Chronic disease and related conditions at emergency treatment facilities in the New Orleans area after Hurricane Katrina.

BACKGROUND: Disaster preparations usually focus on preventing injury and infectious disease. However, people with chronic disease and related conditions (CDRCs), including obstetric/gynecological conditions, may be vulnerable to disruptions caused by disasters. METHODS: We used surveillance data collected after Hurricane Katrina to characterize the burden of visits for CDRCs at emergency treatment facilities (eg, hospitals, disaster medical assistance teams, military aid stations). In 6 parishes in and around New Orleans, health care providers at 29 emergency treatment facilities completed a standardized questionnaire for injury and illness surveillance from September 8 through October 22, 2005. RESULTS: Of 21,673 health care visits, 58.0% were for illness (24.3% CDRCs, 75.7% non-CDRCs), 29.1% for injury, 7.2% for medication refills, and 5.7% for routine or follow-up care. The proportion of visits for CDRCs increased with age. Among men presenting with CDRCs, the most common illnesses were cardiovascular disease (36.8%), chronic lower-respiratory disease (12.3%), and diabetes/glucose abnormalities (7.7%). Among women presenting with CDRCs, the most common were cardiovascular disease (29.2%), obstetric/gynecological conditions (18.2%), and chronic lower-respiratory disease (12.0%). Subsequent hospitalization occurred among 28.7% of people presenting with CDRCs versus 10.9% of those with non-CDRCs and 3.8% of those with injury. CONCLUSIONS: Our data illustrate the importance of including CDRCs as a part of emergency response planning.

Weight regain in U.S. adults who experienced substantial weight loss, 1999-2002.

BACKGROUND: Relatively few studies have focused on who is at risk for weight regain after weight loss and how to prevent it. The objectives of this study were to determine the prevalence and predictors of weight regain in U.S. adults who had experienced substantial weight loss. METHODS: Data were analyzed from the 1999-2002 National Health and Nutrition Examination Survey (NHANES). This study examined U.S. adults aged 20-84 years who were overweight or obese at their maximum weight (body mass index >/=25) and had experienced substantial weight loss (weighed 10% less than their maximum weight 1 year before they were surveyed) (n=1310). RESULTS: Compared to their weight 1 year ago, 7.6% had continued to lose weight (>5%), 58.9% had maintained their weight (within 5%), and 33.5% had regained weight (>5%). Factors associated with weight regain (vs weight maintenance or loss) included Mexican American ethnicity (versus non-Hispanic white) (odds ratio [OR]=2.0; 95% confidence interval [CI]=1.3-3.1), losing a greater percentage of maximum weight (>/=20% vs 10% to <15%) (OR=2.8; 95% CI=2.0-4.1), having fewer years since reaching maximum weight (2-5 years vs >10 years) (OR=2.1; 95% CI=1.2-3.7), reporting greater daily screen time (>/=4 hours vs 0-1 hour) (OR=2.0; 95% CI=1.3-3.2), and attempting to control weight (OR=1.8; 95% CI=1.1-3.0). Finally, weight regain was higher in those who were sedentary (OR=1.8; 95% CI=1.0-3.0) or not meeting public health recommendations for physical activity (OR=2.0; 95% CI=1.2-3.5). CONCLUSIONS: How to achieve the skills necessary for long-term maintenance of weight loss in the context of an obesogenic environment remains a challenge.

Weight-control practices among U.S. adults, 2001-2002.

BACKGROUND: Approximately $50 billion a year is spent by Americans on weight-loss products and services. Despite the high cost, few national studies have described specific weight-loss and weight-maintenance practices among U.S. adults. This analysis describes the use of specific practices by U.S. adults who tried to lose weight or tried only not to gain weight during the previous 12 months. METHODS: Data were analyzed from the 2001-2002 National Health and Nutrition Examination Survey (NHANES) conducted on a nationally representative sample of the U.S. population. This study focused on adults aged 20 years or older who were both interviewed and examined (n =5027). RESULTS: Fifty-one percent of U.S. adults tried to control their weight in the previous 12 months, including those who tried to lose weight (34% of men, 48% of women) and those who tried only not to gain weight (11% vs 10%, respectively). Among 2051 adults who tried to control their weight, the top four practices were the same: ate less food (65% among those who tried to lose weight, 52% among those who tried only not to gain weight); exercised (61% vs 46%, respectively); ate less fat (46% vs 42%); and switched to foods with lower calories (37% vs 36%). Less than one fourth combined caloric restriction with the higher levels of physical activity (300 or more minutes per week) recommended in the 2005 dietary guidelines by the U.S. Department of Health and Human Services and U.S. Department of Agriculture. CONCLUSIONS: Although weight control is a common concern, most people who try do not use recommended combinations of caloric restriction and adequate levels of physical activity.