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Objective: Studies have consistently shown that African American individuals lose less weight in response to behavioral interventions, but the mechanisms leading to this result have been understudied. Methods: Data were derived from the PROmoting Successful Weight Loss in Primary CarE in Louisiana (PROPEL) study, which was a cluster‐randomized, two‐arm trial conducted in primary care clinics. In the PROPEL trial, African American individuals lost less weight compared with patients who belonged to other racial groups after 24 months. In the current study, counterfactual mediation analyses among 445 patients in the intervention arm of PROPEL were used to determine which variables mediated the relationship between race and weight loss. The mediators included treatment engagement, psychosocial, and lifestyle factors. Results: At 6 months, daily weighing mediated 33% (p = 0.008) of the racial differences in weight loss. At 24 months, session attendance and daily weighing mediated 35% (p = 0.027) and 66% (p = 0.005) of the racial differences in weight loss, respectively. None of the psychosocial or lifestyle variables mediated the race‐weight loss association. Conclusions: Strategies specifically targeting engagement, such as improving session attendance and self‐weighing behaviors, among African American individuals are needed to support more equitable weight losses over extended time periods. [ABSTRACT FROM AUTHOR]

Objective: This study tested whether initial weight change (WC), self‐weighing, and adherence to the expected WC trajectory predict longer‐term WC in an underserved primary‐care population with obesity. Methods: Data from the intervention group (n = 452; 88% women; 74% Black; BMI 37.3 kg/m2 [SD: 4.6]) of the Promoting Successful Weight Loss in Primary Care in Louisiana trial were analyzed. Initial (2‐, 4‐, and 8‐week) percentage WC was calculated from baseline clinic weights and daily at‐home weights. Weights were considered adherent if they were on the expected WC trajectory (10% at 6 months with lower [7.5%] and upper [12.5%] bounds). Linear mixed‐effects models tested whether initial WC and the number of daily and adherent weights predicted WC at 6, 12, and 24 months. Results: Percentage WC during the initial 2, 4, and 8 weeks predicted percentage WC at 6 (R2 = 0.15, R2 = 0.28, and R2 = 0.50), 12 (R2 = 0.11, R2 = 0.19, and R2 = 0.32), and 24 (R2 = 0.09, R2 = 0.11, and R2 = 0.16) months (all p < 0.01). Initial daily and adherent weights were significantly associated with WC as individual predictors, but they only marginally improved predictions beyond initial weight loss alone in multivariable models. Conclusions: These results highlight the importance of initial WC for predicting long‐term WC and show that self‐weighing and adherence to the expected WC trajectory can improve WC prediction. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to test the hypothesis that ephedrine + caffeine (EC) reduces the fall in resting energy expenditure (REE) following bariatric surgery. Methods: This 32‐week, randomized, double‐blinded, placebo‐controlled trial included 142 patients who underwent Roux‐en‐Y gastric bypass (RYGB) or sleeve gastrectomy (SG) surgery. Participants were randomized to either EC or placebo for 27 weeks, beginning 5 weeks post surgery. The primary end points were change in REE (measured), percentage of predicted REE ([measured REE/Harris‐Benedict equation‐predicted REE] × 100), and body composition. Secondary outcomes included change in percentage of weight. Adverse events (AEs) were recorded. Results: The reduction in REE was smaller in the EC versus the placebo group, but it was not significant. Percentage of predicted REE was increased in the EC versus the placebo group (difference, mean [SE]: 5.82 [2.29], p = 0.013). Percentage of weight (difference: −3.83 [1.39], p = 0.007) was reduced in the EC versus the placebo group. Percentage of predicted REE was increased and body weight decreased in the EC‐treated participants who underwent SG compared with those who underwent SG and were treated with placebo (difference in percentage of predicted REE = 8.06 [2.83], p = 0.006; difference in weight percentage = −4.37 [1.92], p = 0.025). Percentage of fat‐free mass was increased in the SG participants treated with EC versus placebo (difference: 1.31 [0.63], p = 0.042). The most common AEs were anxiety, dizziness, insomnia, and tremors. Most AEs were not different from placebo by Week 32. Conclusions: EC enhances weight loss and reduces the fall in REE following bariatric surgery. Adrenergic symptoms mostly resolve over time. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to report the results of five weight-loss interventions in primary care settings in underserved patients and to compare the level of pragmatism across the interventions using the Pragmatic Explanatory Continuum Indicator Summary (PRECIS-2) tool. Methods: Data from 54 primary care clinics (2,210 patients) were pooled from the Promoting Successful Weight Loss in Primary Care in Louisiana (PROPEL) and Rural Engagement in Primary Care for Optimizing Weight Reduction (REPOWER) cluster-randomized trials. Clinics were randomized to one of five comparators: PROPEL usual care, PROPEL combination of in-clinic and telephone visits, REPOWER in-clinic individual visits, REPOWER in-clinic group visits, or REPOWER telephone group visits. Results: At 24 months, weight loss (kilograms) was -0.50 (95% CI: -1.77 to 0.76), -3.05 (-4.10 to -2.01), -4.30 (-5.35 to -3.26), -4.79 (-5.83 to -3.75), and -4.80 (-5.96 to -3.64) in the PROPEL usual care, REPOWER in-clinic individual visits, REPOWER telephone group visits, REPOWER in-clinic group visits, and PROPEL in-clinic and telephone visits arms, respectively. At 24 months, percentage of weight loss was -0.360 (-1.60 to 0.88), -3.00 (-4.02 to -1.98), -4.23 (-5.25 to -3.20), -4.67 (-5.69 to -3.65), and -4.69 (-5.82 to -3.56), respectively, in the five arms. The REPOWER in-clinic individual visits intervention was the most pragmatic and reflects the current Centers for Medicare and Medicaid Services funding model, although this intervention produced the least weight loss. Conclusions: Clinically significant weight loss over 6 months in primary care settings is achievable using a variety of lifestyle-based treatment approaches. Longer-term weight-loss maintenance is more difficult to achieve. [ABSTRACT FROM AUTHOR]

Objective: Naringenin, a citrus flavonoid, prevents diet-induced weight gain and improves glucose and lipid metabolism in rodents. There is evidence that naringenin activates brown fat and increases energy expenditure in mice, but little is known about its effects in humans. The goal of this study was to examine the effects of naringenin on energy expenditure in adipose tissue.Methods: Human white adipocyte cultures (hADSC) and abdominal subcutaneous adipose tissue (pWAT) were treated with naringenin for 7 to 14 days. Expression (quantitative real-time polymerase chain reaction, immunoblotting) of candidate genes involved in thermogenesis and glucose metabolism was measured. Oxygen consumption rate was measured in hADSC using a Seahorse flux analyzer.Results: In hADSC, naringenin increased expression of the genes associated with thermogenesis and fat oxidation, including uncoupling protein 1 and adipose triglyceride lipase, and key factors associated with insulin sensitivity, including glucose transporter type 4, adiponectin, and carbohydrate-responsive element-binding protein (P < 0.01). Similar responses were observed in pWAT. Basal, ATP-linked, maximal and reserve oxygen consumption rate increased in the naringenin-treated hADSC (P < 0.01).Conclusions: Naringenin increases energy expenditure in hADSC and stimulates expression of key enzymes involved in thermogenesis and insulin sensitivity in hADSC and pWAT. Naringenin may promote conversion of human white adipose tissue to a brown/beige phenotype. [ABSTRACT FROM AUTHOR]

Objective: Given the disease burden and economic costs of obesity in the United States, scalable approaches to weight loss and weight management are needed. This study evaluated self-reported weight-loss outcomes associated with a commercial intensive lifestyle intervention marketed to employers and delivered electronically to employees.Methods: Data were collected for participants who enrolled in an online intensive lifestyle intervention weight-loss program from July 2015 through June 2016. An intent-to-treat analysis of participants who attended at least one session is reported.Results: Ninety-six companies, with approximately 437,215 eligible adult beneficiaries, launched Real Appeal in July 2015. In the first 12 months of the program, 69,598 adults enrolled and 87% met at-risk criteria for prediabetes, diabetes, or cardiovascular disease. The intent-to-treat cohort (n = 52,461), all of whom attended at least one session, lost an average of 2.8% body weight, with 23% achieving 5% or more weight loss. Active participants (n = 38,836) lost an average of 3.5% body weight, with 29% achieving 5% weight loss. Program completers (n = 27,164) lost an average of 4.3% body weight, with 36% of the cohort achieving 5% weight loss.Conclusions: This study demonstrated that an employer-offered, online, behavioral weight-loss program was an effective, scalable solution for engaging more than 50,000 participants with overweight and obesity. [ABSTRACT FROM AUTHOR]

Objective: Multiple factors contribute to the rising rates of obesity and to difficulties in weight reduction that exist in the worldwide population. Caloric intake via sugar-sweetened beverages may be influential. This study tested the hypothesis that liquid sucrose intake promotes obesity by increasing serum insulin levels and tissue lipid accumulation.Methods: C57BL/6J mice were given 30% sucrose in liquid form. Changes in weight gain, body composition, energy expenditure (EE), and tissue lipid content were measured.Results: Mice drinking sucrose gained more total body mass (TBM), had greater fat mass, and displayed impaired glucose tolerance relative to control mice. These metabolic changes occurred without alterations in circulating insulin levels and despite increases in whole body EE. Lipid accrued in liver, but not skeletal muscle, of sucrose-consuming mice. Oxygen consumption (VO2 ) correlated with fat-free mass and moderately with TBM, but not with fat mass. ANCOVA for treatment effects on EE, with TBM, VO2 , lean body mass, and fat-free mass taken as potential covariates for EE, revealed VO2 as the most significant correlation.Conclusions: Weight gain induced by intake of liquid sucrose in mice is associated with lipid accrual in liver, but not skeletal muscle, and occurs without an increase in circulating insulin. [ABSTRACT FROM AUTHOR]

Objective: Dietary methionine restriction (MR) improves biomarkers of metabolic health, in part through coordinated increases in energy intake and energy expenditure (EE). Some metabolic benefits of dietary MR are secondary to its effects on energy balance, so this study's purpose was to examine how age at initiation of MR influences its effects on energy balance and body composition.Methods: Energy balance was examined in rats provided control or MR diets for 9 months after weaning or in rats between 6 and 12 months of age.Results: Rats provided the control diet for 9 months after weaning increased their body weight (BW) and fat mass by five- and eightfold, respectively, while BW and fat accumulation in the MR group were reduced to 50% of that of controls. In adult rats fed the respective diets between 6 and 12 months of age, dietary MR increased energy intake by ∼23%, but the 15% increase in EE was sufficient to prevent increases in BW or fat mass.Conclusions: Dietary MR produces comparable increases in EE in young, growing animals and in mature animals, but young animals continue to deposit new tissue because of the proportionately larger effect of MR on energy intake relative to maintenance requirements. [ABSTRACT FROM AUTHOR]

Objective: To examine the joint association of birth weight and physical activity/sedentary time with childhood obesity in 12 countries.Methods: A cross-sectional study of 5,088 children aged 9 to 11 years was conducted. Birth weight was recalled by parents or guardians. Moderate-to-vigorous physical activity (MVPA) and sedentary behavior were objectively measured using accelerometry.Results: The association of birth weight with the odds of obesity, central obesity, and high body fat was significant among children with either low MVPA or high sedentary time but not among children with either high MVPA or low sedentary time. In comparison with children with normal birth weight and high MVPA, children with high birth weight and low MVPA showed 4.48- to 5.18-fold higher odds of obesity, central obesity, and high body fat; children with normal birth weight and low MVPA showed 3.00- to 3.30-fold higher odds of obesity, central obesity, and high body fat, and children with high birth weight and high MVPA showed 1.16- to 1.68-fold higher odds of obesity, central obesity, and high body fat.Conclusions: High MVPA is more important than high birth weight as a correlate of obesity in children. [ABSTRACT FROM AUTHOR]

Objective Caffeine and ephedrine was an effective combination therapy for weight loss until ephedrine was removed from the market due to safety concerns. This study investigated the combination of caffeine and albuterol as a possibly safer alternative to ephedrine. Methods In a series of experiments using cultured adipocytes, rat models, and humans, the effects of caffeine and albuterol on lipolysis, metabolic rate, food intake, and body composition were evaluated. Results Both caffeine and albuterol enhanced lipolysis in cultured adipocytes. Acute treatment of humans with caffeine and/or albuterol increased resting metabolic rate. Longer-term studies of rats revealed a trend for increased metabolic rate with albuterol treatment. There was increased lean mass gain concurrent with decreased fat mass gain with caffeine/albuterol treatment that was greater than albuterol treatment alone. Conclusions In rats, albuterol with caffeine produced significantly greater increases in lean body mass and reductions in fat mass without changes in food intake after 4-8 weeks of treatment. Since caffeine and albuterol are approved for the treatment of asthma in children and adolescents at the doses tested and change body composition without changing food intake, this combination may deserve further exploration for use in treating pediatric obesity. [ABSTRACT FROM AUTHOR]

Objective The aim was to assess associations between lifestyle behaviors and obesity in a multinational study of children from 12 countries representing a wide range of human development. Methods The sample included 6,025 children 9-11 years of age. Behavioral risk factors included nocturnal sleep duration, moderate to vigorous physical activity (MVPA), television viewing (TV time), and healthy and unhealthy diet pattern scores. Multilevel analyses were used to obtain odds ratios for obesity expressed per standard deviation of each behavioral risk factor. Results The odds ratios (95% confidence intervals) for obesity from multilevel, multivariable models were 0.79 (0.71-0.90) for nocturnal sleep duration, 0.52 (0.45-0.60) for MVPA, 1.15 (1.05-1.27) for TV time, 1.08 (0.96-1.20) for healthy diet score, and 0.93 (0.83-1.04) for unhealthy diet score in boys and 0.71 (0.63-0.80) for nocturnal sleep duration, 0.43 (0.35-0.53) for MVPA, 1.07 (0.96-1.19) for TV time, 1.05 (0.93-1.19) for healthy diet score, and 0.96 (0.82-1.11) for unhealthy diet score in girls. Conclusions Behavioral risk factors are important correlates of obesity in children, particularly low MVPA, short sleep duration, and high TV viewing. [ABSTRACT FROM AUTHOR]

Dcpp2, Prrt1, and Has1 are plausible candidate genes for the Mnic1 (macronutrient intake-carbohydrate) locus on mouse chromosome 17, based on their map positions and sequence variants, documented expression in salivary glands, and the important role of saliva in oral food processing and taste. We investigated the effects of genotype and diet on gene expression in salivary glands (parotid, submandibular, sublingual) of carbohydrate-preferring, C57 BL6J. CAST/EiJ-17.1 subcongenic mice compared to fat-preferring wild-type C57 BL/6J. To achieve accurate normalization of real-time quantitative RT- PCR data, we evaluated multiple reference genes to identify the most stably expressed control genes in salivary gland tissues, and then used geometric averaging to produce a reliable normalization factor. Gene expression was measured in mice fed different diets: (1) rodent chow, (2) macronutrient selection diets, (3) high-fat diet, and (4) low-fat diet. In addition, we measured salivary hyaluronan concentrations. All three genes showed strain differences in expression, in at least one major salivary gland, and diet effects were observed in two glands. Dcpp2 expression was limited primarily to sublingual gland, and strongly decreased in B6. CAST-17.1 subcongenic mice compared to wild-type B6, regardless of diet. In contrast, both genotype and diet affected Prrt1 and Has1 expression, in a gland-specific manner, for example, Prrt1 expression in the parotid gland alone was strongly reduced in both mouse strains when fed macronutrient selection diet compared to chow. Notably, we discovered an association between diet composition and salivary hyaluronan content. These results demonstrate robust effects of genetic background and diet composition on candidate gene expression in mouse salivary glands. [ABSTRACT FROM AUTHOR]

Objective The Lower Mississippi Delta (LMD) region of the United States is characterized by high levels of obesity and physical inactivity. The objective was to test the effectiveness of adapting the 2010 Dietary Guidelines for Americans (DG), with and without a physical activity (PA) component, for attenuating weight gain. Methods Overall, 121 white and African-American adults (35-64 years; body mass index 25-34.9 kg/m2) were randomized to a DG only group ( n = 61) or a DG + PA group ( n = 60). Both groups received a 12-week dietary education and behavior change intervention. The DG + PA group also received PA education and a pedometer. Changes in weight (kg), %weight, and waist circumference (WC; cm) were determined. Analyses considered all completers ( n = 99) and those who engaged with ≥80% of the intervention ( n = 83). General linear models compared mean changes between groups after adjustment for baseline values, race, and sex. Results Weight, %weight, and WC significantly decreased from baseline to follow-up in both groups ( p < 0.05; unadjusted values). Adjusted analysis showed a main effect of group for weight ( p = 0.041) and %weight ( p = 0.047) in the completers analysis, and WC ( p = 0.046) in the ≥80% attendance analysis, with the DG + PA group improving weight-related outcomes more. Conclusions Low-burden behavioral interventions could be effective strategies in attenuating unhealthy weight gain in the LMD. [ABSTRACT FROM AUTHOR]

The prevention of weight gain to address the obesity epidemic rather than weight loss involves promoting small changes in food choices and physical activity. People United to Sustain Health (PUSH) was designed to increase fruit and vegetable consumption, physical activity, and food security to prevent weight gain in rural adults. Forty-nine participants were randomized into a treatment group which received access to a 'Rolling Store,' nutrition education and physical activity, and a control group which received family coping classes. Forty-one (84%) of participants completed the study. At the end of 6 months, weight for all participants was maintained from baseline to completion with no significant differences between the groups. The mean fruit consumption over 6 months for the treatment group increased and was significantly greater than change in the control group ( p = 0.01). This community-based participatory research study was considered successful because weight gain was prevented. [ABSTRACT FROM AUTHOR]

Introduction Engaging community residents to obtain their feedback in conducting clinical research, and including them as leaders in implementing applicable health advances is crucial for success and sustaining large center awards. Methods Forty-four adult men and women participated in one of four focus groups. Two groups each (one African American and one Caucasian) were conducted in Baton Rouge and in New Orleans. Results In an effort to determine the knowledge, attitudes, and beliefs Louisiana residents have about the Louisiana Clinical and Translational Science (LA CaTS) Center concept, four main themes emerged from focus group participants concerning the state's research institutions, and what it means to have these institutions operating under one umbrella to improve the quality of health of its people: (1) academic/research institutions of the State are uniformly widely recognized and held in high regard; (2) increasing awareness of clinical research is a necessity; (3) establishing the LA CaTS Center is an excellent idea; and (4) effective communication including delivery style is crucial to partnerships and especially to the community. Conclusion Focus group discussions can provide insight into community residents' perceptions, beliefs, motivations, and patterns of behavior for strategically planning for large center awards. [ABSTRACT FROM AUTHOR]

BMI and waist circumference (WC) are used to identify individuals with elevated obesity-related health risks. The current thresholds were derived largely in populations of European origin. This study determined optimal BMI and WC thresholds for the identification of cardiometabolic risk among white and African-American (AA) adults. The sample included 2,096 white women, 1,789 AA women, 1,948 white men, and 643 AA men aged 18-64 years. Elevated cardiometabolic risk was defined as ≥2 risk factors (blood pressure ≥130/85 mm Hg; glucose ≥100 mg/dl; triglycerides ≥150 mg/dl; high-density lipoprotein-cholesterol <40 mg/dl (men) or <50 mg/dl (women)). Receiver Operating Characteristic (ROC) curves were used to identify optimal BMI and WC thresholds in each sex-by-ethnicity group. The optimal BMI thresholds were 30 kg/m2 in white women, 32.9 kg/m2 in AA women, 29.1 kg/m2 white men, and 30.4 kg/m2 in AA men, whereas optimal WC thresholds were 91.9 cm in white women, 96.8 cm in AA women, 99.4 in white men, and 99.1 cm in AA men. The sensitivities at the optimal thresholds ranged from 63.5 to 68.5% for BMI and 68.4 to 71.0% for WC and the specificities ranged from 64.2 to 68.8% for BMI and from 68.5 to 71.0% for WC, respectively. In general, the optimal BMI and WC thresholds approximated currently used thresholds in men and in white women. There are no apparent ethnic differences in men; however, in AA women the optimal BMI and WC values are ~3 kg/m2 and 5 cm higher than in white women. [ABSTRACT FROM AUTHOR]

Cross-sectional studies have reported significant temporal increases in prevalence of childhood obesity in both genders and various racial groups, but recently the rise has subsided. Childhood obesity prevention trials suggest that, on average, overweight/obese children lose body weight and nonoverweight children gain weight. This investigation tested the hypothesis that overweight children lose body weight/fat and nonoverweight children gain body weight/fat using a longitudinal research design that did not include an obesity prevention program. The participants were 451 children in 4th to 6th grades at baseline. Height, weight, and body fat were measured at month 0 and month 28. Each child's BMI percentile score was calculated specific for their age, gender and height. Higher BMI percentile scores and percent body fat at baseline were associated with larger decreases in BMI and percent body fat after 28 months. The BMI percentile mean for African-American girls increased whereas BMI percentile means for white boys and girls and African-American boys were stable over the 28-month study period. Estimates of obesity and overweight prevalence were stable because incidence and remission were similar. These findings support the hypothesis that overweight children tend to lose body weight and nonoverweight children tend to gain body weight. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine sex and race differences in the relationship between anthropometric measurements and adiposity in white and African-American (AA) adults. Visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) areas were measured with computed tomography (CT). Fat mass (FM) was measured with dual-energy-X-ray absorptiometry (DXA). Correlation coefficients were used to assess the relationship of waist circumference (WC) and BMI to VAT, SAT, and FM within sex-by-race groups. General linear models were used to compare relationships between WC or BMI, and adiposity across sex and race, within age groups (18-39 and 40-64 years). The sample included 1,667 adults (men: 489 white; 120 AA; women: 666 white, 392 AA). WC and BMI correlations were highest for FM and SAT compared to VAT. Women had higher FM levels than men regardless of WC, but the sex difference in FM was attenuated in younger AA adults with a high BMI. For a given level of WC or BMI, women had higher levels of SAT than men; however, significant interactions indicated that the relationship was not consistent across all levels of BMI and WC. Sex and race differences in VAT varied significantly with WC and BMI. In general, white adults had higher levels of VAT than AA adults at higher levels of BMI and WC. Sex differences, and in some instances race differences, in the relationships between anthropometry and fat-specific depots demonstrate that these characteristics need to be considered when predicting adiposity from WC or BMI. [ABSTRACT FROM AUTHOR]

J. Neurochem. (2010) 114, 1581–1589. Long term consumption of a high fat diet (HFD) contributes to increased morbidity and mortality. Yet the specific effects of HFD consumption on brain aging are poorly understood. In the present study 20-month old male C57Bl/6 mice were fed either ‘western diet’ (41% fat), very high fat lard diet (60% fat), or corresponding control diets for 16 weeks and then assessed for changes in metabolism and brain homeostasis. Although both HFDs increased adiposity and fasting blood glucose, only the high fat lard diet increased age-related oxidative damage (protein carbonyls) and impaired retention in the behavioral test. This selective increase in oxidative damage and cognitive decline was also associated with a decline in NF-E2-related factor 2 (Nrf2) levels and Nrf2 activity, suggesting a potential role for decreased antioxidant response. Taken together, these data suggest that while adiposity and insulin resistance following HFD consumption are linked to increased morbidity, the relationship between these factors and brain homeostasis during aging is not a linear relationship. More specifically, these data implicate impaired Nrf2 signaling and increased cerebral oxidative stress as mechanisms underlying HFD-induced declines in cognitive performance in the aged brain. [ABSTRACT FROM AUTHOR]

As use of self-reported data to classify obesity continues, ethnic differences in reporting errors remain unclear. The objective of this study is to elucidate misreporting disparities between African Americans (AAs) and European Americans (EAs). The Pennington Center Longitudinal Study (PCLS) is an ongoing investigation of environmental, behavioral, and biological factors associated with obesity, diabetes, and other common diseases. Self-reported and measured height and weight were collected during initial screening for eligibility in various studies by telephone and clinic visits. All ethnicity–sex groups (15,656 adults aged 18–65 years, 53% obese, 34% AA, 37% men) misreported heights and weights increasingly as measured values increased (P < 0.0001). More AA vs. EA women (P < 0.001) misreported height and weight, but more EA vs. AA men misreported their weight (P < 0.02). Obesity was underestimated more in AA vs. EA women (self-reported − measured prevalence = −4.0% (AA) vs. −2.6% (EA), P < 0.0001), but less in AA vs. EA men (−3.2% (AA) vs. −4.2% (EA), P < 0.0001)). With measured obesity prevalence equalized at 53% in all groups, the self-reported obesity prevalence in women was 50.4% (AA) vs. 49.6% (EA), and in men 49.8% (AA) vs. 47.3 (EA). Underestimation in women was −2.6% (AA) vs. −3.4% (EA); in men it was −3.2% (AA) vs. −5.7% (EA), P < 0.003. Self-reported height and weight portend underestimation of obesity prevalence and the effect varies by ethnicity and gender. However, comparisons depend on the true prevalence within ethnicity–gender groups. After controlling for obesity prevalence, disparity in underestimation was greater in EA than in AA men (P < 0.003) but not women.Obesity (2009) 17 3, 571–577. doi:10.1038/oby.2008.582 [ABSTRACT FROM AUTHOR]

Background: Previous investigations have shown that low academic achievers are more likely to smoke cigarettes, drink alcohol, and use marijuana and other illicit drugs. This study investigated the relationship between academic performance and substance use among public high school students in Mississippi. Methods: The sampling frame for the 2003 Mississippi Youth Risk Behavior Survey was obtained from the Mississippi Department of Education. A 2-stage cluster sample design produced a representative sample of Mississippi students in grades 9-12 who attended public schools. During the spring 2003, 34 of the 45 sampled schools (75. 6%) participated. Results: A total of 1488 from the 1672 sampled students (89. 0%) completed an 87-item questionnaire (overall response rate 67. 3%). Low academic performance (students with mostly Cs or below) during the 12 months preceding the survey was more prevalent among males, non-Hispanic blacks, frequent smokers, binge drinkers, and marijuana users. Logistic regression identified gender, race, frequent smoking, and marijuana use as statistically significant factors associated with increased odds for low academic performance. Adjusted odds ratios were 1. 2 for binge drinkers versus other students to 2. 6 for non-Hispanic black students versus non-Hispanic white students. Conclusions: The present findings highlight the extensive use of cigarettes, alcohol, and marijuana among Mississippi public high school students. Because poor academic achievers are more prevalent among students who participate in these substance-use behaviors, multifaceted approaches that encourage high levels of academic performance, while dissuading student involvement in risky/problem behaviors, may both improve low levels of academic achievement and reduce behaviors that contribute to poor health in adulthood. [ABSTRACT FROM AUTHOR]

This study investigated racial differences of tobacco use and social exposure to tobacco products in a sample of middle school students. Questionnaires were administered in January 2005 to 290 students in a Mississippi Delta-area middle school. The participants were 51.0% female and 56.6% African American. Unadjusted odds ratios revealed that Caucasian students were statistically more likely than were African American students to (1) have ever tried smoking, (2) have ever been a daily smoker, (3) have smoked in the past 30 days, (4) live with someone who smokes, (5) have seen a parent or guardian smoke, and (6) have friends who smoke. In contrast, African Americans were more likely to report “no one is allowed to smoke” in their home. Caucasian females had the highest rates of smoking, as well as the highest exposure to social smoking behaviors. This study not only showed that Caucasians were indeed smoking more but also that African American adolescents do not have the same exposure to social smoking, particularly African American females. Of particular interest was why the differences eventually dissipate and smoking rates are virtually the same in adulthood. A greater understanding of the impact of exposure to tobacco use on an adolescent’s own tobacco use is vital to prevention efforts, especially in regard to racial differences. Future research on youth tobacco prevention and cessation programs should focus on sociocultural and racial differences in the development of tobacco use in adolescents. (J Sch Health. 2006;76(5):195-200) [ABSTRACT FROM AUTHOR]

ABSTRACT: Researchers examined trends and compared subgroup differences in violence-related behaviors on school property among Mississippi public high school students from 1993 to 2003. Findings are based on data from the Mississippi Youth Risk Behavior Surveillance System (YRBSS), a representative sample (N = 9,058) of Mississippi high school students. Males, non-Hispanic Whites, heavy smokers, and binge drinkers reported violence-related behaviors on school property more frequently than their counterparts. A statistically significant linear decrease occurred during 1993-2003 in the percent of students carrying a weapon (p < 0.0001) and having a physical fight (p < 0.0001). The percent of students threatened or injured with a weapon on school grounds did not decrease significantly (p = 0.2800). Violence-related behaviors were reported somewhat less frequently among 12th graders but overall, grade was not a statistically significant factor. Trends observed in Mississippi appear to be occurring throughout the United States and perhaps globally. Parents, school officials, and community administrators are committed to reducing violence-related behavior on school property. Although the decreases are encouraging, the percent of students who reported violence-related behaviors remains at a level that causes serious concern. Efforts must continue and perhaps increase to curb behaviors that may lead to school violence. Future studies should elucidate mechanisms associated with the self-reported decreasing behaviors so intervention programs can be properly focused. (J Sch Health. 2005;75(2):67-71). [ABSTRACT FROM AUTHOR]