Community-based exercise and weight control: diabetes risk reduction and glycemic control in Zuni Indians

Article Abstract:

Non-insulin-dependent diabetes mellitus (NIDDM) occurs mainly in people over 40 years of age, and is associated with an increased risk of developing cardiovascular disease (CVD). Several studies have shown that obesity increases the risk of developing NIDDM, and that both obesity and NIDDM are common among American Indians. CVD and NIDDM are major health problems that affect the Zuni Indians of southwest New Mexico. It is estimated that 28 percent of the Zuni Indians have NIDDM. Therefore, by promoting weight reduction and preventing obesity, it may be possible to reduce the risk of developing NIDDM and CVD. This article describes the results of a community-based exercise and weight control program designed to promote weight loss and reduce the incidence of obesity and NIDDM in Zuni Indians. The program, called The Zuni Diabetes Project, was started in 1983. The exercise portion of the program includes aerobic exercise sessions offered several times a day for five days a week. The weight loss portion of the program took the form of a contest, including six teams with 35-to-50 members each. All team members were weighed once a week over a 10-week period, and weekly weight losses for each team were posted on large display boards throughout the community. After 10 weeks, the participants were divided into three categories, those who did not finish the program; those who finished, but lost less than 5 pounds; and those who lost 5 pounds or more. The 30 diabetics who participated in the exercise program experienced greater weight loss, had lower blood sugar (glucose) levels, and required less medication compared with diabetics who did not participate in the program. The weight-loss competition was successful in achieving a weight loss of 5 pounds or more in 45 percent of the participants. It is concluded that community-based exercise programs and weight-loss competitions are effective in promoting weight loss in Zuni Indians. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Prevention, Obesity, Weight loss, Zunis

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Physical-activity-assessment measures compared in a biethnic rural population: the San Luis Valley Diabetes Study

Article Abstract:

Previous studies have suggested a relationship between levels of physical activity and incidence of disease. Since there is no single method suitable for the evaluation of physical activity across different ethnic groups, proposed associations between activity and disease have been difficult to verify. The purpose of the San Luis Valley Diabetes Study (SLVDS) was to evaluate the risk factors for and incidence of non-insulin-dependent diabetes mellitus (NIDDM) in Hispanic and non-Hispanic whites (NHW) living in rural southern Colorado. During this study, three different methods of evaluating physical activity (both work and leisure activity) were compared in 246 NHW adults and in 257 Hispanic adults. The three methods were: a questionnaire that required participants to recall their physical activities performed over the previous seven days (physical activity recall, PAR); a ranking of usual activity; and a history of participation in vigorous activity. PAR was used to predict the amount of energy expended (EE) during physical activity. The results of the study showed that EE was largely determined by physical activity required at work rather than leisure-time activity. The EE at work increased as the self-reported level of work-associated activity increased for all subjects combined and in individual ethnic groups and occupational subgroups. The EE during leisure activities increased with self-reported leisure-associated activity only for NHW men and employed women. It is concluded that PAR can be useful for assessing physical activity in research settings such as this one, but that other methods of evaluating physical activity that account for ethnic influences on activities and perceptions are needed for evaluating the relationship between physical activity and disease in different ethnic populations. (Consumer Summary produced by Reliance Medical Information, Inc.)

Measurement, Physical fitness, Exercise

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Diagnostic practice and the estimated prevalence of craniosynostosis in Colorado

Article Abstract:

The appearance of localized epidemics of craniosynostosis may be due to variations in diagnostic criteria among practitioners. Craniosynostosis is premature closure of the plates which form the skull, and is usually treated by extensive surgery. There are no clear diagnostic guidelines. Between 1986 and 1989, the rate of craniosynostosis cases reported in Colorado was twice the national average, but only half the children had x-ray confirmed cases. When considering only x-ray confirmed cases, occurrence rates of 14.1 per 10,000 live births do not exceed rates found elsewhere. This suggests that high recognition and referral rates based on low thresholds for recognition caused the apparent epidemic.

Analysis, Usage, Diagnostic errors, Demographic aspects, Craniofacial dysostosis, Diagnosis, Radioscopic, Radioscopic diagnosis

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