Medicine and Health Sciences Commons^™

Effects Of Prenatal Food And Micronutrient Supplementation On Child Growth From Birth To 54 Months Of Age: A Randomized Trial In Bangladesh, Ashraful Islam Khan, Iqbal Kabir, Eva-Charlotte Ekström, Kajsa Åsling-Monemi, Dewan Shamsul Alam, Edward A. Frongillo Jr., Md Yunus, Shams Arifeen, Lars-Åke Persson

Faculty Publications

Background: There is a lack of information on the optimal timing of food supplementation to malnourished pregnant women and possible combined effects of food and multiple micronutrient supplementations (MMS) on their offspring's growth. We evaluated the effects of prenatal food and micronutrient interventions on postnatal child growth. The hypothesis was that prenatal MMS and early invitation to food supplementation would increase physical growth in the offspring during 0-54 months and a combination of these interventions would further improve these outcomes.

Methods: In the large, randomized MINIMat trial (Maternal and Infant Nutrition Interventions in Matlab), Bangladesh, 4436 pregnant women were enrolled …

Long-Term Effects Of Changes In Cardiorespiratory Fitness And Body Mass Index On All-Cause And Cardiovascular Disease Mortality In Men: The Aerobics Center Longitudinal Study, Duck-Chul Lee, Xuemei Sui, Enrique G. Artero, I-Min Lee, Timothy S. Church, Paul A. Mcauley, Fatima C. Stanford, Harold W. Kohl Iii, Steven N. Blair

Faculty Publications

Background - The combined associations of changes in cardiorespiratory fitness and body mass index (BMI) with mortality remain controversial and uncertain.

Methods and Results - We examined the independent and combined associations of changes in fitness and BMI with all-cause and cardiovascular disease (CVD) mortality in 14,345 men (mean age 44 years) with at least 2 medical examinations. Fitness, in metabolic equivalents (METs), was estimated from a maximal treadmill test. BMI was calculated using measured weight and height. Changes in fitness and BMI between the baseline and last examinations over 6.3 years were classified into loss, stable, or gain groups. …

College Student Reactions To Health Warning Labels: Sociodemographic And Psychosocial Factors Related To Perceived Effectiveness Of Different Approaches, Carla J. Berg, James F. Thrasher, J. Lee Westmaas, Taneisha Buchanan, Erika A. Pinsker, Jasjit S. Ahluwalia

Faculty Publications

Objective. To examine factors associated with perceiving different types of pictorial cigarette health warning labels as most effective in motivating smokers to quit or preventing smoking initiation among college students.

Method. We administered an online survey to 24,055 students attending six Southeast colleges in Fall, 2010. We obtained complete data for the current analysis from 2600.

Results. Current smoking prevalence was 23.5%. The largest majority (78.6%) consistently rated gruesome images as most effective, 19.5% rated testimonial images as most effective, and only a small proportion rated either standard (1.6%) or human suffering images (0.3%) as most effective. Subsequent analyses focused …

Relationship Between Vancomycin Trough Concentrations And Nephrotoxicity: A Prospective Multicenter Trial, John A. Bosso, Jean Nappi, Celeste Rudisill, Marlea Wellein, P Brandon Bookstaver, Jenna Swindler, Patrick D. Mauldin

Faculty Publications

Several single-center studies have suggested that higher doses of vancomycin, aimed at producing trough concentrations of >15 mg/liter, are associated with increased risk of nephrotoxicity. We prospectively assessed the relative incidence of nephrotoxicity in relation to trough concentration in patients with documented methicillin-resistant Staphylococcus aureus (MRSA) infections at seven hospitals throughout South Carolina. Adult patients receiving vancomycin for at least 72 h with at least one vancomycin trough concentration determined under steady-state conditions were prospectively studied. The relationship between vancomycin trough concentrations of >15 mg/ml and the occurrence of nephrotoxicity was assessed using univariate and multivariate analyses, controlling for age, …

Associations Between Physical Activity And Submaximal Cardiorespiratory And Pulmonary Responses In Men, John C. Sieverdes, Xuemei Sui, Steven N. Blair

Faculty Publications

Background: Habitual physical activity (PA) is associated with higher cardiorespiratory fitness values, but additional information is needed on the contributions of specific types and amounts of PA. Therefore the main aim of this study was to analyze the heart and lung function of a large cohort of men and compare these outcomes with various modes and volumes of PA.

Methods: We used data from 30,594 men from the Aerobics Center Longitudinal Study who were categorized into sedentary, swimmer, walker, and runner groups using self-report PA data collected during 1970-2005. Additional PA categories using MET-minutes/week were used to group men into …

Colonoscopy Screening Rates Among Patients Of Colonoscopy-Trained African American Primary Care Physicians, Sudha Xirasagar, Thomas G. Hurley, James B. Burch, Ali Mansaray, James R. Hébert

Faculty Publications

Background - When performed competently, colonoscopy screening can reduce colorectal cancer rates, especially in high-risk groups such as African Americans (AAs). Training primary care physicians (PCPs) to perform colonoscopy may improve screening rates among underserved high-risk populations.

Methods - We compared colonoscopy screening rates and computed adjusted odds ratios for colonoscopy-eligible patients of trained AA PCPs (study group) vs. untrained PCPs (comparison group), before and since initiating colonoscopy training. All colonoscopies were performed at a licensed ambulatory surgery center with specialist standby support. Retrospective chart review was conducted on 200 consecutive, established outpatients aged ≥50 years at each of 12 …

The Association Between The Type, Context, And Levels Of Physical Activity Amongst Adolescents, Harriet Koorts, Calum Mattocks, Andy R. Ness, Kevin Deere, Steven N. Blair, Russell R. Pate, Chris Riddoch

Faculty Publications

Background: Little is known about how the type and context of physical activity behaviors varies among adolescents with differing activity levels. The aim of this study was to assess differences in the type and context of physical activity behaviors in adolescents by level of objectively measured physical activity. Methods: Cross-sectional analysis of 2728 adolescents (1299 males, 1429 females) participating in the Avon Longitudinal Study of Parents and Children (ALSPAC). The mean (SD) age was 13.8 (+0.1) years. Physical activity was measured using an Actigraph over 7 days. Adolescents were categorized into tertiles of activity (less, moderately, highly active) using counts/min …

Social And Clinical Predictors Of Prostate Cancer Treatment Decisions Among Men In South Carolina, Sara E. Wagner, Bettina F. Drake, Keith Elder, James R. Hébert

Faculty Publications

OBJECTIVE:

To assess social and clinical influences of prostate cancer treatment decisions among white and black men in the Midlands of South Carolina.

METHODS:

We linked data collected on treatment decision making in men diagnosed with prostate cancer from 1996 through 2002 with clinical and sociodemographic factors collected routinely by the South Carolina Central Cancer Registry (SCCCR). Unconditional logistic regression was used to assess social and clinical influences on treatment decision.

RESULTS:

A total of 435 men were evaluated. Men of both races who chose surgery (versus radiation) were more likely to be influenced by their physician and by family/friends. …

Mechanisms Of The Contextual Interference Effect In Individuals Poststroke, Nicolas Schweughofer, Jeong-Yoon Lee, Hui-Ting Goh, Youggeun Choi, Sung Shin Kim, Jill Campbell Stewart Pt,Phd, Rebecca Lewthwaite, Carolee J. Winstein

Faculty Publications

Although intermixing different motor learning tasks via random schedules enhances long-term retention compared with “blocked” schedules, the mechanism underlying this contextual interference effect has been unclear. Furthermore, previous studies have reported inconclusive results in individuals poststroke. We instructed participants to learn to produce three grip force patterns in either random or blocked schedules and measured the contextual interference effect by long-term forgetting: the change in performance between immediate and 24-h posttests. Nondisabled participants exhibited the contextual interference effect: no forgetting in the random condition but forgetting in the blocked condition. Participants at least 3 mo poststroke exhibited no forgetting in …

A Randomized Trial Of A Diet And Exercise Intervention For Overweight And Obese Women From Economically Disadvantaged Neighborhoods: Sisters Taking Action For Real Success (Stars), Sarah Wilcox, Patricia A. Sharpe, Deborah Parra-Medina, Michelle L. Granner, Brent E. Hutto

Faculty Publications

Background - Lower socioeconomic status at both the individual and neighborhood level is associated with increased health risks. Weight loss can reduce this risk, but few high quality weight loss studies target this population.

Objectives - STARS tests a culturally-appropriate, group-based behavioral and social support intervention on body weight and waist circumference in women from financially disadvantaged neighborhoods.

Design - A stratified (by BMI) randomized trial. Randomization to group was generated by a random numbers table with allocation concealment by opaque envelopes.

Methods - Participants 25-50 years who had a BMI ≥ 25 kg/m² and a waist circumference ≥ …

Adipose Tissue Endocannabinoid System Gene Expression: Depot Differences And Effects Of Diet And Exercise, Tongjian You, Beth L. Disanzo, Xuewen Wang, Rongze Yang, Dawei Gong

Faculty Publications

Background: Alterations of endocannabinoid system in adipose tissue play an important role in lipid regulation and metabolic dysfunction associated with obesity. The purpose of this study was to determine whether gene expression levels of cannabinoid type 1 receptor (CB1) and fatty acid amide hydrolase (FAAH) are different in subcutaneous abdominal and gluteal adipose tissue, and whether hypocaloric diet and aerobic exercise influence subcutaneous adipose tissue CB1 and FAAH gene expression in obese women.

Methods: Thirty overweight or obese, middle-aged women (BMI = 34.3 ± 0.8 kg/m², age = 59 ± 1 years) underwent one of three 20-week weight …

Prescribing Exercise In Primary Care: Ten Practical Steps On How To Do It, Karim M. Khan, Richard Weller, Steven N. Blair

Faculty Publications

No abstract provided.

Combined Impact Of Lifestyle Factors On Cancer Mortality In Men, Chong-Do Lee, Xuemei Sui, Steven P. Hooker, James R. Hébert, Steven N. Blair

Faculty Publications

PURPOSE - The impact of lifestyle factors on cancer mortality in the U.S. population has not been thoroughly explored. We examined the combined effects of cardiorespiratory fitness, never smoking, and normal waist girth on total cancer mortality in men.

METHODS - We followed a total of 24,731 men ages 20-82 years who participated in the Aerobics Center Longitudinal Study. A low-risk profile was defined as never smoking, moderate or high fitness, and normal waist girth, and they were further categorized as having 0, 1, 2, or 3 combined low-risk factors.

RESULTS - During an average of 14.5 years of follow-up, …

Effect Of School Racial Composition On Trajectories Of Depressive Symptoms From Adolescence Through Early Adulthood, Katrina M. Walsemann, Bethany A. Bell, Bridget J. Goosby

Faculty Publications

Introduction: We investigate the effect of high school racial composition, measured as percent of non-Hispanic White students, on trajectories of depressive symptoms from adolescence to early adulthood. We also explore whether the effect of school racial composition varies by respondent race/ethnicity and if adult socio-economic status mediates this relationship.

Methods: We analyzed four waves of data from the National Longitudinal Study of Adolescent Health using 3-level linear growth models. We restricted our sample to respondents enrolled in grades 9-12 in 1994/5 who were interviewed at a minimum in Waves I and IV. This resulted in 10,350 respondents enrolled in 80 …

Food Insecurity And Sexual Risk In An Hiv Endemic Community In Uganda, Cari L. Miller, David R. Bangsberg, David M. Tuller, Jude Senkungu, Annet Kawuma, Edward A. Frongillo Jr., Sheri D. Weiser

Faculty Publications

Food insecurity has been linked to high-risk sexual behavior in sub-Saharan Africa, but there are limited data on these links among people living with HIV/AIDS, and on the mechanisms for how food insecurity predisposes individuals to risky sexual practices. We undertook a series of in-depth open-ended interviews with 41 individuals living with HIV/AIDS to understand the impact of food insecurity on sexual-risk behaviors. Participants were recruited from the Immune Suppression Clinic at the Mbarara University of Science and Technology in Mbarara, Uganda. Interviews were recorded, transcribed verbatim, translated, and coded following the strategy of grounded theory. Four major themes emerged …

Stimulant Reduction Intervention Using Dosed Exercise (Stride) - Ctn 0037: Study Protocol For A Randomized Controlled Trial, Madhukar H. Trivedi, Tracy L. Greer, Bruce D. Grannemann, Timothy S. Church, Eugene Somoza, Steven N. Blair, Jose Szapocznik, Mark Stoutenberg, Chad Rethorst, Diane Warden, Kolette M. Ring, Robrina Walker, David W. Morris, Andrzej S. Kosinski, Tiffany Kyle, Bess H. Marcus, Becca Crowell, Neal Oden, Edward Nunes

Faculty Publications

Background: There is a need for novel approaches to the treatment of stimulant abuse and dependence. Clinical data examining the use of exercise as a treatment for the abuse of nicotine, alcohol, and other substances suggest that exercise may be a beneficial treatment for stimulant abuse, with direct effects on decreased use and craving. In addition, exercise has the potential to improve other health domains that may be adversely affected by stimulant use or its treatment, such as sleep disturbance, cognitive function, mood, weight gain, quality of life, and anhedonia, since it has been shown to improve many of these …

Equating Accelerometer Estimates Of Moderate-To-Vigorous Physical Activity: In Search Of The Rosetta Stone, Daniel B. Bornstein, Michael W. Beets, Wonwoo Byun, Gregory J. Welk, Matteo Bottai, Marsha Dowda, Russell R. Pate

Faculty Publications

Purpose - No universally accepted ActiGraph accelerometer cutpoints for quantifying moderate-to-vigorous physical activity (MVPA) exist. Estimates of MVPA from one set of cutpoints cannot be directly compared to MVPA estimates using different cutpoints, even when the same outcome units are reported (MVPA min•d^-1). The purpose of this study was to illustrate the utility of an equating system that translates reported MVPA estimates from one set of cutpoints into another, to better inform public health policy.

Design - Secondary data analysis.

Methods - ActiGraph data from a large preschool project (N=419, 3-6yr-olds, CHAMPS) was used to conduct the analyses. …

Associations Of American Indian Children's Screen-Time Behavior With Parental Television Behavior, Parental Perceptions Of Children's Screen Time, And Media-Related Resources In The Home, Daheia J. Barr-Anderson, Jayne A. Fulkerson, Mary Smyth, John H. Himes, Peter J. Hannan, Bonnie Holy Rock, Mary Story

Faculty Publications

Introduction: American Indian children have high rates of overweight and obesity, which may be partially attributable to screen-time behavior. Young children's screen-time behavior is strongly influenced by their environment and their parents' behavior. We explored whether parental television watching time, parental perceptions of children's screen time, and media-related resources in the home are related to scree time (ie, television, DVD/video, video game, and computer use) among Oglala Lakota youth residing on or near the Pine Ridge Reservation in South Dakota.

Methods: We collected baseline data from 431 child and parent/caregiver pairs who participated in Bright Start, a group-randomized, controlled, school-based …

The Association Between The Food Environment And Weight Status Among Eastern North Carolina Youth, Stephanie B. Jilcott, Scott Wade, Jared T. Mcguirt, Qiang Wu, Suzanne Lazorick, Justin B. Moore

Faculty Publications

Objective: To examine associations between various measures of the food environment and BMI percentile among youth.

Design: Cross-sectional, observational.

Setting: Pitt County, eastern North Carolina.

Subjects:We extracted the electronic medical records for youth receiving well child check-ups from January 2007 to June 2008. We obtained addresses for food venues from two secondary sources and ground-truthing. A geographic information systems database was constructed by geocoding home addresses of 744 youth and food venues. We quantified participants' accessibility to food venues by calculating 'coverage', number of food venues in buffers of 0●25, 0●5, 1 and 5 miles (0●4, 0●8, 1●6 and …

Building Capacity In Physical Activity And Public Health, Russell R. Pate, Jennifer L. Gay, David R. Brown, Michael Pratt

Faculty Publications

No abstract provided.

Validity Of Estimating Minute-By-Minute Energy Expenditure Of Continuous Walking Bouts By Accelerometry, Erin E. Kuffel, Scott E. Crouter, Jere D. Haas, Edward A. Frongillo Jr., David R. Bassett Jr

Faculty Publications

Background: Objective measurement of physical activity remains an important challenge. For wearable monitors such as accelerometer-based physical activity monitors, more accurate methods are needed to convert activity counts into energy expenditure (EE).

Purpose: The purpose of this study was to examine the accuracy of the refined Crouter 2-Regression Model (C2RM) for estimating EE during the transition from rest to walking and walking to rest. A secondary purpose was to determine the extent of overestimation in minute-by-minute EE between the refined C2RM and the 2006 C2RM.

Methods: Thirty volunteers (age, 28 ± 7.7 yrs) performed 15 minutes of seated rest, 8 …

Pathways To Sexual Risk Taking Among Female Adolescent Detainees, Vera Lopez, Albert M. Kopak, Alyssa G. Robillard, Mary Rogers Gillmore, Rhonda Conerly Holliday, Ronald L. Braithwaite

Faculty Publications

Sexual risk taking among female delinquents represents a significant public health problem. Research is needed to understand the pathways leading to sexual risk taking among this population. This study sought to address this issue by identifying and testing two pathways from child maltreatment to non-condom use among 329 White and 484 African American female adolescent detainees: a relational pathway and a substance use coping pathway. The relational pathway indicated that child maltreatment would be related to non-condom use via depressive self-concept and condom use self-efficacy. The substance use coping pathway suggested that depressive self-concept and alcohol-based expectancies for sexual enhancement …

The Contribution Of Dance To Daily Physical Activity Among Adolescent Girls, Jennifer R. O'Neill, Russell R. Pate, Steven P. Hooker

Faculty Publications

Background: Structured physical activity (PA) programs are well positioned to promote PA among youth, however, little is known about these programs, particularly dance classes. The aims of this study were to: 1) describe PA levels of girls enrolled in dance classes, 2) determine the contribution of dance classes to total moderate-to-vigorous physical activity (MVPA), and 3) compare PA between days with a dance class (program days) and days without a dance class (non-program days).

Methods: Participants were 149 girls (11-18 years) enrolled in dance classes in 11 dance studios. Overall PA was assessed with accelerometry for 8 consecutive days, and …

How Many Steps/Day Are Enough? For Children And Adolescents, Catrine Tudor-Locke, Cora L. Craig, Michael W. Beets, Sarahjane Belton, Greet M. Cardon, Scott Duncan, Yoshiro Hatano, David R. Lubans, Timothy S. Olds, Anders Raustorp, David A. Rowe, John C. Spence, Shigeho Tanaka, Steven N. Blair

Faculty Publications

Worldwide, public health physical activity guidelines include special emphasis on populations of children (typically 6-11 years) and adolescents (typically 12-19 years). Existing guidelines are commonly expressed in terms of frequency, time, and intensity of behaviour. However, the simple step output from both accelerometers and pedometers is gaining increased credibility in research and practice as a reasonable approximation of daily ambulatory physical activity volume. Therefore, the purpose of this article is to review existing child and adolescent objectively monitored step-defined physical activity literature to provide researchers, practitioners, and lay people who use accelerometers and pedometers with evidence-based translations of these public …

How Many Steps/Day Are Enough? For Adults, Catrine Tudor-Locke, Cora L. Craig, Wendy J. Brown, Stacy A. Clemes, Katrien Decocker, Billie Giles-Corti, Yoshiro Hatano, Shigeru Inoue, Sandra M. Matsudo, Nanette Mutrie, Jean-Michel Oppert, David A. Rowe, Michael D. Schmidt, Grant M. Schofield, John C. Spence, Pedro J. Teixeira, Mark A. Tully, Steven N. Blair

Faculty Publications

Physical activity guidelines from around the world are typically expressed in terms of frequency, duration, and intensity parameters. Objective monitoring using pedometers and accelerometers offers a new opportunity to measure and communicate physical activity in terms of steps/day. Various step-based versions and translations of physical activity guidelines are emerging, reflecting public interest in such guidance. However, there appears to be a wide discrepancy in the exact values that are being communicated. It makes sense that step-based recommendations should be harmonious with existing evidence-based public health guidelines that recognized that "some physical activity is better than none" while maintaining a focus …

How Many Steps/Day Are Enough? For Older Adults And Special Populations, Catrine Tudor-Locke, Cora L. Craig, Yukitoshi Aoyagi, Rhonda C. Bell, Karen A. Croteau, Ilse De Bourdeaudhuij, Ben Ewald, Andrew W. Gardner, Yoshiro Hatano, Lesley D. Lutes, Sandra M. Matsudo, Farah A. Ramirez-Marrero, Laura Q. Rogers, Davod A. Rowe, Michael D. Schmidt, Mark A. Tully, Steven N. Blair

Faculty Publications

Older adults and special populations (living with disability and/or chronic illness that may limit mobility and/or physical endurance) can benefit from practicing a more physically active lifestyle, typically by increasing ambulatory activity. Step counting devices (accelerometers and pedometers) offer an opportunity to monitor daily ambulatory activity; however, an appropriate translation of public health guidelines in terms of steps/day is unknown. Therefore this review was conducted to translate public health recommendations in terms of steps/day. Normative data indicates that 1) healthy older adults average 2,000-9,000 steps/day, and 2) special populations average 1,200-8,800 steps/day. Pedometer-based interventions in older adults and special populations …

Results Of The "Active By Choice Today" (Act) Randomized Trial For Increasing Physical Activity In Low-Income And Minority Adolescents, Dawn K. Wilson, M. Lee Van Horn, Heather Kitzman-Ulrich, Ruth P. Saunders, Russell R. Pate, Hannah G. Lawman, Brent Hutto, Sarah Griffin, Nicole Zarrett, Cheryl L. Addy, Leslie Mansard, Gary Mixon, Porschia V. Brown

Faculty Publications

Objective - This study reports the results of the "Active by Choice Today" (ACT) trial for increasing moderate-to-vigorous physical activity (MVPA) in low-income and minority adolescents.

Design - The ACT program was a randomized controlled school-based trial testing the efficacy of a motivational plus behavioral skills intervention on increasing MVPA in underserved adolescents. Twenty-four middle schools were matched on school size, percentage minorities, percentage free or reduced lunch, and urban or rural setting before randomization. A total of 1,563 6th grade students (mean age, 11.3 years, 73% African American, 71% free or reduced lunch, 55% female) participated in either a …

Serum Igf-1 Concentrations Change With Soy And Seaweed Supplements In Healthy Postmenopausal American Women, Jane Teas, Mohammad R. Irhimeh, Susan Druker, Thomas G. Hurley, James R. Hébert, Todd M. Savarese, Mindy S. Kurzer

Faculty Publications

Insulin-like growth factor 1 (IGF-1) is an anabolic hormone important for growth and development. However, high-circulating serum concentrations in adults are associated with increased risk of postmenopausal breast cancer. Nutritional status and specific foods influence serum IGF-1 concentrations. Breast cancer incidence is typically low in Asian countries where soy is commonly consumed. Paradoxically, soy supplement trials in American women have reported significant increases in IGF-1. Seaweed also is consumed regularly in Asian countries where breast cancer risk is low. We investigated the possibility that seaweed could modify soy-associated increases in IGF-1 in American women. Thirty healthy postmenopausal women (mean age …

Adherence To Accelerometer Protocols Among Women From Economically Disadvantaged Neighborhoods, Patricia A. Sharpe, Sarah Wilcox, Laura J. Rooney, Donna Strong, Rosie Hopkins-Campbell, Jean Butel, Barbara E. Ainsworth, Deborah Parra-Medina

Faculty Publications

Background: Objective measurement of physical activity with accelerometers is a challenging task in community-based intervention research. Challenges include distribution of and orientation to monitors, nonwear, incorrect placement, and loss of equipment. Data collection among participants from disadvantaged populations may be further hindered by factors such as transportation challenges, competing responsibilities, and cultural considerations. Methods: Research staff distributed accelerometers and provided an orientation that was tailored to the population group. General adherence strategies such as follow-up calls, daily diaries, verbal and written instructions, and incentives were accompanied by population-specific strategies such as assisting with transportation, reducing obstacles to wearing the accelerometer, …

Media Attention On African Americans With Human Immunodeficiency Virus, Charles S. Beverley Jr., Edith M. Williams, Saundra H. Glover

Faculty Publications

Human immunodeficiency virus (HIV) is a disease that has captured the attention of the media in various ways and to varying degrees. One of the ongoing debates and areas of research in HIV that provide many opportunities for discovery is the disproportionate number of African Americans infected with HIV compared to the amount of attention they receive in the media. This manuscript addresses the question that has preoccupied the minds of many people: Why have African Americans infected with HIV received so little media attention? Analysis of this question suggests that there are many reasons for this lack of media …