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Cholinesterase inhibitors such as organophosphate and carbamate insecticides are commonly used pesticides in agriculture worldwide that can increase parasympathetic activity via inhibition of acetylcholinesterase (AChE) activity. Alterations in the cholinergic [...]

BACKGROUND: Increased arterial stiffness could represent an intermediate subclinical outcome in the mechanistic pathway underlying associations between average long-term pollution exposure and cardiovascular events. OBJECTIVE: We hypothesized that 20 years [...]

BACKGROUND: Low doses of some persistent organic pollutants (POPs) associate cross-sectionally with type 2 diabetes, whereas associations with high POP exposures are inconsistent. OBJECTIVES: We investigated whether several POPs prospectively [...]

Objectives. We sought to document incidence, case-fatality, and recurrence rates of venous thromboembolism (VTE) in women and to explore the relationship of demographic, lifestyle, and anthropometric factors to VTE incidence. Methods. Data from participants aged 55 to 69 years in the Iowa Women's Health Study were linked to Medicare data for 1986 through 2004 (n=40377) to identify hospitalized VTE patients. Results. A total of 2137 women developed VTE, yielding an incidence rate of 4.04 per 1000 person-years. The 28-day case-fatality rate was 7.7%, and the 1-year recurrence rate was 3.4%. Educational attainment, physical activity, and age at menopause were inversely associated with VTE. Risk of secondary (particularly cancer-related) VTE was higher among smokers than among those who had never smoked. Body mass index, waist circumference, waist-to-hip ratio, height, and diabetes were positively associated with VTE risk. Hormone replacement therapy use was associated with increased risk of idiopathic VTE. Conclusions. VTE is a significant source of morbidity and mortality in older women. Risk was elevated among women who were smokers, physically inactive, overweight, and diabetic, indicating that lifestyle contributes to VTE risk. (Am J Public Health. 2010;100:1506-1513. doi: 10.2105/AJPH.2008. 157776)

BACKGROUND: Although both nutrition and chemicals are important environmental factors modulating epigenetic changes, they are commonly studied separately by researchers in different fields. However, these two environmental factors cannot be [...]

Although away-from-home eating is adversely associated with weight, other comorbidities have not been examined; therefore, we sought to determine the associations of fast food (e.g. Wendy's, McDonalds) and restaurant (sit-down style) consumption (times per week) with weight and multiple metabolic outcomes, including homeostatic model assessment insulin resistance (HOMA-IR), waist circumference, and plasma triglycerides (TG), LDL cholesterol, and HDL cholesterol (HDL-C). We used 3 waves of data (exam y 7, 10, and 20) from the Coronary Artery Risk Development in Young Adults Study, a prospective cohort study of black and white young adults [aged 25-42 y in 1992-93, n = 3643 (men, 1659; women, 1984)]. Individuals in the highest (vs. Iowest) quartile of baseline (defined as the mean of y 7 and 10) fast food consumption had higher y 20 weight [adjusted mean (95% CI): 5.6 kg (CI, 2.1,9.2); P= 0.002], HOMA-IR [0.9 (CI, 0.4, 1.3); P < 0.001], waist circumference [5.3 cm (CI, 2.8, 7.9); P < 0.000], TG concentrations [0.25 mmol/L (CI, 0.10, 0.40), 22.7 mg/dL (CI, 9.1,36.3); P = 0.001 }, and Iower HDL-C concentrations [-0.014 mmol/L (CI, -0.215, -0.067), 5.4 mg/dL (CI, -8.3, -2.6); P < 0.000]. Baseline restaurant consumption was unrelated to y 20 outcomes. Adjusted change in weekly restaurant (P < 0.05) and fast food intake (P < 0.001) was associated with 13-y changes in body weight [0.09 kg (CI, 0.02, 0.17) and 0.15 kg (CI, 0.06, 0.24), respectively] and waist circumference [0.08 cm (CI, 0.02, 0.14) and 0.12 cm (CI, 0.04, 0.20), respectively]. Fast food consumption may be an important target for the prevention of adverse metabolic health outcomes. J. Nutr. 139:2113-2118, 2009. doi: 10.3945/jn.109.109520

Objectives. We assessed whether markers of acculturation (birthplace and number of US generations) and socioeconomic status (SES) are associated with markers of subclinical cardiovascular disease--carotid artery plaque, internal carotid intima-media thickness, and albuminuria--in 4 racial/ethnic groups. Methods. With data from the Multi-Ethnic Study of Atherosclerosis (n = 6716 participants aged 45-84 years) and race-specific binomial regression models, we computed prevalence ratios adjusted for demographics and traditional cardiovascular risk factors. Results. The adjusted US-to foreign-born prevalence ratio for carotid plaque was 1.20 (99% confidence interval [CI]=0.97, 1.39) among Whites, 1.91 (99% C1=0.94, 2.94) among Chinese, 1.62 (99% CI=1.28, 2.06) among Blacks, and 1.23 (99% CI=1.15, 1.31) among Hispanics. Greater carotid plaque prevalence was found among Whites, Blacks, and Hispanics with a greater number of generations with US residence (P< .001) and among Whites with less education and among Blacks with lower incomes. Similar associations were observed with intima-media thickness. There was also evidence of an inverse association between albuminuria and SES among Whites and Hispanics. Conclusions. Greater US acculturation and lower SES were associated with a higher prevalence of carotid plaque and greater intima-media thickness but not with albuminuria. Maintenance of healthful habits among recent immigrants should be encouraged.

BACKGROUND: Persistent organic pollutants (POPs), which are endocrine disruptors that accumulate in adipose tissue, can increase the risk of periodontal disease through the disturbance of the immune system. OBJECTIVE: We [...]

A study was conducted to determine the connection of circulating oxidized low-density lipoprotein (LDL) with the development of metabolic syndrome. Results revealed that higher oxidized LDL was responsible for metabolic syndrome, which in turn raised the risk of diabetes.

In recent years, newer technologies have been developed to reduce the trans-fat content of fats and oils used in manufacturing food products. To examine the implications of these changes on foods in the marketplace, a survey was conducted to assess current levels of trans and saturated fat in three food categories: margarines and butters; cookies and snack cakes; and savory snacks. A sampling of products from each category was conducted at a Wal-Mart Supercenter in the Minneapolis-St Paul, MN, metropolitan area in July of 2006. All information was obtained from product labels, except price, which was recorded from price listings on product shelving. Most margarines and butters (21 of 29), cookies and snack cakes (34 of 44), and savory snacks (31 of 40) were labeled as containing 0 g trans fat. However, some products contained substantial amounts of trans fat. Most notably, 3 of 40 savory snack products were labeled as containing [greater than or equal to] 3 g trans fat. Significant inverse correlations were found between product price and the saturated and transfat content of margarines (r = -0.45) and savory snacks (r = -0.32). In conclusion, it appears that the food industry has made progress in reducing the trans-fat content in a variety of products. Nonetheless, consumers need to read product labels because the trans-fat content of individual products can vary considerably. Products that are lower in trans and saturated fat tend to cost more, which may be a barrier to their purchase for price-conscious consumers.

Background: Coarse particulate matter ([PM.sub.10-2.5]) is primarily mechanically generated and includes crustal material, brake and tire wear, and biological particles. [PM.sub.10-2.5] is associated with pulmonary disease, which can lead to right ventricular (RV) dysfunction. Although RV characteristics have been associated with combustion-related pollutants, relationships with [PM.sub.10-2.5] remain unknown. Objectives: To quantify cross-sectional associations between RV dysfunction and [PM.sub.10-2.5] mass and components among older adults and susceptible populations. Methods: We used baseline cardiac magnetic resonance images from 1,490 participants (45-84 y old) from the Multi-Ethnic Study of Atherosclerosis and assigned 5-y residential concentrations of [PM.sub.10-2.5] mass, copper, zinc, phosphorus, silicon, and endotoxin, using land-use regression models. We quantified associations with RV mass, end-diastolic volume, and ejection fraction after control for risk factors and copollutants using linear regression. We further examined personal susceptibility. Results: We found positive associations of RV mass and, to a lesser extent, end diastolic volume with [PM.sub.10-2.5] mass among susceptible populations including smokers and persons with emphysema. After adjustment for copollutants, an interquartile range increase in [PM.sub.10-2.5] mass (2.2 [micro]g/[m.sup.3]) was associated with 0.5 g (95% CI: 0.0, 1.0), 0.9 g (95% CI: 0.1, 1.7), and 1.4 g (95% CI: 0.4, 2.5) larger RV mass among former smokers, current smokers, and persons with emphysema, respectively. No associations were found with healthy individuals or with ejection fraction. Conclusions: Alterations to RV structure may represent a mechanism by which long-term [PM.sub.10-2.5] exposure increases risks for adverse respiratory and cardiovascular outcomes, especially among certain susceptible populations. https://doi.org/10.1289/EHP658, Introduction Air pollution is a well-established risk factor for adverse respiratory outcomes, including chronic lung diseases (Andersen et al. 2011; Karakatsani et al. 2003; Lindgren et al. 2009; Schikowski et [...]

The identification of nutrients and the study of their bioactivity were significant developments in the evolution of contemporary nutrition science. This review argues for shifting the focus towards food in order to better understand the nutrition-health interface. It begins by introducing the concept of food synergy (a perspective that more information can be obtained by looking at foods than at single food components) to denote the action of the food matrix (the composite of naturally occurring food components) on human biological systems. A proposal is then made for the means by which food-focused research might build the knowledge base for etiologic discovery and appropriate dietary advice. The diet-heart disease dilemma is put forward as an example of where a nutrient-based approach has limitations, and a summary of studies targeting food composition strengthens the case for a food-based approach. Finally, the argument is made that evidence from interventions points back to the central position of food in the relationship between nutrition and health, a position that begs for more whole food-based research. Key words: foods, nutrients, heart disease, food synergy, apples, fruit, pomegranates, broccoli, peanuts, tomatoes

BACKGROUND: Persistent organic pollutants (POPs) can influence the immune system, possibly increasing the risk of rheumatoid arthritis (RA). In addition, as metabolic change due to obesity has been proposed as [...]

Objective. We sought to examine the relation between physical activity and incident hypertension in young adults over 15 years of follow-up in the Coronary Artery Risk Development in Young Adults study. Methods. A total of 3993 Black and White men and women aged 18 to 30 years were examined at baseline, and 2, 5, 7, 10, and 15 years later. Blood pressure and physical activity were measured at each exam. Hypertension was defined as systolic 140 mm Hg or higher, diastolic 90 mm Hg or higher, or antihypertensive medication use. Average physical activity and incident hypertension over 15 years of follow-up were analyzed. Results. There were 634 cases of incident hypertension over 15 years of follow-up. Those who were more versus less physically active experienced a reduced risk (hazard rate ratio = 0.83; 95% confidence interval = 0.73, 0.93) for incident hypertension, after adjustment for race, sex, age, education, and family history of high blood pressure. Conclusions. Physical activity merits attention in the prevention of incident hypertension among young adults, particularly as they move into middle age. doi:10.2105/AJPH.2004.055889

Objectives. Using data from a large cohort of adults aged 45 to 84 years-old, we investigated whether availability of recreational resources is related to physical activity levels. Methods. Data from a multiethnic sample of 2723 adult residents of New York City, NY; Baltimore, Md; and Forsyth County, NC, were linked to data on locations of recreational resources. We measured the availability (density) of resources within 0.5 (0.8 km), 1, 2, and 5 miles of each participant's residence and used binomial regression to investigate associations of density with physical activity. Results. After adjustment for potential confounders, individuals in the tertile of participants residing in areas with the highest density of resources were more likely to report physical activity during a typical week than were individuals in the lowest tertile. Associations between availability of recreational resources and physical activity levels were not present for the smallest area assessed (0.5 miles) but were present for areas ranging from 1 to 5 miles. These associations were slightly stronger among minority and low-income residents. Conclusions. Availability of resources may be 1 of several environmental factors that influence individuals' physical activity behaviors. doi:10.2105/AJPH.2006.087734

Objective Describe secular trends in overall diet quality for coronary heart disease (CHD) prevention during the past two decades (1980-1982 through 2000-2002). Design Dietary data were drawn from the Minnesota Heart Survey, a repeated population-based survey designed to examine trends in mortality, morbidity, and risk factors for CHD within geographically defined independent probability samples. Subjects/setting Adults residing in the Minneapolis/St Paul, MN, metropolitan area. Main outcomes measures Dietary intake was assessed by an interviewer administered 24-hour dietary recall from a subsample of survey participants. A Heart Disease Prevention Eating Index was developed to measure overall diet quality by compliance with the current American Heart Association Dietary Guidelines. Statistical analyses A generalized linear mixed model was used to examine trends in Heart Disease Prevention Eating Index scores and trends in each element of the index. Results Age-adjusted mean Heart Disease Prevention Eating Index scores increased in both sexes during the past 2 decades, particularly driven by improvements in total grain, whole grain, total fat, saturated fatty acids, transfatty acids, and cholesterol intake. Energy, balance, sodium intake, and fish intake were observed to change unfavorably or stay at a low compliance level. Conclusions Of concern is that improvements in mean Heart Disease Prevention Eating Index appear to have plateaued in 1995-1997, with the mean Heart Disease Prevention Eating Index scores similar between the 1995-1997 and 2000-2002 survey periods. Public health programs for CHD prevention may benefit by applying findings from this study in designing interventions to promote further improvements in the diets of American adults.

Flavonoids have anti-inflammatory and antioxidative effects and thus may protect against diabetes. Therefore, we hypothesized that consumption of flavonoids and specific food and beverage sources of flavonoids would be associated with reduced risk of incident diabetes. At baseline (1986), diet (by food frequency questionnaire) and health information were collected from 35,816 postmenopausal women free of diabetes. Self-reported incident diabetes was ascertained 5 times during the study (1987, 1989, 1992, 1997, and 2004). Cox proportional hazards regression was used to calculate hazard ratios for incident diabetes according to categories of total flavonoids and anthocyanidins, flavones, flavanones, flavonols, flavan-3-ol monomers, isoflavones, and proanthocyanidins. Hazard ratios according to intake categories of flavonoid-rich foods and beverages were also calculated (apples, pears, berries, broccoli, bran, citrus, tea, and red wine). Flavonoid consumption was not associated with diabetes risk after multivariable adjustment. Although other flavonoid-rich foods and beverages were not associated, red wine was inversely associated with diabetes. Women who reported drinking red wine [greater than or equal to] 1 time/wk had a 16% reduced risk of diabetes than those drinking wine

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jada.2006.08.014 Byline: Lisa J. Harnack, Leslie A. Lytle, Mary Story, Deborah A. Galuska, Kathryn Schmitz, David R. Jacobs, Shujun Gao Abstract: Evaluate the validity and reliability of a short (10-item) calcium food frequency questionnaire (FFQ) for use with middle-school-aged (11 to 14 years of age) children.

Objective Evaluate the validity and reliability of a short (10-item) calcium food frequency questionnaire (FFQ) for use with middle-school--aged (11 to 14 years of age) children. Design The calcium FFQ was completed twice, with 1 week between administrations. Three 24-hour dietary recalls were collected from each participant after the second administration of the calcium FFQ. Subjects/setting Students in an ethnically diverse middle school in Minneapolis, MN (n = 248). Main outcome measures Calcium intake estimates from the calcium FFQ and dietary recalls. Statistical analyses Correlations between calcium intake estimates from the first and second questionnaire administrations of the calcium FFQ were calculated and paired t tests were conducted to compare mean calcium intake estimates from each questionnaire administration. Mean intake estimates from the calcium FFQ and the dietary recalls were compared. Also, correlations between intake estimates from the calcium FFQ and the recalls were calculated. Results Correlation between calcium intake estimates derived from the first and second administration of the calcium FFQ was 0.74. Mean calcium intake estimates from the calcium FFQ and the average of the three dietary recalls were 856 mg/day and 993 mg/day, respectively (P<0.001). The correlation between calcium intake estimates derived from the calcium FFQ and the average of the recalls was 0.43. Conclusions Reliability of the FFQ was found to be good while validity was weaker, with calcium intake from the calcium FFQ moderately associated with estimates from dietary recalls. Where a brief instrument for assessing calcium intake of middle-school--aged children is needed, the calcium FFQ evaluated in this study may be useful.

Although oxidative stress has been proposed as a mechanism of lead and cadmium toxicity mostly based on in vitro experiments or animal studies, it is uncertain whether this mechanism is [...]

The association between dietary fiber intake and risk of colorectal cancer is evaluated. Results reveal that dietary fiber intake is inversely associated with risk of colorectal cancer in age-adjusted analyses.

We examined the 16-year mortality experience among participants in the baseline examination (1985-86) of the Coronary Artery Risk Development in Young Adults (CARDIA) Study, a U.S. cohort of 5115 urban adults initially 18-30 years old and balanced by sex and race (black and whites) in the USA. We observed 127 deaths (annual mortality of 0.15%). Compared to white women, the rate ratio (95% confidence interval) of all-cause mortality was 9.3 (4.4, 19.4) among black men, 5.3 (2.5, 11.4) among white men and 2.7 (1.2, 6.1) among black women. The predominant causes of death, which also differed greatly by sex-race, were AIDS (28% of deaths), homicide (16%), unintentional injury (10%), suicide (7%), cancer (7%) and coronary disease (7%). The significant baseline predictors of all-cause mortality in multivariate analysis were male sex, black race, diabetes, self-reported liver and kidney disease, current cigarette smoking and low social support. Two other factors, self-reported thyroid disease and high hostility, were significant predictors in analyses adjusted for age, sex and race. In conclusion, we found striking differences in the rates and underlying cause of death across sex-race groups and several independent predictors of young adult mortality that have major implications for preventive medicine and social policies. Keywords: Mortality; Young adults; Risk factors; Race/ethnicity; Smoking; Psychosocial factors; Hostility; Social support; USA

The consumption of fruits and vegetables reduces the risk of major chronic degenerative diseases. The active compounds and the mechanisms involved in this protective effect have not been well defined. The objective of this study was to determine the contribution of various food groups to total antioxidant intake, and to assess the correlations of the total antioxidant intake from various food groups with plasma antioxidants. We collected 7-d weighed dietary records in a group of 61 adults with corresponding plasma samples, and used data from a nationwide survey of 2672 Norwegian adults based on an extensive FFQ. The total intake of antioxidants was ~17 mmol/d with [beta]-carotene, [alpha]-tocopherol, and vitamin C contributing KEY WORDS: * total antioxidants * coffee * wine * vegetables * carotenoids

Low physical fitness may increase the risk of cardiovascular disease, especially in people who are overweight or obese. This was the conclusion of a study of 2,478 people. Those who were overweight and had low physical fitness had between three and six times the risk of developing diabetes, high blood pressure, and the metabolic syndrome. Those with normal body weight had twice the risk of developing these conditions if they had low physical fitness.

Objective. Nutritional status is associated with pulmonary health and survival in children with cystic fibrosis (CF). This study evaluated the weight gain pattern of children with CF in relation to the longitudinal trends of their pulmonary function. Our hypothesis was that children who experience continuous weight gain at a given rate will have better average forced expiratory volume in 1 second (FE[V.sub.1]) and change in FE[V.sub.1] than children who have weight gain patterns that deviate from this rate, even when total weight gain seems adequate. Methods. Prospectively collected data were examined in 319 children, aged 6 to 8, who were routinely followed at the Minnesota Cystic Fibrosis Center. One to 67 measurements of weight (kg), height (cm), and FE[V.sub.1] (mL) were taken per child during this 2-year period. The data were analyzed by repeated measure regression analysis and by growth pattern analysis. Results. At baseline, a 1-kg higher initial weight was associated with a 55-mL higher average FE[V.sub.1]. During the follow-up period, a 1-kg gain in weight was associated with an increase in FE[V.sub.1] by 32 mL. Children who had a steady weight gain tended to experience greater increases in FE[V.sub.1] than children who experienced periodic losses in weight. Conclusions. We established that children who weigh more and who gain weight at an appropriate and uninterrupted rate have a better FE[V.sub.1] trajectory. Aggressive nutritional support to maintain growth in these children may therefore improve FE[V.sub.1], which can be taken as a surrogate for better lung health, and may ultimately lead to better survival. Pediatrics 2003;112:588-592; cystic fibrosis, growth, pulmonary, function, longitudinal studies., Cystic fibrosis (CF) is the most common life-shortening disease in white individuals and is characterized by multiorgan involvement with primarily pulmonary and gastrointestinal manifestations, as well as abnormally high levels [...]

People who are overweight may be able to lower their risk of insulin resistance by eating dairy products. Insulin resistance is considered a precursor of type 2 diabetes. In a study of 3,157 people who were followed for 10 years, the benefit of dairy products was seen in blacks, whites, men, and women, but not in people with normal weights., Context Components of the insulin resistance syndrome (IRS), including obesity, glucose intolerance, hypertension, and dyslipidemia, are major risk factors for type 2 diabetes and heart disease. Although diet has been postulated to influence IRS, the independent effects of dairy consumption on development of this syndrome have not been investigated. Objective To examine associations between dairy intake and incidence of IRS, adjusting for confounding lifestyle and dietary factors. Design The Coronary Artery Risk Development in Young Adults (CARDIA) study, a population-based prospective study. Setting and Participants General community sample from 4 US metropolitan areas of 3157 black and white adults aged 18 to 30 years who were followed up from 1985-1986 to 1995-1996. Main Outcome Measure Ten-year cumulative incidence of IRS and its association with dairy consumption, measured by diet history interview. Results Dairy consumption was inversely associated with the incidence of all IRS components among individuals who were overweight (body mass index [greater than or equal to]25 kg/[m.sup.2] at baseline but not among leaner individuals (body mass index Conclusions Dietary patterns characterized by increased dairy consumption have a strong inverse association with IRS among overweight adults and may reduce risk of type 2 diabetes and cardiovascular disease.

A predominantly plant-based diet reduces the risk for development of several chronic diseases. It is often assumed that antioxidants contribute to this protection, but results from intervention trials with single antioxidants administered as supplements quite consistently do not support any benefit. Because dietary plants contain several hundred different antioxidants, it would be useful to know the total concentration of electron-donating antioxidants (i.e., reductants) in individual items. Such data might be useful in the identification of the most beneficial dietary plants. We have assessed systematically total antioxidants in a variety of dietary plants used worldwide, including various fruits, berries, vegetables, cereals, nuts and pulses. When possible, we analyzed three or more samples of dietary plants from three different geographic regions in the world. Total antioxidants was assessed by the reduction of [Fe.sup.3+] to [Fe.sup.2+] (i.e., the FRAP assay), which occurred rapidly with all reductants with half-reaction reduction potentials above that of [Fe.sup.3+]/[Fe.sup.2+]. The values, therefore, expressed the corresponding concentration of electron-donating antioxidants. Our results demonstrated that there is more than a 1000-fold difference among total antioxidants in various dietary plants. Plants that contain most antioxidants included members of several families, such as Rosaceae (dog rose, sour cherry, blackberry, strawberry, raspberry), Empetraceae (crowberry), Ericaceae (blueberry), Grossulariaceae (black currant), Juglandaceae (walnut), Asteraceae (sunflower seed), Punicaceae (pomegranate) and Zingiberaceae (ginger). In a Norwegian diet, fruits, berries and cereals contributed 43.6%, 27.1% and 11.7%, respectively, of the total intake of plant antioxidants. Vegetables contributed only 8.9%. The systematic analysis presented here will facilitate research into the nutritional role of the combined effect of antioxidants in dietary plants. KEY WORDS: * antioxidants * berries * fruits * vegetables * diet * humans

M. Messina is an adjunct associate professor in the Department of Nutrition, School of Public Health. Loma Linda University, Loma Linda, Calif.; J.W. Lampe is an associate member of the Cancer Prevention Research Program, Fred Hutchinson Cancer Research Center, Seattle, Wash.; D.F. Birt is a professor and chair of the Department of Food Science and Nutrition, Iowa State University, Ames; L.J. Appel is with the Welch Center for Prevention, Epidemiology and Clinical Research. Johns Hopkins, University, Baltimore, Md., E. Pivonka is president and B. Berry, MS, RD, is vice-president of programs, at the Produce for Better Health Foundation in Wilmington, Del.; D.R. Jacobs Jr. is with the Institute for Nutrition Research. University of Oslo, Norway, and is professor of epidemiology at the School of Public Health. University of Minnesota, Minneapolis., ********** Technological advances have provided nutrition scientists with unprecedented capabilities for identifying and isolating food components and for evaluating their possible health effects. Consequently, there is greater recognition of, and [...]

Byline: John M. Flack, John H. Kvasnicka, Julius M. Gardin, Samuel S. Gidding, Teri A. Manolio, David R. Jacobs Abstract: Objective To describe the epidemiology of echocardiographic mitral valve prolapse (MVP) and its anthropometric, physiologic, and psychobehavioral correlates with a cross-sectional analysis at 4 urban clinical centers. Patients A biethnic, community-based sample of 4136 young (aged 23 to 35 years) adult participants in the Coronary Artery Risk Development in Young Adults (CARDIA) study who had echocardiograms during their third examination between 1990 and 1991. Measurements Echocardiographic mitral valve prolapse, Doppler mitral regurgitation, blood pressure, anthropometry, and 4 psychobehavioral scales. Results Definite echocardiographic MVP prevalence was 0.6% overall and was similar across the 4 ethnicity/sex groups. Most participants (21 of 26, 80%) with definite echocardiographic MVP were unaware of their condition. Relative to persons with normal echocardiograms, those with echocardiographic MVP were taller (174.6 cm vs 171.0 cm, P < .01), leaner (26.7 mm vs 37.4 mm sum of triceps and subscapular skinfolds, P < .01), had lower body mass index (22.0 kg/m.sup.2 vs 26.2 kg/m.sup.2, P < .01), and more often has Doppler mitral regurgitation (34.8% vs 11.8%, P < .01). Women with echocardiographic MVP had higher ethnicity-adjusted hostility scores (19.9 vs 16.1, P < .05) than women with no MVP. Among 111 (2.7%) of 4136 participants reporting prior physician diagnosis of MVP, only 5 (0.45%) of 111 had definite echocardiographic MVP. Conclusions These data document a low prevalence of definite echocardiographic MVP and suggest a constellation of anthropometric, physiologic, and psychobehavioral characteristics in young adults with echocardiographic MVP. Most definite echocardiographic MVP diagnoses were discordant with self-reported MVP status, and false-positive diagnoses of echocardiographic MVP were made more often in women and whites. (Am Heart J 1999;138:486-92.) Author Affiliation: Detroit, Mich; St Paul and Minneapolis, Minn; Orange, Calif; Chicago, Ill; and Bethesda, Md Article History: Received 19 August 1998; Accepted 30 November 1998 Article Note: (footnote) [star] From aWayne State University School of Medicine, the Detroit Medical Center, and the John D. Dingell Veterans Administration Medical Center; bSaint Josephs Hospital, Saint Paul; cUniversity of California Irvine, Orange; dNorthwestern University Medical School, Chicago; the eNational Heart, Lung, and Blood Institute, Bethesda; and the fUniversity of Minnesota School of Public Health, Minneapolis., [star][star] Supported by NHLBI/NIH N01-HV-48047, 48048, 48049, 48050, 95095, and 95100, NIH 1R29-DEO-86680/82, NIH/NHLBI R01HL-46630-01A1,NHLBI/NIH R01-HL-34767, and NIH-N01-WH-32101. Dr. Flack is supported by and/or affiliated with Merck, Parke-Davis, Pfizer, Smith-Kline, Astra Merck, and Bristol Myers Squibb., a Reprint requests to: John M. Flack, MD, MPH, Department of Internal Medicine, Cardiovascular Epidemiology and Clinical Applications Program, Division of Endocrinology, Metabolism, and Hypertension, Wayne State University School of Medicine, Harper Hospital, 3990 John Rd, 1 W S, Detroit, MI 48201. E-mail: jflack@intmed.wayne.edu , aa 0002-8703/99/$8.00 + 0 4/1/96332

This study examined the relationship between smoking status and weight change from baseline to Year 7 in a large biracial cohort, the Coronary Artery Risk Development in Young Adults study. Unadjusted for covariates, only male smokers weighed less than nonsmokers, with no effect among women. Adjusted for covariates, male and female smokers weighed less than nonsmokers at baseline, adjusted for age, total energy intake, alcohol intake, and physical fitness. Over the 7-year follow-up, all smoking status groups gained weight, including continuous smokers and initiators. Weight gain was greatest among those who quit smoking. Weight gain attributable to smoking cessation was 4.2 kg for Whites and 6.6 kg for Blacks. Smoking had a small weight-attenuating effect on Blacks. No such effects, however, were observed among Whites. These results suggest, at least in younger smokers, that smoking has minimal impact on body weight.