ABSTRACT
SUMMARY: This analysis compares femur neck bone mineral density (FNBMD) and bone determinants in adults between National Health and Nutrition Examination Survey (NHANES) III (1988-1994) and NHANES 2005-2008. FNBMD was higher in NHANES 2005-2008 than in NHANES III, but between-survey differences varied by age, sex, and race/ethnicity. The likelihood that FNBMD has improved appears strongest for older white women. INTRODUCTION: Recent data on hip fracture incidence and femur neck osteoporosis suggest that the skeletal status of older US adults has improved since the 1990s, but the explanation for these changes remains uncertain. METHODS: The present study compares mean FNBMD of adults ages 20 years and older between the third (NHANES III, 1988-1994) and NHANES 2005-2008. Dual-energy X-ray absorptiometry systems (pencil beam in NHANES III, fan beam in NHANES 2005-2008) were used to measure hip BMD, and several bone determinants are compared between surveys to assess their potential role in explaining observed FNBMD differences. RESULTS: FNBMD was higher overall in NHANES 2005-2008 than in NHANES III, but between-survey differences varied by age, sex, and race/ethnicity. Although FNBMD differences in several groups were small enough (≤3%) to be attributable to use of different dual-energy X-ray absorptiometry (DXA) systems in the two surveys, variability in size and direction of the differences does not support artifactual differences in DXA methodology as the sole explanation. Several FNBMD determinants (body size, smoking, selected bone-active medications, self-reported health status, calcium intake, and caffeine consumption) changed in a bone-improving direction in older adults, but FNBMD in older non-Hispanic white women remained significantly higher in 2005-2008 even after adjusting for DXA methodology or for the selected bone determinants. CONCLUSION: The likelihood that FNBMD has improved appears strongest for older white women, but the reason for the improvement in this group remains unclear.
Subject(s)
Bone Density/physiology , Femur Neck/physiology , Absorptiometry, Photon/methods , Adult , Black or African American/statistics & numerical data , Aged , Aging/ethnology , Aging/physiology , Body Mass Index , Female , Forecasting , Health Surveys , Humans , Male , Mexican Americans/statistics & numerical data , Middle Aged , Nutrition Surveys , Sex Characteristics , White People/statistics & numerical data , Young AdultABSTRACT
UNLABELLED: This analysis examines lumbar spine bone mineral density (BMD) of US adults from NHANES 2005-2008 by age, sex, and race/ethnicity. Prevalence of low spine BMD and agreement between the prevalence of low BMD at the spine and femur neck in older adults are also assessed. INTRODUCTION: Lumbar spine BMD data from a representative sample of the US population have not been previously available. METHODS: We used data from the National Health and Nutrition Examination Survey 2005-2008 to examine demographic patterns in lumbar spine BMD among US adults age ≥20 years and the prevalence of low lumbar spine BMD in adults age ≥50 years. Agreement between the prevalence of low BMD at the femur neck and spine in older adults was also assessed. Dual-energy X-ray absorptiometry was used to measure lumbar spine and femur neck BMD. World Health Organization definitions were used to categorize skeletal status as normal, osteopenia, or osteoporosis. RESULTS: Compared to non-Hispanic whites, non-Hispanic blacks had higher and Mexican Americans had lower lumbar spine BMD. Lumbar spine BMD declined with age in women, but not in men. Approximately 4.7 million (10%) older US women and 1 million (3%) older men had lumbar spine osteoporosis in 2005-2008. Roughly one third of them differed in skeletal status at the spine and hip but most were normal at one site and osteopenic at the other. Only 3-10%, depending on sex, had osteoporosis at one skeletal site but not at the other skeletal site. Between 76% and 87% with discordant skeletal status had lumbar spine T-scores within 1 unit of the category threshold. CONCLUSIONS: These findings suggest that measuring either the femur neck or the lumbar spine will correctly classify the majority of individuals who present for care as osteoporotic or not.
Subject(s)
Bone Density/physiology , Femur Neck/physiology , Lumbar Vertebrae/physiology , Osteoporosis/ethnology , Absorptiometry, Photon/methods , Adult , Black or African American/statistics & numerical data , Aged , Aging/physiology , Bone Diseases, Metabolic/diagnosis , Bone Diseases, Metabolic/ethnology , Bone Diseases, Metabolic/physiopathology , Female , Femur Neck/physiopathology , Health Surveys , Humans , Lumbar Vertebrae/physiopathology , Male , Mexican Americans/statistics & numerical data , Middle Aged , Osteoporosis/diagnosis , Osteoporosis/physiopathology , Osteoporosis, Postmenopausal/diagnosis , Osteoporosis, Postmenopausal/ethnology , Osteoporosis, Postmenopausal/physiopathology , Prevalence , Sex Characteristics , United States/epidemiology , White People/statistics & numerical data , Young AdultABSTRACT
SUMMARY: Total body bone density of adults from National Health and Nutrition Examination Survey (NHANES) 1999-2004 differed as expected for some groups (men>women and blacks>whites) but not others (whites>Mexican Americans). Cross-sectional age patterns in bone mineral density (BMD) of older adults differed at skeletal sites that varied by degree of weight-bearing. INTRODUCTION: Total body dual-energy X-ray absorptiometry (DXA) data offer the opportunity to compare bone density of demographic groups across the entire skeleton. METHODS: The present study uses total body DXA data (Hologic QDR 4500A, Hologic, Bedford MA, USA) from the NHANES 1999-2004 to examine BMD of the total body and selected skeletal subregions in a wide age range of adult men and women from three race/ethnic groups. Total body, lumbar spine, pelvis, right leg, and left arm BMD and lean mass from 13,091 adults aged 20 years and older were used. The subregions were chosen to represent sites with different degrees of weight-bearing. RESULTS: Mean BMD varied in expected ways for some demographic characteristics (men>women and non-Hispanic blacks>non-Hispanic whites) but not others (non-Hispanic whites>Mexican Americans). Differences in age patterns in BMD also emerged for some characteristics (sex) but not others (race/ethnicity). Differences in cross-sectional age patterns in BMD and lean mass by degree of weight-bearing in older adults were observed for the pelvis, leg, and arm. CONCLUSION: This information may be useful for generating hypotheses about age, race, and sex differences in fracture risk in the population.
Subject(s)
Arm Bones/physiology , Arm/physiology , Bone Density/physiology , Leg Bones/physiology , Lumbar Vertebrae/physiology , Pelvic Bones/physiology , Absorptiometry, Photon/methods , Adult , Age Factors , Aged , Aged, 80 and over , Arm/diagnostic imaging , Arm Bones/diagnostic imaging , Black People/statistics & numerical data , Female , Humans , Leg Bones/diagnostic imaging , Lumbar Vertebrae/diagnostic imaging , Male , Mexican Americans/statistics & numerical data , Middle Aged , Pelvic Bones/diagnostic imaging , Sex Factors , United States/ethnology , Weight-Bearing , White People/statistics & numerical data , Young AdultABSTRACT
The existence of three different ethnic groups, living within a defined geographic area in Texas and maintaining fairly distinct life-styles, provided an excellent opportunity to compare their dietary behaviors. Information about food consumption was obtained by 24-hour dietary recall from a group of 431 whites, blacks, and Mexican Americans residing in two counties in southeast Texas. Food group and subgroup contributions to 11 nutrients were calculated. The intake patterns of Mexican Americans demonstrated both an adherence to traditional or familiar Mexican food items, such as beans and tortillas, and a preference for foods not previously reported to be commonly consumed by that ethnic group, specifically beef. The current study provides a base of information necessary to implement dietary changes acceptable within the context of a particular culture's world view. Results revealed differences in food intake patterns that would be helpful in designing practical nutrition education programs specifically targeted toward these ethnic groups. For example, inadequate sources of nutrients were identified, as were sources of excess fat.
Subject(s)
Black or African American , Culture , Food , Hispanic or Latino , Nutritional Physiological Phenomena , White People , Adult , Diet , Diet Surveys , Female , Food Preferences , Humans , Male , Mexico/ethnology , Middle Aged , TexasABSTRACT
Dietary intake was assessed among 431 black, white, and Mexican American men and women in southeast Texas using 24-hour dietary recall interviews. These data were collected to provide information on ethnic-specific food sources of selected nutrients; this information was used to construct a food frequency questionnaire for a study of nutrient intake and cancer. Nutrient content of total fat, total vitamin A, and vitamin C was determined for all foods consumed and was aggregated across unique food codes. These aggregated food codes were then ranked according to the contribution of each food to the total population intake of each nutrient. Ethnic differences existed in food sources of nutrients that would not be identified if data from only the analysis of the combined data set were used. Generally, however, the food sources identified from analyses of the combined data set included those foods that were important nutrient sources for each of the ethnic groups as well.
Subject(s)
Diet Surveys , Ethnicity , Food , Nutrition Surveys , Adult , Black or African American , Ascorbic Acid/administration & dosage , Dietary Fats/administration & dosage , Female , Food Analysis , Hispanic or Latino , Humans , Male , Mental Recall , Middle Aged , Texas , Vitamin A/administration & dosage , White PeopleABSTRACT
Ethnic groups in the United States exhibit different patterns of cardiovascular disease and cancer morbidity and mortality. This has, in part, been attributed to differences in dietary intake. However, there is limited comparative information available regarding the dietary patterns of whites, blacks, and Hispanics residing in the same geographic area. Selected nutrient intakes were obtained by an interviewer-administered 24-hr dietary recall from 231 white, 102 black, and 98 Mexican-American persons residing in the same communities in Southeast Texas. Mean caloric intakes were highest for whites, followed by Mexican Americans and blacks. Mexican Americans had carbohydrate intakes that were significantly higher, but total fat intakes that were significantly lower, than those of whites. Blacks of both sexes had the highest cholesterol intakes and black males had the highest saturated fat intakes. Neither was significantly higher than that of whites or Mexican Americans. Overall, the mean vitamin A and C values were highest for blacks and lowest for whites, although the differences were not statistically significant. Mean calcium and phosphorus intakes were significantly higher for whites compared with those for blacks and Mexican Americans. Blacks had significantly lower mean fiber values than whites or Mexican Americans. International ethnic differences in disease distribution have long been used to provide clues to etiologic factors. National ethnic differences in disease distribution related to dietary intake can further elucidate these causative and/or preventive factors. However, to do so will require additional attention to dietary methodology of the type presented here.
Subject(s)
Diet/trends , Ethnicity , Adult , Black or African American , Diet Surveys , Female , Hispanic or Latino , Humans , Interviews as Topic , Male , Middle Aged , Texas , White PeopleABSTRACT
There is a need for standardization of risk factor questionnaires for epidemiological research. This paper describes the development and implementation of a comprehensive cancer risk evaluation program at the University of Texas M.D. Anderson Cancer Center. A detailed self-administered questionnaire is given to all newly registered adult patients. The format of the instrument, coding systems, quality control measures, and data entry mechanisms are discussed. The criteria for the choice of a data base management system are outlined. The identification of high-risk patient subgroups is possible, and it is feasible to link this data base with clinical and biochemical data. There is considerable potential for collaborative research using this risk evaluation program, bringing together basic scientists, clinicians, and epidemiologists.