Prior Week Research Articles

Particulate matter air pollution and ambient temperature: opposing effects on blood pressure in high-risk cardiac patients.

Fine particulate matter air pollution (PM2.5) and extreme temperatures have both been associated with alterations in blood pressure (BP). However, few studies have evaluated their joint haemodynamic actions among individuals at high risk for cardiovascular events. We assessed the effects of short-term exposures during the prior week to ambient PM2.5 and outdoor temperature levels on resting seated BP among 2078 patients enrolling into a cardiac rehabilitation programme at the University of Michigan (from 2003 to 2011) using multiple linear regression analyses adjusting for age, sex, BMI, ozone and the same-day alternate environmental factor (i.e. PM2.5 or temperature). Mean PM2.5 and temperature levels were 12.6 ± 8.2 μg/m and 10.3 ± 10.4°C, respectively. Each standard deviation elevation in PM2.5 concentration during lag days 4-6 was associated with significant increases in SBP (2.1-3.5 mmHg) and DBP (1.7-1.8 mmHg). Conversely, higher temperature levels (per 10.4°C) during lag days 4-6 were associated with reductions in both SBP (-3.6 to -2.3 mmHg) and DBP (-2.5 to -1.8 mmHg). There was little evidence for consistent effect modification by other covariates (e.g. demographics, seasons, medication usage). Short-term exposures to PM2.5, even at low concentrations within current air quality standards, are associated with significant increases in BP. Contrarily, higher ambient temperatures prompt the opposite haemodynamic effect. These findings demonstrate that both ubiquitous environmental exposures have clinically meaningful effects on resting BP among high-risk cardiac patients.

Infection, vaccination, and childhood arterial ischemic stroke: Results of the VIPS study.

Minor infection can trigger adult arterial ischemic stroke (AIS) and is common in childhood. We tested the hypotheses that infection transiently increases risk of AIS in children, regardless of stroke subtype, while vaccination against infection is protective. The Vascular Effects of Infection in Pediatric Stroke study is an international case-control study that prospectively enrolled 355 centrally confirmed cases of AIS (29 days-18 years old) and 354 stroke-free controls. To determine prior exposure to infections and vaccines, we conducted parental interviews and chart review. Median (interquartile range) age was 7.6 years for cases and 9.3 for controls (p = 0.44). Infection in the week prior to stroke, or interview date for controls, was reported in 18% of cases, vs 3% of controls, conferring a 6.3-fold increased risk of AIS (p < 0.0001); upper respiratory infections were most common. Prevalence of preceding infection was similar across stroke subtypes: arteriopathic, cardioembolic, and idiopathic. Use of vasoactive cold medications was similarly low in both groups. Children with some/few/no routine vaccinations were at higher stroke risk than those receiving all or most (odds ratio [OR] 7.3, p = 0.0002). In an age-adjusted multivariate logistic regression model, independent risk factors for AIS included infection in the prior week (OR 6.3, p < 0.0001), undervaccination (OR 8.2, p = 0.0004), black race (compared to white; OR 1.9, p = 0.009), and rural residence (compared to urban; OR 3.0, p = 0.0003). Infection may act as a trigger for childhood AIS, while routine vaccinations appear protective. Hence, efforts to reduce the spread of common infections might help prevent stroke in children.

Prevalence and Overlap of Noncardiac Conditions in the Evaluation of Low-risk Acute Chest Pain Patients.

When patients present to the emergency department with a complaint concerning for heart disease, this often becomes the primary focus of their evaluation. While patients with noncardiac causes of chest pain outnumber those with cardiac causes, noncardiac etiologies are frequently overlooked. We investigated symptoms and noncardiac conditions in a cohort of patients with chest pain at low risk of cardiac disease. We analyzed data from a prospective registry of patients who were evaluated in our chest pain evaluation center. Registry participants completed standardized and validated instruments for depression (by Patient Health Questionnaire PHQ-9), anxiety (by Generalized Anxiety Disorder GAD-7), and Gastroesophageal Reflux Disorder (GERD; by GERD Symptom Frequency Questionnaire). Chest pain characteristics were recorded; severity was reported on a 10-point scale. A total of 195 patients were included in the investigation. Using the instruments noted above, the prevalence of depression was 34%, anxiety was 30%, and GERD was 44%, each of at least moderate severity. 32.5% of patients had 2 or more conditions. The median for the severity of angina was 7/10 and the number of episodes over the preceding week was 2, respectively. Severity of angina was associated with PHQ-9 (r = 0.238; P < 0.001) and GAD-7 (r = 0.283; P < 0.001) scores. The number of angina episodes over the prior week correlated with GERD Symptom Frequency Questionnaire (r = 0.256; P < 0.001) and PHQ-9 (r = 0.175; P = 0.019) scores. No correlation was observed between any of the scores and body mass index, smoking tobacco, diabetes mellitus, hypertension, or hyperlipidemia. In our cohort of low-risk acute chest pain patients, depression, anxiety, and GERD were common, substantial overlap was observed. The severity of these noncardiac causes of chest pain causes correlated with the self-reported severity and frequency of angina, but weakly. These conditions should be part of a comprehensive plan of care for chest pain management.

Diet, interleukin-17, and childhood asthma in Puerto Ricans

BackgroundDietary patterns might influence the pathogenesis of asthma in Puerto Ricans, the ethnic group most affected by this disease in the United States. ObjectiveTo examine the association among diet, T-helper cell type 17 cytokines, and asthma in Puerto Rican children. MethodsAs part of a case–control study of 678 Puerto Rican children 6 to 14 years old in San Juan, participants completed a 75-item questionnaire on the child's food consumption in the prior week. Foods were aggregated into 7 groups: fruits, vegetables, grains, protein foods, dairy, fats, and sweets. Logistic regression was used to evaluate consumption frequency of each group, plasma T-helper cell type 17 cytokine levels, and asthma. Based on this analysis, a food score (range −2 [unhealthy diet: high consumption of dairy products and sweets, low consumption of vegetables and grains] to +2 [healthy diet: high consumption of grains and vegetables, low consumption of dairy and sweets]) was created to identify dietary patterns. ResultsHigh consumption of grains was associated with lower odds of asthma (adjusted odds ratio [aOR] 0.52, 95% confidence interval [CI] 0.33–0.82), whereas frequent consumption of dairy products (aOR 1.93, 95% CI 1.32–2.84) or sweets (aOR 1.82, 95% CI 1.08–2.72) was associated with higher odds of asthma. A healthier diet (each 1-point increment in food score) was associated with lower levels of interleukin-17F (β = −1.48 pg/mL, 95% CI −1.78 to −1.20) and with 36% decreased odds of asthma (aOR 0.64, 95% CI 0.53–0.77). ConclusionA healthy diet, with frequent consumption of vegetables and grains and low consumption of dairy products and sweets, was associated with lower levels of interleulin-17F and decreased odds of childhood asthma in Puerto Ricans.

Hydroregime Prediction Models for Ephemeral Groundwater-Driven Sinkhole Wetlands: a Planning Tool for Climate Change and Amphibian Conservation

Hydroregimes of ephemeral wetlands affect reproductive success of many amphibian species and are sensitive to altered weather patterns associated with climate change. We used 17 years of weekly temperature, precipitation, and water-depth measurements for eight small, ephemeral, groundwater-driven sinkhole wetlands in Florida sandhills to develop a hydroregime predictive model. To illustrate its utility for climate-change planning, we forecasted weekly wetland water-depths and hydroperiods (2012–2060) using our model and downscaled climate data from the CSIRO Mk3.5 Global Circulation Model under an A1B emissions scenario. We then examined how forecasted water depths and hydroperiods might alter reproductive success, and thereby populations, of five anuran species. Precipitation and water-depth from the prior week were significant predictors of water depth. Our model forecasted shallower depths and shortened hydroperiods for most wetlands when used with the CSIRO Mk3.5 A1B scenario. The forecasted hydroregimes would likely provide adequate reproductive opportunity for only one of the five species we examined. We demonstrate the utility of our model in examining how different climate-change scenarios might affect hydroregimes and, indirectly, biological diversity. Climate change uncertainty highlights the importance of retaining multiple, hydrologically diverse wetlands on landscapes to maximize the potential for successful reproduction by species having differing hydroregime requirements.

Feelings of energy are associated with physical activity and sleep quality, but not adiposity, in middle-aged postmenopausal women.

Feelings of fatigue and low energy are widespread among middle-aged women and have been shown to negatively affect quality of life. The aim of the present study was to examine the associations among adiposity, physical activity, and feelings of fatigue and energy in postmenopausal women. Postmenopausal women (N = 74; mean [SD] age, 58.9 [3.8] y) were assessed for adiposity (via dual-energy x-ray absorptiometry), steps per day, minutes of moderate to vigorous physical activity per day (via an accelerometer), prior week intensity of psychological vigor (via the Profile of Mood States-Short Form), and prior month frequency of energy feelings (via the vitality scale of the 36-item Medical Outcomes Survey--Short Form). Sleep quality was measured using the Pittsburgh Sleep Quality Index, depression was measured using the Beck Depression Inventory-II, and perceived stress was measured using the Perceived Stress Scale. Adiposity was negatively related to steps per day (r = -0.55, P < 0.05) and minutes of moderate to vigorous physical activity per day (r = -0.48, P < 0.05). Adiposity was not significantly related to vigor, vitality, or any other psychological measures. Greater vitality was associated with lower total number of medications (r = -0.31, P < 0.01), more steps per day (r = 0.28, P < 0.05), and higher minutes of moderate to vigorous physical activity per day (r = 0.37, P < 0.01). Prior week feelings of vigor were unrelated to any variable of interest. Regression analyses revealed that minutes of moderate to vigorous physical activity per day independently explained 8% of the variance in vitality, whereas sleep quality was also a significant predictor of vitality (both P < 0.05). Engaging in recommended amounts of moderate to vigorous physical activity per day is associated with higher monthly frequency of energy feelings, regardless of adiposity status, in middle-aged postmenopausal women.

Fast Food Consumption and Academic Growth in Late Childhood.

The objective of this study is to examine the associations between fast food consumption and the academic growth of 8544 fifth-grade children in reading, math, and science. This study uses direct assessments of academic achievement and child-reported fast food consumption from a nationally representative sample of kindergartners followed through eighth grade. More than two thirds of the sample reported some fast food consumption; 20% reported consuming at least 4 fast food meals in the prior week. Fast food consumption during fifth grade predicted lower levels of academic achievement in all 3 subjects in eighth grade, even when fifth grade academic scores and numerous potential confounding variables, including socioeconomic indicators, physical activity, and TV watching, were controlled for in the models. These results provide initial evidence that high levels of fast food consumption are predictive of slower growth in academic skills in a nationally representative sample of children.

The Guys Group: Navigating the Terrain of Adult Life Using Aspects of the Expanded Core Curriculum

As has been well documented, the skills outlined in the expanded core curriculum (ECC) provide students with visual impairments (that is, those who are blind or have low vision) with access to the core curriculum as well as skills for living and employment (Sapp & Hatlen, 2010). The ECC identifies nine areas of instruction: compensatory or functional academic skills, including communication modes; orientation and mobility; social interaction skills; independent living skills; recreation and leisure skills; career education; use of assistive technology; sensory efficiency skills; and self-determination. Those of us in the field of visual impairment understand that general classroom teaching alone may not be able to adequately address these domains and that alternative instructional models need to be explored. With this goal in mind, at the beginning of the 2011-2012 school year, the school psychologists of the California School for the Blind (CSB) implemented a program that designated one class period per week to specific ECC classes. Teachers proposed class topics they felt would be important for students to learn. Students also had the opportunity to propose topics of interest that would arise in this designated time slot. Students and teachers also expressed interest in developing supplemental discussion groups to address ECC-based practical living skills, including any obstacles to learning that students might encounter. To explore this discussion group approach, the CSB school psychologists asked me to lead what they termed a guys group, with the help of a male paraeducator. The idea was to hold weekly meetings to discuss ECC-related skills as well as sensitive topics related to aspects of adolescence--such as dating, anxiety, body image, and alcohol and drugs--which could be explored most openly in a single-sex group. Although not described in the report presented here, a school psychologist created a separate group for female students. As further described below, students took an active role in shaping the format and content of the group. There were six students, ages 16 to 22, who volunteered to participate. This report describes the implementation of the group for male students, as well as lessons learned, to help inform future curriculum development. GUYS GROUP AND ECC STANDARDS In addition to addressing personal issues, the Guys Group curriculum fit nicely into several of the ECC categories: social interaction, independent living skills, recreation and leisure, orientation and mobility, assistive technology, self-determination, and career education. As the group leader, spent time before each session preparing a lesson plan that focused on reasonable topics that would flow from one class to the next. asked the group what topics they wanted to discuss. Early on, the students selected the following topics: addiction, anxiety, body image, and how are men and boys with visual impairments perceived differently than those who are sighted? was afraid that would have a hard time getting the group to open up and talk, but from the beginning this was never a problem. conducted some research on group checkin styles (that is, approaches to initiating discussions in a group context to help group members reflect on the prior week) and presented a few options to the students. The group decided on a check-in that included talking about something that was good about their day or week and something that was bad. The group check-in quickly became a favorite part of the weekly experience. Students would remind me if the check-in had not begun or if a particular group member had not yet taken his turn. One student commented, It's a cool place to come to and have the floor to talk freely without judgment or ridicule. Things get real in here sometimes. Another student said, I like being able to come in here and go on tangents; you know, talk about the questions I've been pondering all day. …

Pilot evaluation of Scrambler therapy for the treatment of chemotherapy-induced peripheral neuropathy.

Chemotherapy-induced peripheral neuropathy (CIPN), a common side effect of chemotherapy, needs better effective treatments. Preliminary data support the use of Scrambler therapy, a device which treats pain via noninvasive cutaneous electrostimulation, for the treatment of CIPN. The current manuscript reports data from a pilot trial, performed to investigate the effect of Scrambler therapy for the treatment of established CIPN. Eligible patients had CIPN symptoms of ≥1 month duration with tingling and/or pain ≥4/10 during the prior week. Patients were treated with Scrambler therapy to the affected area(s) for up to ten daily 30-min sessions. Symptoms were monitored using a neuropathy questionnaire consisting of numerical analog scales ranging from 0 to 10, daily before therapy as well as weekly for 10 weeks after therapy. Descriptive summary statistics formed the basis of data analysis. Thirty-seven patients were enrolled. Twenty-five patients were treated primarily on their lower extremities while 12 were treated primarily on their upper extremities. There was a 53 % reduction in pain score from baseline to day 10; a 44 % reduction in tingling; and a 37 % reduction in numbness. Benefit appeared to last throughout 10 weeks of follow-up. There were no substantial adverse events. Preliminary data support that Scrambler therapy may be effective for the treatment of CIPN: a prospective placebo-controlled clinical trial should be performed.

Prevalence of suicidal ideation and other suicide warning signs in veterans attending an urgent care psychiatric clinic

BackgroundSuicide prevention in the clinical setting is focused on evaluating risk in the coming hours to days, yet little is known about which factors increase acute risk. PurposeTo determine the prevalence of factors that may serve as warnings of heightened acute risk. MethodsVeterans attending an urgent care psychiatric clinic (n=473) completed a survey on suicidal ideation and other acute risk warning signs. ResultsMore than half the sample (52%) reported suicidal ideation during the prior week. Of these, more than one-third (37%) had active ideation which included participants with a current suicide plan (27%) and those who had made preparations to carry out their plan (12%). Other warning signs were also highly prevalent, with the most common being: sleep disturbances (89%), intense anxiety (76%), intense agitation (75%), hopelessness (70%), and desperation (70%). Almost all participants (97%) endorsed at least one warning sign. Participants with depressive syndrome and/or who screened positive for post-traumatic stress disorder endorsed the largest number of warning signs. Those with both depressive syndrome and post-traumatic stress disorder were more likely to endorse intense affective states than those with either disorder alone. All p-values for group comparisons are <.008. ConclusionOur major findings are the strikingly high prevalence of past suicidal ideation, suicide attempts, current suicidal ideation and intense affective states in veterans attending an urgent care psychiatric clinic; and the strong associations between co-occurring post-traumatic stress disorder and depressive syndrome with intense affective states.

Musculoskeletal Pain in Obese Compared With Healthy-Weight Children

To investigate whether obesity is associated with musculoskeletal pain in children. Obese (n=107) and healthy-weight (n=132) 10- to 13-year-old children (132 males, 107 females) participated in an observational case-control study. Children self-reported pain location (excluding abdominal pain), pain intensity (current and prior week), and pain prevalence (overall and lower limb) using the Pediatric Pain Questionnaire. Body composition was assessed (dual-energy x-ray absorptiometry) and children wore an accelerometer for 8 days. After adjustment for accelerometry (weekly average counts per hour) and socioeconomic status, obese children had more intense pain (worst pain, P=0.006), pain in more locations (P≤0.005), and a higher prevalence of lower limb pain (60% vs. 52% respectively, P=0.012) than healthy-weight children. Significant relationships were observed between body mass index and total pain locations (P≤0.004, unadjusted and adjusted) and worst pain intensity (P≤0.009, adjusted for socioeconomic status/accelerometry). There were no significant relationships between percent body fat and pain variables (unadjusted/adjusted analyses, P=0.262 to 1.0). Obesity in children was associated with increased overall and lower limb musculoskeletal pain, for which body mass index was a stronger predictor than adiposity. Clinicians treating obese children should screen for pain and prescribe exercise programs that take their symptoms into account.

Editorial: third international tenebrionoidea symposium.

Editorial: third international tenebrionoidea symposium.

FRI0103 The Omeract Preliminary Flare Questionnaire (PFQ) is Responsive to Change and Able to Detect Clinically Important Worsening Indicating Need for Treatment Change in the Canadian Early Arthritis Cohort

BackgroundRheumatoid arthritis (RA) flares are common, poorly defined, and understudied. A new tool is being developed that can measure significant inflammatory RA flares that may signal need for treatment change....

Major depressive disorder and bone mass in adolescents and young adults.

Depression has been associated with reduced bone mass in adults, but the mechanisms remain unclear. In addition, little is known about the association between depression and bone health during growth and development. To address this knowledge gap, we examined bone density and structure in 222 adolescents and young adults (69% females, mean ± SD age: 19.0 ± 1.5 years), enrolled within 1 month of starting a selective serotonin reuptake inhibitor (SSRI) or unmedicated. Psychiatric functioning was assessed with self-report and researcher-administered instruments, including the Longitudinal Interval Follow-up Evaluation for Adolescents (A-LIFE). Anthropometric and laboratory measures included dual-energy x-ray absorptiometry and peripheral quantitative computed tomography scans. Linear multivariable regression analysis tested the association between depression and bone mass, after accounting for relevant confounders. The presence of current depression was associated with a significant reduction in age-sex-height-race-specific bone mineral density (BMD) and content (BMC) of total body less head and lumbar spine. The findings varied by assessment method with self-report scales, capturing symptom severity over the prior week or two, yielding the weakest associations. Depression was also associated with reduced cortical thickness and a trend for increased endosteal circumference. In contrast, generalized anxiety disorder was not associated with bone deficits. In sum, depressive illness is associated with significantly lower bone mass in youths. Future investigations must examine whether bone recovery is possible following depression remission or whether remedial interventions are warranted to optimize bone mass in order to minimize the long-term risk of osteoporosis.

Using memories to motivate future behaviour: An experimental exercise intervention

This study tested a novel memory-based experimental intervention to increase exercise activity. Undergraduate students completed a two-part online survey ostensibly regarding college activity choices. At Time 1, they completed questionnaires that included assessments of exercise-related attitudes, motivation and self-reported behaviours. Next, they described a memory of a positive or negative experience that would increase their motivation to exercise; students in a control condition did not receive a memory prompt. Finally, they rated their intentions to exercise in the future. Eight days following Time 1, students received a Time 2 survey that included an assessment of their self-reported exercise during the prior week. Students in the positive memory condition reported higher levels of subsequent exercise than those in the control condition; students in the negative memory condition reported intermediate levels of exercise. Activating a positive motivational memory had a significant effect on students' self-reported exercise activity even after controlling for prior attitudes, motivation and exercise activity.

Influence of Nurse Aide Absenteeism on Nursing Home Quality

In this analysis, the association of nurse aide absenteeism with quality is examined. Absenteeism is the failure of nurse aides to report for work when they are scheduled to work. Data used in this investigation came from survey responses from 3,941 nursing homes; Nursing Home Compare; the Online System for Survey, Certification and Administrative Reporting data; and the Area Resource File. Staffing characteristics, quality indicators, facility, and market information from these data sources were all measured in 2008. The specific quality indicators examined are physical restraint use, catheter use, pain management, and pressure sores using negative binomial regression. An average rate of 9.2% for nurse aide absenteeism was reported in the prior week. We find that high levels of absenteeism are associated with poor performance on all four quality indicators examined. The investigation presented, to our knowledge, is one of the first examining the implications of absenteeism in nursing homes. Absenteeism can be a costly staffing issue, one of the potential costs identified in this analysis is an impact on quality of care.

Fluctuations in depression and well-being are associated with sexual risk episodes among HIV-positive men.

Research has suggested a weak association between depression and sexual risk behavior in men who have sex with men (MSM). The purpose of this study was to investigate the relationship between within-person fluctuations in depression and well-being and episodes of sexual risk-taking among HIV-positive MSM. One hundred six sexually active HIV-positive MSM living in New York City completed a structured weekly survey over 6 weeks. In Weeks 1, 3, and 5, they responded to items assessing their sexual behavior, depression, and well-being in the prior week. Multilevel logistic regression analyses were conducted to explore the relationship between changes in levels of depression and well-being, and episodes of unprotected anal intercourse (UAI). Within-person deviations from participants' average levels of depression and well-being were associated with the probability of risk. The probability of a risk episode was higher in weeks when depression was higher than participants' average levels (any UAI episode: odd ratio [OR] = 1.71, 95% confidence interval [CI] [1.00, 2.90], p < .05; serodiscordant UAI episode: OR = 2.49, 95% CI [1.31, 4.73], p < .05). The probability of a risk episode was lower in weeks when well-being was higher than participants' average levels (any UAI: OR = 0.40, 95% CI [0.22, 0.74], p < .05; serodiscordant UAI: OR = 0.42, 95% CI [0.22, 0.81], p < .05). Between-person differences in depression and well-being were not associated with risk episodes (ps > .05). This study is among the first to examine the association of within-person changes in depression and well-being with sexual risk behavior in a diverse sample. It contributes new evidence to literature exploring the relationship between depression and sexual risk. Future research should employ longitudinal designs to explore pathways linking within-person changes in depression with risk behavior.

Capitalising on Positive Work Events by Sharing them at Home

The authors integrate existing theory on work–family integration and interpersonal capitalisation on positive work events by examining the effects of sharing positive work events with one's spouse on employee life satisfaction. A field study was conducted with 131 employees of a large Midwestern university, who completed surveys online. Participants provided accounts of their most important positive event during the prior week and indicated whether they had shared this event with their spouse. They also retrospectively rated their positive affect and life satisfaction over the course of the study. Results based on hierarchical regression analysis indicated that having shared that event with one's spouse was positively associated with positive affect and life satisfaction after controlling for personality and event characteristics. These results were corroborated in a subsample of 99 employees whose spouses provided independent reports of whether the event was shared with them. This research reveals that sharing positive events with others has unique and significant contributions to positive affect and life satisfaction. More importantly, these findings show that the interpersonal act of sharing is effective when conducted cross‐domain: the act of sharing positive work events with family members increases positive affect and life satisfaction.

Pre-test Data and Lessons Learned from a Group Research Project Examining Changes in Physical Activity Behavior Following Construction of a Rails-to-Trails Facility

Built environments in rural settings may provide greater challenges than those in urban settings due to physical characteristics inherent to low-density population areas. Multiuse recreational trails, such as those that repurpose abandoned railroad lines, may provide a physical activity resource that is well suited to rural areas. However, the direct impact of trail availability on physical activity behavior is not generally known because it is unclear whether activity reported in most trail research represents increases in physical activity or displacement of activity in individuals who previously exercised in other locations. This research, initiated by a group of students in a graduate seminar, represents to our knowledge, the first instance in which PA was assessed prior to the availability of an entirely new rails-to-trails facility. The research was implemented using a nonequivalent dependent variable design to counter the lack of a control group; the nonequivalent dependent variable chosen was weekly servings of fruit and vegetables. Participants responding to intercept interviews classified days of activity during the prior week as mild, moderate or vigorous. Baseline results for 244 participants suggested generally low levels of activity prior to trail availability; number of reported days of activity decreased with described intensity. We also discuss several issues encountered in planning and implementing this group project including those related to data collection, variable levels of commitment among student members, and inconsistent project management, and offer potential solutions to these concerns.

Relationship Between BMI and Food Purchases in Low-Income, Urban African American Adult Carry-Out Customers

Carry-outs are an important source of calorically dense foods in low-income urban neighborhoods. However, little is known about how customer body mass index (BMI) relates to purchasing behavior. A random sample of 184 adult carry-out customers was surveyed on frequency of visits, demographic information, and purchases made over the prior week at 8 carry-outs. This information was used to determine healthy food purchasing scores. BMI was negatively associated with purchasing a healthy side dish (β = −0.052, P = .025) and positively associated with purchasing a healthy drink (β = 0.051, P = .022), adjusting for age, sex, education, and employment. Based on these findings, efforts could be made to improve the food environment by increasing promotion of these healthier options.