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Differences in health status between employed men and employed women were examined. 56,203 participants in a stratified random sample of Hawaii's adult population were interviewed during 1981-1986 in the Hawaii Health Surveillance Program. Multiple regression analysis controlling for sociodemographic and occupational variables showed that although the differences were small, employed women reported more health problems than employed men, especially acute conditions and those requiring more hospital services. The findings of this study indicate a need for further study to understand the nature of the observed differences and to develop relevant preventive programs.

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The effect of work on women's health was examined in this study by comparing selected health indicators and specific chronic conditions among employed men, employed women and housewives. The study analyzed data from the Hawaii Health Surveillance Program. The study group was comprised of 56,203 subjects and represented a randomly stratified sample of the population interviewed during the period 1981-1986. Housewives as a group were older, less educated and reported the lowest family income compared to employed men or employed women. The prevalence of several specific chronic conditions were higher among housewives than in employed men and employed women. Multiple regression analysis tested the difference in several health indicators (chronic conditions, hospital episodes and restricted activity days) between employed men, employed women and housewives, controlled for sociodemographic variables. The health status of housewives was clearly worse than that of employed men and employed women by all health indicators; employed women had more hospital episodes than employed men. The results suggest that mostly healthy women are selected for the labor force. Among employed women, those in poor health and needing hospital services more frequently, are probably at high risk of dropping out of work. Our study projects the importance of promoting occupational good health for employed women during their working life.

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During 1984-1985, 540 employees of 2 pharmaceutical factories of the Teva concern participated in a physical activity program. To evaluate its effects on employees' health, the participants were randomly divided into 2 groups of equal size. The test group participated in regular physical exercise before lunch for 15 minutes, 5 days a week. The controls played social games for the same time periods while seated. The physical activity program included stretching, relaxing, and aerobic exercises. The program was carried out by employees who had been trained to be instructors by the researchers and were supervised by a professional teacher. During the 7 months of the study, adherence was about 90%. The results in test and control groups were determined by questionnaires. After 7 months, the test group clearly showed increased interest in sports activities, increased job satisfaction and work efficiency, and decreased fatigue during work.

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The health-promotion and education project, Segev, is an Israeli version of the American Health Foundation's Know Your Body project. The aim of this cohort study was to change knowledge, attitudes, health behavior and risk factors for cardiovascular disease in elementary school children. We present the results of questionnaires about knowledge of, and attitudes to health in 656 Jewish children who started first grade in 1983-4 and completed 4 questionnaires in the first and third grades. The results indicate a statistically significant increase in knowledge and attitude scores in the experimental group after 1 and 3 years of intervention. They indicate that changes in knowledge of, and attitudes to health are possible after even a relatively short school health education program.

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A school health education and promotion program, the Israeli version of the American Health Foundation's "Know Your Body" program, was developed by the Department of Public Health of the Municipality of Jerusalem in 1983. Eight experimental and eight control schools participated in this cohort study of Arab and Jewish first-grade children. After the first 2 years of intervention, comparison of experimental and control groups showed a significant increase in serum high density lipoproteins among Jewish children and a decrease in serum total cholesterol and body mass index among both Jewish and Arab children. These results indicate that changes in cardiovascular disease risk factors such as blood total cholesterol, high density lipoproteins, and body mass index are possible after a health education program is introduced to first-grade students for a relatively short period of time.

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The aim of the study was to determine factors associated with running time in children aged 12 years, according to sex and sexual maturation of girls. The physical ability was measured, using a 1000 meter run in a group of 942 boys and girls aged 12. In addition, data was collected on family sports activities and the children's sports activities, using questionnaires for parents and children. Before the 1000 meter run, physical examination was carried out. Nutrition habits of the family in the home and outside were self-reported in a questionnaire. The mean time for run in boys was shorter by 40 seconds than that for girls. Premenarche girls ran significantly faster than postmenarche girls (p less than 0.05). The best predictors for short running time were triceps skinfold thickness and sport motivation of the children. Weaker correlation was observed between food variables, family characteristics and running time. The highest prediction of running time by the measured variables was found for postmenarche girls, explained by the high correlation of running time with the behavioral variables. In boys and premenarche girls, the best predictors for running time were the physical and physiological characteristics of the children.

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Several studies have demonstrated an inverse relationship between physical activity and coronary heart disease (CHD). Other studies have reported a negative correlation between aerobic capacity and obesity and CHD risk factors among adolescents. In this study, the possibility of modifying physical ability in adolescents aged 13 has been examined through a physical ability intervention program. During 1984-1985, all eligible eighth graders from five Jerusalem public schools participated in the program. Physical ability was defined in the biological dimension by the running time for 1000 meters, and in the psychological dimension by sport motivation. The intervention program involved a periodic and progressive increase of physical effort of children in 16 gym lessons during the regular curriculum. The major findings were that the test group improved their running time and had better sport motivation than did the control group, and there were differences between boys and girls and an influence of sexual maturation on running time in girls.

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As part of initial health screening for the "Know Your Body" Program-based comprehensive health education program, 841 Jerusalem first- and second-grade schoolchildren were tested for total serum cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides. The same population, which included 643 Jewish (76.5%) and 198 Arab children (23.5%), had their nutritional habits evaluated by means of a parent-completed food-frequency questionnaire. Arab schoolchildren had significantly lower total, high-density lipoprotein, and low-density lipoprotein cholesterol levels and higher triglyceride levels than the Jewish children studied (total cholesterol: Arab mean, 153.1 mg/dl, Jewish mean, 170.3 mg/dl; high-density lipoprotein cholesterol: Arab mean, 46.4 mg/dl, Jewish mean, 48.5 mg/dl; low-density lipoprotein cholesterol: Arab mean, 90.7 mg/dl, Jewish mean, 108.5 mg/dl; triglycerides: Arab mean, 77.9 mg/dl, Jewish mean, 66.3 mg/dl). No significant differences in consumption level of foods high in saturated fats and/or cholesterol were found between populations, although the Arab children showed a tendency to eat more of these foods. Significant differences in total cholesterol values were also found among Jewish children of different origins, but no significant differences were found in consumption levels of saturated fats and cholesterol. Further studies are needed to determine the reasons for the differences in total cholesterol and lipoprotein levels found between Jewish and Arab schoolchildren.

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The determinants of blood pressure level were analyzed in a group of 1154 Jerusalem school children aged 12. After controlling for age, significant differences in blood pressure measurements were found between three groups: boys, pre-menarche girls and post-menarche girls. A comparison of the means of selected biological variables showed that girls who have reached menarche have levels of systolic blood pressure, weight, height and Quetelet's index higher than boys and pre-menarche girls. However, levels of triceps skinfold thickness and pulse rate were similar in the two groups of girls and higher than in boys. Using multiple regression analysis, we found that much of the variance (boys 29%, post-menarche girls 21% and pre-menarche girls 15%) of systolic blood pressure could be explained by a combination of biological variables (Quetelet, pulse rate, triceps skinfold thickness and height) while these variables explained a much smaller proportion (boys 12%, post-menarche girls 17% and pre-menarche 9%) of diastolic blood pressure variance. The predictive power of systolic blood pressure by the measured biological variables was higher in boys than in girls. However, diastolic blood pressure was better predicted by the biological variables in the group of girls with menarche than in other groups. Elevated blood pressure was observed in 3.2% of the examined children. High values for Quetelet's index were observed in 6.4%. The prevalence of elevated measurements of blood pressure and Quetelet's index were significantly higher in girls with menarche. Among children aged 12, the association between sociodemographic characteristics and blood pressure level was weak, as measured in multiple regression analysis.

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Jerusalem Lipid Research Clinic Program. International Journal of Epidermiology 1984; 13: 177-183. The relationship between cigarette smoking and plasma lipids and lipoproteins was examined in a random sample of 1115 male and 563 female adult participants in the Jerusalem Lipid Research Clinics Program. Differences in plasma lipids and lipoproteins, cigarette smoking, alcohol consumption, and body mass index were demonstrated between the four country of origin groups in both sexes. Using multiple linear regression analysis, an inverse association was shown between smoking and HDL cholesterol, significant only in females (p less than 0.001). Potential confounding variables-Quetelet's index of body mass, alcohol consumption, age, and country of origin groups-revealed only a weak effect on the smoking-HDL-cholesterol association. Examination of an interaction between origin group and smoking showed the same smoking-lipid level association in each of the four country of origin groups, and in both sexes. A strong association was found between smoking and LDL-cholesterol only in females (p less than 0.01). Triglycerides and VLDL-cholesterol showed a weak association with smoking in this study.

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The possible association between coronary artery disease risk factors and drusen was examined in 149 Jewish adults, of both sexes and from different ethnic origins, aged 55 years and above. Areas of drusen were examined 5 degrees and 25 degrees around the macula. Risk factors were examined according to standard procedure used by Lipid Research Clinics. Statistical analysis, including comparison of groups with and without drusen by Student's t test, Pearson's correlation coefficient and step-wise multiple regression analysis, showed similar associations. The multiple regression showed a significant association between drusen and diastolic blood pressure in both males and females and association with glucose only in females.

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The relationships between coronary artery disease risk factors and corneal arcus were examined in 150 adults aged 55 years and above of both sexes and from different ethnic origins. The width of the corneal arcus was measured accurately by a digitiser, and the risk factors for coronary artery disease were examined according to the standard procedure used by the Lipid Research Clinics. The results show that the corneal arcus is more frequent in males; the frequency and size of corneal arcus are positively associated with age; there is a positive correlation between the size of corneal arcus and the levels of cholesterol and low-density lipoprotein in males; and that there is negative correlation between corneal arcus and diastolic blood pressure in both sexes. No associations were found between corneal arcus and other coronary artery disease risk factors such as triglyceride, high-density lipoprotein, very low-density lipoprotein, weight, Quetelet's ratio, glucose, and smoking.

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The presence of risk factors for cardiovascular diseases were investigated in 7- and 11-year-old schoolchildren (808 subjects). Data analysis was performed according to sex, age, and country of origin of the father. The following variables were investigated: weight, height, total plasma cholesterol (TCH), high density lipoprotein cholesterol (HDL), plasma triglycerides, and systolic and diastolic blood pressure. Significant differences were found between sex, age, and origin groups for most variables. The prevalence of hypercholesterolemia (greater than 180 mg/dl) varied between 9.6 and 14.1%, in the different sex and age groups, and that of low HDL cholesterol (less than 40 mg/dl), 6.8-12.1%. Elevated systolic blood pressure (greater than 130 mm Hg) was found in 4.4-6.7% of the 7-year-old children, and in 13,4-18.6% of the 11 year-olds. Elevated diastolic blood pressure (greater than 85 mm Hg) was found predominantly in the 11-year-old children, 6.2-9.1%. These findings demonstrate the necessity to initiate health programs related to prevention of cardiovascular diseases in childhood.

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The food intake of 17-yr-old Jerusalem residents was assessed in a random sample, including 627 males and 551 females, by a 24-h dietary recall method. The intake of energy in boys and girls was lower than the recommended energy intake for this age, but the intake relative to body weight was low only in girls. In boys and girls, the intakes of fat relative to energy were 32.4 and 33.7%, respectively; those of saturated fatty acids (SFA) (9.8 and 10.5%) were lower and those of carbohydrates (53.9 and 52.5%) were higher than intakes found in other Western countries. The P:S (polyunsaturated to saturated fatty acids) ratio of their diets was high and ranged from 0.79 to 1.29 in various sex and origin groups. Intake of cholesterol per 1,000 kcal was similar to that in Western countries. There were marked differences in nutrient intake of subjects whose fathers had immigrated from different countries. Boys whose fathers were born in Israel or Europe had higher intakes of fat and cholesterol, and both boys and girls had a higher intake of SFA and a lower intake of carbohydrates and starch as well as a lower P:S ratio than did their counterparts whose fathers were born in Asia and North Africa. Thus, the nutrient intake of youngsters in Jerusalem differs markedly from that of populations in other Western countries.

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During 1976-80, nutrient intake was assessed in a cross-sectional sample of 1,589 middle-aged Jerusalem residents (1,028 males and 561 females) using the protocols and methods of the North American Lipid Research Clinics (LRCs) Prevalence Studies. All subjects were parents of 17-yr-old youngsters studied previously. Energy intake in both males and females was lower than the recommended energy intake for this age-group. Intake of fat relative to energy in males and females was 32.1 and 34.0%, of saturated fatty acids (SFA) 10.0 and 11.0%, and of total carbohydrates 50.2 and 49.9%, respectively. Cholesterol consumption was 210 and 238 mg/1,000 kcal in males and females, respectively. The mean polyunsaturated to saturated fatty acids (P:S) ratio of the diet was 0.95 in males and 0.84 in females. There were marked differences in the nutrient intake of subjects of different ethnic origin. Subjects from Israel and Europe consumed more total fat and SFA and less total carbohydrates than did their counterparts from Asia and North Africa. Consumption of polyunsaturated fatty acids (PFA) was highest in subjects from Israel. The P:S ratio of the diet was highest in the North African group, followed by the Israeli group, and lowest in subjects from Europe. The highest sucrose intake was found in subjects from North Africa and the highest cholesterol intake in immigrants from Europe. Nutrient intake of Jerusalem adults differed markedly from that of populations in other Western countries.

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The relationship of weight, height, Quetelet index, hematocrit and blood levels of thyroxine, globulin, bilirubin, creatinine, aspartate aminotransferase, uric acid, alkaline phosphatase and glucose to smoking was studied in a Jerusalem population sample of youngsters aged 17 yr and their parents. Among youngsters, male smokers had a higher body mass index than did male nonsmokers. In adults, both men and women smokers were slightly leaner than ex-smokers and, in women, smokers were clearly leaner than those who had never smoked. Generally, the associations of smoking with the biochemical variables were weaker in youngsters than in adults. In men, lower mean levels of creatinine, bilirubin, aspartate aminotransferase and uric acid were observed among smokers. Hematocrit levels were somewhat higher in both young and adult smokers of both sexes, being more so in adults. Smokers showed consistently lower globulin levels than did nonsmokers. Plasma glucose levels were somewhat lower in youngsters of both sexes who smoked. Serum thyroxine levels were slightly increased in female smokers, suggesting a hormonal effect of smoking. These findings are discussed in light of the published literature.

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