Nonobese White Women Research Articles

Measuring obesity in the absence of a gold standard

Reliable measures of body composition are essential to develop effective policies to tackle obesity. The lack of an acceptable gold-standard for measuring fatness has made it difficult to evaluate alternative measures of obesity. We use latent class analysis to characterise existing diagnostics. Using data on US adults we show that measures based on body mass index and bioelectrical impedance analysis misclassify large numbers of individuals. For example, 45% of obese White women are misclassified as non-obese using body mass index, while over 50% of non-obese White women are misclassified as being obese using bioelectrical impedance analysis. In contrast the misclassification rates are low when waist circumference is used to measure obesity. These results have important implications for our understanding of differences in obesity rates across time and groups, as well as posing challenges for the econometric analysis of obesity.

Risk of long-term hot flashes after natural menopause

This study aims to estimate the risk of hot flashes relative to natural menopause and to evaluate the associations of hormone levels, behavioral variables, and demographic variables with the risk of hot flashes after menopause. We performed annual assessment of 255 women who were premenopausal at baseline and reached natural menopause within 16 years of follow-up. The prevalence of moderate/severe hot flashes increased in each premenopausal year, reaching a peak of 46% in the first 2 years after the final menstrual period (FMP). Hot flashes decreased slowly after menopause and did not return to premenopausal levels until 9 years after the FMP. The mean (SD) duration of moderate/severe hot flashes after the FMP was 4.6 (2.9) years (for any hot flashes, 4.9 [3.1] y). One third of women at 10 years or more after menopause continued to experience moderate/severe hot flashes. African-American women (obese and nonobese) and obese white women had significantly greater risks of hot flashes compared with nonobese white women (interaction, P = 0.01). In multivariable analysis, increasing follicle-stimulating hormone levels before the FMP (P < 0.001), decreasing estradiol (odds ratio, 0.87; 95% CI, 0.78-0.96; P = 0.008), and increasing anxiety (odds ratio, 1.05; 95% CI, 1.03-1.06; P < 0.001) were significant risk factors for hot flashes, whereas higher education levels were protective (odds ratio, 0.66; 95% CI, 0.47-0.91; P = 0.011). Moderate/severe hot flashes continue, on average, for nearly 5 years after menopause; more than one third of women observed for 10 years or more after menopause have moderate/severe hot flashes. Continuation of hot flashes for more than 5 years after menopause underscores the importance of determining individual risks/benefits when selecting hormone or nonhormone therapy for menopausal symptoms.

Toward an understanding of health services use in women with binge eating disorder.

This study examined health services use in community samples of 102 white and 60 black women with binge eating disorder (BED), 164 white and 85 black healthy comparison women, and 86 white and 21 black women with a noneating Axis I psychiatric disorder. Participants were matched on age, ethnicity, and education and were asked about their use of emergency room visits, outpatient physician visits for medical care, outpatient psychotherapy visits, and days spent in the hospital over the previous 12 months. Total health services use was computed. There were no between-group differences in outpatient physician visits or inpatient hospital days. Relative to healthy comparison women, women with BED and women with other Axis I disorders had increased total health services use, psychotherapy visits, and emergency department visits. Relative to women with noneating Axis I disorders, women with BED had less use of psychotherapy visits. Although obese white women were more likely to report emergency department visits than obese black women were, nonobese white women were less likely to report emergency department visits than nonobese black women were. That health services use by women with BED compared more with that of women with other Axis I disorders than with that of healthy women suggested that BED has clinical significance and is not benign in terms of its impact on the health care system. It appeared, however, that despite the availability of effective treatments, few women with BED received psychotherapy.

Energy and Selected Nutrient Intakes of Black and White, Obese and Non-Obese Low-Income Women

LEARNING OUTCOME: To compare caloric and nutrient intakes of Black and White, obese and non-obese, low income women. This study was conducted to assess and compare the energy and selected nutrient intakes of 65 Black and White, obese and non-obese, low-income Expanded Food and Nutrition Education Program (EFNEP) women. Participants were assigned to either non-obese or obese group based on Body Mass Index (BMI) calculation with 28 in the non-obese group and 37 in the obese group. Three random-repeat 24-hour food recalls were collected from each participant. Descriptive statistics, two-way analysis of variances (ANOVA) and multivariate analysis (MANOVA) were calculated (P<0.05). Results suggest that non-obese and obese low-income women have similar energy and nutrient intakes. However certain trends were observed. The group tending to have a higher fat intakes (i.e. Black obese) tended to have a lower fiber intake. Non-obese White women tended toward inadequate intakes for dietary fiber, calcium, and vitamin E. Obese White women tended to have inadequacies only for dietary fiber. Non-obese Black women appeared to have inadequate intakes for fiber, calcium, vitamin A and vitamin E. White women tended to have a significantly higher vitamin A intake (p=.0522) and caloric intakes (p=.04206) than Blacks. White obese women consumed higher levels of energy and vitamin A than the other three subgroups. The non-obese group tended to have lower daily intakes than the obese group for energy, total fat, calcium, vitamin C and vitamin A, but higher intakes of fiber and iron. Adequate intakes were observed for iron, vitamin C and vitamin A for Whites and iron and vitamin C for Blacks. Overall, non-obese and obese, White and Black women appeared to have nutrient inadequacies that should be addressed in educational programs.

Influence of body habitus and race on bone mineral density of the midradius, hip, and spine in aging women.

Osteoporosis and fractures of the hip are less common in black women and in obese white women than in nonobese white women. To determine the effects of race, age, and body weight on bone mineral density (BMD), BMD of the lumbar spine, trochanter, and femoral neck were determined by dual-photon absorptiometry in 131 nonobese white women and 34 nonobese black women, all of whom were within 30% of their ideal body weight, and in 24 obese white women and 27 obese black women, all of whom weighed more than 30% of their ideal body weight and were in the same age range as the nonobese women. All of them were 51 years of age or older, and most of them were postmenopausal. BMD of the midradius was measured by single-photon absorptiometry. Whereas body weight was significantly higher in the black as compared to the white women, the ages of the two groups were not different from each other. BMD declined with age and increased with body weight in both the black and white women at each of the four sites measured. After adjusting for age and weight by covariate analyses, black women had greater BMDs than white women at the midradius, lumbar spine, and femoral neck (p less than 0.001), but not at the trochanter (p = 0.18). The increases in BMD observed in the obese and black women in the present study are consistent with the previous findings that osteoporosis and fractures of the hip are less common in black and in obese white women than in nonobese white women.

Effects of Parental Weight and Fatness on Relative Weight and Fatness of Young Children Comparison of Cross‐Sectional and Prospective Clinical Dataa

Fatness follows family lines. %in and adoption studies suggest that genetic factors play a major role in the familial transmission of fatness,'-I4 although environmental influences are also recogni~ed.~ The fatness of young children as a function of the fatness of their mothers is examined in data selected from a cross-sectional epidemiological study (Ten-State Nutrition Survey) and a prospective clinical study. Only data from obese (0) or nonobese white women and children were included.

The effects of race and body habitus on bone mineral density of the radius, hip, and spine in premenopausal women.

The incidence of osteoporosis and fractures of the hip are diminished in blacks and in obese subjects. To determine whether bone mass is increased in them, bone mineral density (BMD) of the lumbar spine, trochanter, and femoral neck was measured by dual photon absorptiometry in 89 nonobese white and 51 nonobese black women, all of whom were within 30% of their ideal body weight and between the ages of 20 and 50 yr, and in 21 obese white women and 21 obese black women, all of whom weighed 30% on more than their ideal body weight and were in the same age range. The BMD of the mid radius was also measured by single photon absorptiometry. The mean BMD of the mid radius was higher in black than in white nonobese women [0.73 +/- 0.01 (+/- SE) vs. 0.70 +/- 0.01 g/cm2; P less than 0.01] and was not altered by obesity in either group. The mean BMD was higher in the black than in the white nonobese women at the lumbar spine (1.23 +/- 0.02 vs. 1.16 +/- 0.01 g/cm2; P less than 0.01), trochanter (0.78 +/- 0.02 vs. 0.72 +/- 0.01 g/cm2; P less than 0.01) and femoral neck (0.96 +/- 0.02 vs 0.90 +/- 0.02 g/cm2; P less than 0.02). The mean body weight was higher in the obese than in the nonobese white women (92 +/- 2 vs. 61 +/- 1 kg; P less than 0.001) and black women (94 +/- 3 vs. 63 +/- 1 kg; P less than 0.001). The mean BMD was higher in the obese than in the nonobese white women at the lumbar spine (1.24 +/- 0.03 g/cm2; P less than 0.05), trochanter (0.89 +/- 0.04; P less than 0.001), and femoral neck (0.99 +/- 0.03; P less than 0.01) and was higher in the obese than in the nonobese black women at the lumbar spine (1.33 +/- 0.03 g/cm2; P less tham 0.01), trochanter (0.88 +/- 0.04 g/cm2; P less than 0.05), and femoral neck (1.04 +/- 0.03 g/cm2; P less than 0.05). Multivariate regression analysis revealed positive correlations between body weight and BMD at each of the 3 weight-bearing sites, but not at the mid radius, in both the black women and white women.(ABSTRACT TRUNCATED AT 400 WORDS)