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The influence of spiritual factors on the ability of African-American elders to carry out instrumental activities of daily living (IADL) independent of age, gender, education, and self-rated health is explored using the religion-health explanatory model in a cross-sectional sample of 96 African-American community dwelling adults 62 to 93 years of age. The Reed spiritual perspective (SPS) and self-transcendence (STS) scales are used to study spiritual factors (Reed, 1991). The typical respondent was 75 years of age, female, widowed with 10.4 years of education. Self-rated health and age are strongly related to IADL in models that include the other variables ( R2 = 0.41, p < 0.01). Those who are younger and those who self-report better health have higher IADL scores than those without these characteristics. Spiritual factors are significantly related to IADL in a model that includes an interaction of STS with education ( R2 = 0.50). Among the least educated, STS is associated with higher scores of IADL. Addition of the interaction to the model resulted in a significant positive association of both STS and education with IADL. SPS was unrelated to IADL. Caregivers concerned with functional ability may want to consider interventions based on increasing a sense of self-transcendence, and to consider educational level as a potential moderator of this relationship. Criticism of the religion-health literature has suggested that putative health effects of religion may be exaggerated, because of failure to take confounding variables into account (Sloan, Bagiella, & Powell, 1999). However, this study and a recent survey by Musick, House, and Williams (2004) are evidence that it is just as likely that health benefits of religion would be hidden by confounders as that they would be exaggerated by them.

Background: Adolescence is characterized by profound changes in physical, psychological, and social functioning thought to be accompanied by intense and varying moods.Purpose: Within a psychophysiological framework, this study examined the prevalence of 12 self-reported mood states of adolescents; investigated associations between specific mood states and ambulatory blood pressure readings; and explored effects of interactions among moods, gender, ethnic group, and maturation on ambulatory blood pressures.Methods: The sample included 371 African American, European American, and Hispanic American adolescents 11 to 16 years old. Systolic (SBP) and diastolic (DBP) blood pressures were measured every 30 min with an ambulatory monitor and were synchronized with electronic activity monitoring and moods self-recorded during waking hours in a checklist diary.Results: Moods differed significantly by gender, ethnic group, and maturation. Controlling for height, maturation, gender, ethnic group, mother’s education, position, location, activity, other moods, and interactions of moods with other variables in a multilevel, random coefficients regression model, both positive and negative mood states were associated with higher levels of SBP and DBP; being relaxed or bored, or having a feeling of accomplishing things were associated with lower SBP and DBP. There were significant interaction effects of moods with physical maturity, gender, and ethnic group on ambulatory SBP and DBP.Conclusions: Further study of the modifying effects of gender, ethnic group, and stage of development on reports of moods, and their associations with cardiovascular responses is recommended.

To compare the utility of 10 commonly used body composition indicators (BCIs) in relation to demographic characteristics and cardiovascular risk factors.A cross-sectional, school sample was studied.Three hundred and eighty-four Black, White and Hispanic adolescents 11-16 years of age from Houston, Texas, USA (Heartfelt Study) were studied.BCIs include impedance and skinfold estimates of fat-free mass (FFM); fat mass (FM) and per cent body fat (PBF); resistance mass index (RMI); body mass index (BMI); and waist and abdomen circumferences. The cardiovascular risk factors (blood pressures/heart rates) are summarized by factor analysis. Sexual maturity was clinically assessed.Two distinct classes of BCIs emerged with respect to demographic influences: (1) RMI, impedance and skinfold estimators, for which sexual dimorphism is evident, and (2) BMI and circumferences, for which it is not. All BCIs were strongly related to general (systolic) blood pressure, but only body fat variables were related to heart rates. Skinfold-derived FM, PBF and mid-body circumferences were the variables most strongly related to cardiovascular risk factors.RMI, impedance or skinfold estimators are necessary for research requiring an accurate description of body composition changes during adolescence and for assessing the role of lean and fat tissue in disease aetiology. A 2-skinfold method is just as effective as the more complicated impedance. Mid-body circumferences are closely related to blood pressures and heart rates, suggesting their importance as indicators of abdominal fat in adolescents.

Obesity has reached epidemic proportions in the U.S. and more developed countries, particularly so among adolescents. A substantial impact on public health could be achieved if other factors causing obesity besides the conventional ones of diet and physical activity could be identified and acted upon. The present study investigates whether there is a link between low sleep quality and obesity in a tri-ethnic, cross-sectional sample (n = 383) of male and female adolescents ages 11-16 years old (Heartfelt Study). Sleep quality was expressed as two variables, total sleep time and sleep disturbance time obtained by 24-hour wrist actigraphy. Percent body fat and body mass index (BMI) were used together to define obesity. The potential influence of demographic and behavioral confounders were considered in models that described the relation of sleep to obesity occurrence. Obese adolescents experienced less sleep than nonobese adolescents (P < 0.01). For each hour of lost sleep, the odds of obesity increased by 80%. Sleep disturbance was not directly related to obesity in the sample, but influenced physical activity level (P < 0.01). Daytime physical activity diminished by 3% for every hour increase in sleep disturbance. The above observations were independent of potential confounding variables. Inadequate and poor sleep quality in adolescents may be important factors to consider in the prevention of childhood obesity.

To compare growth patterns of obesity indices derived from body composition and anthropometric measures, the authors analyzed data from Project HeartBeat!, a longitudinal study of cardiovascular disease risk factors in childhood and adolescence. A total of 678 children initially aged 8, 11, and 14 years in The Woodlands and Conroe, Texas, were enrolled and followed with 4-monthly examinations between October 1991 and August 1995. Trajectories of change from age 8 years to age 18 years were estimated for body mass index, percent body fat, abdominal circumference, the sum of two skinfolds, and the sum of six skinfolds. All indices varied importantly with age. Percent body fat, sum of two skinfolds, and sum of six skinfolds shared similar growth patterns, with strong divergence between males and females. Males' body fat decreased with age and females' increased or remained nearly constant with age. In contrast, both body mass index and abdominal circumference increased monotonically with age in both sexes, exhibiting little sex difference as children reached late adolescence. Sex differences were more striking among Blacks than among non-Blacks. The authors conclude that growth patterns of adiposity differ according to the measure chosen. Furthermore, changes in different obesity indices may not relate in the same way to changes in blood pressure or blood lipid concentrations.

OBJECTIVE: To investigate whether within-individual variation is a factor in the generally reported poor tracking of central body fat distribution (CBFD) during development and whether two measurements of CBFD during each measurement occasion would improve the estimate of tracking over time. METHODS: A longitudinal study compared the results of two measurements of body fat (BF) and CBFD during each measurement occasion to the results of one measurement of BF and CBFD during each occasion every 4 months over 1–3 y. A total of 345 boys and 333 girls in three age cohorts of 8, 11 and 14 y at baseline were examined. BF variables were: body mass index (BMI); fat mass and percentage body fat from bioelectrical impedance; two skinfold sums; and abdominal circumference. CBFD variables were: waist/hip and waist/thigh ratios; conicity; and log upper-lower skinfold ratio. RESULTS: Three-year tracking of BF varied from 0.79 to 0.90 for one- and from 0.81 to 0.93 for two-occasion measurements showing no apparent sex- or cohort-effects. Three-year tracking of CBFD was lower than that of BF (0.68–0.75), but improved significantly with two-occasion measurements (0.75–0.82). CONCLUSIONS: Within-individual variation is a significant factor in reported low tracking of CBFD in childhood. Estimates of tracking currently in the literature may underestimate the predictive value of CBFD, possibly because this research has used one-occasion measurement. The increased use of two-occasion measurement should significantly improve the tracking of CBFD during development and provide a more realistic understanding of its predictive value.

An uncertain relation between health and angry/hostile behaviour exists in the literature on adolescents. With data from a pilot study, one possible reason for this is explored: health measures such as blood pressure as well as angry/hostile behaviours may change with, or depend upon physical maturity, body size and body fatness. The sample consists of 60 African-, Hispanic-, and Anglo-American adolescents (15 to 16 years of age) drawn from a public school in Houston, TX. Using resting diastolic blood pressure as a model, in a sex stratified analysis, the following conclusions were reached: Physical maturity in girls and body height in boys were related to ethnicity in the sample and were confounders of the blood pressure and anger relationship. In girls secretive anger ('anger-in') and hostility were associated with increased body fat; expressive anger ('anger-out') in boys is associated with increased conicity (central body fat distribution) (p0.01). These associations were independent of height and physical maturity. Hostility was not significantly related to diastolic blood pressure in boys after adjusting for height and conicity. 'Anger-in' was significantly and positively related to diastolic blood pressure in girls (p0.01). This relationship was strongly mediated by per cent body fat, because the association of 'anger-in' and blood pressure was no longer statistically significant when the model included body fat. The results suggest that measures of physical maturity and more refined measures of body fat and body fat distribution should be considered in studies attempting to link adolescent blood pressure with anger expression.

Distinctions between male and female adult patterns of cardiovascular disease are well established. Although risk for cardiovascular disease begins early in life, little research has been focused on the beginning of gender difference patterns. This pilot study examined blood pressure reactivity, gender, and biologic maturity in adolescents talking about angry life circumstances and the usual progression of their day. Systolic and diastolic blood pressure increased during talking, and the addition of biologic maturity to the analysis distinguished males from females. Males had higher systolic blood pressures than did females throughout the protocol, and, generally, mature subjects had higher systolic and diastolic blood pressures than did less mature subjects. These pilot data confirm the effects of talking on blood pressure. The data suggest that biologic maturity enhances understanding of gender differences in adolescent blood pressure reactivity and continued study of the gender-blood pressure reactivity distinctions in adolescents may further understanding of adult patterns of gender differences in cardiovascular disease.

Precision estimates are given for indices of body mass, fatness and body fat distribution in a sample of n = 19 subjects selected at random from a larger study of cardiovascular disease risk in school-aged children. The value of this study is that little is known about the measurement precision of ratio indices and multivariate constructs of body fat distribution in children or any other age group. Intra- and inter-observer precisions were highest for weight, height, body mass index and six body circumferences (0.95-0.99), and were lower and more variable for five skinfold thicknesses (0.80-0.99). The measurement precision of ratio indices derived from the circumferences (waist/hip and waist/thigh) and the skinfolds (subscapular/thigh and triceps/subscapular) were lower and more variable than precisions of the single variables. Circumference ratio precisions varied from 0.81 to 0.96 and skinfold ratios varied from 0.28 to 0.94. Precisions of a multivariate construct of central fat distribution from five skinfold measures were better (0.77-0.95), suggesting its greater efficacy. Inter-examiner precisions tended to be significantly lower than intra-examiner precisions for skinfold thicknesses and all composite indices. The lower precisions of ratio indices, compared to the measurement accuracy of the variables which make them up, needs to be considered in epidemiological studies of body fat distribution.

The authors studied the association of cardiovascular risk variables with body fat distribution (BFD) in a cross-sectional sample of 743 Texas schoolchildren of both sexes ages 6-14 years. This association is well known in adults and several useful indices of BFD are available. Whether they are applicable to children remains a question of importance for epidemiological investigations in this age group. Canonical correlations between anthropometric (five skinfolds, four circumferences) and risk (blood pressures, cholesterol, pulse) variables ranged from 0.37 to 0.82 depending on sex/age group (p < 0.01). The skinfold vector suggested an association of risk with central fat at most but not all ages. The circumference vectors, on the other hand, suggest that size or fatness, not BFD, was related to risk. Partial correlation and stepwise regression of fatness and BFD indices with cardiovascular risk factors as dependent variables, showed that 'fatness' or 'size' was more clearly associated with risk factors than BFD. The variables most consistently entering the regression were hip circumference and sum of skinfolds. These results contrast with studies of adults or sexually mature adolescents, in which BFD is more clearly related to CV risk variables and the hip circumference is a 'low-risk' variable.

Multivariate associations were sought between risk factor levels (total cholesterol, high density lipoprotein (HDL) cholesterol, triglycerides, glucose, and systolic and diastolic blood pressures) and two sets of anthropometric variables (four circumferences and six skinfolds) to select a set of anthropometric indicators of body fat distribution that correlate most highly with risk of disease. Subjects were men (n = 285) and women (n = 672) from a study of gallbladder disease in a Mexican American population in Starr County, Texas, 1985-1986. The canonical correlations showed that circumferences (0.49-0.61) and skinfolds (0.42-0.60) were equally well correlated to risk factor levels independently of sex and age. Weights from the canonical analyses suggest that measurements at or above the waist and on the lower limb (thigh) are most heavily loaded toward risk (waist = highest risk; thigh = lowest risk). The simplest and most reliable index of body fat distribution for both sexes is the ratio of waist to thigh circumferences. The more commonly used waist/hip ratio proved more valid in women, but not in men. Simple skinfold indices of body fat distribution were more poorly correlated to risk factor levels than the corresponding circumference ratios. In women, body mass index and waist circumference by themselves did as well as body fat distribution indices in explaining variation in risk factors, suggesting the involvement of visceral fat in the body fat/body fat distribution disease relation.

Reference percentiles (5th, 10th, 50th, 85th, 90th, and 95th) of black and nonblack children ages 8–17 years from Project HeartBeat! (n = 678) are presented for body mass index (BMI), percent body fat (PBF), fat-free mass (FFM), and fat mass (FM) derived from bioelectrical impedance. Project HeartBeat! is a mixed longitudinal study in which three cohorts of children (seen initially at age 8, 11, or 14 years) were followed for 4 years and measured thrice-yearly from 1991 through 1995. Weight, height, and BMI of Project HeartBeat! children are similar in central tendency and variability to those of nationally representative samples for nonblack children but not black children, for whom there is an excess of children at or above the 95th percentile for weight and BMI. Values of PBF above which cardiovascular risk variables increase (as suggested in the literature) are located at the 85th percentile of the Project HeartBeat! distributions. This percentile of PBF may be tentatively considered as a cutoff point with epidemiological significance for children. Am. J. Hum. Biol. 16:135–150, 2004. © 2004 Wiley-Liss, Inc.

Background: The State-Trait Anger Expression Inventory (STAXI), a self-report questionnaire, is designed to measure the experience and expression of anger. Reliability and validity of the STAXI have been well established among African and European Americans aged 13 years and older. However, little is known of the use of this instrument among adolescents younger than 13 years and Hispanic American adolescents. Objectives: Objectives were (a) to test ethnic, sex, and age group differences in STAXI scores in a sample of 11-to-16-year-old African, Hispanic, and European American adolescents; and (b) to assess the psychometric properties of the STAXI among these same adolescents with special emphasis on Hispanic youths, for whom no data are available. Methods: A cross-sectional design was used with stratified quota sampling techniques. Participants (N = 394) were African, Hispanic, and European Americans aged 11-16 years and were drawn from one public middle school and two public high schools in Houston, Texas. Results: Internal consistency reliability for the anger scales (STAXI) ranged from 0.61 (anger-in) to 0.91 (state-anger) for the younger group (aged 11-13 years), and 0.68 (anger-in) to 0.88 (state-anger) for the older Hispanic Americans (aged 14-16). No notable differences were seen among the three ethnic groups in regards to internal consistency. Results of factor analyses of the five anger scales were similar to those reported originally by the scale author. Ethnicity and age had statistically significant main effects on the anger scales, and there was only one interaction. Discussion: The use of the STAXI among a tri-ethnic adolescent population is warranted. The anger-in scale may be less reliable, especially among younger adolescents.

To identify the best variable or combination of sexual maturity variables to use in investigations of adolescent health, and explore possible re-scaling of five-stage sexual maturity stages into dummy variables' ('advanced'/'delayed').Cross-sectional.Tri-ethnic sample of 384 US adolescents 11-16 years of age (Heartfelt Study).Sexual maturity variables are genital. breast and pubic hair stages obtained by clinical examination by nurse practitioners, testes size, menarche and age at menarche.Principal factor analysis of sexual maturity variables, height and age, revealed high commonality among the variables, as no more than a single factor appeared in 27 of 28 factor analyses (by sex and age groups). Genital stage (boys) and breast stage (girls) were most highly related to the first principal factor independent of age and ethnicity. ANOVA of 'key variables' indirectly reflecting endocrine function suggested that some stages could be combined.A single variable should suffice to describe sexual maturity at the studied ages, or variables could be combined in a (unstandardized) sexual maturity index (SMI): SMI (Girls)=0.998 x BREAST+0.900 x PUBIC HAIR + 1.815 x YEARS SINCE MENARCHE. SMI (Boys)= 1.104 x GENITAL + 1.328 x PUBIC HAIR + 5.997 x TESTES SIZE (mL).

This study explores the potential influence of growth, body/composition, and sexual maturity on the relation of anger expression and blood pressure in adolescents. Baseline data from Project HeartBeat! (82 boys and 85 girls, 14 years of age) examined the ability of anger expression (STAXI scale) to predict blood pressure, after controlling for the effects of ethnicity (African-American/non-African-American), height, weight, percentage body fat, and sexual maturity. Blood pressures were unrelated to anger expression in models that included the above developmental variables. However, girls scoring high on healthy anger expression (“anger-control”) had significantly lower levels of percentage body fat (P = 0.015) independent of the above factors. The literature suggests that body fat or body mass is often, though not unanimously, associated with unhealthy forms of anger expression in adolescents. Research is required into the biological, social, and behavioral origins of the association between body fat and anger expression. Height and sexual maturity, virtually ignored in this literature, should be included in future research. Am. J. Hum. Biol. 13:531–538, 2001. © 2001 Wiley-Liss, Inc.

Hostility, a phenomenon that has been linked to cardiovascular disease and all-cause mortality, is often measured by the Cook-Medley hostility (Ho) scale. Although there is an adolescent version of the Ho scale, it has had little testing with only Anglo-American samples. This pilot study tested the reliability and validity of the adolescent version of the Ho scale with a multiethnic sample of adolescents. Sixty adolescents participated. Reliability was measured using Chronbach's alpha. The Ho scale was correlated with the Speilberger State-Trait Anger Expression Inventory (1988) scales to determine concurrent validity. A factor analysis assessed construct validity; content validity was assessed by analyzing tape-recorded descriptions of a circumstance that provoked anger, as remembered by each adolescent. Internal consistency reliability was .75. The hostility measure was most highly correlated with anger expression (r = .62, p = .000) and trait anger (r = .50, p = .000). The factor analysis generated three factors (suspicious alienation, cynical aggression and justified mistrust), that accounted for 34.5% of the variance. The content analysis resulted in five anger-provoking themes: aggression, unfulfilled personal expectations, mistrust/lying, criticism of effort, and rejection. The majority of items in the scale (74%) were related to one of the themes.

The association of body fat distribution with single and combined site osteoarthritis was investigated using data from the US Health Examination Survey I, 1960-1962 (HES I) and the first National Health and Nutrition Examination Survey I, 1971-1975 (NHANES I). The study included 1,636 adults aged 35-79 years from HES I with hands and feet radiographs and four anthropometric fat distribution measures--subscapular and triceps skinfolds, waist girth, and seat breadth--and 3,885 adults aged 45-74 from NHANES I with knee radiographs and subscapular and triceps skinfold measures. Sex-specific data, adjusted for age, race, and body mass index, were analyzed using polychotomous logistic regression. There was a positive association of body mass index with knee osteoarthritis and with combined hands and feet osteoarthritis. A peripheral body girth pattern was associated with combined site osteoarthritis of the hands and feet; however, there was no consistent pattern of association of body fat distribution with knee osteoarthritis nor with osteoarthritis of the hands or feet only. These findings suggest that the central body fat pattern observed in previous studies to be associated with cardiovascular and gallbladder disease, and with diabetes, is not associated with osteoarthritis of the hands, feet, or knees.

Association between socioeconomic score (SES) and age-related statural loss were investigated in a cross-sectional sample of 718 adults from rural Colombia. Estimates of statural aging were calculated by estimating the maximum statural attainment of each subject from statural relationships with subischial length. Statural loss was correlated with SES, r=-0.06 (not significant) for men, and r=-0.14 (p less than 0.01) for women. Subjects with a high SES tended to lose stature at a slower rate than those with a low SES. For women, the difference in rates of statural loss between the low SES groups was significant (p less than 0.05).

During adolescence and the third decade of life a redistribution of bodily fat is occurring away from the extremities towards the trunk. During this time the process is occurring in both sexes although more rapidly in males than females, hence it is a masculinizing process. The process is seen in human populations from various ethnic and cultural backgrounds. Masculinizing characteristics like this one are predictors of chronic diseases such as diabetes and atherosclerosis late in life. The period from adolescence through young adulthood may be a sensitive time for the development of characteristics that predispose one to the chronic diseases of aging. Socioanthropological investigations of chronic disease related to human obesity may benefit by focusing on this developmental period.

This study is a randomized controlled double-blind trial on the effects of nutrition supplementation of pregnant and lactating women on their offspring. The study was conducted by the late Dr. Bacon Chow in 14 villages in Sui-Lin township, a farming area about 180 miles from Taipei, Taiwan. Two hundred ninety-four women were randomly assigned to one of two treatment groups. The daily supplement for one group provided 800 kcal and 40 g of protein/day; for the other group it only provided 80 kcal/day. Supplementation began after 3 wk of the delivery of a first study infant, continued throughout lactation, and through the pregnancy and lactation of a second study infant. Between group comparisons on the birth weight, number of low birth weight infants, or incidence of fetal deaths showed no statistically significant fmdungs. However, the birth weight of the second study infant was statistically different and higher than that of the first study infant in the high supplement group. Moreover, in the low supplement group there was a correlation of 0.22 (p = 0.06) between the change scores foi birth weight from the first to the second study infant and the quantity of supplements consumed during the last trimester of pregnancy. There was also in this same group a significant slope in a linear regression of birth weight on total daily caloric intake during the 3rd trimester of pregnancy for the male second study infants. These findings are partly in agreement with fmdings from three other large supplementation studies in Colombia, Guatemala, and New York. In this study the fmdmgs indicate that caloric supplemen- tation does result in a small yet statistically meaningful increment in birth weight within a population which is not nutritionally at risk. Am. J. Clin. Nutr. 34: 2133-2144, 1981.

Age-associated changes in adult stature of a cross-sectional sample of 634 adults from rural Colombia were estimated by multiple regression of stature and age controlling for subischial length, and from equations predicting maximum attained stature from subischial length. From these analyses the estimated rate of loss in stature due to aging per se for men was 0.12 cm/yr, while for women it was 0.03 cm/yr. When corrected for aging, several secular trends in adult stature were evident, although none were statistically significant.

Parent-offspring correlations and heritabilities of body measurements from midparent-offspring regressions are presented for school-aged children from the village of Tenza, Colombia (N = 403 families). Parent-child correlations and midparent regressions in this subsistence farming sample, are similar in magnitude to those for well nourished, urban industrial samples, suggesting that the environmental component of variability in body size is the same regardless of the environment. Tenza children are significantly shorter and lighter than upper class Bogota children, and Tenza parents have mean heights and weights similar to those of other lower class Colombian samples. Thus, chronic undernutrition has affected the growth of parents and continues to affect the growth of the present generation. Although it has been hypothesized that heritability of growth might be reduced in samples experiencing malnutrition and its sequelae, such a reduction may only be observable where environment of parents during their development is different from that of their offspring, which is not the case here. The pattern of heritabilities with respect to different body measurements in Tenza, is similar to that seen in well nourished samples, except that measurements of breadth (biacromial, bicristal, bicondylar) have heritabilities similar in magnitude to those of linear measurements (height, sitting-height, subischial length) especially in males; and heritabilities of some measurements related to adiposity are significantly higher in daughters than in sons.

The relationship between body fat distribution patterns and somatotype among 824 men was sought from Sheldon, Dupertuis and MacDermott's Atlas of Men (1954). The men were classified photoscopically into obese, overweight and normal weight classes and then into android (central), intermediate and gynoid (generalized) classes of body fat patterning independently and blindly by two observers. Android fat men were found by both observers to be older and more often classed as obese than gynoid fat men. The android obese were significantly more mesomorphic and less endomorphic than the gynoid obese (P less than 0.01). Results suggest that android obesity involves more than an upper body distribution of subcutaneous fat: it is a deep body obesity involving excess lean body mass as well.

The frequency of defective colour vision was studied in two neighbouring villages in the Andes Mountains of Colombia using AO H-R-R Pseudoisochromatic plates. The frequency of the red-green colour-blindness in males is almost the same in both villages (2.36-2.53%), being similar to frequencies reported for other mestizo' populations in Latin America. In one of the communities, families in which colour-blindness occurred were wealthier (P is less than 0.05) than non-colour-blind families, but there were no significant differences by colour vision class in numbers of surviving children nor mother's marriage age. These findings are consistent with the idea that in societies at the agricultural level, colour-blindness is selectively neutral. The association of colour-blindness with higher socio-economic status is expected given the history of European conquest in the New World, and suggests that the major cause of varying rates of the defect in Latin American populations is socio-economic heterogeneity and by inference different degrees of European-Amerindian admixture.

Six skinfold measurements for male and female athletes (N=456) at the 1976 Montreal Olympic Games were analyzed to identify principal components of fatness and anatomical distribution of fat, i.e., fat patterning. As in non-athletes, two principal components were evident among the athletes. All skinfolds were correlated positively with the first component, which was termed fatness, while extremity fat measurements were correlated positively and trunk measurements were correlated negatively with the second principal component, which was termed an extremity/trunk ratio component. The two principal components accounted for about 85% of the variance. The first component was related to control variables in order of descending contribution to its variance as follows: sex (21–31%), sport (19%), ethnicity (3%), and age (1–3%). Likewise, the second component (extremity/trunk ratio) was related to the control variables: sex (20–35%), age (4–7%), ethnicity (2%), and sport (2%). Fatness is more influenced by sport and by inference training than is the anatomical distribution or patterning of fat on the extremities relative to the trunk. The latter characteristic may be more dependent on biological or environmental factors unrelated to sport and training.

The ratios of circumferences (waist/hip, waist/thigh) have been proposed in lieu of skinfold measurements for studies of obesity and body fat distribution in adults. The skinfold method has been used successfully in children to study the growth and development of patterns of body fat distribution, but circumferences have not. We studied the relationship between these two methodologies as indicators of body fat and its anatomical distribution among 365 normal children aged 6-11 years, using canonical correlation analysis. With this method, weighted vectors of four body circumferences on the one hand and five skinfolds on the other are formed in such a way that the correlation between the two sets of variables is maximized. Weights (regression coefficients) are assigned each variable and their strength and sign help us to select the best combination of circumferences which describe a component of centralised obesity. A first canonical correlation was substantial in both boys and girls (0.84) and was independent of age. It appeared to relate to fatness level. A second canonical correlation was low (0.34 in boys, 0.35 in girls) (p less than 0.01). It too was age independent and in both sexes it reflected differences between fat on the trunk and on the lower extremity, and was thus a component of centralised fat distribution. The simple waist/thigh ratio correlated better with this canonical variable (0.67-0.88) than the more commonly used waist/hip ratio (0.45-0.79). The 'best' index of centralised fat in children is therefore, the waist/thigh circumference ratio, the same one that has been suggested for adults.

Many studies have explored the relationship between blood pressure and body size and composition in adults and preadults, but none has inquired into the relationship of blood pressure and the anatomical distribution of subcutaneous fat (fat patterning). Fat patterning has an association with chronic diseases (diabetes and cardiovascular disease) in adults. We sought the relationship between fatness, fat patterning, weight, and height among adolescents (12 to 17 years of age) of two ethnic groups (black and white) from the Health Examination Survey. Systolic blood pressure adjusted for age was related to body build variables in all sex/ethnic groups in decreasing order of importance as follows: body weight (independent of height), fatness (as assessed by a two skinfold index), and an excess of fat on trunk relative to fat on the leg (pattern index). Neither fatness nor fat patterning was significantly related to blood pressure after weight entered the regression equation. Relative fat patterning may be less important in predicting cardiovascular risk factors in adolescents than it is in adults. The fact that body weight was more important than fatness suggests that the weight/blood pressure association is due to components of body mass other than body fat.

Assortative mating for stature, weight, and the ponderal and Quetelet's indices is considered in a large sample of Philadelphia Blacks and Whites. The husband-wife correlation for stature is positive and significant in Whites (r = 0.34, d.f. = 382), but negligible in Blacks (r = 0.06, d.f. = 420). Correlations for weight and the body indices are positive and significant in both samples, those for body indices showing some dependency on the husband-wife correlations for stature and weight. When couples are grouped into statural mating combinations on the basis of short (S), medium (M) and tall (T), White spouses' statures show an approximately linear relationship to one another. The distribution of Black spouses' statures, however, is not completely independent, even though the husband-wife correlation is close to zero. There are elements of both positive and negative assortative mating among Blacks, resulting in an excess of certain mating types over that expected on the basis of chance. These mating types are usually those in which the husband is shorter than the wife, except at the heterogeneous extremes of the bivariate array.

Skinfold measurements (triceps, subscapular, suprailiac and medial calf) in four samples (376 boys, 352 girs, 338 men and 380 women from rural Colombia) were subjected to principal components analysis to identify components of obesity and relative fat patterning. Three components emerged which were similar in the four samples: a first component of fatness explaining 70-80% of the variance and two fat pattern components each explaining 10-15% of the variance: trunk-extremity and upper-lower body. Fatness and the trunk-extremity pattern components changed with age in children (7-12 years), but none of the components changed with age in adults (25-60+). The fatter tended to be more patterned in both age groups. Canonical correlation analysis revealed that socioeconomic status was more related to fatness than to patterning. With the exception of brothers, all first degree relatives (sib, parent-off-spring) and spouses were correlated in fatness. Some of the correlations between relatives--usually sibs, but not spouses--were also significant for the pattern components, suggesting a genetic basis for the known stability of this characteristic (Garn, '55a). Principal components analysis is a useful multivariate alternative for quantitative studies of anthropometric patterning.

Diabetes Alert is a multidisciplinary genetic and epidemiological study of Type II (non insulin-dependent) diabetes in Texas Mexican Americans. We report the anthropometry of 1,155 individuals 10 to 70 or more years with particular reference to overweight, fatness, and anatomical fat patterning in the sample. Children ages 10-18 of both sexes are growing at the 50th percentile of the reference data (U.S. Health and Nutrition Examination Survey-1) for height, Wt/Ht2, and triceps and subscapular skinfolds. Adults are well below median height but well above median Wt/Ht2 and skinfolds. Prevalence of obesity (Wt/Ht2 greater than or equal to 30) among adults is typically 30% or higher by age 30. Diabetics compared to age/sex-matched non diabetics have shorter sitting heights, have more upper body fat (subscapular skinfold), have less lower body fat (lateral calf skinfold), and were heavier at maximum weight and at age 18. The ratio of lower to upper body fat distribution decreases over the life cycle, being highest at adolescence and lowest at ages 40-50 in both sexes. Our results show a precipitous weight gain after maturity in the sample and an association of diabetes with differences in anatomical fat patterning. The age-related changes in fat patterning need to be explained in terms of their ecological and genetic influences.

Estimates of the prevalence of energy–protein malnutrition almost universally employ physical growth measurements. In this study we focus on this disease and the role of body size of relatives as mediators of responses in individuals to one type of nutrition intervention: supplementation of pregnant and lactating women. In this study, initiated by Dr. Bacon Chow and others in 1967, during gestation of a first infant a mother was untreated, while during the lactation of the first infant and the gestation and lactation of a second infant she was treated with either a calorie supplement or a placebo. Supplement–placebo group differences were sought in sibling and mother–child correlations in growth from birth to 30 months, in order to assess the role of heredity as a mediator of supplement effects. There were 108 pairs of siblings whose mothers had received a high-calorie–high-protein supplement as described above and 105 pairs of siblings whose mothers had received a placebo. Among the latter, sibling correlations for most measurements are statistically significant at birth, and of the same magnitude seen in previous studies (∼0.5), while among supplemented siblings, birth correlations are unusually low and often insignificant. The sibling correlations in Rohrer's index (wt/L3) differed the most between groups (p < 0.01). Group differences in the sibling correlation tended to disappear over the first 2.5 years of life. Correlations between mothers and their second children in subscapular skinfold tended to be higher in the supplemented than in the placebo group, birth to 30 months. In both supplement groups mother–second child correlations for body weight were higher than mother–first child correlations, suggesting the occurrence of secular changes in the environment unconnected with the treatment. The results suggest that: (1) genetic analysis of components of anthropometric variation may be a more sensitive method than the more conventional comparison of group means in detecting supplement effects; and (2) infant relative weight (Rohrer index), particularly the addition of subcutaneous fat, may be more affected by maternal supplementation than growth in weight or length alone.

SummaryHistory of adult weight gain and fat patterning is compared in Mexican American diabetics and age and sex matched non-diabetics. Diabetics differed little from non-diabetics in overall body fatness at the time of the examination. However, history of adult weight gain and current fat patterning were very different. Diabetics were heavier than non-diabetics at age 18. They subsequently gained weight faster and attained a substantially higher weight, at an earlier age, than non-diabetics. Discriminant function analysis was used to test for differences in patterning. Diabetics tend to have more trunk fat, as reflected particularly in the subscapular skinfold, and less lower extremity (leg) fat. Fat patterning in this population does not appear to be influenced by age when weight gain occurred, but is related to diabetic status, especially in women.

Studies on nutritional supplementation of pregnant mothers have observed small but sometimes significant effects on fetal growth. Previously we also reported significant changes in physical resemblance of siblings at birth due to this kind of supplementation, using data collected by the late Dr. Bacon Chow and associates. This suggested that components of variation in physical growth may change as a result of supplementation. To explore this further, we sought the effects of nutritional supplementation on somatic growth, holding constant the birth measurements of a previous (unsupplemented) sibling. Only head circumference at birth came close to showing a statistically significant (P less than 0.06) supplement effect on its mean (+ 0.36 cm) when the measurement of the first infant was held constant. Both increases and decreases in weight for length as assessed by Rohrer's Index (wt/l3) occurred with supplementation. Increases in the index occurred by a significant (P less than 0.01) gain in birth weight (238 g) between 1st and 2nd siblings in the supplement group but not in the placebo group. Decreases in this index resulted from a significant gain in birth length (1.3 cm) in supplemented families with a previous (untreated) sibling having a below average length for average weight. These non-linear effects on somatic growth suggest that responses to maternal nutritional supplementation may be more effective in a subgroup of the population where the normal adaptive responses to low energy protein intakes may have failed or where nutritional conditions over pregnancy may have varied considerably.

Recent work suggests that android or male-type obesity is characterized by fat cell enlargement on the trunk and upper body. This implies adult differences in patterns of body fat distribution may have developmental origins connected with differences in maturation or age of onset of obesity. To investigate this, we studied adolescent females (N = 455, 12 years), males (N = 527, 14 years) and young adults (N = 393 females and N = 413 males, 17 years) of the US Health Examination Survey. Five skinfolds and five maturity indicators were available. Individuals were classed as normal weight, overweight or obese on the basis of the body mass index (WT/HT2). Fat patterning was studied by principal components analysis of the log residual skinfold thickness at the five sites, which revealed trunk/extremity and upper/lower trunk fat distribution components in all sex/age groups studied. The means of both components were significantly (P less than 0.05) greater in obese than in normal weight individuals indicating that obesity in adolescence and young adulthood consists of fat concentrated on the upper aspect of the trunk. The effect was independent of maturity, which was a significant correlate of the trunk/extremity patterning component only and in males only. Advanced physiological maturity is probably not a determinant of adult patterns of body fat distribution, but obesity which occurs in adolescence may be.

Principal components analyses of subcutaneous fat measurements covering arm, trunk, and leg areas of the body were performed on 44 samples varying in sex, age, and ethnicity of subjects; measurement technique; and number of sites studied. Three major components emerged, similar in all samples: A first component of obesity, a second component of anatomical fat distribution contrasting trunk and extremity fat, and a third distributional component contrasting leg and arm fat. These components did not appear to vary with age (school children to older adults), sex, ethnicity (Black-White), technique (caliper, ultrasound, or X-rays), or number of sites (five to 13). The three major components are similar to vectors or obesity and relative fat patterning reported earlier by anthroposcopic (Skerlj et al., 1953) and graphic (Garn, 1955) methods. One of the pattern components (trunk-extremity) appears to correspond to a body build continuum associated with adult chronic diseases (Vague, 1956). The stability of these components among samples that differ in several characteristics suggests the validity of these components in describing aspects of body build of anthropological and epidemiological importance.

The association between body fat distribution patterns and cardiovascular disease risk variables (high density lipoprotein (HDL) cholesterol, total cholesterol, diastolic and systolic blood pressures, and fasting blood glucose levels) was sought in a sample of Mexican American adults who were studied during 1981-1983 in Starr County, Texas. In the sample, all diabetics were excluded to see whether centralized obesity carried any risk for cardiovascular disease independent of diabetes. A component of centralized body fat distribution was identified through the use of principal components analysis of five skinfold measurements, which included the upper and lower extremities and trunk areas. The centralized obese were compared with generalized (peripheral) obese and nonobese controls in four subgroups of the population: younger and older adult males and females. The means of all cardiovascular risk variables were in a direction indicating that the centralized obese were significantly at greater risk than nonobese controls (in particular, HDL cholesterol, total cholesterol, and blood glucose levels). The generalized obese differed from the centralized obese in having significantly lower blood glucose levels, and tended to be intermediate between centralized obese and nonobese controls in the other variables. The data confirm that centralized obesity as defined by a linear combination of skinfold measures works in the same way as the waist-to-hip circumference ratio in describing a body build factor which heightens the risk of cardiovascular disease in the obese independent of the clinical diabetic state.

The question has arisen whether patterns of body fat distribution can be identified by body circumferences, a method which is said to be more reliable and simpler than skinfold thickness or like measures of subcutaneous fat (Ashwell et al., Int. J. Obes. 6: 143-152, 1982). Here we address the question of whether body circumferences are inherently more reliable than skinfold thicknesses in 77 intra- and 224 interexaminer replicates from the Health Examination Survey of 12 to 17-year-olds in the U.S.A. Reliability of six body circumferences (0.96) was significantly (P less than .01) higher than that of skinfold thicknesses at five sites (0.91), suggesting that circumferences are a more reliable method. However, the reliability of skinfolds is still high, and skinfolds may be used in studies which focus on preadults or other groups in which the validity of circumferences as measures of body fat distribution is unknown.

Studies of lung function in high altitude populations have suggested the influence of hypoxic environment on the development of this characteristic independent of confounding variables such as ethnicity and habitual exercise. However, often the effect of altitude on vital capacity is greater in children than adults, suggesting that more than developmental adaptation is operative. Also selective migration could account for the similarity of migrants and permanent residents at a destination altitude. To explore these problems we studied the lung function (FVC, FEV1, PFR) of 377 individuals who had migrated between altitudes in northern Chile. Migrant measurements were adjusted to those of permanent residents of appropriate age, sex and height at the altitudes of origin and destination. The measurements were then related to ethnicity (Spanish-Aymara ancestry), occupation and permanence, the latter combining information on both age at migration to and length of stay at a destination altitude. Upward migration was associated with increased chest depth, FVC and FEV1, but not height or other chest measurements. Downward migration had no significant effect. The flow-dependent test PFR was so sensitive to observer variability and occupation that it was difficult to establish its relationship to permanence. Unlike the body measurements, lung function measurements (especially PFR) tended to deviate from permanent controls at the origin altitude in a direction suggestive of selective migration, nor was permanence itself independent of ethnicity and occupation. Because of these difficulties the question of developmental adaptation in lung function may not be answerable in cross-sectional studies like the present and previous efforts, but rather in longitudinal investigations in which the control is the individual him/herself.

Recent studies of the effects of hypoxia on human growth and adult size have focused mainly on the variability of single measurements. In this paper we explore changes with altitude and ethnicity (Spanish-Aymara ancestry) in body proportions of permanent residents of an altitudinal gradient (0-4000 meters) in northern Chile. Body proportion or shape is assessed by anthropometric indices and principal components of 14 bone measurements. Ethnicity independent of altitude had its major effect on proportions and a lesser effect on size. Aymara had larger relative sitting heights, broader builds and prominent facial development as compared to non-Aymara (Spanish). Altitude also affected head and chest proportions during growth. On the whole, the effects of altitude and Aymara ancestry on the measurements and indices were independent (not necessarily of similar direction or magnitude), in spite of a correlation of ethnicity and altitude in Andean populations.

The effect of maternal supplementation during both gestation and lactation on infant growth from birth to 12 mth was investigated in the double-blind, randomly allocated control trial conducted in Taiwan by the late Bacon F. Chow. The supplement was a milk-based formula providing 800 kcal and 40 g protein daily. The placebo provided less than 40 kcal per diem but resembled the supplement in appearance. Supplementation was limited to mothers and began after birth of one infant and continued without interruption until weaning of a second infant. Supplement effects were tested by comparing both supplement and placebo groups and first- and second-infant groups with respect to weight, length and head circumference. Both comparisons of growth curves and analyses of variance were carried out. Both strategies agreed in failing to detect differences in growth between supplement and placebo groups. However, differences were found between first and second infants in the supplement group.

The relationship between weight change and hypertension was examined among men and women 25–64 years of age surveyed in the National Health and Nutrition Examination Survey (NHANES-I). Any single weight measurement (current weight, weight at an earlier age, or the difference between these two weights) was found to be a significant univariate predictor of hypertension, with current weight being most predictive. Initial weight and weight change were not associated with increased blood pressure, however, when controlling for current weight. These results do not distinguish a difference in risk of hypertension in adults with overweight or obesity of long-standing vs that of adults with overweight or obesity of more recent onset.

A randomized controlled double-blind study of nutrition supplementation of pregnant and lactating women was conducted in Suilin township, Taiwan. Pregnant mothers were randomly assigned to one of two treatment groups consisting of either a high (800 kcal and 40 g protein) calorie daily supplement or a placebo. For each mother treatment began following the delivery of her first study infant, continued throughout the lactation period; and through the pregnancy and lactation of her second study infant. Comparisons of sibling-sibling anthropometric correlations at birth between groups show that among the placebo group the sibling correlations are statistically significant and of the same magnitude seen in previous studies (approximately 0.5), while among high calorie siblings correlations are unusually low and often not significant. This is particularly true for male fetuses, suggesting that the latter are more sensitive to nutritional environmental variations in utero, than are female fetuses. Reduction in familial correlations, presumed measures of genetic influence, in nutritionally stressed populations, will occur when the environment of relatives differ, but are not due to malnutrition per se.