Racial Discrimination and Low Household Education Predict Higher Body Mass Index in African American Youth.

OBJECTIVE: The purpose of this study was to examine the relationships between environmental factors, including household education, community violence exposure, racial discrimination, and cultural identity, and BMI in African American adolescents. METHODS: A community-based sample of 198 African American youth (120 girls, 78 boys; ages 11-19 years) from Washtenaw County, Michigan, were included in this analysis. Violence exposure was assessed by using the Survey of Children's Exposure to Community Violence; racial discrimination by using the Adolescent Discrimination Distress Index; cultural identity by using the Acculturation, Habits, and Interests Multicultural Scale for Adolescents; and household education by using a seven-category variable. Measured height and body weight were used to calculate BMI. RESULTS: Racial discrimination was positively associated with BMI, whereas household education was inversely associated with BMI in African American adolescents (discrimination: ß = 0.11 ± 0.04, p = 0.01; education: ß = -1.13 ± 0.47, p = 0.02). These relationships were significant when accounting for the confounding effects of stress, activity, diet, and pubertal development. Significant gender interactions were observed with racial discrimination and low household education associated with BMI in girls only (discrimination: ß = 0.16 ± 0.05, p = 0.003; education: ß = -1.12 ± 0.55, p = 0.045). There were no significant relationships between culture, community violence exposure, and BMI (all p's > 0.05). CONCLUSION: Environmental factors, including racial discrimination and low household education, predicted higher BMI in African American adolescents, particularly among girls. Longitudinal studies are needed to better understand the mechanisms by which these environmental factors increase obesity risk in African American youth.

The effect of timing of postmastectomy radiation on implant-based breast reconstruction: a retrospective comparison of complication outcomes.

BACKGROUND: The optimal timing of postmastectomy radiation for women undergoing delayed permanent implant exchange continues to remain controversial. The objective of our study is to compare complication rates when tissue expanders are exchanged for permanent implants pre- vs postradiation. METHODS: A retrospective review of 54 consecutive patients who underwent implant-based breast reconstruction and received postmastectomy radiation was conducted. Complications including infection, implant loss, and capsular contracture (measured in Baker score) were compared between the 2 groups. RESULTS: Of the patients studied, 32 patients had radiation before placement of permanent implants, whereas 22 patients received radiation after implant placement. There was no difference in individual complication rates between the 2 groups. CONCLUSIONS: In our study of 54 patients, the timing of radiation did not affect individual complication rates for patients who underwent implant-based breast reconstruction after immediate tissue expander placement.