Sensitivity and specificity of obesity diagnosis in pediatric ambulatory care in the United States.

Objective: We examined the sensitivity and specificity of an obesity diagnosis in a nationally representative sample of pediatric outpatient visits.

Methods: We used the 2005 to 2009 National Ambulatory Medical Care and National Hospital Ambulatory Medical Care surveys. We included visits with children 2 to 18 years, yielding a sample of 48 145 database visits.

Factors affecting subspecialty referrals by pediatric primary care providers for children with obesity-related comorbidities.

Objective: To determine referral patterns from pediatric primary care to subspecialists for overweight/obesity and related comorbidities.

Methods: We used the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey to identify overweight/obesity and 5 related comorbidities in primary care visits between 2005 and 2009 by children 6 to 18 years. The primary outcome was whether the visit ended in referral.

Effects of diet composition on postprandial energy availability during weight loss maintenance.

Background: The major circulating metabolic fuels regulate hunger, and each is affected by dietary composition. An integrated measure of postprandial energy availability from circulating metabolic fuels may help inform dietary recommendations for weight maintenance after weight loss.

Aim: We examined the effect of low-fat (LF, 60% of energy from carbohydrate, 20% fat, 20% protein), low-glycemic index (LGI, 40%-40%-20%), and very low-carbohydrate (VLC, 10%-60%-30%) diets on total postprandial metabolic fuel energy availability (EA) during weight loss maintenance.

eVITAL: a preliminary taxonomy and electronic toolkit of health-related habits and lifestyle.

Objectives: To create a preliminary taxonomy and related toolkit of health-related habits (HrH) following a person-centered approach with a focus on primary care.

Methods: From 2003-2009, a working group (n = 6 physicians) defined the knowledge base, created a framing document, and selected evaluation tools using an iterative process. Multidisciplinary focus groups (n = 29 health professionals) revised the document and evaluation protocol and participated in a feasibility study and review of the model based on a demonstration study with 11 adult volunteers in Antequera, Spain.

Nutrition attitudes and knowledge in medical students after completion of an integrated nutrition curriculum compared to a dedicated nutrition curriculum: a quasi-experimental study.

Background: Nutrition education has presented an ongoing challenge to medical educators. In the 2007-2008 academic year, Harvard Medical School replaced its dedicated Preventive Medicine and Nutrition course with an integrated curriculum. The objective of the current study was to assess the effect of the curriculum change on medical student attitudes and knowledge about nutrition.

Methodology for the development of a taxonomy and toolkit to evaluate health-related habits and lifestyle (eVITAL).

Background: Chronic diseases cause an ever-increasing percentage of morbidity and mortality, but many have modifiable risk factors. Many behaviors that predispose or protect an individual to chronic disease are interrelated, and therefore are best approached using an integrated model of health and the longevity paradigm, using years lived without disability as the endpoint.

Findings: This study used a 4-phase mixed qualitative design to create a taxonomy and related online toolkit for the evaluation of health-related habits.

Proteoglycan interactions with Sonic Hedgehog specify mitogenic responses.

Sonic Hedgehog (Shh) has dual roles in vertebrate development, promoting progenitor cell proliferation and inducing tissue patterning. We found that the mitogenic and patterning functions of Shh can be uncoupled from one another. Using a genetic approach to selectively inhibit Shh-proteoglycan interactions in a mouse model, we found that binding of Shh to proteoglycans was required for proliferation of neural stem/precursor cells, but not for tissue patterning.