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Fat has been used in many studies on magnetic resonance (MR) imaging as the tissue of reference in comparing regional signal intensities from various tissues using different imaging parameters. This is a retrospective study of 78 patients selected to assess the influence of different factors such as age, gender, obesity, and weight loss on the T1 and T2 relaxation parameters of fat in different areas of the body. The T1 values of fat were not influenced by the factors studied or by anatomic location of the fat. The T2 values were significantly lower in patients older than 65 years and in patients with significant weight loss caused by carcinoma or chronic disease. Nevertheless, these variations were small, with considerable overlap of the mean and rather large standard deviation values. In conclusion, fat is a valuable reference tissue for MR studies and is relatively uninfluenced by the factors studied.
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PMID:MR imaging of fat. 394 Mar 97

This article analyzes the current Cuban health education program which is aimed at the reduction of chronic disease (cardiovascular disease and cancer) and compares it to disease prevention policy in the US. US health promotion policy stresses the belief that individuals shoulder responsibility for their own health by change of habits (diet, smoking, drinking) and it appears that Cuba supports the same policy. Early in 1981 the campaign against sedentarianism, obesity and smoking began under the Ministry of Public Health. Per capita cigarette consumption in Cuba is 3rd highest in the world, and anti-smoking campaigns are directed at improving public awareness; similar educational campaigns are used in attempting to increase occupational safety and health and decrease traffic accidents. Finally, the article discusses the relationship of individual and social responsibility regarding disease prevention and how this relates to socialist countries. Cricits of health education policy in the US fault it for ignoring the unequal ability of Americans to adopt more healthy behavior and for underestimating the social, economic, and political causes of disease. Many critics hypothesize that health education in a less bourgeois society would be more equitable and less individualistic. While the Cuban program appears to be every bit as individualistic as the North American Program, theirs may not be comparable to the US program because Cubans are less likely than Americans to reify the state. At least among supporters of the revolution, Cubans do not automatically make a conceptual distinction between the individual and the society. Discussions about responsibility for disease prevention take on new meaning in this light.
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PMID:Health education in Cuba: a preface. 395 13

A cohort of over 5000 men of Japanese ancestry, aged 46-69 and free of chronic disease at entry examination were studied for factors associated with remaining free of major chronic diseases during a 12 yr followup period. Over 1600 disease-free men were compared with 3400 individuals who developed coronary heart disease (CHD), stroke, cancer or a variety of other conditions. From more than 30 variables examined in multivariate analyses, blood pressure, obesity, cigarette smoking, alcohol consumption, serum glucose, uric acid and triglyceride, were inversely associated with staying healthy while forced vital capacity and years spent in Japan were directly associated with health. Of these nine variables, blood pressure was the strongest discriminator between healthy status and all categories of disease, while cigarette smoking and alcohol consumption were the next most important factors. This study suggests that the use of individuals who remain free of disease as a "standard" for health can facilitate the evaluation of risk factors for both total illness and a broad range of specific chronic diseases in a single population.
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PMID:Biological and social predictors of health in an aging cohort. 399 53

The assessment of obesity by anthropometry or body composition in studies of chronic disease epidemiology is not always feasible. In this paper we test the accuracy and validity of two alternative methods: body silhouettes and reported weights and heights in a sample of Mexican American adults (n = 166) participating in the Diabetes Alert Study. The body silhouettes were those developed by A. Stunkard and colleagues. We compared the silhouettes obtained independently by three different observers, one with minimal experience in assessing obesity, the other two skilled in anthropometry. Correlations between the expert observers were 0.89-0.90. Those between the expert and less skilled observers were lower (0.64 to 0.85) and were better for female than male subjects. Results suggest an acceptable level of precision for persons with some training in obesity assessment. Body silhouettes compared well with the body mass index (r = 0.85 to 0.92 for the expert vs r = 0.65 to 0.84 for the less skilled observer), being higher for female subjects. The body silhouettes are thus useful for categorizing normal, overweight and obese individuals. The poorer performance on male subjects may relate to the female-like obesity depicted in both sexes in this particular set of silhouettes. A substantial proportion of subjects could not recall their weight or height. For those who could recall their measurements, accuracy was good but measurement error higher than that for measured variables. These problems of recall in this sample from rural Texas point to the potential usefulness of the body silhouette method when actual height and weight measurements cannot be made.
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PMID:Alternative measurements of obesity: accuracy of body silhouettes and reported weights and heights in a Mexican American sample. 405 26

Reducing health risk factors in childhood is a critical component of well-child pediatric care. Risks to eventual adult health status must be considered with equal importance as risks to the child's immediate health. Heart disease, cancer and stroke risk begins in childhood, when risk factors, especially obesity and positive family history, may easily be identified. Obese children (and those at high risk of obesity based on parental obesity) constitute a special group of children for whom chronic disease risk factor evaluation is of particular importance. This is based on observations that cardiovascular risk factors tend to aggregate among obese children (similar to adults), particularly with respect to elevated blood pressure, elevated serum cholesterol and triglycerides, and decreased cardiovascular response to exercise. In addition, many obese adolescents adopt cigarette smoking with the notion that it may aid weight reduction, thereby compounding their risk status. Risk reduction in childhood can be successfully approached both through school-based programs incorporating risk evaluation with health education curricula, or by relatively simple office- or clinic-based procedures designed to evaluate and track risk status over time. Such practices, though not currently prevalent, are increasingly being incorporated into routine pediatric care, especially following the American Association of Pediatrics Nutrition Committee's recommendations with respect to children with positive family histories for early coronary events.
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PMID:Nutrition intervention and health risk reduction in childhood: creating healthy adults. 657 Nov 57

The Los Angeles "Know Your Body" (KYB) program is an organized health education activity for children designed to encourage positive health behavior and discourage or interrupt behavioral patterns that are linked to illness, injury, disability, or death. Components of KYB include a 20-week curriculum; a survey of health knowledge, attitudes, and behaviors; in-service training for elementary school teachers; and a clinical screening that provides feedback to students on selected indices. As part of a KYB field demonstration in Los Angeles conducted by the UCLA Division of Cancer Control, Jonsson Comprehensive Cancer Center, 1,503 Los Angeles and Santa Monica-Malibu children ages 9-11 in grades 4 and 5 underwent baseline health screening evaluations in March 1981, measuring height, weight, triceps skinfold thickness, serum cholesterol, pulse rate recovery following exercise, and blood pressure. The population mean for serum cholesterol was 182.6 mg/dl, with no significant racial/ethnic, sex, or age differences. Significant racial/ethnic differences were found in obesity, with Hispanics having the highest prevalence, Asians the lowest. Black students scored significantly higher in pulse rate recovery following exercise, suggesting better relative cardiovascular fitness, and Asians scored lowest. Blacks were more likely to exceed the 95th percentile in diastolic and systolic blood pressure. Overall, 48% of the children had one or more chronic disease risk factors.
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PMID:Baseline chronic disease risk factors in a racially heterogeneous elementary school population: The "Know Your Body" program, Los Angeles. 662 39

Two studies are presented which describe the development of a problem-oriented psychosocial screening instrument for use in health care settings. Reliability and validity data are presented on the Chronic Illness Problem Inventory (CIPI) which demonstrate its ability to document accurately patient's specific problems in areas of physical limitations, psychosocial functioning, health care behaviors and marital adjustment. A study is also presented which compares the problems of patients with three distinct chronic illnesses: pain, obesity, and respiratory ailments. Results indicate a significantly greater severity of problems for pain patients and especially patients with multiple pain complaints. Problem areas common to all three illness groups are discussed in the context of providing better comprehensive treatment for chronically ill patients.
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PMID:The chronic illness problem inventory: problem-oriented psychosocial assessment of patients with chronic illness. 673 96

In a prospective study comparing Doppler ultrasound and contrast venography in 112 patients, we identified all false-negative and false-positive results obtained by Doppler and are reporting those errors that we believe are commonly occurring pitfalls of this technique. There were 21 false-negative and nine false-positive examinations. False-negative examinations were caused by the following factors: thrombi isolated to the veins of the calf (13 patients); nonocclusive clot involving or proximal to the popliteal vein (3); incorrect interpretation of examinations done by inexperienced personnel (2); acute thrombosis masked by changes of severe chronic disease (1); misinterpretation of increased saphenous flow in the presence of an occluded superficial femoral vein (1); and bilateral clot with one leg having significantly more evidence of venous obstruction than the other (1). Factors in the nine false-positive examinations were chronic disease interpreted as acute thrombosis (3), interpretation of weak signals in the calf as thrombosis (3), weak signals due to obesity (2), and excess Doppler probe pressure distorting venous flow (1). We conclude that results of the Doppler examination should be questioned when there is a suspicion of thrombus in the deep veins of the calf, the question of a nonocclusive thrombus, or the presence of chronic venous changes related to previous deep venous thrombosis.
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PMID:Pitfalls of the Doppler examination for venous thrombosis. 685 72

During adolescence and the third decade of life a redistribution of bodily fat is occurring away from the extremities towards the trunk. During this time the process is occurring in both sexes although more rapidly in males than females, hence it is a masculinizing process. The process is seen in human populations from various ethnic and cultural backgrounds. Masculinizing characteristics like this one are predictors of chronic diseases such as diabetes and atherosclerosis late in life. The period from adolescence through young adulthood may be a sensitive time for the development of characteristics that predispose one to the chronic diseases of aging. Socioanthropological investigations of chronic disease related to human obesity may benefit by focusing on this developmental period.
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PMID:The changes with age of the anatomical distribution of fat. 698 Apr 68

Overweight is a common problem in the United States, especially among minority women and persons of lower socioeconomic status and lower educational attainment. Moreover, the prevalence of reported inactivity may be highest in these same population subgroups. Both overweight and sedentary behavior are important risk factors for chronic disease morbidity and mortality; however, there is encouraging evidence that moderate to higher levels of physical activity may provide protection from certain chronic diseases, even among persons with established risk factors. Several methodological issues preclude the ability to determine accurately the impact of physical activity on body weight and adiposity. These issues include (a) a low prevalence of higher-intensity physical activity in the general population, (b) measurement error with regard to self-reported activity, especially that of lower-intensity, (c) inappropriate time frame of the physical activity assessment, (d) effect modification by age and gender, and (e) failure to adjust for important statistical confounders. Despite these methodological issues, the inverse association between physical activity and weight has been reported in several cross-sectional epidemiologic studies, which consistently report lower body weight, or more favorable distribution of body fat, with higher categorical levels of self-reported physical activity. Directionality of the physical activity and weight relation cannot be determined from these studies, however, and the few longitudinal epidemiologic studies that have assessed the influence of physical activity on the risk of weight gain report inconclusive results. This is possibly because a one-time assessment of physical activity if not adequate in describing the contribution of habitual physical activity on long-term weight maintenance. Therefore, longitudinal population-based studies with multiple assessments of physical activity over long follow-up periods are necessary to determine this relationship. In any case, the evidence suggests that persons concerned with overweight, or especially the prevention of overweight and obesity, should increase their physical activity. Sociodemographic characteristics such as age, gender, educational level, and weight are associated with physical activity patterns and choices. Therefore, these characteristics should be considered by professionals when implementing physical activity interventions for weight control. Walking is accessible to all segments of the U.S. population. Because walking is convenient, low cost, and safe, and can result in weight loss if done regularly for durations of at least 20-30 min, its relative merits should be stressed in weight reduction and maintenance programs. Furthermore, to reduce the morbidity and mortality associated with overweight, obesity, and sedentary behavior, priority for intervention programs should be directed at persons in the most vulnerable sectors of the population.
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PMID:Physical activity, body weight, and adiposity: an epidemiologic perspective. 755 54


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