Frances C. Wheeler

Leisure time physical activity: are there black/white differences?

BACKGROUND Behavioral risk factor surveillance survey data collected during 1984 and 1985 in South Carolina were analyzed. METHODS This article is based on telephone interviews conducted with 2,005 individuals (431 black, 1574 white), mean age, 45.1 years, selected by random-digit dialing. Information on the type, frequency, and duration of leisure time physical activity was used to estimate leisure time energy expenditure (kcal/week) averaged over the previous month. The median level of leisure time energy expenditure differed significantly (all P less than 0.001) by gender (men = 741, women = 421), age (six categories; youngest, 18-29 years = 780; oldest, 70+ = 301), annual household income (four categories; lowest, less than or equal to

Waist-to-Hip Ratio in a Biracial Population: Measurement, Implications, and Cautions for Using Guidelines to Define High Risk for Cardiovascular Disease

10,000 = 300; highest, greater than

Community intervention and trends in dietary fat consumption among black and white adults

35,000 = 870), body mass index (kg/m2, less than or equal to 24.1 = 601, greater than or equal to 30.1 = 180), and race (black = 301, white = 601). RESULTS Leisure time energy expenditure generally decreased with increasing age and body mass index and increased with increasing levels of education and income among all race/gender groups. Logistic regression analyses revealed that after adjustment for gender (if applicable), age, income, and body mass index, the variable race made a statistically significant contribution to the model, in the total sample (P less than .03) and for women P less than .001), but not for men. CONCLUSIONS Our results suggest that blacks living in the South, particularly black women, have lower levels of leisure time physical activity compared with their white counterparts after control for several important confounders.

Correlates of high-density lipoprotein cholesterol in black and white women.

Cutoff points for high waist-to-hip ratio (WHR) that may define high risk for cardiovascular disease have been suggested for men (0.95) and women (0.80). The WHRs of groups defined by age, race, and sex among 3,118 South Carolina adults were compared with these cutoff points. Measurement methodology, mean WHRs, and prevalence of elevated WHR in this biracial study population were compared with data from other populations. A review of anthropometric measurement methods used in recent epidemiologic studies indicates that a standard method for measuring waist and hip girth is required before comparisons of mean levels can be valid. The paucity of evidence that a high WHR is associated with cardiovascular disease mortality in black populations, and the high number of women who have an elevated WHR in this and other epidemiologic studies, support the following conclusion: Current WHR cutoff points, which are based on evidence from primarily white populations, may not be appropriate for women, older age groups, and some racial or ethnic groups in the United States.

The need for accurate nutrition survey methodology: the South Carolina experience.

OBJECTIVE This study assessed whether a state public health department could effectively implement an affordable nutrition intervention program at the community level. DESIGN Cross-sectional data were collected via telephone surveys of 9,839 adults, aged 18 years or older, in 1987, 1989, and 1991 in two South Carolina communities. Nutrition education programs began in 1988 in one community. The other community served as a comparison site. We assessed and compared changes in community levels of dietary fat and weekly meat consumption, salt use, and nutrition promotion awareness with analysis of covariance regression techniques that included race, sex, and age as covariates. RESULTS We observed favorable changes in most eating behaviors and levels of awareness in both communities. The intervention community experienced greater absolute changes that the comparison community in use of animal fats (-8.9% vs -4.0%; P = .02) and liquid or soft vegetable fats (+8.4% vs +3.6%; P = .04), and in awareness of restaurant nutrition information (+33.0% vs +19.4%; P = .0001). Although the primary type of dietary fat used differed between black and white respondents, we observed significant change among both groups. CONCLUSIONS These results suggest that community-wide nutrition education programs may have augmented regional or national changes in dietary behavior among white and black adults in the intervention community.

The role of family history of disease and personal morbidity in eating behavior

The relationships of high-density lipoprotein (HDL) cholesterol with body composition, leisure-time physical activity, cigarette smoking, and education were examined in a community-based sample of 480 Black and 1337 White women. Univariate and multivariate analyses indicated inverse associations of HDL with body mass index and waist-to-hip ratio in both groups, and with cigarette smoking and low educational attainment among White women only. Since correlates of HDL cholesterol differ for Black and White women, further investigation of the differences in these correlates is warranted.

Are Race Differences in the Prevalence of Hypertension Explained by Body Mass and Fat Distribution? A Survey in a Biracial Population

Assessment of two nutrition-related risk factors, obesity and fat intake, was completed on a representative sample of South Carolina adults. Obesity estimates determined from self-reported heights and weights were less than prevalences determined from direct measurements (white males 21.4% vs. 28.2%; white females 20.8% vs. 24.5%; black males 29.2% vs. 30.1%; black females 43.6% vs. 50.6%; and total 24.9 vs. 29.8%). Nine fat-intake habits were identified from dietary mannerisms involving the consumption of red meat, fat on meat, fried fish/chicken, butter, eggs, whole milk, bacon/sausage, and cheese and the use of solid fats when cooking vegetables. The mean number of the nine habits exhibited was four. The total number of habits did not correlate well with serum cholesterol, as 27% of the individuals with none of the nine fat intake habits had blood cholesterol values greater than 6.2 mmol/L (239 mg/100 mL), while only 17% of the individuals with seven habits had the high level of cholesterol. These nine habits explained less than 10% of the variability of serum cholesterol values.

Is race related to glycemic control? An assessment of glycosylated hemoglobin in two South Carolina communities

Abstract This study investigates the role of perceived personal morbidity and perceived family history of disease as possible determinants of eating habits. Two parallel models were examined: Model A focused on the effects of personal hypercholesterolemia and family history of heart disease on fat/cholesterol consumption; Model B focused on the effects of personal hypertension and family history of hypertension on salt intake. Using cross-sectional data, each model was tested in two age groups: 18-50 years (n ≉ 2400) and > 50 years (n ≉ 1500). In both models and in both age groups, analyses of covariance revealed a significant main effect of perceived personal morbidity (hypercholesterolemia, hypertension), but a nonsignificant main effect of perceived family history of disease (heart disease, hypertension). In both models, however, a significant interaction between family history and personal morbidity was noted among persons 18-50 years of age. Overall, the results suggest that perceived personal morbid...