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Epidemic Obesity in the United States

Epidemic Obesity in the United States Abstract SUSTAINED CALORIC imbalance with consequent overweight has become the behavioral norm for the American population. This phenomenon is documented in the data from the US National Health and Examination Survey of 1976 through 1980 (NHANES-II), displayed in the article by Denke et al in this issue of the Archives.1 Of the white men aged 20 to 74 years described there, an absolute majority had a body mass index (BMI) greater than 25.0 kg/m2, equivalent to more than 12% above desirable weight.2 ("Normal" BMI has been described as between 20.0 and 25.0 kg/m2).3 This pattern of overweight was the consistent NHANES-II finding for white men aged 35 to 44 years on up, and similar results were recorded for black men.4 While median BMI levels were slightly lower for younger white women, they exceeded 25.0 for those aged 55 to 74 years, and among black women, References 1. References 6,22,26,29-33,40(pp 124,126),47-51. 2. Denke MA, Sempos CT, Grundy SM. Excess body weight: an underrecognized contributor to high blood cholesterol levels in white American men . Arch Intern Med. 1993;153:1093-1103.Crossref 3. Hypertension Detection and Follow-Up Program Cooperative Group. Mortality findings for stepped-care and referred-care participants in the Hypertension Detection and Follow-up Program, stratified by other risk factors . Prev Med. 1985;14:312-335.Crossref 4. Garrow JS. Treatment of obesity . Lancet. 1992;340:409-413.Crossref 5. National Center for Health Statistics, Najjar M, Rowland M. Anthropometric reference data and prevalence of overweight: United States, 1976-80. Washington, DC: Government Printing Office; 1987;11;238:1-73. Dept of Health and Human Services publication No. (PHS) 87-1688. 6. INTERSALT Cooperative Research Group (Paul Elliott, guest ed). The INTERSALT Study: an international cooperative study of electrolyte excretion and blood pressure: further results . J Hum Hypertens. 1989;3:279-407. 7. Rose G. The Strategy of Preventive Medicine . New York, NY: Oxford University Press; 1992. 8. Rose G. Population distributions of risk and disease . Nutr Metab Cardiovasc Dis. 1991;1:37-40. 9. Stamler J, Dyer AR, Shekelle RB, Neaton J, Stamler R. Relationship of baseline major risk factors to coronary and all causes mortality, and to longevity: findings from long-term follow-up of Chicago cohorts . Cardiologia . In press. 10. Stamler J, Shekelle RB. Lower dietary cholesterol and saturated fat intake, lower serum cholesterol, and expected effects on coronary risk and on longevity . Lipid Rev. 1989;3:89-96. 11. Stamler J, Shekelle RB. Reduction of dietary cholesterol, saturated fat intakes and serum cholesterol: expected effects on coronary risk and on longevity . In: Lewis B, Assmann G, eds. The Social and Economic Contexts of Coronary Prevention . London, England: Current Medical Liturature; 1990:3-10. 12. Stamler J, Berkson DM, Lindberg HA. Risk factors: their role in the etiology and pathogenesis of the atherosclerotic diseases . In: Wissler RW, Geer JC, eds. The Pathogenesis of Atherosclerosis . Baltimore, Md: Williams & Wilkins; 1972:41-119. 13. MacMahon S, Peto R, Cutler J, et al. Blood pressure, stroke, and coronary heart disease, I . Lancet. 1990;335:765-774.Crossref 14. Klag MJ, Ford DE, Mead LA, et al. Serum cholesterol in young men and subsequent cardiovascular disease . N Engl J Med. 1993;328:313-318.Crossref 15. Berkson DM, Stamler J. Epidemiology of the killer chronic diseases . In: Winick M, ed. Nutrition and the Killer Diseases . New York, NY: John Wiley & Sons Inc; 1981:17-55. 16. Pan WH, Nanas S, Dyer A, et al. The role of weight in the positive association between age and blood pressure . Am J Epidemiol. 1986;124:612-623. 17. Stamler J. Epidemiologic findings on body mass and blood pressure in adults . Ann Epidemiol. 1991;1:347-362.Crossref 18. Must A, Jacques PF, Dallal GE, Bajema CJ, Dietz WH. Long-term morbidity and mortality of overweight adolescents . N Engl J Med. 1992;327:1350-1355.Crossref 19. Hulley SB, Walsh JM, Newman TB. Health policy on blood cholesterol: time to change directions . Circulation. 1992;86:1026-1029.Crossref 20. Hulley SB, Newman TB, Grady D, Garber AM, Baron RB, Browner WS. Should we be measuring blood cholesterol in young adults ? JAMA. 1993;269:1416-1419.Crossref 21. National Center for Health Statistics. United States life tables eliminating certain causes of death. In: US Decennial Life Tables for 1979-1981. Washington DC: Government Printing Office; 1(2); 1988. Dept of Health and Human Services publication No. (PHS) 88-1150-2. 22. Ackerknecht EH. Rudolf Virchow: Doctor, Statesman, Anthropologist . Madison: University of Wisconsin Press; 1953. 23. National Diet-Heart Study Research Group. The National Diet-Heart Study final report . Circulation. 1968;37:I1-I428.Crossref 24. Caggiula AW, Christakis G, Farrand M, et al. The Multiple Risk Intervention Trial (MRFIT), IV: intervention on blood lipids . Prev Med. 1981;10:443-475.Crossref 25. Treatment of Mild Hypertension Research Group. The Treatment of Mild Hypertension Study . Arch Intern Med. 1991;151:1413-1423.Crossref 26. The Treatment of Mild Hypertension Research Group. Treatment of Mild Hypertension Study (TOMHS): final results . JAMA . In press. 27. Stamler J, Lectures on Preventive Cardiology . New York, NY: Grune & Stratton; 1967. 28. Nanas S, Pan WH, Stamler J, et al. The role of relative weight in the positive association between age and serum cholesterol in men and women . J Chronic Dis. 1987;40:887-892.Crossref 29. National Center for Health Statistics. Health, United States, 1989, and Prevention Profile . Hyattsville, Md: Public Health Service; 1990:174. 30. Stamler J. Primary prevention of coronary heart disease: the last 20 years . Am J Cardiol. 1981;47:722-735. 31. Working Group on Arteriosclerosis of the National Heart, Lung, and Blood Institute. Prevention . In: Report of the Working Group on Arteriosclerosis of the National Heart, Lung and Blood Institute . Bethesda, Md: US Dept of Health and Human Services; 1981;2:261-422. National Institutes of Health publication No. 81-2035. 32. Stamler J. Epidemiology, established risk factors, and the primary prevention of coronary heart disease . In: Parmley WW, Chatterjee K, eds. Cardiology . Philadelphia, Pa: JB Lippincott; 1987:1-41. 33. Stamler J. Established major coronary risk factors . In: Marmot M, Elliott P, eds. Coronary Heart Disease Epidemiology: From Aetiology to Public Health . New York, NY: Oxford University Press; 1992:35-66. 34. Harlan WR, Landis JR, Flegal KM, Davis CS, Miller ME. Secular trends in body mass in the United States, 1960-1980 . Am J Epidemiol. 1988;128:1065-1074. 35. Flegal KM, Harlan WR, Landis JR. Secular trends in body mass index and skinfold thickness with socioeconomic factors in young adult women . Am J Clin Nutr. 1988;48:535-543. 36. Flegal KM, Harlan WR, Landis JR. Secular trends in body mass index and skin-fold thickness with socioeconomic factors in young adult men . Am J Clin Nutr. 1988;48:544-551. 37. Liu K, Cedres LB, Stamler J, et al. Relationship of education to major risk factors and death from coronary heart disease, cardiovascular diseases and all causes: findings of three Chicago epidemiologic studies . Circulation. 1982;66:1308-1314.Crossref 38. Dyer AR, Stamler J, Shekelle RB, Schoenberger J. The relationship of education to blood pressure: findings on 40 000 employed Chicagoans . Circulation. 1976;54:987-992.Crossref 39. Hypertension Detection and Follow-up Program Cooperative Group. Race, education and prevalence of hypertension . Am J Epidemiol. 1977;106:351-361. 40. National Center for Health Statistics, National Heart, Lung, and Blood Institute Collaborative Lipid Group. Trends in serum cholesterol levels among US adults aged 20 to 74 years . JAMA. 1987;257:937-942.Crossref 41. US Bureau of the Census. Statistical Abstract of the United States. 110th ed. Washington, DC: US Bureau of the Census; 1990. 42. Stamler R, Shipley M, Elliott P, Dyer A, Sans S, Stamler J, on behalf of the INTERSALT Cooperative Research Group. Higher blood pressure in adults with less education . Hypertension. 1992;19:237-241.Crossref 43. Pell S, Fayerweather WE. Trends in the incidence of myocardial infarction and in associated mortality and morbidity in a large employed population . N Engl J Med. 1985;312:1005-1012.Crossref 44. Recent trends in mortality from cardiovascular diseases . Stat Bull Metropol Life Ins Co. 1979;60:3-8. 45. Enstrom JE. Trends in mortality among California physicians after giving up smoking: 1950-1979 . BMJ. 1983;286:1101-1105.Crossref 46. Feldman JJ, Makuc DM, Kleinman JC, Cornoni-Huntley J. National trends in educational differentials in mortality . Am J Epidemiol. 1989;129:919-933. 47. Rogot E, Hrubec Z. Trends in mortality from coronary heart disease and stroke among US veterans: 1954-1979 . J Clin Epidemiol. 1989;42:245-256.Crossref 48. Block G, Dresser CM, Hartmen AM, Carroll MD. Nutrient sources in the American diet: quantitative data from the NHANES II survey, I: vitamins and minerals . Am J Epidemiol. 1985;122:13-26. 49. Block G, Dresser CM, Hartman AM, Carroll MD. Nutrient sources in the American diet: quantitive data from the NHANES II survey, II: macronutrients and fats . Am J Epidemiol. 1985;122:27-40. 50. Putnam JJ. Food consumption, 1970-1990 . Food Rev. 1991;14:2-12. 51. Popkin BM, Haines PS, Patterson RE. Dietary changes in older Americans, 1977-1987 . Am J Clin Nutr. 1992;55:823-830. 52. National Research Council (US) Committee On Diet and Health. Diet and Health: Implications for Reducing Chronic Disease . Washington, DC: National Academy Press; 1989. 53. Wilkinson RG. Glasgow, Edinburgh, and the health divide: is it ever too late for prevention ? BMJ. 1992;305:1239-1240.Crossref 54. Garrow JS. Obesity and Related Diseases . New York, NY: Churchill Livingstone Inc; 1988. 55. Ravussin E, Swinburn BA. Pathophysiology of obesity . Lancet 1992;340:404-408.Crossref 56. Stunkard AJ, Wadden TA, eds. Obesity: Theory and Therapy . 2nd ed. New York, NY: Raven Press; 1992. 57. Lichtman SW, Pisarska K, Raynes-Berman E, Pestone M, Dowling H, Offenbacher E. Discrepancy between self-reported and actual caloric intake and exercise in obese subjects . N Engl J Med. 1992;327:1893-1898.Crossref 58. Danforth E, Sims EAH. Obesity and efforts to lose weight . N Engl J Med. 1992; 327:1947-1948.Crossref 59. Stamler J. Population studies . In: Levy RI, Rifkind BM, Dennis BH, Ernst ND, eds. Nutrition, Lipids, and Coronary Heart Disease: A Global View . New York, NY: Raven Press; 1979:25-88. 60. Stamler J, Buzzard M, Ruth K, Garside D. Nutrient Analyses of Food and Agriculture Organization (FAO) Food Balance Sheets for 27 Countries, 1961 to 1988 . Chicago, III: Northwestern University Medical School, Department of Preventive Medicine; 1992. Privately printed. 61. Baba S, Pan WH, Ueshima H, et al. Blood pressure levels, related factors, and hypertension control status of Japanese and Americans . J Hum Hypertens. 1991;5:317-332. 62. US-Peoples Republic of China Collaborative Study of Cardiovascular and Cardiopulmonary Epidemiology. Baseline Survey, Subsample (1983-86), Part 2: Nutrition: Data Preview . Bethesda, Md: US Dept of Health and Human Services; 1992. 63. People's Republic of China—United States Cardiovascular and Cardiopulmonary Epidemiology Research Group. An epidemiological study of cardiovascular and cardiopulmonary disease risk factors in four populations in the People's Republic of China . Circulation. 1992;85:1083-1096.Crossref 64. Tao S, Li Y, Xiao Z, et al for the PRC-USA Cardiovascular and Cardiopulmonary Epidemiology Research Group. Serum lipids and their correlates in Chinese urban and rural populations of Beijing and Guangzhou . Int J Epidemiol. 1992;21:893-903.Crossref 65. US Dept Health Human Services. Healthy People 2000: National Health Promotion and Disease Prevention Objectives (Summary Report). Washington, DC: US Government Printing Office; 1991. Dept of Health and Human Services publication No. (PHS) 91-50213. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Epidemic Obesity in the United States

Archives of Internal Medicine , Volume 153 (9) – May 10, 1993

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American Medical Association
Copyright
Copyright © 1993 American Medical Association. All Rights Reserved.
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0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1993.00410090006001
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Abstract

Abstract SUSTAINED CALORIC imbalance with consequent overweight has become the behavioral norm for the American population. This phenomenon is documented in the data from the US National Health and Examination Survey of 1976 through 1980 (NHANES-II), displayed in the article by Denke et al in this issue of the Archives.1 Of the white men aged 20 to 74 years described there, an absolute majority had a body mass index (BMI) greater than 25.0 kg/m2, equivalent to more than 12% above desirable weight.2 ("Normal" BMI has been described as between 20.0 and 25.0 kg/m2).3 This pattern of overweight was the consistent NHANES-II finding for white men aged 35 to 44 years on up, and similar results were recorded for black men.4 While median BMI levels were slightly lower for younger white women, they exceeded 25.0 for those aged 55 to 74 years, and among black women, References 1. References 6,22,26,29-33,40(pp 124,126),47-51. 2. Denke MA, Sempos CT, Grundy SM. Excess body weight: an underrecognized contributor to high blood cholesterol levels in white American men . Arch Intern Med. 1993;153:1093-1103.Crossref 3. Hypertension Detection and Follow-Up Program Cooperative Group. Mortality findings for stepped-care and referred-care participants in the Hypertension Detection and Follow-up Program, stratified by other risk factors . Prev Med. 1985;14:312-335.Crossref 4. Garrow JS. Treatment of obesity . Lancet. 1992;340:409-413.Crossref 5. National Center for Health Statistics, Najjar M, Rowland M. Anthropometric reference data and prevalence of overweight: United States, 1976-80. Washington, DC: Government Printing Office; 1987;11;238:1-73. Dept of Health and Human Services publication No. (PHS) 87-1688. 6. INTERSALT Cooperative Research Group (Paul Elliott, guest ed). The INTERSALT Study: an international cooperative study of electrolyte excretion and blood pressure: further results . J Hum Hypertens. 1989;3:279-407. 7. Rose G. The Strategy of Preventive Medicine . New York, NY: Oxford University Press; 1992. 8. Rose G. Population distributions of risk and disease . Nutr Metab Cardiovasc Dis. 1991;1:37-40. 9. Stamler J, Dyer AR, Shekelle RB, Neaton J, Stamler R. Relationship of baseline major risk factors to coronary and all causes mortality, and to longevity: findings from long-term follow-up of Chicago cohorts . Cardiologia . In press. 10. Stamler J, Shekelle RB. Lower dietary cholesterol and saturated fat intake, lower serum cholesterol, and expected effects on coronary risk and on longevity . Lipid Rev. 1989;3:89-96. 11. Stamler J, Shekelle RB. Reduction of dietary cholesterol, saturated fat intakes and serum cholesterol: expected effects on coronary risk and on longevity . In: Lewis B, Assmann G, eds. The Social and Economic Contexts of Coronary Prevention . London, England: Current Medical Liturature; 1990:3-10. 12. Stamler J, Berkson DM, Lindberg HA. Risk factors: their role in the etiology and pathogenesis of the atherosclerotic diseases . In: Wissler RW, Geer JC, eds. The Pathogenesis of Atherosclerosis . Baltimore, Md: Williams & Wilkins; 1972:41-119. 13. MacMahon S, Peto R, Cutler J, et al. Blood pressure, stroke, and coronary heart disease, I . Lancet. 1990;335:765-774.Crossref 14. Klag MJ, Ford DE, Mead LA, et al. Serum cholesterol in young men and subsequent cardiovascular disease . N Engl J Med. 1993;328:313-318.Crossref 15. Berkson DM, Stamler J. Epidemiology of the killer chronic diseases . In: Winick M, ed. Nutrition and the Killer Diseases . New York, NY: John Wiley & Sons Inc; 1981:17-55. 16. Pan WH, Nanas S, Dyer A, et al. The role of weight in the positive association between age and blood pressure . Am J Epidemiol. 1986;124:612-623. 17. Stamler J. Epidemiologic findings on body mass and blood pressure in adults . Ann Epidemiol. 1991;1:347-362.Crossref 18. Must A, Jacques PF, Dallal GE, Bajema CJ, Dietz WH. Long-term morbidity and mortality of overweight adolescents . N Engl J Med. 1992;327:1350-1355.Crossref 19. Hulley SB, Walsh JM, Newman TB. Health policy on blood cholesterol: time to change directions . Circulation. 1992;86:1026-1029.Crossref 20. Hulley SB, Newman TB, Grady D, Garber AM, Baron RB, Browner WS. Should we be measuring blood cholesterol in young adults ? JAMA. 1993;269:1416-1419.Crossref 21. National Center for Health Statistics. United States life tables eliminating certain causes of death. In: US Decennial Life Tables for 1979-1981. Washington DC: Government Printing Office; 1(2); 1988. Dept of Health and Human Services publication No. (PHS) 88-1150-2. 22. Ackerknecht EH. Rudolf Virchow: Doctor, Statesman, Anthropologist . Madison: University of Wisconsin Press; 1953. 23. National Diet-Heart Study Research Group. The National Diet-Heart Study final report . Circulation. 1968;37:I1-I428.Crossref 24. Caggiula AW, Christakis G, Farrand M, et al. The Multiple Risk Intervention Trial (MRFIT), IV: intervention on blood lipids . Prev Med. 1981;10:443-475.Crossref 25. Treatment of Mild Hypertension Research Group. The Treatment of Mild Hypertension Study . Arch Intern Med. 1991;151:1413-1423.Crossref 26. The Treatment of Mild Hypertension Research Group. Treatment of Mild Hypertension Study (TOMHS): final results . JAMA . In press. 27. Stamler J, Lectures on Preventive Cardiology . New York, NY: Grune & Stratton; 1967. 28. Nanas S, Pan WH, Stamler J, et al. The role of relative weight in the positive association between age and serum cholesterol in men and women . J Chronic Dis. 1987;40:887-892.Crossref 29. National Center for Health Statistics. Health, United States, 1989, and Prevention Profile . Hyattsville, Md: Public Health Service; 1990:174. 30. Stamler J. Primary prevention of coronary heart disease: the last 20 years . Am J Cardiol. 1981;47:722-735. 31. Working Group on Arteriosclerosis of the National Heart, Lung, and Blood Institute. Prevention . In: Report of the Working Group on Arteriosclerosis of the National Heart, Lung and Blood Institute . Bethesda, Md: US Dept of Health and Human Services; 1981;2:261-422. National Institutes of Health publication No. 81-2035. 32. Stamler J. Epidemiology, established risk factors, and the primary prevention of coronary heart disease . In: Parmley WW, Chatterjee K, eds. Cardiology . Philadelphia, Pa: JB Lippincott; 1987:1-41. 33. Stamler J. Established major coronary risk factors . In: Marmot M, Elliott P, eds. Coronary Heart Disease Epidemiology: From Aetiology to Public Health . New York, NY: Oxford University Press; 1992:35-66. 34. Harlan WR, Landis JR, Flegal KM, Davis CS, Miller ME. Secular trends in body mass in the United States, 1960-1980 . Am J Epidemiol. 1988;128:1065-1074. 35. Flegal KM, Harlan WR, Landis JR. Secular trends in body mass index and skinfold thickness with socioeconomic factors in young adult women . Am J Clin Nutr. 1988;48:535-543. 36. Flegal KM, Harlan WR, Landis JR. Secular trends in body mass index and skin-fold thickness with socioeconomic factors in young adult men . Am J Clin Nutr. 1988;48:544-551. 37. Liu K, Cedres LB, Stamler J, et al. Relationship of education to major risk factors and death from coronary heart disease, cardiovascular diseases and all causes: findings of three Chicago epidemiologic studies . Circulation. 1982;66:1308-1314.Crossref 38. Dyer AR, Stamler J, Shekelle RB, Schoenberger J. The relationship of education to blood pressure: findings on 40 000 employed Chicagoans . Circulation. 1976;54:987-992.Crossref 39. Hypertension Detection and Follow-up Program Cooperative Group. Race, education and prevalence of hypertension . Am J Epidemiol. 1977;106:351-361. 40. National Center for Health Statistics, National Heart, Lung, and Blood Institute Collaborative Lipid Group. Trends in serum cholesterol levels among US adults aged 20 to 74 years . JAMA. 1987;257:937-942.Crossref 41. US Bureau of the Census. Statistical Abstract of the United States. 110th ed. Washington, DC: US Bureau of the Census; 1990. 42. Stamler R, Shipley M, Elliott P, Dyer A, Sans S, Stamler J, on behalf of the INTERSALT Cooperative Research Group. Higher blood pressure in adults with less education . Hypertension. 1992;19:237-241.Crossref 43. Pell S, Fayerweather WE. Trends in the incidence of myocardial infarction and in associated mortality and morbidity in a large employed population . N Engl J Med. 1985;312:1005-1012.Crossref 44. Recent trends in mortality from cardiovascular diseases . Stat Bull Metropol Life Ins Co. 1979;60:3-8. 45. Enstrom JE. Trends in mortality among California physicians after giving up smoking: 1950-1979 . BMJ. 1983;286:1101-1105.Crossref 46. Feldman JJ, Makuc DM, Kleinman JC, Cornoni-Huntley J. National trends in educational differentials in mortality . Am J Epidemiol. 1989;129:919-933. 47. Rogot E, Hrubec Z. Trends in mortality from coronary heart disease and stroke among US veterans: 1954-1979 . J Clin Epidemiol. 1989;42:245-256.Crossref 48. Block G, Dresser CM, Hartmen AM, Carroll MD. Nutrient sources in the American diet: quantitative data from the NHANES II survey, I: vitamins and minerals . Am J Epidemiol. 1985;122:13-26. 49. Block G, Dresser CM, Hartman AM, Carroll MD. Nutrient sources in the American diet: quantitive data from the NHANES II survey, II: macronutrients and fats . Am J Epidemiol. 1985;122:27-40. 50. Putnam JJ. Food consumption, 1970-1990 . Food Rev. 1991;14:2-12. 51. Popkin BM, Haines PS, Patterson RE. Dietary changes in older Americans, 1977-1987 . Am J Clin Nutr. 1992;55:823-830. 52. National Research Council (US) Committee On Diet and Health. Diet and Health: Implications for Reducing Chronic Disease . Washington, DC: National Academy Press; 1989. 53. Wilkinson RG. Glasgow, Edinburgh, and the health divide: is it ever too late for prevention ? BMJ. 1992;305:1239-1240.Crossref 54. Garrow JS. Obesity and Related Diseases . New York, NY: Churchill Livingstone Inc; 1988. 55. Ravussin E, Swinburn BA. Pathophysiology of obesity . Lancet 1992;340:404-408.Crossref 56. Stunkard AJ, Wadden TA, eds. Obesity: Theory and Therapy . 2nd ed. New York, NY: Raven Press; 1992. 57. Lichtman SW, Pisarska K, Raynes-Berman E, Pestone M, Dowling H, Offenbacher E. Discrepancy between self-reported and actual caloric intake and exercise in obese subjects . N Engl J Med. 1992;327:1893-1898.Crossref 58. Danforth E, Sims EAH. Obesity and efforts to lose weight . N Engl J Med. 1992; 327:1947-1948.Crossref 59. Stamler J. Population studies . In: Levy RI, Rifkind BM, Dennis BH, Ernst ND, eds. Nutrition, Lipids, and Coronary Heart Disease: A Global View . New York, NY: Raven Press; 1979:25-88. 60. Stamler J, Buzzard M, Ruth K, Garside D. Nutrient Analyses of Food and Agriculture Organization (FAO) Food Balance Sheets for 27 Countries, 1961 to 1988 . Chicago, III: Northwestern University Medical School, Department of Preventive Medicine; 1992. Privately printed. 61. Baba S, Pan WH, Ueshima H, et al. Blood pressure levels, related factors, and hypertension control status of Japanese and Americans . J Hum Hypertens. 1991;5:317-332. 62. US-Peoples Republic of China Collaborative Study of Cardiovascular and Cardiopulmonary Epidemiology. Baseline Survey, Subsample (1983-86), Part 2: Nutrition: Data Preview . Bethesda, Md: US Dept of Health and Human Services; 1992. 63. People's Republic of China—United States Cardiovascular and Cardiopulmonary Epidemiology Research Group. An epidemiological study of cardiovascular and cardiopulmonary disease risk factors in four populations in the People's Republic of China . Circulation. 1992;85:1083-1096.Crossref 64. Tao S, Li Y, Xiao Z, et al for the PRC-USA Cardiovascular and Cardiopulmonary Epidemiology Research Group. Serum lipids and their correlates in Chinese urban and rural populations of Beijing and Guangzhou . Int J Epidemiol. 1992;21:893-903.Crossref 65. US Dept Health Human Services. Healthy People 2000: National Health Promotion and Disease Prevention Objectives (Summary Report). Washington, DC: US Government Printing Office; 1991. Dept of Health and Human Services publication No. (PHS) 91-50213.

Journal

Archives of Internal MedicineAmerican Medical Association

Published: May 10, 1993

References