardiovascular risk in adolescent girls is discussed. Developmentally appropriate and culturally competent interventions are recommended to increase physical activity and healthy eating behaviors among adolescents.