Nutrition & Food Science
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Item Is a new waist circumference and BMI needed for African Americans for the diagnosis of metabolic syndrome?(2012) Udahogora, Margaret; Jackson, Robert T.; Nutrition; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)African Americans are noted as having a low prevalence metabolic syndrome (MetS), which is partly attributed to a reported use of MetS criteria, such as waist circumference that is not appropriate for this population group. The purpose of this study was: 1) to investigate the gender specific optimal waist cut off points, which best identify individuals with metabolic abnormalities consistent with MetS, and are independent of body mass index (BMI) cutoff values; 2) to determine the gender specific cutoff values of BMI in relation to multiple metabolic risk factors; and 3) to assess the prevalence of metabolic syndrome. In this cross-sectional study, NHANES data from 1999-2006 was analyzed. 1445 participants had complete variables for metabolic syndrome criteria. The waist circumference of 95 cm for males and 98 cm for females were found as appropriate cut-off values to identify central obesity. Body mass index at which metabolic syndrome was observed was 28 kg/m² for males and 32 kg/m² for females. Using our newly estimated waist circumference thresholds, the age-adjusted prevalence of MetS was 30.9% in males and 30.3% in females. The results indicate that for the early detection of metabolic syndrome in African American adult males, a lower cutoff value of 95 cm, rather than the 102 cm currently used is needed. The metabolic syndrome abnormalities appear at higher body mass index and waist circumference among women. Based on our findings, the prevalence of metabolic syndrome is currently underestimated among African American adult males.Item The Relationship of Low Birth Weight and Current Obesity to Diabetes in African-American Women(2007-04-26) Harris, B. Michelle; Lei, David K. Y.; Nutrition; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Aims: (1) To test the fetal origins of chronic disease by examining birth weight, current obesity, and odds of developing type 2 diabetes (T2DM) in African-American women 38-57 years. (2) To assess birth weight and obesity in relation to fasting plasma glucose (FPG). Background: African-American women suffer disproportionately in prevalence and complications of T2DM. According to the fetal origins of chronic disease, T2DM is related to low birth weight with subsequent adult obesity. Several studies have substantiated this hypothesis; none have focused on African-American women. Outcome Measure: Self-reported physician diagnosis of T2DM. Exposure Measures: Birth weight, an indicator for fetal growth; waist-to-hip ratio, a marker for abdominal obesity. Other factors: physical activity, body mass index (BMI), history of gestational diabetes, blood pressure. Design: Retrospective, case-control observational study. Method: Convenience sample of urban African-American women. Cases (n=95) reported a physician diagnosis of T2DM. Controls (n=186), matched on race and age, reported no T2DM diagnosis. To verify control status, participants were screened for elevated FPG (cut-point, <126>mg/dL, as defined by the American Diabetes Association). Vital and family records were sources for birth weight. Current weight, height, and waist and hip circumferences were measured; BMI and waist-to-hip ratio were calculated. Confounding factors were collected on a 68-item questionnaire. Logistic regression analysis tested the proposed model for the odds of having T2DM. Multiple linear regression analysis was employed to assess FPG. Sample size was estimated. Results: The odds ratio for T2DM increased as waist-to-hip ratio increased (OR=1.13, 95% CI=1.08, 1.19, p<.0001). Birth weight did not contribute independently to the model's ability to examine T2DM (OR=0.92, 95% CI=0.74, 1.14, p=.4409). Birth weight and waist-to-hip ratio each contributed independently to assessing FPG. Conclusions: This study found an interaction between birth weight and abdominal obesity when examining T2DM in African-American women: those born small and who subsequently developed abdominal obesity had a greater odds for T2DM. Abdominal obesity, but not birth weight, was independently associated with T2DM. FPG significantly increased with increasing abdominal obesity and decreasing birth weight. African-American women are cautioned to maintain healthy body measures (waist-to-hip ratio <0.80 and BMI <25) to address T2DM.