Ruth M. Holliday

1. Skinfold thicknesses at seven sites were measured during and after pregnancy in eighty- four women; in forty-eight of these, total body water was measured concurrently. 2. Early in pregnancy (10 weeks) the skinfold measurements were highly correlated with each other and with maternal weight, ratio of observed weight to standard weight-for-height,‘dry’ (water-free) weight, and with calculated estimates of body fat. 3. At nearly all sites, skinfold thicknesses increased up to about 30 weeks of pregnancy. Increases were greater at ‘central’ and least at ‘peripheral’ sites, and were not proportional to the initial skinfold thickness. 4. From 30 to 38 weeks of pregnancy, the patterns were variable: the mid-thigh skinfold continued to increase and at the other sites there was little change or a decrease. 5. All sites decreased by a surprisingly large amount between 38 weeks of pregnancy and the end of the first post-partum week. The evidence suggests that this change, which was not related to the presence or absence of oedema, occurred about the time of parturition. 6. From the end of the first post-partum week to 6–8 weeks post partum, the changes were again variable. 7. The increase of skinfolds during pregnancy was greater in underweight than in overweight women, and in primiparae than in multiparae. The pattern of change was not affected in any consistent manner by oedema. 8. The changes in skinfold thicknesses during pregnancy, especially up to about 30 weeks, showed patterns similar to those of total body-weight and ‘dry’ body-weight. A formula is given by means of which ‘dry’ weight can be predicted from five skinfolds, height and duration of gestation.

Data from the Diet and Reinfarction Trial were examined to check the prognostic effects of plasma fibrinogen, plasma viscosity, white blood cell count, haemoglobin and mean platelet volume in 92 deaths among 1755 men who had recently recovered from acute myocardial infarction. All these variables were significantly associated with all-cause mortality over the following 18 months (haemoglobin negatively, the others positively). Those who gave up smoking following their infarct had a lower mortality than those who continued to smoke (4.1% and 7.9% respectively), and this effect appeared to be mediated by fibrinogen levels. Smoking habit accounted for only part of the prognostic effect of fibrinogen and white blood cell count. Haematological variables have an important prognostic significance after myocardial infarction. Cessation of smoking after myocardial infarction is worthwhile and has a favourable effect on plasma fibrinogen.

The effect of dietary advice on nutrient intakes was examined in a random subsample of 459 men who were taking part in a randomized controlled trial of secondary prevention of myocardial infarction. The trial is of factorial design, to examine the effect of three dieteary aims, alone and in combination: A reduction in total fat to 30% of energy, together with an increase in polyunsaturated/saturated fat ratio (P/S) to 1.0. An increase in fatty fish consumption to at least 300 g/week (3 g eicosapentaenoic acid (EPA)). An increase in cereal fibre intake to 18 g/day (total fibre 30 g/day). Men were randomly allocated to one of the eight regimens (fat, fish, fibre, fat plus fish, fat plus fibre, fish plus fibre, fat plus fish plus fibre, or none of these) and are being followed up for at least two years. Six months after the advice was given, nutrient intakes were assessed from 7‐d weighed intake records. Of those advised to reduce fat intake and increase P/S ratio, mean intakes were 31% of energy and 0.85, respectively. This compared with 35% of energy and 0.45 for those not given this advice. Mean EPA intake was 2.5 g/week for the fish advice group and 0.79 g/week for the no fish advice group. Mean cereal fibre intake of the fibre advice group was 15 g/d (26 g/d total fibre) compared with 9 g/d (20 g/d total fibre) for the no fibre advice group. Thus for each of the dietary aims, the advice had a substantial effect on intakes.

A respiratory survey was conducted in two British towns, one with a high mortality (Caerphilly) and one with a low mortality (Bath) from respiratory disease. A total of 513 men aged 65-74 years were seen. The Caerphilly men had poorer lung function than the Bath men; the overall difference in FEV1 and FVC for men aged 70 and 1.68m tall was 0.16 1 and 0.17 1 respectively. These differences appeared to be largely due to the greater tendency of the Caerphilly men to smoke and to an effect related to social class. Respiratory symptoms were also more common in Caerphilly, principally because of the effects of smoking and occupational group, although when these factors were allowed for there was still a significantly greater prevalence of breathless wheezing in Caerphilly.