Albert Damon

Predicting coronary heart disease from body measurements of Framingham males

Among 1625 Framingham (Mass.) Study males, aged 35–69 when measured, ratings of somatotype (body build) and gynandromorphy (morphological femininity in the male physique) were calculated from 7 body measurements. The 198 men who developed coronary heart disease (CHD) within 12 yr of entry into the Study were significantly more endomorphic, or fat, and less ectomorphic, or linear and fragile, than the 1427 men who did not. The observed effect was confined to the 55 men aged 35—49, and within this group, to the 26 men with angina pectoris, coronary insufficiency, or sudden death (CHD-NMI). These 26 men were significantly (0.01 > p > 0.001) more endomorphic, more mesomorphic (muscular, bony), and l than the 29 men with myocardial infarction (CHD-MI) or those without CHD (NCHD). Gynandromorphy did not distinguish among any of the age or disease categories. In the 35–49 yr age group, a 3-way discriminant analysis regressed body measurements directly on disease status (NCHD, CHD-MI, CHD-NMI), bypassing the intermediate somatotype ratings. The function discriminating CHD-MI from the other two groups was not significant; that discriminating CHD-NMI was highly significant (p < 0.001). Men scoring above various cut-off points on this latter function had risks of developing CHD-NMI between 4:1 and 7:1 relative to those scoring below (“relative risk,” or likelihood ratio). The “risk ratio” (predictive value for CHD-NMI/predictive value for NCHD plus CHD-MI) was 2.6, higher than published risk ratios for serum cholesterol (2.1) or blood pressure levels (1.3) among all Framingham Study males. Of the 7 body measurements taken singly, weight, chest depth, arm girth, and subscapular skinfold, but not height, triceps skinfold, or hand grip strength distinguished among the 3 CHD-outcome groups at highly significant levels. In conjunction with other measurements, however, in the discriminant function which distinguished subjects with CHD-NMI, triceps skinfold and grip strength also became significant, with negative coefficients. This pattern—positive association of CHD-NMI with weight, chest depth, arm girth, and subscapular skinfold, but negative association with triceps skinfold—showed, as did somatotype, that mesomorphy as well as adiposity contributed to the risk of CHD other than myocardial infarction. As for prediction of new cases, 6 men aged 35–49 when measured developed CHD-NMI between the twelth and fourteenth year of observation. Their mean score on the appropriate discriminant function was in the expected direction and close to that for the previous 26 men with CHD-NMI. As in earlier reports, physique contributed to the risk of coronary heart disease independently of blood pressure and serum cholesterol. The relative risk, 3:1 for physique with normal levels of blood pressure and serum cholesterol, rose with elevated levels of these other risk factors. Comparison of the present findings with those in the literature disclosed a pattern which resolves many of the apparent contradictions. When studies were grouped according to sample characteristics—population or selected sample—age of subjects, and manifestation of CHD, the differences long observed clinically, epidemiologically, biochemically, and pathologically between CHD in early and late adult life, and between male survivors of MI and those with other manifestations of CHD, were confirmed from the distinct standpoint of physique.

HOST FACTORS IN POLYCYTHEMIA VERA

Excerpt The occurrence of polycythemia vera predominantly in middle life is well documented. Males seem to be affected more frequently than females, but to an extent that varies widely from one rep...

The Functional Anthropometry of Old Men

Means, standard deviations, and percentiles are presented for forty-seven functional measurements of 133 ambulatory Spanish-American War veterans with a mean age of 81.6 years and an age range from 72 to 91 years. Practical applications of the data are noted. As compared with younger men, the veterans were smaller, lighter, weaker, and had shorter reaches but deeper chests. Their skinfolds did not differ.

Constitution and Smoking

Among 167 adult male factory workers of Neapolitan parentage but of American birth or upbringing, the lean men smoked significantly more than the fat ones. Smoking was positively correlated with serum cholesterol but was not associated with morphological masculinity, blood pressure, diet, or consumption of alcohol.

Predicting Age from Body Measurements and Observations

From 51 body measurements and two qualitative observations on 600 men ranging in age from the third to the eighth decade of life (mean age, 43 years), sixteen measurements plus grayness of hair and baldness were entered into a multiple-regression equation to predict chronologic age. Ten variables gave an R of 0.77, predicting age with a standard error of estimate 5.88 years. The predictors, in order of their contribution, were grayness of hair (r = 0.64), hand grip, ear breadth and length, sitting height, nose breadth, bideltoid breadth, abdominal depth, triceps skinfold, and baldness. Eight variables did not contribute significantly: height, weight, chest depth and expansion, bi-iliac breadth, upper arm and calf circumferences, and nose length. Functional traits predicted age more closely than did gross body dimensions.

Constitution, genetics, and body form in peptic ulcer: a review.

Abstract Constitutional factors of several kinds have been demonstrated in peptic ulcer. Genetic studies show increased frequency of ulcer among the relatives of ulcer patients, as well as concordance of site. Ulcers, particularly duodenal, are more frequent in non-secretors and in persons of blood group 0. The blood group association has been reported among Japanese and Nigerians as well as among Europeans and Americans. Gastric hypersecretion, a major factor in duodenal ulcer, probably has a constitutional basis—anatomic, genetic, or physiological. On the average, linearity of build characterizes not only persons who develop peptic ulcer, but also those who do poorly with it. Persons with gastric and duodenal ulcers differ epidemiologically, behaviorally, and genetically. There is therefore a real constitutional basis for peptic ulcer, though its total effect for the population is small in comparison with the environmental determinants reflected in the altered site, sex ratio, and frequency of peptic ulcer during the present century. For the individual, however, the influence of heredity or constitution may be crucial.

DELINEATION OF THE BODY BUILD VARIABLES ASSOCIATED WITH CARDIOVASCULAR DISEASES

In 1959, a Conference on Methodology in Epidemiological Studies of Cardiovascular Diseases was held in Princeton, N . J., under the auspices of the American Heart Association and the National Heart Institute. The published report (Conference, 1960) summarized the state of knowledge up to tha t time and provided standardized definitions and techniques in the interest of comparability from one investigation to another. In addition, guidelines were offered for future studies in areas deemed important. One section of the report concerned body form, the relation of which to cardiovascular diseases was summarized for both coronary heart disease and hypertension. Evidence for an association between body form and coronary heart disease came a t that time from two sets of American investigators who used Sheldon’s (1940) somatotype technique for describing body build, and from two sets of Swedish investigators who used Lindegird’s (1953) anthropometric system. Lindegird’s system attempts to ascertain the major factors in body build without the photography and subjective judgment inherent in the somatotype. In the United States, Gertler, White and their colleagues (1954), working with clinical material, characterized young coronary patients -that is, those who sustained myocardial infarction under the age of 40predominantly as “mesomorphic”, or bony and muscular, and secondarily as “endomorphic”, or round and fat. Spain and his colleagues (1953). working with autopsy material, confirmed the predominant mesomorphy of men who died of coronary occlusion under the age of 46. Furthermore, among 73 apparently healthy white men of similar age who died from violent means, the degree of coronary artery atherosclerosis was definitely greater in the dominant mesomorphs than in the dominant ectomorphs. In a later study, Spain et al. (1955) reported that among endomorphs and mesomorphs, but

Previous pulmonary disease and lung cancer: A case-control study

Abstract Among more than 17,000 men examined medically and anthropometrically at Harvard University between 1880 and 1920, 130 had died of lung cancer by 1 January 1966. Each lung cancer decedent was matched with the next man of the same age to be examined. Mean age at examination was 19.9 yr. Of the controls, 87 had died and 43 were still alive on 1 January 1966. The lung cancer decedents and the controls did not differ in the number or nature of prior pulmonary diseases reported during their medical examination at Harvard. Among the controls, significantly more of those without early pulmonary disease were still alive than of those with early pulmonary disease.

Human ecology in the Solomon Islands: Biomedical observations among four tribal societies

Data are presented from the first four groups studied in a longrange investigation of human ecology in the Solomon Islands. The groups varied in habitat, way of life, genetic background, and exposure to Western influence. Coverage of residents in designated hamlets was 78% for Kwaio, Malaita Island; 91% for Nasioi, Bougainville Island; and over 95% for both Lau and Baegu of Malaita. In all, 1626 persons were studied: 256 Nasioi, 443 Kwaio, 442 Lau, and 485 Baegu. All four groups were demographically “young,” with a high ratio of persons under 15 to those over 45 years of age, but a significant proportion lived to old age. Nutrition was adequate, though low in protein and fat. They had very little color-blindness and virtually no myopia, astigmatism, glaucoma, or hypertensive and coronary heart disease. Malaria, trachoma, and intestinal parasitism reflected differences in habitat and ways of life, but tuberculosis did not. Despite a density as high as that recorded for any human population, the Lau, living on small artificial islets in a saltwater lagoon, enjoyed robust health.

Anthropometry in the Normative Aging Study of Veterans: Physique and Age, Serum Cholesterol, Uric Acid, and Personality

The notion that human body form and function are related is strong in folklore and literature, and in medicine dates back at least to Hippocrates. The Normative Aging Study is in a position to test this belief among large numbers of healthy subjects followed over their adult lifetimes. The goals, procedures, and early findings of the morphologic aspect of the Normative Aging Study are presented in this article.