Obesity Clinical Trial
To determine if the Black-white differences in the development of obesity in pubescent females were due to differences in psychosocial, socioeconomic and other environmental factors. Also, to determine whether differences in the development of obesity led to Black-white differences in other coronary heart disease risk factors, such as blood pressure and serum lipids.
BACKGROUND:
Although not all scientists agree that obesity is an independent risk factor for coronary
heart disease, it may be a strong univariate predictor of coronary heart disease, and
impacts on coronary heart disease through at least some of its relationships with other risk
factors: positive association with blood pressure, inverse association with high density
lipoprotein cholesterol (HDLC), positive association with triglyceride and very low density
lipoprotein cholesterol (VLDLC), and a positive association with hyperglycemia and diabetes.
A number of these have been shown to be major coronary heart disease risk factors.
Prevention of obesity, or weight reduction towards desirable body weight may reduce the
incidence of coronary heart disease and some of its risk factors. There is evidence to
suggest that once obesity begins and/or advances in childhood, it will track into adulthood,
with a reasonably high level of certainty. Obesity becomes progressively more difficult to
treat with maturation to adulthood. Thus, better understanding of the pathophysiology of
obesity in late childhood and early adolescence should, in the long-run, provide the basis
for effective prevention or intervention programs in order to have a long-range impact upon
the consequence of obesity. The age group 9 and 10 at entry has been selected to assure that
many of the individuals are enrolled prior to puberty, and followed through this transition
period when obesity becomes more apparent among Black adolescent females than among white.
Support for this research grew out of recommendations made at the Working Conference on
Coronary Heart Disease in Black Populations held in September 1983 and sponsored by the
NHLBI. The group recommended this research to identify the physiological and/or behavioral
factors which contribute to obesity in Black females. In addition, the 1981 Report of the
Working Group on Arteriosclerosis of the NHLBI stated that research is needed to
characterize the behaviors that create and maintain caloric imbalance. The initiative was
approved by the September 1984 National Heart, Lung, and Blood Advisory Council and the
Request for Proposals was released in November 1984.
The NGHS I was initiated in 1985 as a contract-supported program with three field centers
and a coordinating center. Annual exams were conducted at baseline and through the years of
follow-up. The study was renewed by means of the cooperative agreement mechanism in 1992 as
the NGHS II to permit two additional years of follow-up exams. The study was again renewed
in 1994 as NGHS III to continue annual examinations.
DESIGN NARRATIVE:
In this longitudinal study, there were a baseline examination and annual examinations. Data
collected included: physical examination; anthropometric measurements; dietary information
including food pattern and nutrient intake; physical activity; lipid, lipoprotein, and
apolipoprotein profiles; family socioeconomic status; and psychosocial information. The
study was renewed twice to continue the longitudinal investigation until the subjects
reached the age of 19 to 20. Following the girls until that age allowed the documentation of
the transition in risk factors when Black girls no longer have a cardiovascular risk
advantage and to study the factors surrounding the transition. The longer follow-up also
allowed for studies on the influence of smoking on body weight and the relationship of
adolescent pregnancy to subsequent adiposity development, body fat patterning, blood
pressure, and blood lipids.
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