Federal communication about obesity in the Dietary Guidelines and checkoff programs

The new Dietary Guidelines for Americans focus on obesity prevention. They recommend increased consumption of whole grains, fruits, vegetables, fish, and low-fat dairy products, within a balanced diet whose total calories have been moderately reduced. Meanwhile, other well-known and well-funded federally sponsored consumer communications promote increased total consumption of beef, pork, and dairy products, including energy dense foods such as bacon cheeseburgers, barbecue pork ribs, pizza, and butter. These latter communications are sponsored by the federal government's commodity promotion programs, known as "checkoff" programs. The programs are established by Congress, approved by a majority of the commodity's producers, managed jointly by a producer board and the U.S. Department of Agriculture, and funded through a tax on the producers. The federal government enforces the collection of more than 600 million US dollars annually in mandatory assessments, approves the advertising and marketing programs, and defends checkoff communication in court as the federal government's own message-in legal jargon, as its own "government speech." Federal support for promoting fruits and vegetables is small by comparison. The checkoff programs recently have become more clearly identified as federal programs. After a recent decision by the U.S. Supreme Court upholding the constitutionality of the checkoff programs, calls for consistency with the Dietary Guidelines may get louder. The current inconsistencies in federal communication undermine the effectiveness of the Dietary Guidelines as an antidote to the shortcomings of the private sector market for information about weight and obesity.     

Toward Comprehensive Obesity Prevention Programs in Native American Communities

Obesity is a particularly important challenge to the health status of Native Americans. This challenge is manifest in the increasing rates of non-insulin-dependent diabetes mellitus among Native Americans. Most studies of Native American infants, preschool children, schoolchildren, and adults have confirmed a high prevalence of over weight Historical studies suggest that for many Native American communities the high rates of obesity are a relatively recent phenomenon. The specific reasons for the increase in obesity among Native Americans have not been determined, although it has been hypothesized that Native Americans have a genetic predisposition to over weight in a “westernized” environment of abundant food and decreased energy expenditure. Few detailed studies of diet or of physical activity levels of contemporary Native Americans have been published. Community-based interventions to modify diet and activity levels to prevent obesity in Native American communities are needed. Preliminary evidence from two formative school-based programs in the Southwest suggest that Native American communities are receptive to school-based interventions, and that such programs may be able to slow the rate of excess weight gain and to improve fitness in schoolchildren. Because of the cultural diversity among Native Americans, future studies should focus on collecting community- and region-specific data, and should emphasize the need for obesity prevention through culturally appropriate community-and school-based behavioral interventions.     

Towards a theory of ethnic separatism

In the decades between 1896 and the mid-1960s it was unusual for the federal government to act to defend or advance Black Americans' interests. In this article two such rare instances are analysed. Both occurred in the 1920s, a decade with a distinctive political complexion. In 1923 Black Americans called upon the federal government's Veterans Bureau [VB] to make good its assurance that African Americans would staff a newly opened hospital in Tuskegee, Alabama, for blacks. At the end of the decade, the Superintendent of Prisons was petitioned to abrogate the new practice at the federal penitentiary in Atlanta, Georgia, of leasing out exclusively Black American prisoners to local governments for contract work. Each case was formulated and justified within the prejudicial framework of segregated race relations, but Black Americans sought fair treatment within its unsalubrious confines. The cases demonstrate the capacity of the federal government to act on racial issues when political circumstances permitted.     

Immigrants as settler colonists: boundary work between Dakota Indians and white immigrant settlers

With territorial expansion of the US came dispossession of Native Americans, supported by policies that made white immigrants settler colonists. On Indian reservations, the federal government encouraged land-taking by allotting land to Indians and making land available to homesteaders, many of them recent immigrants. Few scholars have studied relationships between Natives and newcomers. This paper draws on the concept of boundary work to analyse intergroup relations at the Spirit Lake Dakota Indian Reservation, where white settlers (principally Scandinavians) lived alongside Dakotas. To survive and coexist, Indians and immigrants marked and interpreted boundaries of belonging and exclusion. By establishing common practices, they enacted a mutuality that both reflected and subverted racial–ethnic hierarchies.     

Federal agency biodefense funding, FY2012-FY2013

Since 2001, the United States government has spent substantial resources on preparing the nation against a bioterrorist attack. Earlier articles in this series have analyzed civilian biodefense funding by the federal government for fiscal years (FY) 2001 through proposed funding for FY2012. This article updates those figures with budgeted amounts for FY2013, specifically analyzing the budgets and allocations for civilian biodefense at the Departments of Health and Human Services, Defense, Homeland Security, Agriculture, Commerce, and State; the Environmental Protection Agency; and the National Science Foundation. As in previous years, our analysis indicates that the majority (>90%) of the "biodefense" programs included in the FY2013 budget have both biodefense and non-biodefense goals and applications-that is, programs to improve infectious disease research, public health and hospital preparedness, and disaster response more broadly. Programs that focus solely on biodefense represent a small proportion (<10%) of our analysis, as the federal agencies continue to prioritize all-hazards preparedness. For FY2013, the federal budget for programs focused solely on civilian biodefense totals $574.2 million, and the budget for programs with multiple goals and applications, including biodefense, is $4.96 billion, for an overall total of $5.54 billion.     

Federal Agency biodefense funding, FY2011-FY2012

Since 2001, the United States government has spent substantial resources on preparing the nation against a bioterrorist attack. Earlier articles in this series have analyzed civilian biodefense funding by the federal government for fiscal years (FY) 2001 through proposed funding for FY2011. This article updates those figures with budgeted amounts for FY2012, specifically analyzing the budgets and allocations for biodefense at the Departments of Health and Human Services, Defense, Homeland Security, Agriculture, Commerce, and State; the Environmental Protection Agency; and the National Science Foundation. This article also includes an updated assessment of the proportion of biodefense funding provided for programs that address multiple scientific, public health, healthcare, national security, and international security issues in addition to biodefense. The FY2012 federal budget for civilian biodefense totals $6.42 billion. Of that total, $5.78 billion (90%) is budgeted for programs that have both biodefense and nonbiodefense goals and applications, and $637.6 million (10%) is budgeted for programs that have objectives solely related to biodefense.     

PROFITS AND PLAGIARISM: THE CASE OF MEDICAL GHOSTWRITING

This paper focuses on medical ghostwriting in the United States. I argue that medical ghostwriting often involves plagiarism and, in those cases, can be treated as an act of research misconduct by both the federal government and research institutions. I also propose several anti‐ghostwriting measures, including: 1) journals should implement guarantor policies so that researchers may be better held accountable for their work; 2) research institutions and the federal government should explicitly prohibit medical ghostwriting and outline appropriate penalties; and 3) a publicly available database should be created to record researchers' ethics violations.     

WebBLAST 2.0: an integrated solution for organizing and analyzing sequence data.

SUMMARY: WebBLAST is a suite of programs intended to assist in organizing sequencing data and to provide first-pass sequence analysis in an automated fashion. Data processing is fully automated, with end-users being presented both graphical and tabular summaries of data that can be viewed using any Web browser. AVAILABILITY: The program is free and available at http://genome.nhgri.nih. gov/webblast.     

GeneMachine: gene prediction and sequence annotation

MOTIVATION: A number of free-standing programs have been developed in order to help researchers find potential coding regions and deduce gene structure for long stretches of what is essentially 'anonymous DNA'. As these programs apply inherently different criteria to the question of what is and is not a coding region, multiple algorithms should be used in the course of positional cloning and positional candidate projects to assure that all potential coding regions within a previously-identified critical region are identified. RESULTS: We have developed a gene identification tool called GeneMachine which allows users to query multiple exon and gene prediction programs in an automated fashion. BLAST searches are also performed in order to see whether a previously-characterized coding region corresponds to a region in the query sequence. A suite of Perl programs and modules are used to run MZEF, GENSCAN, GRAIL 2, FGENES, RepeatMasker, Sputnik, and BLAST. The results of these runs are then parsed and written into ASN.1 format. Output files can be opened using NCBI Sequin, in essence using Sequin as both a workbench and as a graphical viewer. The main feature of GeneMachine is that the process is fully automated; the user is only required to launch GeneMachine and then open the resulting file with Sequin. Annotations can then be made to these results prior to submission to GenBank, thereby increasing the intrinsic value of these data. AVAILABILITY: GeneMachine is freely-available for download at http://genome.nhgri.nih.gov/genemachine. A public Web interface to the GeneMachine server for academic and not-for-profit users is available at http://genemachine.nhgri.nih.gov. The Web supplement to this paper may be found at http://genome.nhgri.nih.gov/genemachine/supplement/.     

Federal consistency and ocs oil and gas development: A review and assessment of the “directly affecting”; controversy

Abstract

Attempts by the federal government, notably the Department of the Interior, to accelerate development of hydrocarbon resources on the Outer Continental Shelf have resulted in litigation between coastal states and the federal government. A principal issue involved has been whether federal consistency provisions contained in the Coastal Zone Management Act apply to federal lease sale decisions. Language contained in this statute (Section 307(c)(l)) requires federal activities directly affecting the coastal zone to be conducted in a manner consistent, to the maximum extent practicable, with state coastal zone management programs.

This paper reviews the evolution of this controversy in intergovernmental relations since its inception, and describes various proposals which have been made to define the term “directly affecting.”; Events involved in OCS Lease Sales Nos. 48, 53, and 68, offshore California, are described to illustrate the varying state/federal perspectives on federal consistency requirements. This assessment concludes that voluntary consistency determinations by federal agencies would best promote harmonious state/federal relations in developing hydrocarbon resources on the Outer Continental Shelf.     

Amerindians show no association of PC-1 gene Gln121 allele and obesity: a thrifty gene population genetics

PC-1 Gln121 gene is a risk factor for type 2 diabetes, obesity and insulin resistance in European/American Caucasoids and Orientals. We have aimed to correlate for the first time this gene in Amerindians with obesity and their corresponding individuals genotypes with obesity in order to establish preventive medicine programs for this population and also studying the evolution of gene frequencies in world populations. Central obesity was diagnosed by waist circumference perimeter and food intake independent HDL-cholesterol plasma levels were measured. HLA genes were determined in order to more objectively ascertain participants Amerindians origin. 321 Amerindian blood donors who were healthy according to the blood doning parameters were studied. No association was found between PC-1 Gln121 variant and obesity. Significant HDL-cholesterol lower values were found in the PC-1 Lys121 bearing gene individuals versus PC-1 Gln121 bearing gene ones (45.1 ± 12.7 vs. 48.7 ± 15.2 mg/dl, p < 0.05). Population analyses showed a world geographical gradient in the PC-1 Gln121 allele frequency: around 9% in Orientals, 15% in European Caucasoids and 76% in Negroids. The conclusions are: (1) No association of PC-1 Gln121 gene is found with obesity in Amerindians when association is well established in Europeans. (2) PC-1 Gln121 gene is associated to higher levels of HDL-cholesterol than the alternative PC-1 Lys121 allele. This may be specific for Amerindians. (3) Amerindians have an intermediate frequency of this possible PC-1 Gln121 thrifty gene when compared with Negroid African Americans (78.5%) or Han Chinese (7.5%, p < 0.0001). Historical details of African and other groups may support the hypothesis that PC-1 Gln121 is indeed a thrifty gene.     

A public domain image-analysis program for the single-cell gel-electrophoresis (comet) assay

The single-cell gel electrophoresis (or comet) assay has gained widespread acceptance as a cheap and simple genotoxicity test, but it requires a computer-assisted image-analysis system. As commercial programs are expensive and inflexible, we decided to develop an image-analysis system based on public domain programs and make it publicly available for the scientific community. Our system is based on the scientific image-processing program NIH Image, and was written in its Pascal-like macro language. User interaction was kept as simple as possible, to enable the measurement of a large number of cells with a few keystrokes. Therefore, the time for image analysis is very low, even on slow computers. The comet macro can be obtained from http://mailbox.univie.ac.at/christoph.helma++ +/comet/, NIH Image is available at http://rsb.info.nih.gov/nih-image/. Both programs are free of charge.     

Changes in the Regional Prevalence of Child Obesity in 4th, 8th,and 11th Grade Students in Texas From 2000–2002 to 2004–2005

Although national and state estimates of child obesity are available, data at these levels are insufficient to monitor effects of local obesity prevention initiatives. The purpose of this study was to examine regional changes in the prevalence of obesity due to statewide policies and programs among children in grades 4, 8, and 11 in Texas Health Services Regions (HSRs) between 2000–2002 and 2004–2005, and nine selected counties in 2004–2005. A cross‐sectional, probability‐based sample of 23,190 Texas students in grades 4, 8, and 11 were weighed and measured to obtain BMI. Obesity was >95th percentile for BMI by age/sex using Centers for Disease Control and Prevention growth charts. Child obesity prevalence significantly decreased between 2000–2002 and 2004–2005 for 4th grade students in the El Paso HSR (?7.0%, P = 0.005). A leveling off in the prevalence of obesity was noted for all other regions for grades 4, 8, and 11. County‐level data supported the statistically significant decreases noted in the El Paso region. The reduction of child obesity levels observed in the El Paso area is one of the few examples of effective programs and policies based on a population‐wide survey: in this region, a local foundation funded extensive regional implementation of community programs for obesity prevention, including an evidence‐based elementary school‐based health promotion program, adult nutrition and physical activity programs, and a radio and television advertising campaign. Results emphasize the need for sustained school, community, and policy efforts, and that these efforts can result in decreases in child obesity at the population level.     

VISTA : visualizing global DNA sequence alignments of arbitrary length

Summary: VISTA is a program for visualizing global DNA sequence alignments of arbitrary length. It has a clean output, allowing for easy identification of similarity, and is easily configurable, enabling the visualization of alignments of various lengths at different levels of resolution. It is currently available on the web, thus allowing for easy access by all researchers. Availability: VISTA server is available on the web at http://www-gsd.lbl.gov/vista. The source code is available upon request. Contact: vista@lbl.gov     

Differential Impact of Obesity in Related Populations

To search for genetic and environmental determinants of obesity, we compared the prevalences and the impact of obesity in three populations from two cities: Mexican Amcricans (n=820) and non-Hispanic whites (n=1112)from San Antonio, Texas, and Mexicans from Mexico City (n= 1878). In the age range examined, 35–64 years, only Mexican men and women showed a significant increase in the prevalence of obesity with age. On the other hand, genetic ancestry, especially in women, made significant differences in the rates of obesity. Mexican Americans showed relatively high, and non-Hispanic whites low, rates of obesity. To discriminate between genetic and environmental influences mediating the impact of obesity on a set of hemodynamic and metabolic variables, we compared this impact between Mexican Americans and both non-Hispanic whites (same macro-environment, different gene pools), and Mexicans (same gene pool, different environments). We found that obesity always worsens the hemodynamic and metabolic profiles of individuals, but the magnitude of the effects may be variable. We showed that the levels of insulin concentrations for a given level of obesity were similar in Mexicans and Mexican Americans, suggesting that genetic influences predominate in determining insulin levels; the levels of triglycerides and HDL for a given level of obesity were similar in Mexican Americans and non-Hispanic whites, suggesting predominant environmental influences on lipid levels. On the other hand, the levels of glucose and systolic blood pressure for a given level of obesity were usually different between Mexican Americans and either of the other two populations, suggesting that these levels may result from genotype-by-environment interactions.     

Prevalence of Pre‐obesity and Obesity in Urban Adult Mexicans in Comparison with Other Large Surveys

Objective: 1. To estimate the prevalence of pre‐obesity and obesity in a 1992 to 1993 national survey of the Mexican urban adult population. 2. To compare our findings with other national surveys and with data for Mexican Americans. Research Methods and Procedures: The national representative sample of the Mexican urban adult population included 8462 women and 5929 men aged 20 to 69 years from 417 towns of >2500 people. Body mass index (BMI), calculated from measured weight and height, was classified using the World Health Organization categories of underweight (BMI < 18.5 kg/m²), normal weight (BMI 18.5 to 24.9 kg/m²), pre‐obesity (PreOB = BMI 25 to 29.9 kg/m²) and obesity (OB = BMI 30+ kg/m²). Estimates for Mexican Americans were calculated from U.S. survey data. Results: Overall, 38% of the Mexican urban adult population were classified as pre‐obese and 21% as obese. Men had a higher prevalence of pre‐obesity than women did at all ages, but women had higher values of obesity. Both pre‐obesity and obesity increased with age up to the age range brackets of 40 to 49 or 50 to 59 years for both men and women. Both pre‐obesity and obesity prevalence estimates were remarkably similar to data for Mexican Americans from 1982 through 1984. Comparison with other large surveys showed that countries differed more in the prevalence of obesity than of pre‐obesity, leading to differences in the PreOB/OB ratio, and that countries also differed in the gender ratio (female/male) for both pre‐obesity and obesity. Discussion: Pre‐obesity and obesity were high in our population and increased with age. Our approach of characterizing large surveys by PreOB/OB and gender ratios appeared promising.     

Trends of Abdominal Adiposity in White,Black, and Mexican‐American Adults, 1988 to 2000

Objective: To describe changes in the distribution of waist circumference (WC) and abdominal obesity (AO) in white, black, and Mexican‐American adults from 1988 through 2000. Research Methods and Procedures: Nationally representative cross‐sectional surveys of adults 20 to 79 years of age were examined using data from U.S. National Health and Nutrition Examination Surveys of 1988 to 1994 and 1999 to 2000. AO was defined as WC ≥102 cm in men and ≥88 cm in women. Results: There was a gradient of increasing WC and AO with increasing age in both study periods in whites and blacks. In men, the average increase between the study periods in overall WC in whites, blacks, and Mexican Americans were 3, 3.3, and 3.4 cm, respectively. The corresponding values in women were 2.4, 5.3, and 3.7 cm, respectively. In men, the percentage change in prevalence of AO between 1988 and 2000 ranged from 5.5% in Mexican‐American men to 8.2% in white men. In women, there was a 1.7% decrease in AO in Mexican Americans, whereas there was an increase of 6.3% for whites and 7% for blacks. Discussion: Despite increased understanding of the need for screening and treatment for obesity, this study indicates increasing prevalence of AO in white and black Americans. Without concerted effort to reduce the prevalence of overall obesity, the increasing prevalence of AO is likely to lead to increased prevalence of metabolic syndromes in the United States. Our results highlight the need to design evidence‐based programs that show promise for long‐term health behavior changes to facilitate the prevention of AO and related comorbidities.     

Addressing consumer grievances in medicine: policies and practices of newborn screening programs in the United States

Newborn screening programs collectively administer the largest genetic testing initiative in the United States. The redress of grievances is an important mechanism for consumers to provide input into clinical and public health programs. In this study, we evaluated mechanisms for addressing consumer grievances in newborn screening programs. To do this, we surveyed all 50 state plus the District of Columbia newborn screening programs by questionnaire regarding protocols for receipt and redress of problems reported by parents of newborns and ascertained the existence and nature of complaints and how complaints were documented and addressed. Pertinent state and federal legislation and regulation were also reviewed. Six of 49 newborn screening programs reported having formal policies for handling consumer grievances. Four states reported having pertinent legislation or regulation. Thirty-eight of 49 states reported having received complaints from 1993 to 1995. Thirteen of 49 newborn screening programs reported that they actively seek feedback from consumers. Consumer grievances ranged from minor complaints to potentially life-threatening concerns. In general, complaints are managed on an ad hoc basis; formal policies are typically lacking. As newborn screening programs affect a vast number of Americans, a proactive and comprehensive approach, including solicitation of consumer feedback, could benefit both newborn screening programs and the public served by them.     

Relationships of BMI to Cardiovascular Risk Factors Differ by Ethnicity

The burden of cardiovascular risk associated with obesity disproportionately affects African Americans and little is known about ethnic/racial differences in the relationship of obesity to cardiometabolic risk. This report assesses whether obesity is similarly associated with cardiometabolic risk factors in African Americans and whites of European ancestry. Cross‐sectional observational data from the Jackson Heart Study (JHS) and the Framingham Heart Study (FHS) were compared. This analysis uses participants aged 35–74 years with BMI >18.5 kg/m², and free of prevalent cardiovascular disease (CVD), from the initial JHS clinical examination (2000–2004) and the FHS Offspring (1998–2001) and Third Generation (2002–2005) cohorts. Participants were evaluated for the presence of lipid abnormalities, hypertension, and diabetes. Overall, 4,030 JHS (mean age 54 years, 64% women) and 5,245 FHS (mean age 51 years, 54% women) participants were available for analysis. The prevalence of all risk factors except high triglycerides and low high‐density lipoprotein (HDL) was substantially higher in JHS (all P < 0.001) and BMI was associated with increasing prevalence of most CVD risk factors within each race. For diabetes mellitus, hypertension, and low HDL, steeper relationships to BMI were observed in FHS than in JHS (P values <0.001–0.016). There were larger proportional increases in risk factor prevalence with increasing BMI in whites than in African Americans. The higher prevalence rates of cardiometabolic risk factors at nearly all levels of BMI in African Americans, however, suggest that additional factors contribute to the burden of CVD risk in African Americans.     

Obesity in Minority Populations: An Epidemiologic Assessment

This article reviews issues relating to the prevalence, health implications, and prevention and treatment perspectives of obesity in U.S racial and ethnic minority groups. The growing interest in obesity in minority populations reflects an awareness of the high prevalence of obesity among black, Hispanic, Asian and Pacific Islander and Native Americans as well as a generally increased interest in minority health. In addition, the fact that some aspects of obesity among minorities differ from those in whites suggests that new insights may be gained from studying obesity in diverse populations. However, there are many methodological problems to be overcome, including some that arise from the way minority groups are defined. Under the assumption that all obesity results from a period of sustained positive energy balance at the individual level, an epidemiologic explanation for the excess of obesity in minorities at the population level seems readily apparent. A surplus of obesity-promoting forces and a deficit of obesity-inhibiting forces, caused by secular changes in food availability and physical activity, accompany the early phases of modernization and economic advancement. The high prevalence of obesity in minority populations can be viewed as a function of the slope and timing of these secular changes. Genetic predisposition, cultural attitudes, and exposure to maternal obesity and diabetes in utero may be potentiating factors. In this context, interventions targeting individuals would seem inevitably to put racial and ethnic minority groups on the path toward the same weight control crisis now observed in the majority white population. This suggests that the underlying causes of the societal energy balance problem must be addressed at the population level in order for effective clinical approaches to be developed for minority populations with a high obesity prevalence.