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Background: US breast cancer mortality is declining, but thousands of women still die each year., Methods: Two established simulation models examine 6 strategies that include increased screening and/or treatment or elimination of obesity versus continuation of current patterns. The models use common national data on incidence and obesity prevalence, competing causes of death, mammography characteristics, treatment effects, and survival/cure. Parameters are modified based on obesity (defined as BMI  ≥  30 kg/m(2) ). Outcomes are presented for the year 2025 among women aged 25+ and include numbers of cases, deaths, mammograms and false-positives; age-adjusted incidence and mortality; breast cancer mortality reduction and deaths averted; and probability of dying of breast cancer., Results: If current patterns continue, the models project that there would be about 50,100-57,400 (range across models) annual breast cancer deaths in 2025. If 90% of women were screened annually from ages 40 to 54 and biennially from ages 55 to 99 (or death), then 5100-6100 fewer deaths would occur versus current patterns, but incidence, mammograms, and false-positives would increase. If all women received the indicated systemic treatment (with no screening change), then 11,400-14,500 more deaths would be averted versus current patterns, but increased toxicity could occur. If 100% received screening plus indicated therapy, there would be 18,100-20,400 fewer deaths. Eliminating obesity yields 3300-5700 fewer breast cancer deaths versus continuation of current obesity levels., Conclusions: Maximal reductions in breast cancer deaths could be achieved through optimizing treatment use, followed by increasing screening use and obesity prevention., (© 2013 American Cancer Society.)

Deep inspirations modulate airway caliber and airway closure and their effects are impaired in asthma. The association between asthma and obesity raises the question whether the deep inspiration (DI) effect is also impaired in the latter condition. We assessed the DI effects in obese and nonobese nonasthmatics. Thirty-six subjects (17 obese, 19 nonobese) underwent routine methacholine (Mch) challenge and 30 of them also had a modified bronchoprovocation in the absence of DIs. Lung function was monitored with spirometry and forced oscillation (FO) [resistance (R) at 5 Hz (R5), at 20 Hz (R20), R5-R20 and the integrated area of low-frequency reactance (AX)]. The response to Mch, assessed with area under the dose-response curves (AUC), was consistently greater in the routine challenge in the obese (mean ± SE, obese vs. nonobese AUC: R5: 15.7 ± 2.3 vs. 2.4 ± 2.0, P < 0.0005; R20: 5.6 ± 1.4 vs. 1.4 ± 1.2, P = 0.027; R5-R20: 10.2 ± 1.6 vs. 0.9 ± 0.1.4, P < 0.0005; AX: 115.6 ± 22.0 vs. 1.5 ± 18.9, P < 0.0005), but differences between groups in the modified challenge were smaller, indicating reduced DI effects in obesity. Given that DI has bronchodilatory and bronchoprotective effects, we further assessed these components separately. In the obese subjects, DI prior to Mch enhanced Mch-induced bronchoconstriction, but DI after Mch resulted in bronchodilation that was of similar magnitude as in the nonobese. We conclude that obesity is characterized by increased Mch responsiveness, predominantly of the small airways, due to a DI effect that renders the airways more sensitive to the stimulus.

Objective: To highlight complexities in defining vitamin D sufficiency in children., Study Design: Serum 25-(OH) vitamin D [25(OH)D] levels from 140 healthy obese children age 6 to 21 years living in the inner city were compared with multiple health outcome measures, including bone biomarkers and cardiovascular risk factors. Several statistical analytic approaches were used, including Pearson correlation, analysis of covariance (ANCOVA), and "hockey stick" regression modeling., Results: Potential threshold levels for vitamin D sufficiency varied by outcome variable and analytic approach. Only systolic blood pressure (SBP) was significantly correlated with 25(OH)D (r = -0.261; P = .038). ANCOVA revealed that SBP and triglyceride levels were statistically significant in the test groups [25(OH)D <10, <15 and <20 ng/mL] compared with the reference group [25(OH)D >25 ng/mL]. ANCOVA also showed that only children with severe vitamin D deficiency [25(OH)D <10 ng/mL] had significantly higher parathyroid hormone levels (Δ = 15; P = .0334). Hockey stick model regression analyses found evidence of a threshold level in SBP, with a 25(OH)D breakpoint of 27 ng/mL, along with a 25(OH)D breakpoint of 18 ng/mL for triglycerides, but no relationship between 25(OH)D and parathyroid hormone., Conclusions: Defining vitamin D sufficiency should take into account different vitamin D-related health outcome measures and analytic methodologies., (Copyright © 2011 Mosby, Inc. All rights reserved.)

Racial and ethnic disparities in obesity persist despite a narrowing in obesity risk associated with socioeconomic status. The household environment has been shown to be important in understanding obesity-promoting behaviors in diverse populations. Our current study was designed to examine the relationship between household density and obesity in young Black and White adults aged 18-30 years from the Coronary Artery Risk Development in Young Adults (CARDIA) cohort. All sociodemographic and leisure-time physical activity (LTPA) information for this study was collected by questionnaire between 1990-1991. Height was collected using a mounted centimeter ruler. Weight was measured on a balance beam scale. Obesity was defined as a body mass index > or = 30 kg/m2. Household density (HD) was defined as the ratio of people to bedrooms in the home. High HD was defined as a ratio > 1. Bivariate analysis showed that more women tend to live in high density households compared to men (45.4% vs 38.9%; P < .01) and more Blacks tend to live in high density households compared to Whites (53.7% vs 31.8%). Leisure-time physical activity index was lower in Blacks than in Whites (2.5% vs 2.6%; P < .01). Blacks had a higher prevalence of obesity than Whites (27.1% vs 11.8%; P < .01). Logistic regression analysis showed that Black women within high HD were at highest risk for obesity compared to White women living within low HD (OR = 4.88%; 95% CI: 3.56-6.67). HD may provide an important context in understanding racial disparities in obesity-promoting behaviors.

To determine whether age of bottle-weaning is associated with overweight in young children, National Health and Nutrition Examination Survey III data for 3027 children aged 3-5 years were analyzed. The main outcome measure, the child's body mass index (BMI), was measured as: <85%, 85-95%, >95%. Mean bottle-weaning age was 18.78 months. After adjustment for potential confounders, each additional month of bottle use corresponded to a 3% increase in the odds of being in a higher BMI category (95% CI 0.0099-0.0535). Prolonged bottle use in young children is associated with increased risk of overweight. From a preventive medicine standpoint, decreasing exposure to this potential risk for childhood overweight is indicated.

Objective: The potential effects of ethnicity, gender, and adiposity on the serum lipid profile in persons with spinal cord injury (SCI) were determined. SUBJECTS:&EMSP;:Subjects with SCI were recruited during their annual physical examination from Rancho Los Amigos Medical Center, Downey, California. Sedentary able-bodied controls were Bridge and Tunnel Officers of the Triboro Bridge and Tunnel Authority of the New York City metropolitan area. METHODS:&EMSP;:Serum lipid profiles were investigated in 320 subjects with SCI and compared to those obtained from 303 relatively sedentary able-bodied controls. Serum lipid studies were obtained in the fasting state. Data were collected between 1993 and 1996. All lipid determinations were performed by the same commercial laboratory. MAIN OUTCOME MEASURES:&EMSP;:The dependent variables were the values from the lipid profile analysis. The independent variables consisted of study group, gender, ethnic group, age, duration of injury, and anthropometric measurements. RESULTS:&EMSP;:The serum high-density lipoprotein cholesterol (HDL-c) level was reduced in the SCI compared with the control group (mean±SEM) (42±0.79 vs 47±0.67 mg/dl, P<0.0005). The serum HDL-c level was significantly lower in males with SCI than males in the control group (39±0.83 vs 45±0.70 mg/dl, P<0.0001), but not for females (51±1.54 vs 54±1.52 mg/dl, n.s.). Within the subgroups for whites and Latinos, HDL-c values were also lower in subjects with SCI than in controls (whites: 41±1.02 vs 46±0.86 mg/dl, P<0.0001; Latinos: 37±1.53 vs 42±1.59 mg/dl, P<0.05), but not for African Americans (49±1.56 vs 51±1.27 mg/dl, n.s.). African Americans had higher HDL-c values than whites or Latinos (SCI: 49±1.56 vs 41±1.02 or 37±1.53 mg/dl, P<0.0001; controls: 51±1.27 vs 46±0.86 mg/dl, P<0.01 or 42±1.59 mg/dl, P<0.0005). In persons with SCI, the serum HDL-c values were inversely... [ABSTRACT FROM AUTHOR]