The purpose of the study was to address the hypothesis that elevated body iron increases the risk... more The purpose of the study was to address the hypothesis that elevated body iron increases the risk of cancer occurrence and death, and to determine the dose response. Subjects were 3,287 men and 5,269 women participating in the first National Health and Nutrition Examination Survey who had a transferrin saturation determination at enrollment (197 1-1975), who remained alive and cancer-free for at least 4 years, and who were followed to 1988 for cancer outcome. Among 379 men who developed cancer over the study period, the mean transferrin saturation at enrollment was 32. I% whereas among 2,908 who remained cancer-free it was 30.7%; the difference for mortality was 32.3% among 233 deaths vs. 30.8% among 3,054 men not dying of cancer. The mean differences among women were not significant. The mean differences in TIBC and serum iron among men were consistent with the findings for transferrin saturation, and all 3 differences were stable over time when examined by years since blood test. Men and women were divided into 5 groups on the basis of baseline transferrin saturation: 0 to 30%, 3-0%, 40-50%, 50-60%, and 60% and higher. Nineteen percent of men had a baseline transferrin saturation above 40% (the last 3 groups), whereas only 10 percent of women had transferrin saturation above 40%. For men and women combined, risk of cancer occurrence in each group relative to the first was I .O, 0.95, I. 16, I .38 and I .8 I ; for mortality the relative risks were 1.0, 0.96, 1.22, 1.
This analysis demonstrates that a technologically appropriate low-cost pregnancy screening strate... more This analysis demonstrates that a technologically appropriate low-cost pregnancy screening strategy using medical auxiliary personnel can be effective in screening high-risk pregnancy and may be appropriate as a public health program. The screening program revealed that women were classified as low risk or high risk as a dichotomous variable with essentially the same frequency by physicians and by medical auxiliary personnel. The accuracy of the screening was assessed by determining the number of false positive and false negative screenings performed by medical auxiliary personnel and by physicians. Features associated with succes of medical auxiliary personnel include: 1) female married with supportive husband 2) outside source of income self-employed 3) minimal education level high school 4) residence and/or work in the community 5) prior ethnomedical identity. Evaluation of this pregnancy screening trial indicated that voluntary medical auxiliary personnel can have an appropriate role in health care delivery interfacing Western and traditional medical technology. Theoretically better allocation of limited medical resources as permitted by pregnancy screening should result in better health in the population.
Publisher Summary This chapter discusses the effects of individual nutrient supplementation on ev... more Publisher Summary This chapter discusses the effects of individual nutrient supplementation on evaluation of carotenoid intake. The methods described in the chapter are for estimating dietary intake excluding vitamin supplements. As individuals and populations vary in the extent to which they consume vitamin supplements, it is important to be able to evaluate dietary intake methods independently as well as vitamin supplementation. Several specific methods exist for the dietary assessment of nutrient intake. The chapter provides correlation between dietary carotenoid intake and blood carotenoid levels. Carotenoid intake may also be evaluated based on resulting levels of carotenoids in body fluids and tissues or as reflected in the coloration of skin and other tissues. It is reasonable to assume that for dietary carotenoids to have a physiologic effect, they must, after consumption, appear in the blood and tissues to a significant extent. Therefore, the evaluation of carotenoid intake may also be directed by the evaluation of the profile of carotenoids in human plasma following food consumption.
Forensic anthropology has traditionally focused on the analysis of skeletal remains. In the past ... more Forensic anthropology has traditionally focused on the analysis of skeletal remains. In the past few decades, forensic anthropology has also proven valuable in the analysis of burned, mummified, decomposed, fragmented, and partially skeletonized remains. By analyzing skeletal remains and soft tissues that have been preserved by processes other than natural decomposition, the unique taphonomic processes leading to particular states of preservation can be illuminated (Garland and Janaway 1989; Micozzi 1991). Preservation of soft tissues in nature is essentially a competition between decay and desiccation. Climatological factors such as temperature and humidity largely decide the outcome of this contest (Aufderheide 1980; Micozzi 1986). Geological factors which can enhance soft tissue preservation include immersion in water under certain conditions, freezing, and the actions of soil elements such as salts. Biological actions of microbiological organisms and plant products may also cause preservation of soft tissues. In modern cultural and forensic contexts, humans may also place remains in preservative environments intentionally or unintentionally. Human actions have long affected the process of postmortem decomposition. Embalming and anatomical preparation leave distinct taphonomic characteristics. Evidence of postmortem and perimortem medical procedures (e.g., autopsy and surgery) are recognizable in skeletal and soft tissue remains. Intentional human actions resulting in “unnatural” postmortem preservation of soft tissues are documented in the forensic and anthropological literature (Berryman et al. 1991; Micozzi 1991; Sledzik and Ousley 1991).
The authors studied the relation between benign breast disease and subsequent breast cancer in 16... more The authors studied the relation between benign breast disease and subsequent breast cancer in 16,692 women with biopsy-diagnosed benign breast disease who had participated in the Breast Cancer Detection Demonstration Project throughout the United States. Women were classified into one of five benign breast disease categories: atypical hyperplasia, proliferative disease without atypia, nonproliferative disease, fibroadenoma, and other benign breast disease. A total of 485 incident cases of breast cancer were identified in the women from August 1973 to February 1986 after a median follow-up period of 8.3 years from the diagnosis of benign breast disease. Age-adjusted incidence rates were calculated for benign breast disease types stratified by family history and calcification status. Relative risk (RR) estimates of breast cancer for women in the five benign breast disease categories, compared with the screened women who did not develop recognizable breast disease (normal subjects), were computed using the proportional hazards model. Results indicated that risk was associated with the degree of epithelial atypia. Over all age groups, women with nonproliferative disease, proliferative disease without atypia, and atypical hyperplasia displayed progressively increasing risks of 1.5, 1.9, and 3.0, respectively, compared with normal subjects, with 95% confidence intervals (CI) exceeding unity. Particularly high risk was seen among women under age 46 years with atypical hyperplasia (RR = 5.7, 95% CI 3.0-10.6). Women with fibroadenoma as the only indication of their benign breast disease had a relative risk of 1.7, with a lower 95% confidence limit of 1.0. No increased risk was seen for women with other benign breast disease. Positive family history (RR = 1.8) and calcification (RR = 1.2) significantly increased a woman's risk proportionately over the risk associated with each benign breast disease subtype. The authors conclude that the risk of developing breast cancer varies by category of benign breast disease and is directly related to the degree of epithelial atypia.
The health delivery system in the Philippines suffers from various inadequacies and disadvantages... more The health delivery system in the Philippines suffers from various inadequacies and disadvantages. There is a severe shortage of both doctors and hospitals especially in rural areas where most of the countrys population lives. Cost of medical care is so high that all but the socioeconomically advantaged cannot afford proper medical care. Physicians in the Philippines occupy the upper class and are removed from the existence of most of their poorer patients. These lower income patients receive care from auxiliary medical personnel e.g. midwives. There is a new movement in the country to provide training for more medical students more adequate training for the auxiliary medical personnel who provide much of the health care in the country and to bring medical facilities and personnel to the areas where they are needed. 2 new medical schools have been established in Mindanao-Sulu and Samar-Leyte both previously underserved in health care delivery. The curriculum at these schools aims at teaching students to deliver appropriate health care without access to sophisticated medical facilities. The new Institute of Primary Health Care a part of this new medical school will concentrate on preventive medicine.
A case of pulmonary paragonmiasis was diagnosed in a woman of the Manobo tribe in Marilog, Calina... more A case of pulmonary paragonmiasis was diagnosed in a woman of the Manobo tribe in Marilog, Calinan, in the Davao region of Mindanao, the second-largest island in the Phillippine Archipelago. She had the first case of this disease reported in Mindanao. The patient was initially mis-diagnosed as having pulmonary tuberculosis, but failure of the standard triad regimen led to microscopic identification of Paragonimus westermani eggs in sputum. Therapy with Bithionol was successful in this case. One additional case was confirmed, and several more suspected, among members of this population group. From an epidemiologic standpoint, careful examination of chest x-rays will allow early differentiation between pulmonary paragonimiasis and tuberculosis, in areas where both conditions are endemic.
Anthropological theory, methodology, and principles may be applied to cross-cultural implementati... more Anthropological theory, methodology, and principles may be applied to cross-cultural implementation of appropriate health care strategies (e.g., Foster 1982). Anthropology has an important role in recognition of traditional beliefs, practices, and personnel that participate in what may be broadly defined as health, or health care (Fabrega 1978; Kleinman 1978). Recognition of traditional ethnomedical resources, and efforts at the description and classification of ethnomedical technology, may be assisted by the further perception of what may be called four levels of effect in traditional health care. In traditional herbal medicine and ethnopharmacology, for example, the use of natural products may be properly described as pharmacologic, nonspecific, symbolic, or toxic.
The American Journal of Clinical Nutrition, Sep 1, 1988
Although the wt/ht2 or Body Mass Index (BMI) has attained growing popularity in the past few year... more Although the wt/ht2 or Body Mass Index (BMI) has attained growing popularity in the past few years (1), the two components of this index and their relative weighting suggest possible limitations on its use. Since stature (ie, standing height) is one component, the BMI may be stature dependent over at least part of the age range. Again, the use of stature as a divisor suggests that the BMI may also be a!fected by relative leg length or relative sitting height. Finally, the use of weight as the numerator suggests that the BMI-like weight itself-may reflect both lean tissue and fat tissue to a comparable degree. If we turn first to the extensive data of the first National Health and Nutrition Examination Survey (NHANES I), readily available on tape and familiar to most readers of this journal (2), the BMI is indeed stature dependent but in different directions at different points in the life cycle. For NHANES I, correlations between stature and the BMI approximate 0.30 for children, shift during adolescence, and become negative in adult years (Table 1). The massive data of the National Collaborative Perinatal Project (NCPP) confirm these trends; correlations between stature and the BMI again approximate 0.30 for children but average -0. 12 for 40 000 3rd and 4th decade women. Thus the assumption that the BMI is independent ofstature is not quite true for adults and especially not true for children. Anthropometric data included in NHANES I also reveal the extent to which BMI reflects body proportions or more specifically sitting height relative to standing height (Table 2). At all ages considered (ages 5-50) the correlation between BMI and relative sitting height (sitting height/stature) is at least 0.15 and generally exceeds 0.20. With n = 596 for adolescent males to n = 3858 for young adult women, all ofthese values of r are statistically significant. However, the point in question is the magnitudes of the correlations and their implications. Children, adolescents, or adults with short legs for their height have higher BMI values, which indicates the extent to which BMI is also a measure of body build or body proportions. When the BMI is further explored in relation to frame size, Lean Body Mass, and fatness, again on an age-specific basis, it is seen to relate to all three. With use of data from the Tecumseh (Michigan) Community Health Survey to include the radiogrammetricallydetermined bony chest breadth (3) as in Table 3, the correlations approximate 0.5 overall. For the same subjects arranged by age intervals, correlations with the triceps skinfold approximate 0.7, as shown in the table. If we further estimate Lean Body Mass by subtracting estimated fat weight from total body weight (4), correlations with BMI then approximate 0.65 for males aged 30-50. Accordingly, it is clear that BMI reflects both the weight of lean tissue and the weight offat tissue and for some age groups, at least, it may be a better measure of amount oflean than of relative fatness. Under these circumstances and with sampies of considerable size (up to and exceeding 40 000), it is clear that the BMI is not quite independent ofstature, especially at the younger ages. Moreover, the BMI is influenced by
Human epidemiologic and animal experimental evidence has suggested that excess intake of macronut... more Human epidemiologic and animal experimental evidence has suggested that excess intake of macronutrients (total calories, protein, fat) and deficient intake of micronutrients (p carotene, selenium) may be associated with increased incidence and decreased survival of breast cancer in women. The overall pattern of evidence, including migrant studies, has further suggested that dietary patterns in early life may be important to the long-term risk of breast cancer. Since cancer is currently thought to be a multistage process with a long latent period, early nutritional patterns which influence childhood growth and development may also influence the adult risk of cancer. Nutrition-mediated factors which may be associated with breast cancer risk include both anthropometric and reproductive variables. Enduring indicators of growth which can be measured in adults (e.g., stature, sitting height, frame size, lean body mass) may be reflective of early nutritional patterns which place women at increased risk of breast cancer. Anthropometric variables which may be related to adult nutritional patterns (e.g., absolute and relative fatness) are also associated with the risk of cancer in defined groups of women. Anthropometry may aid in the study of the relationship between breast cancer and the timing of nutritional excess, growth, menarche, and other risk factors. Other nutrition-related variables which may be associated with breast cancer include breast secretory activity, bowel function, and lactose tolerance. Recognition of the relationships among nutrition, body size, and breast cancer raises a new context for consideration of the adaptiveness of body size in human populations.
We examined the relationship between adult stature and cancer incidence using data from the first... more We examined the relationship between adult stature and cancer incidence using data from the first U.S. National Health and Nutrition Examination Survey and its follow-up study. Among 12,554 participants 25-74 years old, 460 cancers occurred in men and 399 in women after an average follow-up period of approximately 10 years. The age-adjusted relative risk of cancer for the second (Q2) through fourth (Q4) quartiles of stature compared to the first quartile among men were significantly increased: 1.5, 1.4, and 1.4. After adjustment for race, cigarette smoking, income, and body mass index, the all-sites cancer relative risk increased slightly to 1.6, 1.5, and 1.6. For most cancer sites in men, and particularly colorectal cancer (relative risk = 2.1 for Q4), the lowest incidence was observed among those in the shortest quartile of stature. A weaker, positive association was evident among women, restricted primarily to cancer of the breast and colorectum (relative risk in Q4 = 2.1 and 1.6 for the two cancers, respectively). These findings indicate that short stature is associated with reduced risk of cancer, particularly in men, and suggest a role for nutrition early in life in human carcinogenesis.
The American Journal of Clinical Nutrition, Dec 1, 1986
It is useful to develop indices of weight and stature, or body mass indices (BMIs), that are high... more It is useful to develop indices of weight and stature, or body mass indices (BMIs), that are highly correlated with weight, are independent of stature, and accurately reflect body composition. The anthropometric data collected in the NHANES I (1971-74) and NHANES II (1976-80) US population samples were used to test the statistical characteristics and biologic correlations of various BMIs reported in the literature. BMIs that are independent of stature and still highly correlated to weight (r = 0.89-0.98) over all ages and distributions of fatness and leanness are W/S2 in men and both W/S and W/S1.5 in women. These BMIs are also highly correlated to measured and calculated estimates of body composition including subscapular skinfold thickness (r = 0.78-0.80), arm circumference (r = 0.83-0.89), and arm fat area (r = 0.71-0.83).
The purpose of the study was to address the hypothesis that elevated body iron increases the risk... more The purpose of the study was to address the hypothesis that elevated body iron increases the risk of cancer occurrence and death, and to determine the dose response. Subjects were 3,287 men and 5,269 women participating in the first National Health and Nutrition Examination Survey who had a transferrin saturation determination at enrollment (197 1-1975), who remained alive and cancer-free for at least 4 years, and who were followed to 1988 for cancer outcome. Among 379 men who developed cancer over the study period, the mean transferrin saturation at enrollment was 32. I% whereas among 2,908 who remained cancer-free it was 30.7%; the difference for mortality was 32.3% among 233 deaths vs. 30.8% among 3,054 men not dying of cancer. The mean differences among women were not significant. The mean differences in TIBC and serum iron among men were consistent with the findings for transferrin saturation, and all 3 differences were stable over time when examined by years since blood test. Men and women were divided into 5 groups on the basis of baseline transferrin saturation: 0 to 30%, 3-0%, 40-50%, 50-60%, and 60% and higher. Nineteen percent of men had a baseline transferrin saturation above 40% (the last 3 groups), whereas only 10 percent of women had transferrin saturation above 40%. For men and women combined, risk of cancer occurrence in each group relative to the first was I .O, 0.95, I. 16, I .38 and I .8 I ; for mortality the relative risks were 1.0, 0.96, 1.22, 1.
This analysis demonstrates that a technologically appropriate low-cost pregnancy screening strate... more This analysis demonstrates that a technologically appropriate low-cost pregnancy screening strategy using medical auxiliary personnel can be effective in screening high-risk pregnancy and may be appropriate as a public health program. The screening program revealed that women were classified as low risk or high risk as a dichotomous variable with essentially the same frequency by physicians and by medical auxiliary personnel. The accuracy of the screening was assessed by determining the number of false positive and false negative screenings performed by medical auxiliary personnel and by physicians. Features associated with succes of medical auxiliary personnel include: 1) female married with supportive husband 2) outside source of income self-employed 3) minimal education level high school 4) residence and/or work in the community 5) prior ethnomedical identity. Evaluation of this pregnancy screening trial indicated that voluntary medical auxiliary personnel can have an appropriate role in health care delivery interfacing Western and traditional medical technology. Theoretically better allocation of limited medical resources as permitted by pregnancy screening should result in better health in the population.
Publisher Summary This chapter discusses the effects of individual nutrient supplementation on ev... more Publisher Summary This chapter discusses the effects of individual nutrient supplementation on evaluation of carotenoid intake. The methods described in the chapter are for estimating dietary intake excluding vitamin supplements. As individuals and populations vary in the extent to which they consume vitamin supplements, it is important to be able to evaluate dietary intake methods independently as well as vitamin supplementation. Several specific methods exist for the dietary assessment of nutrient intake. The chapter provides correlation between dietary carotenoid intake and blood carotenoid levels. Carotenoid intake may also be evaluated based on resulting levels of carotenoids in body fluids and tissues or as reflected in the coloration of skin and other tissues. It is reasonable to assume that for dietary carotenoids to have a physiologic effect, they must, after consumption, appear in the blood and tissues to a significant extent. Therefore, the evaluation of carotenoid intake may also be directed by the evaluation of the profile of carotenoids in human plasma following food consumption.
Forensic anthropology has traditionally focused on the analysis of skeletal remains. In the past ... more Forensic anthropology has traditionally focused on the analysis of skeletal remains. In the past few decades, forensic anthropology has also proven valuable in the analysis of burned, mummified, decomposed, fragmented, and partially skeletonized remains. By analyzing skeletal remains and soft tissues that have been preserved by processes other than natural decomposition, the unique taphonomic processes leading to particular states of preservation can be illuminated (Garland and Janaway 1989; Micozzi 1991). Preservation of soft tissues in nature is essentially a competition between decay and desiccation. Climatological factors such as temperature and humidity largely decide the outcome of this contest (Aufderheide 1980; Micozzi 1986). Geological factors which can enhance soft tissue preservation include immersion in water under certain conditions, freezing, and the actions of soil elements such as salts. Biological actions of microbiological organisms and plant products may also cause preservation of soft tissues. In modern cultural and forensic contexts, humans may also place remains in preservative environments intentionally or unintentionally. Human actions have long affected the process of postmortem decomposition. Embalming and anatomical preparation leave distinct taphonomic characteristics. Evidence of postmortem and perimortem medical procedures (e.g., autopsy and surgery) are recognizable in skeletal and soft tissue remains. Intentional human actions resulting in “unnatural” postmortem preservation of soft tissues are documented in the forensic and anthropological literature (Berryman et al. 1991; Micozzi 1991; Sledzik and Ousley 1991).
The authors studied the relation between benign breast disease and subsequent breast cancer in 16... more The authors studied the relation between benign breast disease and subsequent breast cancer in 16,692 women with biopsy-diagnosed benign breast disease who had participated in the Breast Cancer Detection Demonstration Project throughout the United States. Women were classified into one of five benign breast disease categories: atypical hyperplasia, proliferative disease without atypia, nonproliferative disease, fibroadenoma, and other benign breast disease. A total of 485 incident cases of breast cancer were identified in the women from August 1973 to February 1986 after a median follow-up period of 8.3 years from the diagnosis of benign breast disease. Age-adjusted incidence rates were calculated for benign breast disease types stratified by family history and calcification status. Relative risk (RR) estimates of breast cancer for women in the five benign breast disease categories, compared with the screened women who did not develop recognizable breast disease (normal subjects), were computed using the proportional hazards model. Results indicated that risk was associated with the degree of epithelial atypia. Over all age groups, women with nonproliferative disease, proliferative disease without atypia, and atypical hyperplasia displayed progressively increasing risks of 1.5, 1.9, and 3.0, respectively, compared with normal subjects, with 95% confidence intervals (CI) exceeding unity. Particularly high risk was seen among women under age 46 years with atypical hyperplasia (RR = 5.7, 95% CI 3.0-10.6). Women with fibroadenoma as the only indication of their benign breast disease had a relative risk of 1.7, with a lower 95% confidence limit of 1.0. No increased risk was seen for women with other benign breast disease. Positive family history (RR = 1.8) and calcification (RR = 1.2) significantly increased a woman's risk proportionately over the risk associated with each benign breast disease subtype. The authors conclude that the risk of developing breast cancer varies by category of benign breast disease and is directly related to the degree of epithelial atypia.
The health delivery system in the Philippines suffers from various inadequacies and disadvantages... more The health delivery system in the Philippines suffers from various inadequacies and disadvantages. There is a severe shortage of both doctors and hospitals especially in rural areas where most of the countrys population lives. Cost of medical care is so high that all but the socioeconomically advantaged cannot afford proper medical care. Physicians in the Philippines occupy the upper class and are removed from the existence of most of their poorer patients. These lower income patients receive care from auxiliary medical personnel e.g. midwives. There is a new movement in the country to provide training for more medical students more adequate training for the auxiliary medical personnel who provide much of the health care in the country and to bring medical facilities and personnel to the areas where they are needed. 2 new medical schools have been established in Mindanao-Sulu and Samar-Leyte both previously underserved in health care delivery. The curriculum at these schools aims at teaching students to deliver appropriate health care without access to sophisticated medical facilities. The new Institute of Primary Health Care a part of this new medical school will concentrate on preventive medicine.
A case of pulmonary paragonmiasis was diagnosed in a woman of the Manobo tribe in Marilog, Calina... more A case of pulmonary paragonmiasis was diagnosed in a woman of the Manobo tribe in Marilog, Calinan, in the Davao region of Mindanao, the second-largest island in the Phillippine Archipelago. She had the first case of this disease reported in Mindanao. The patient was initially mis-diagnosed as having pulmonary tuberculosis, but failure of the standard triad regimen led to microscopic identification of Paragonimus westermani eggs in sputum. Therapy with Bithionol was successful in this case. One additional case was confirmed, and several more suspected, among members of this population group. From an epidemiologic standpoint, careful examination of chest x-rays will allow early differentiation between pulmonary paragonimiasis and tuberculosis, in areas where both conditions are endemic.
Anthropological theory, methodology, and principles may be applied to cross-cultural implementati... more Anthropological theory, methodology, and principles may be applied to cross-cultural implementation of appropriate health care strategies (e.g., Foster 1982). Anthropology has an important role in recognition of traditional beliefs, practices, and personnel that participate in what may be broadly defined as health, or health care (Fabrega 1978; Kleinman 1978). Recognition of traditional ethnomedical resources, and efforts at the description and classification of ethnomedical technology, may be assisted by the further perception of what may be called four levels of effect in traditional health care. In traditional herbal medicine and ethnopharmacology, for example, the use of natural products may be properly described as pharmacologic, nonspecific, symbolic, or toxic.
The American Journal of Clinical Nutrition, Sep 1, 1988
Although the wt/ht2 or Body Mass Index (BMI) has attained growing popularity in the past few year... more Although the wt/ht2 or Body Mass Index (BMI) has attained growing popularity in the past few years (1), the two components of this index and their relative weighting suggest possible limitations on its use. Since stature (ie, standing height) is one component, the BMI may be stature dependent over at least part of the age range. Again, the use of stature as a divisor suggests that the BMI may also be a!fected by relative leg length or relative sitting height. Finally, the use of weight as the numerator suggests that the BMI-like weight itself-may reflect both lean tissue and fat tissue to a comparable degree. If we turn first to the extensive data of the first National Health and Nutrition Examination Survey (NHANES I), readily available on tape and familiar to most readers of this journal (2), the BMI is indeed stature dependent but in different directions at different points in the life cycle. For NHANES I, correlations between stature and the BMI approximate 0.30 for children, shift during adolescence, and become negative in adult years (Table 1). The massive data of the National Collaborative Perinatal Project (NCPP) confirm these trends; correlations between stature and the BMI again approximate 0.30 for children but average -0. 12 for 40 000 3rd and 4th decade women. Thus the assumption that the BMI is independent ofstature is not quite true for adults and especially not true for children. Anthropometric data included in NHANES I also reveal the extent to which BMI reflects body proportions or more specifically sitting height relative to standing height (Table 2). At all ages considered (ages 5-50) the correlation between BMI and relative sitting height (sitting height/stature) is at least 0.15 and generally exceeds 0.20. With n = 596 for adolescent males to n = 3858 for young adult women, all ofthese values of r are statistically significant. However, the point in question is the magnitudes of the correlations and their implications. Children, adolescents, or adults with short legs for their height have higher BMI values, which indicates the extent to which BMI is also a measure of body build or body proportions. When the BMI is further explored in relation to frame size, Lean Body Mass, and fatness, again on an age-specific basis, it is seen to relate to all three. With use of data from the Tecumseh (Michigan) Community Health Survey to include the radiogrammetricallydetermined bony chest breadth (3) as in Table 3, the correlations approximate 0.5 overall. For the same subjects arranged by age intervals, correlations with the triceps skinfold approximate 0.7, as shown in the table. If we further estimate Lean Body Mass by subtracting estimated fat weight from total body weight (4), correlations with BMI then approximate 0.65 for males aged 30-50. Accordingly, it is clear that BMI reflects both the weight of lean tissue and the weight offat tissue and for some age groups, at least, it may be a better measure of amount oflean than of relative fatness. Under these circumstances and with sampies of considerable size (up to and exceeding 40 000), it is clear that the BMI is not quite independent ofstature, especially at the younger ages. Moreover, the BMI is influenced by
Human epidemiologic and animal experimental evidence has suggested that excess intake of macronut... more Human epidemiologic and animal experimental evidence has suggested that excess intake of macronutrients (total calories, protein, fat) and deficient intake of micronutrients (p carotene, selenium) may be associated with increased incidence and decreased survival of breast cancer in women. The overall pattern of evidence, including migrant studies, has further suggested that dietary patterns in early life may be important to the long-term risk of breast cancer. Since cancer is currently thought to be a multistage process with a long latent period, early nutritional patterns which influence childhood growth and development may also influence the adult risk of cancer. Nutrition-mediated factors which may be associated with breast cancer risk include both anthropometric and reproductive variables. Enduring indicators of growth which can be measured in adults (e.g., stature, sitting height, frame size, lean body mass) may be reflective of early nutritional patterns which place women at increased risk of breast cancer. Anthropometric variables which may be related to adult nutritional patterns (e.g., absolute and relative fatness) are also associated with the risk of cancer in defined groups of women. Anthropometry may aid in the study of the relationship between breast cancer and the timing of nutritional excess, growth, menarche, and other risk factors. Other nutrition-related variables which may be associated with breast cancer include breast secretory activity, bowel function, and lactose tolerance. Recognition of the relationships among nutrition, body size, and breast cancer raises a new context for consideration of the adaptiveness of body size in human populations.
We examined the relationship between adult stature and cancer incidence using data from the first... more We examined the relationship between adult stature and cancer incidence using data from the first U.S. National Health and Nutrition Examination Survey and its follow-up study. Among 12,554 participants 25-74 years old, 460 cancers occurred in men and 399 in women after an average follow-up period of approximately 10 years. The age-adjusted relative risk of cancer for the second (Q2) through fourth (Q4) quartiles of stature compared to the first quartile among men were significantly increased: 1.5, 1.4, and 1.4. After adjustment for race, cigarette smoking, income, and body mass index, the all-sites cancer relative risk increased slightly to 1.6, 1.5, and 1.6. For most cancer sites in men, and particularly colorectal cancer (relative risk = 2.1 for Q4), the lowest incidence was observed among those in the shortest quartile of stature. A weaker, positive association was evident among women, restricted primarily to cancer of the breast and colorectum (relative risk in Q4 = 2.1 and 1.6 for the two cancers, respectively). These findings indicate that short stature is associated with reduced risk of cancer, particularly in men, and suggest a role for nutrition early in life in human carcinogenesis.
The American Journal of Clinical Nutrition, Dec 1, 1986
It is useful to develop indices of weight and stature, or body mass indices (BMIs), that are high... more It is useful to develop indices of weight and stature, or body mass indices (BMIs), that are highly correlated with weight, are independent of stature, and accurately reflect body composition. The anthropometric data collected in the NHANES I (1971-74) and NHANES II (1976-80) US population samples were used to test the statistical characteristics and biologic correlations of various BMIs reported in the literature. BMIs that are independent of stature and still highly correlated to weight (r = 0.89-0.98) over all ages and distributions of fatness and leanness are W/S2 in men and both W/S and W/S1.5 in women. These BMIs are also highly correlated to measured and calculated estimates of body composition including subscapular skinfold thickness (r = 0.78-0.80), arm circumference (r = 0.83-0.89), and arm fat area (r = 0.71-0.83).
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Papers by Marc Micozzi