It has often been hypothesized that stress and its biological consequences mediate the relationship between low socioeconomic status (SES) or minority status and poor cardiovascular disease outcomes. The objective of this study was to determine if daily cortisol patterns, a biomarker of the stress response, differ by race/ethnicity and socioeconomic status. Data were collected from 935 black, white and Hispanic adults age 48 to 90 years old. Salivary cortisol samples were collected six times per day over three days: at awakening, 30 minutes later, at 1000h, noon, 1800h and at bedtime. Blacks and Hispanics had lower levels of wake-up cortisol and less steep early declines, while blacks had flatter and Hispanics steeper late day declines relative to whites. Similarly the low socioeconomic status group also had lower levels of wake-up cortisol and less steep decline during the early part of the day. These patterns remained after adjustment for health behaviors and psychosocial factors. This study finds an association between salivary cortisol and race/ethnicity and SES in a multiethnic study population. Further work is needed to determine the health consequences of these differences.

Fitness was strongly and significantly related to academic performance. Cardiovascular fitness showed a dose-response association with academic performance independent of other socio-demographic and fitness variables. The association appears to peak in late middle to early high school. We recommend that policymakers consider physical education (PE) mandates in middle high school, school administrators consider increasing PE time, and PE practitioners emphasize cardiovascular fitness.

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Elevated temperatures are associated with mortality risk in these Latin American cities, with the strongest associations in São Paulo, the hottest city. The elderly are an important population for targeted prevention measures, but vulnerability by sex and education differed by city.

We evaluate men's retrospective fertility histories from the British Household Panel Survey and the U.S. Panel Study of Income Dynamics (PSID). Further, we analyze the PSID men's panel-updated fertility histories for their possible superiority over retrospective collection. One third to one half of men's nonmarital births and births within previous marriages are missed in estimates from retrospective histories. Differential survey underrepresentation of previously married men compared with previously married women accounts for a substantial proportion of the deficits in previous-marriage fertility. More recent retrospective histories and panel-updated fertility histories improve reporting completeness, primarily by reducing the proportion of marital births from unions that are no longer intact at the survey date.

The objective of this study was to compare the impact of two intervention approaches on the prevalence of child overweight and obesity: (i) Coordinated Approach To Child Health BasicPlus (CATCH BP), in which schools were provided evidence-based coordinated school health program training, materials, and facilitator support visits, and (ii) CATCH BP and Community (BPC), in which BP schools received additional promotion of community partnerships with the aim of integrating community members and organizations into schools, local decision making and action, and best practices workshops. Schools (n = 97) in four central Texas districts were recruited to participate in the 4-year project. Of the low-income schools (n = 58), 15 schools were selected to receive the BPC intervention and matched with 15 schools in the BP condition. A serial cross-sectional design was used, in which 4th grade student BMI, physical activity, and diet were assessed in the 30 schools in spring 2007 and 2008. Measurements in spring 2007 included 1,107 students, with 53% female; 61% Hispanic, and 14% African American; and mean age of 9.9 years. Adjusted prevalence of overweight/obesity (≥85th percentile) was 42.0 and 47.4% in spring 2007 for the BP and BPC students, respectively. From spring 2007 to spring 2008, the percent of students classified as overweight/obese decreased by 1.3 percentage points (P = 0.33) in BP schools, compared to a decrease of 8.3 percentage points (P < 0.005) in students from BPC schools; the difference between conditions was significant (P = 0.05). CATCH BPC students also reported more positive trends in related behaviors. Implementation of a community-enhanced school program can be effective in reducing the prevalence of child overweight in low-income student populations.obeSity | VOLUME 18 SUPPLEMENT 1 | FEBRUARY 2010 S37

SummaryTelomere length has emerged as a marker of exposure to oxidative stress and aging. Race ⁄ ethnic differences in telomere length have been infrequently investigated. Leukocyte telomere length (LTL) was assessed 981 white, black and Hispanic men and women aged 45-84 years participating in the Multi-Ethnic Study of Atherosclerosis. Direct measurement and questionnaire were used to assess covariates. Linear regression was used to estimate associations of LTL with race ⁄ ethnicity and age after adjustment for sex, income, education, smoking, physical activity, diet and body mass index. On average blacks and Hispanics had shorter telomeres than whites [adjusted mean differences (standard error) in T ⁄ S ratio compared to whites: )0.041 (0.018) for blacks and )0.044 (0.018) for Hispanics]. Blacks and Hispanics showed greater differences in telomere length associated with age than whites (adjusted mean differences in T ⁄ S ratio per 1 year increase in age )0.0018, )0.0047 and )0.0055 in whites, blacks and Hispanics respectively). Differences in age associations were more pronounced and only statistically significant in women. Race ⁄ ethnic differences in LTL may reflect the cumulative burden of differential exposure to oxidative stress (and its predictors) over the lifecourse.

Objective-Optimism and pessimism are associated with cardiovascular disease mortality and progression, however the biological mechanism remains unclear. This study investigates the association between optimism/pessimism and concentrations of seven inflammation and hemostasis markers.Methods-This cross-sectional study used data from the Multi-Ethnic Study of Atherosclerosis (MESA), a study of 6814 persons aged 45-84 with no history of clinical cardiovascular disease. The Life-Orientation Test-Revised (LOT-R) was used to measure dispositional optimism and pessimism. Regression analyses were used to estimate associations of optimism and pessimism with interleukin-6 (IL-6), C-reactive protein (CRP), fibrinogen, homocysteine, factor VIII, D-dimer, and plasmin-antiplasmin, before and after adjustment for sociodemographics, depression, cynicism, health behaviors, BMI, hypertension, and diabetes.Results-Higher scores on the LOT-R (positive disposition) were related to lower concentrations of IL-6 (p=0.001), fibrinogen (p<0.001) and homocysteine (p=0.031). Associations were stronger for the pessimism subscale. After adjustment for demographics, the percentage differences in inflammatory markers corresponding to a 2-standard deviation increase in pessimism were 6.01% (p=0.001) for IL-6; 10.31% (p=0.001) for CRP; 2.47% (p<0.0001) for fibrinogen, and 1.36% (p=0.07) for homocysteine. Associations were attenuated but significant after adjustment for sociodemographics, depression, cynical distrust, and behaviors. Further adjustment for hypertension, BMI and diabetes reduced associations for CRP and IL-6. Pessimism remained associated with a 1.36% (p=0.02) increase in fibrinogen in the fully adjusted model. Factor VIII, D-dimer and plasminantiplasmin were not associated with the LOT-R or subscales.Corresponding Author: Ana V. Diez-Roux, MD, PhD, Center for Social Epidemiology and Population Health, 109 Observatory, 3rd Floor Tower: Ann Arbor, MI, 48109-2029; Phone (734) Fax: (734) adiezrou@umich.edu. Disclosures: No conflicts of interest to disclose.Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Conclusions-Pessimism is related to higher levels of inflammation. Health behaviors, BMI, hypertension and diabetes appear to play a mediating role. NIH Public Access KeywordsPsychosocial factors; inflammation; coagulation; epidemiology; risk factorsSeveral studies have linked life-orientation, as reflected by levels of optimism and pessimism, to cardiovascular disease risk (1-8). Optimism is generally defined as the tendency to believe that future expectations and goals will be ...