1968-2005 Professor of Pediatrics, Division of Pediatric Cardiology
1968-1996 Director, Division of Pediatric Cardiology
1974-1982 Vice-Chairman, Department of Pediatrics
"The school children of Muscatine, Iowa, were selected ... for this study, not only because of their geographic proximity to ... Iowa City but also because of the stability of the school population ... 1963 to 1968 school terms, ... found a mean of 98% of each grade level of students progressing from one grade to the next and thus remaining in the Muscatine school system.” Lauer et al., Coronary Heart Disease Risk Factors in School Children: The Muscatine Study. J Pediatr. 1975;86:697-706.
Results from the first four decades of Muscatine Study investigations were among the first to
• Levels of cholesterol, blood pressure and body mass index track throughout childhood.
• Elevated childhood levels of cholesterol, blood pressure, and body mass index are predictive of elevated adult levels.
Tracking of a risk factor over time, e.g., during childhood, or from childhood to adulthood, reflects two important concepts: the stability of the risk factor over time relative to other
participants in the study, and the ability to predict future risk factor values or disease outcomes that may result because of the values of a risk factor at an earlier age.
• Children with high cholesterol levels have a significantly higher proportion of first- and second degree relatives with a cardiovascular cause of death when compared to children with normal cholesterol levels.
• The conduct of family studies provided an indirect way to investigate the possible implications
of elevated risk factor levels in children.
• Obese children have higher blood pressure levels than lean children.
• Obese hypertensive children have a significantly higher proportion of first- and second-degree relatives with a cardiovascular cause of death than obese children with normal blood pressure.
• Childhood and concurrent elevated cardiovascular risk factor levels are associated with greater carotid artery intima-media thickness (cIMT) in young and middle-aged adults.
In November 2019 we completed data collection for our latest and most ambitious study yet. We attempted to locate, recruit and survey all 11,377 participants from the 1970s and 80s school screens. We succeeded in surveying 6424, all thanks to the help and willingness of our participants! Data analysis is now underway.
In 2009, the Muscatine Study returned to its roots,
and focused once again on cardiovascular risk factor assessments in Muscatine middle school students. Several examinations were conducted and a curriculum (Planet Health) was introduced in the two Muscatine middle schools between 2009 and 2014; only a couple of resulting observations are summarized here. In 2009-10, a
“baseline” school survey was conducted. All consenting (by both parent and child) middle school students in the Muscatine Community School District were examined (N=812) in our Muscatine Study
trailer. The examination included personal health and physical activity questionnaires, anthropometric and blood pressure measurements, body composition assessment, and fasting lipid and glucose measurements from a finger stick blood sample. These school survey results allowed us to describe trends in the prevalence of Overweight (≥ 85th percentile and < 95th percentile) and Obese (≥ 95th percentile)
Muscatine middle school students, utilizing body size data from Muscatine Study school surveys conducted between 1970 and 2010.
In six biennial school surveys conducted between 1970 and 1981, a total of 11,377 school children from Muscatine, Iowa (predominantly of Northern European origin) underwent 26,919 examinations that measured body size and risk factor levels (School Surveys)
Blood pressure and cholesterol measurements from these school survey examinations, along with measurements from examinations of other childhood populations, were used to establish reference percentiles that could be used by physicians and school nurses caring for children
Young Adult Follow-up Surveys
Between 1982 and 1991, 2,547 individuals who had been examined during childhood were again examined at ages 20 to 38 years (Young-Adult Follow-up Surveys), body size and risk factor levels were obtained and a health history questionnaire was completed
The Muscatine Study Longitudinal Adult Cohort
Since the early 1990s, the latest vascular imaging technology has been used to measure the early atherosclerotic process in a representative cohort (N=865 representing approximately 625 families) of the childhood participants (the Muscatine Study Longitudinal Adult Cohort), with non-invasive measures of coronary artery calcium (CAC), carotid artery intimal-medial thickness (IMT), and brachial artery flow-mediated dilatation (FMD) that allow an assessment of subclinical vascular disease.
The Muscatine Heart Study has also conducted several family studies that have each focused on a different cardiovascular risk factor (cholesterol, blood pressure, triglycerides, body size). Probands for these family studies were identified based on survey risk factor profiles of participating students. For example, The Ponderosity Family Study focused on families of four groups of students: a random sample who participated in all three school surveys conducted in 1977, 1979 and 1981; those who were in the lowest quintile of relative weight at all three surveys; those who were in the highest quintile of relative weight at all three surveys; and those whose relative weight increased by at least two quintiles over the three-survey period.
The Muscatine Study Offspring Cohort
The Muscatine Heart Study Offspring Cohort was established beginning in 2001 for the purpose of investigating associations between cardiovascular risk factors, carotid (cIMT) and abdominal aortic (aIMT) IMT obtained from ultrasound examinations during adolescence and young adulthood. This Cohort currently includes 719 offspring of the Longitudinal Adult Cohort members, representing 395 families.
University of Iowa Investigators
Trudy Burns, MPH, PhD
University of Iowa Staff
Jeni Michelson, BS
Rick Paulos, BA
John Witt, BS
Michael Abramoff, Radiology
Ronald Akers, Sociology
Samuel Becker, Communications
Kathleen Bucher, Human Genetics
William Clarke, Biostatistics
William Connor, Internal Medicine
Sandra Croak-Brosman, Biostatistics
Patricia Davis, Neurology
Jeff Dawson, Biostatistics
Patricia Donohoue, Pediatrics (Endocrinology)
Lloyd Filer, Pediatrics (Nutrition)
David Iovannisci (Children's Hospital Oakland Research Institute, CA), Molecular Genetics
Kathleen Janz, Health and Human Physiology
Michael Jones? – Smoking Study
Edward Lammer (Children's Hospital Oakland Research Institute, CA), Pediatrics (Genetics)
Ronald Lauer, Pediatrics (Cardiology)
Julia Lee, Pediatrics (Cardiology)
Larry Mahoney, Pediatrics (Cardiology)
James Massey, Sociology
Patricia Peyser (University of Michigan), Human Genetics
Gary Pierce, Health and Human Physiology
Paul Pomrehn, Epidemiology
Thomas Reimers, Radiology
Richard Scheiken, Pediatrics (Cardiology)
Helmut Schrott, Internal Medicine
Charles Sing (University of Michigan), Human Genetics
Linda Snetselaar, Epidemiology
Milan Sonka, Electrical Engineering
William Stanford, Radiology
Phyllis Stumbo, Dietician
Marcia Willing, Pediatrics (Genetics)
David Chappell, Internal medicine-Genetic epidemiology of Childhood obesity
Linda Baker, Data Manager
Beth Blecha, Ultrasonography / Image Analysis
Roger Browning, Ultrasonography / Image Analysis
Mary Burr, Image Analysis
Scot D. Heery, RTR
Monica Cerretti, Program Coordinator
Joy Eyman, Data Manager
Theresa Gibbs, Project Nurse
Candace Hooton, Echocardiography
Rebecca Bullock Johnsen
Elena Letuchy, Data Analyst
Mary Ann Reiter, Project Coordinator
Catherine Rost, Project Coordinator
Lynn Russell, Project Nurse
Kathleen Schreiber, Project Coordinator
Mary Fran Sowers, Project Coordinator
Jinx Tracy, Echocardiography
Verna Mae Wilson, Community Coordinator