Dairy Consumption and Related Nutrient Intake in African-American Adults and Children in the United States: Continuing Survey of Food Intakes by Individuals 1994-1996, 1998, and the National Health and Nutrition Examination Survey 1999-2000

Fulgoni, Victor L.; Nicholls, Jill; Reed, Alan; Buckley, Rita; Kafer, Karen; Huth, Peter J.; DiRienzo, Douglas B.; Miller, Gregory D.

doi:10.1016/j.jada.2006.11.007

Cited by 132 publications

(118 citation statements)

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“…To our knowledge, this is the first study in which the association between lower BMD and increased odds of forearm fracture risk has been shown in African American children, a pediatric population that may be at higher risk for bone health deficiencies and fractures. [24][25][26]32,33 Our results add to the growing body of literature, which previously has shown a difference in BMD between generally healthy and largely white children with and without forearm fractures. [12][13][14][15][16] Similarly, this is the first study in which vitamin D deficiency has been associated with increased odds of forearm fracture in any pediatric population.…”

Section: Discussionsupporting

confidence: 61%

“…Although the prevalence of osteoporosis and related fragility fracture is lower in African American women compared with white women, osteoporosis is not uncommon in the African American adult population 70,71 and may be underdiagnosed. 72 Additional study is needed to better understand and improve bone health in the African American population given our study findings of an increased prevalence of factors associated with forearm fracture risk, [24][25][26][27][28][29][30] higher rates of some fractures, 32,33 and the apparent paradox of a relatively increased BMD in comparison with white children. 31 …”

Section: Discussionmentioning

confidence: 99%

“…Dietary risk factors, such as poor dietary intake of calcium and dairy products, are more prevalent in African American children. [24][25][26] African American children are also more likely than white children to be overweight or obese. [27][28][29] Additionally, darker skin pigmentation is a risk factor for vitamin D deficiency.…”

mentioning

confidence: 99%

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Bone Mineral Density and Vitamin D Status Among African American Children With Forearm Fractures

2012

PEDIATRICS

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WHAT'S KNOWN ON THIS SUBJECT: Forearm fractures are unique injuries which are associated with lower bone mineral density in adults and white children. The relationships among bone mineral density, 25-hydroxyvitamin D status, and risk for forearm fracture have not been investigated in African American children. WHAT THIS STUDY ADDS:Our data support an association between both lower bone mineral density and vitamin D deficiency and increased odds of forearm fracture in African American children. Promotion of bone health is indicated in this population.abstract OBJECTIVE: To determine whether African American children with forearm fractures have decreased bone mineral density and an increased prevalence of vitamin D deficiency (serum 25-hydroxyvitamin D level #20 ng/mL) compared with fracture-free control patients. METHODS:This case-control study in African American children, aged 5 to 9 years, included case patients with forearm fracture and control patients without fracture. Evaluation included measurement of bone mineral density and serum 25-hydroxyvitamin D level. Univariable and multivariable analyses were used to test for associations between fracture status and 2 measures of bone health (bone mineral density and 25-hydroxyvitamin D level) while controlling for other potential confounders. RESULTS:The final sample included 76 case and 74 control patients. There were no significant differences between case and control patients in age, gender, parental education level, enrollment season, outdoor play time, height, or mean dietary calcium nutrient density. Cases were more likely than control patients to be overweight (49.3% vs 31.4%, P = .03). Compared with control patients, case patients had lower whole body z scores for bone mineral density (0.62 6 0.96 vs 0.98 6 1.09; adjusted odds ratio 0.38 [0.20-0.72]) and were more likely to be vitamin D deficient (47.1% vs 40.8%; adjusted odds ratio 3.46 [1.09-10.94]). CONCLUSIONS:These data support an association of lower bone mineral density and vitamin D deficiency with increased odds of forearm fracture among African American children. Because suboptimal childhood bone health also negatively impacts adult bone health, interventions to increase bone mineral density and correct vitamin D deficiency are indicated in this population to provide short-term and long-term benefits. Pediatrics 2012;130:e553-e560

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Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

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Bone Mineral Density and Vitamin D Status Among African American Children With Forearm Fractures

2012

PEDIATRICS

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“…Finally, the CSFII/DHKS data are 10 years old and one may be concerned about the relevance of these findings for future research and interventions. To our knowledge, restaurant offerings or consumer behaviours over the past decade were not altered dramatically as indicated by the limited improvement in American adults' VF and dairy consumption (19)(20)(21)(22) . This supports the important pubic health implications of the association we found between the three variables (i.e.…”

Section: Discussionmentioning

confidence: 99%

Reduced away-from-home food expenditure and better nutrition knowledge and belief can improve quality of dietary intake among US adults

Beydoun

Powell

Wang

2008

PHN

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Objective: To test whether reduced away-from-home food expenditure (AFHFE) and better nutrition knowledge and beliefs (NKB) are associated with dietary quality among US adults. Design and subjects: The dietary intake data (average of two 24 h recalls) used were collected from US adults (20-65 years) participating in two cross-sectional surveys, the 1994-96 Continuing Survey of Food Intake by Individuals (CSFII; n 7148) and the CSFII/Diet and Health Knowledge Survey (DHKS; n 4252). Outcome measures: Dietary quality was assessed using selected nutrients and food groups and the 2005 revised US Department of Agriculture Healthy Eating Index (HEI). Exposure variables: (i) Absolute AFHFE (weekly, per capita) and proportion of this exposure out of total food expenditure (relative expenditure); (ii) NKB score using a composite of an eleven-item scale elicited among the CSFII/DHKS subgroup. Statistical analyses performed: We used t tests, x 2 tests, Wilcoxon rank-sum tests and multivariate linear regression models adjusting standard errors for sample design complexity. We utilized a change-in-estimate approach to assess mediation. For effect modification, we tested the significance of interaction terms (NKB 3 AFHFE). Results: Absolute AFHFE was positively associated with grams of fat (b 5 0?14 (SE 0?06)) and saturated fat (b 5 0?02 (SE 0?01)) and negatively associated with fibre (b 5 20?02 (SE 0?01)) and HEI (b 5 20?08 (SE 0?01)). Relative AFHFE mediated NKB effects on intakes such as fat, saturated fat, cholesterol, Na, and fruits and vegetables (change in estimate .10 %). Among subjects with a poor NKB score, higher AFHFE resulted in lower diet quality, particularly Na and cholesterol intakes. Conclusions: Higher AFHFE was associated with a lower dietary quality and interacted antagonistically with NKB in some instances, while mediating the relationship between NKB and dietary quality in others.

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“…A role for vitamin D in cardiovascular disease is plausible given demonstrated effects on parathyroid hormone levels, renin-angiotensin activation, and vascular reactivity 12 . This effect may be more pronounced among blacks because their darker skin tone, high prevalence of lactase deficiency, and lower dietary intake of dairy products 13 increases their risk for low vitamin D.…”

mentioning

confidence: 99%

Vitamin D as a Mediator of Racial Differences in Blood Pressure

2011

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H ypertension is a cardinal risk factor for myocardial infarction, congestive heart failure, stroke, and death. Despite unfavorable trends in the prevalence of diabetes, obesity, and sedentary lifestyles, overall hypertension prevalence was stable at~29% between the 1999-2000 and 2007-2008 time periods 1,2 . This phenomenon has been attributed to improved hypertension awareness, higher treatment rates, and more intense regimens for hypertension. Unfortunately, overall hypertension prevalence among black Americans remains close to 40%, significantly higher than the level observed for whites and Hispanic groups 2,3 . Similar patterns of persistent racial differences despite overall improvement have been observed in cross-sectional studies of blood glucose levels and cholesterol levels 4 . Longitudinal studies also show increased odds of poor blood pressure control over time among Non-Hispanic blacks compared to whites 5 . In addition to increased prevalence of cardiovascular risk factors, mortality from coronary heart disease and stroke remain higher for blacks than other racial/ethnic groups 6 . Therefore, substantial interest exists to explain these persistent disparities and to devise interventions that can address them. In this issue of the Journal, Fiscella and colleagues present evidence that vitamin D deficiency is a potential mediator of racial differences in blood pressure between blacks and whites 7 . In an analysis of NHANES data from [2001][2002][2003][2004][2005][2006], they demonstrated that 25-hydroxyvitamin D (25-OH D) levels appeared to account for approximately one quarter of the difference in mean systolic blood pressure observed between black and white subjects. This study is notable because it is the largest and most robust to date to examine the effect of Vitamin D on racial disparities in blood pressure. The analysis is strengthened by a relatively large sample size with adequate power to detect differences between races based on vitamin D levels. The investigators also extensively adjusted for potential confounders of the relationship between black and white blood pressure measures.In addition to known effects on bone metabolism, Vitamin D has been the subject of intense investigation in recent years given interest in its other systemic effects. Observational studies have associated low vitamin D levels with increased risk for cancer, autoimmune diseases, diabetes, and cardiovascular disease including hypertension [8][9][10][11] While the findings in the present study are provocative, care should be taken in their interpretation. First, the crosssectional nature of the analysis precludes causal inferences. Though the investigators adjusted for key socio-demographic factors, patient-specific health conditions/behaviors, and biomarkers; the potential for bias and confounding remains. For example, information on psychosocial stress, medication non-adherence, and health literacy were not available for inclusion in this analysis. These factors have previously been implicated as mediators of rac...

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Dairy Consumption and Related Nutrient Intake in African-American Adults and Children in the United States: Continuing Survey of Food Intakes by Individuals 1994-1996, 1998, and the National Health and Nutrition Examination Survey 1999-2000

Cited by 132 publications

References 20 publications

Bone Mineral Density and Vitamin D Status Among African American Children With Forearm Fractures

Bone Mineral Density and Vitamin D Status Among African American Children With Forearm Fractures

Reduced away-from-home food expenditure and better nutrition knowledge and belief can improve quality of dietary intake among US adults

Vitamin D as a Mediator of Racial Differences in Blood Pressure

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