51
|
Wang Y, Pan L, Wan SP, Yi HWL, Yang F, He HJ, Li Z, Zhang J, Yong ZP, Shan GL. [Association between socioeconomic status and overweight/obesity in Yi people, Sichuan province]. Zhonghua Liu Xing Bing Xue Za Zhi 2020; 41:315-319. [PMID: 32294827 DOI: 10.3760/cma.j.issn.0254-6450.2020.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To explore the association between socioeconomic status (SES) and overweight/obesity in Yi people in Sichuan province. Methods: A cross-sectional study was conducted in Liangshan Yi Autonomous Prefecture in 2015. Stratified cluster sampling method was used to enroll Yi farmers and rural-to-urban Yi migrants aged 20-80 years. SES was measured by education level, personal annual income, and compound SES index. Unconditional logistic regression models were used to determine the association between SES and overweight/obesity (BMI≥24.0 kg/m(2)). Results: 1 894 Yi farmers and 1 162 rural-to urban migrants were included in the analysis. After adjustment for age, smoking, drinking and physical activity, compared with illiteracy, OR for farmer males with higher education level (primary or junior school, senior high school or higher) were 1.71 (95%CI: 1.13-2.58) and 4.15 (95%CI: 2.10-8.22). Compared with lower income group (<5 000 CNY/y), the higher income group had increased risk (OR=1.66, 95%CI: 1.12-2.44). For farmer males with medium and high SES level, the risk of overweight/obesity were 1.65 (95%CI: 1.02-2.67) and 3.26 (95%CI: 1.97-5.42) compared with low level of SES. For farmer females, the risk increased with the higher income, with OR as 1.49 (95%CI: 1.10-2.02). Compared with low SES level, farmer females with medium level of SES was associated with 1.47 (95%CI: 1.11-1.95) times higher risk of overweight/obesity. In Yi migrants, the association between SES and overweight/obesity was not found. Conclusion: Socioeconomic status was positively associated with overweight/obesity only in Yi farmers.
Collapse
Affiliation(s)
- Y Wang
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing 100005, China
| | - L Pan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing 100005, China
| | - S P Wan
- Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610041, China
| | - H W L Yi
- Puge Center for Disease Control and Prevention, Puge 615300, China
| | - F Yang
- Xichang Center for Disease Control and Prevention, Xichang 615000, China
| | - H J He
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing 100005, China
| | - Z Li
- Xichang Center for Disease Control and Prevention, Xichang 615000, China
| | - J Zhang
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing 100005, China
| | - Z P Yong
- Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, Chengdu 610072, China
| | - G L Shan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing 100005, China
| |
Collapse
|
52
|
Huang LN, Wang HJ, Wang ZH, Ding GQ. Association between Chinese Famine Exposure and the Risk of Overweight/Obesity and Abdominal Obesity in Laterlife: A Cross-sectional Study. Biomed Environ Sci 2020; 33:133-137. [PMID: 32131960 DOI: 10.3967/bes2020.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 12/03/2019] [Indexed: 06/10/2023]
Abstract
This study aimed to examine the association between famine exposure in different stages of life and the risk of overweight/obesity and abdominal obesity in laterlife. A total of 12,458 participants were categorized into non-exposure and four direct exposures, including fetal, childhood, adolescence, and adult exposure. Only risk of being overweight or obesity in adolescence exposure [odds ratio ( OR), 1.45; 95% confidence interval ( CI), 1.08-1.94] was significantly higher than in non-exposure. Childhood ( OR, 1.27; 95% CI, 1.05-1.54) and adolescence ( OR, 1.53; 95% CI, 1.15-2.05) exposures had significantly an increased risk of abdominal obesity compared with non-exposure. Additionally, different famine severity exposures had different influences on the development of overweight/obesity and abdominal obesity. Famine exposure in adolescence, which was a behavior formative period, can increase the risk of overweight/obesity and abdominal obesity in adulthood, specifically in famine severely affect area.
Collapse
Affiliation(s)
- Li Na Huang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Hui Jun Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Zhi Hong Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Gang Qiang Ding
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| |
Collapse
|
53
|
Ochiai H, Shirasawa T, Nishimura R, Yoshimoto T, Minoura A, Oikawa K, Miki A, Hoshino H, Kokaze A. Changes in overweight/obesity and central obesity status from preadolescence to adolescence: a longitudinal study among schoolchildren in Japan. BMC Public Health 2020; 20:241. [PMID: 32066409 PMCID: PMC7027048 DOI: 10.1186/s12889-020-8343-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 02/10/2020] [Indexed: 01/07/2023] Open
Abstract
Background Little is known about changes in overweight/obesity and central obesity status among schoolchildren from preadolescence to adolescence in Japan, where waist circumference (WC) is generally not measured in annual health examinations at elementary and junior high schools. This study examined changes of overweight/obesity and central obesity status among schoolboys and schoolgirls from preadolescence to adolescence in Japan. Methods Study subjects were fourth-grade school children (9 or 10 years of age) from all four of Ina town’s elementary schools in Japan. Measurement of each participant’s height, weight, and WC were made at baseline and 3 years later. Childhood overweight/obesity was determined according to the age- and sex-specific body mass index cut-off points proposed by the International Obesity Task Force. Central obesity was defined as waist-to-height ratio ≥ 0.5. Kappa (κ) statistic was calculated to examine the tracking of overweight/obesity and central obesity. Results Data from 1436 participants (boys: n = 720, girls: n = 716) were analyzed. Overweight/obesity status tracked substantially from fourth grade to seventh grade in both boys (κ = 0.614, P value < 0.001) and girls (κ = 0.619, P value < 0.001). Among participants who were overweight/obese in fourth grade, 55.2% of boys and 63.2% of girls were still overweight/obese in seventh grade. Tracking of central obesity from fourth graders to seventh graders was substantial in boys (κ = 0.651, P value < 0.001) and moderate in girls (κ = 0.544, P value < 0.001). Among participants who had central obesity in fourth grade, 54.1% of boys and 52.6% of girls still had central obesity in seventh grade. Conclusions The present study showed that the tracking of overweight/obesity from preadolescence to adolescence was substantial in boys and girls. Moreover, more than half of those who had central obesity in preadolescence had central obesity in adolescence. This study suggests that it is important to implement a primary prevention program for overweight/obesity and central obesity in elementary schools before fourth grade.
Collapse
Affiliation(s)
- Hirotaka Ochiai
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan.
| | - Takako Shirasawa
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan
| | - Rimei Nishimura
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi Minato-ku, Tokyo, 105-8461, Japan
| | - Takahiko Yoshimoto
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan
| | - Akira Minoura
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan
| | - Kosuke Oikawa
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan
| | - Ayako Miki
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan
| | - Hiromi Hoshino
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan
| | - Akatsuki Kokaze
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan
| |
Collapse
|
54
|
Safarpour P, Daneshi-Maskooni M, Vafa M, Nourbakhsh M, Janani L, Maddah M, Amiri FS, Mohammadi F, Sadeghi H. Vitamin D supplementation improves SIRT1, Irisin, and glucose indices in overweight or obese type 2 diabetic patients: a double-blind randomized placebo-controlled clinical trial. BMC Fam Pract 2020; 21:26. [PMID: 32033527 PMCID: PMC7007689 DOI: 10.1186/s12875-020-1096-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 01/23/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Vitamin D (VD) may increase sirtuin 1 (SIRT1) and subsequently PPAR-γ coactivator 1α (PGC-1α) and irisin levels and these improvements may reduce insulin resistance (IR). The aim was to assess the effects of vitamin D supplementation on SIRT1, irisin, and IR in overweight/obese type 2 diabetes (T2D) patients. METHODS Ninety T2D males and females were recruited as a clinical trial study (mean of age and body mass index (BMI) of intervention and placebo groups were 50.05 ± 10.17 and 50.36 ± 10.2 yrs. and 31.37 ± 3.4 and 30.43 ± 3.2 kg/m2, respectively). The inclusion criteria were T2D, VD deficient, BMI > 25 kg/m2, and serum HbA1c < 8.5%. The exclusion criteria were using vitamin and mineral supplements, having any acute disease, recent modifying dose or type of drugs. The supplementation was 50,000 IU/week VD or placebo for 8 weeks. The demographic characteristics, anthropometrics, dietary intakes and physical activity status, sun exposure status, fasting blood sugar (FBS) and insulin, glycosylated hemoglobin (HbA1c), irisin, SIRT1, 25-hydroxy D3 (25(OH)VD), homeostasis model assessment of insulin resistance (HOMA-IR), and quantitative insulin sensitivity check index (QUICKI) were determined. The significant P-value was ≤0.05. RESULTS The increase of serum VD, SIRT1, and irisin in the intervention group was significant (p < 0.001). HbA1c was decreased significantly by 1%. The changes in the other glucose indices (FBS, insulin, and IR) were non-significant. CONCLUSIONS VD supplementation may improve T2D by decreasing HbA1c and increasing SIRT1 and irisin in VD deficient T2D patients. Further trials are suggested. TRIAL REGISTRATION Iranian Registry of Clinical Trials, IRCT201604202365N11. Registered 21/08/2016, http://en.irct.ir/trial/2019.
Collapse
Affiliation(s)
- Peivasteh Safarpour
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Milad Daneshi-Maskooni
- Department of Nutrition, School of Medicine, Jiroft University of Medical Sciences, Jiroft, Kerman, Iran
| | - Mohammadreza Vafa
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
| | - Mitra Nourbakhsh
- Department of Biochemistry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Leila Janani
- Department of Biostatistics, School of Public Health, Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohsen Maddah
- Department of Medicine, School of Medicine, Guilan University of Medical Sciences, Guilan, Iran
| | - Fatemeh-Sadat Amiri
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Fereshteh Mohammadi
- Department of Medicine, School of Medicine, Guilan University of Medical Sciences, Guilan, Iran
| | - Homa Sadeghi
- Department of Epidemiology, University of Massachusetts Lowell, Lowell, MA, USA
| |
Collapse
|
55
|
Tripathee S, Sweeting H, Chambers S, Maclean A. How men receive and utilise partner support when trying to change their diet and physical activity within a men's weight management programme. BMC Public Health 2020; 20:199. [PMID: 32033544 DOI: 10.1186/s12889-020-8213-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 01/14/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The impacts of interventions designed to change health behaviours are potentially affected by the complex social systems in which they are embedded. This study uses Scottish data to explore how men receive and utilise partner support when attempting to change dietary practices and physical activity within the context of Football Fans in Training (FFIT), a gender-sensitised weight management and healthy living programme for men who are overweight/obese. METHODS Separate semi-structured face-to-face interviews were conducted with 20 men and their cohabiting female partners (total n = 40), 3-12 months after the men had completed FFIT. Data were thematically analysed and individual interviews were combined for dyadic analysis. RESULTS Men's and women's accounts suggested variations in men's need for, and utilisation of, partner support in order to make changes to dietary practices and physical activity. There were also differences in descriptions of women's involvement in men's behaviour changes. Typologies were developed categorising men as 'resolute', 'reliant'/'receptive' and 'non-responsive' and women as 'very involved', 'partially involved' and 'not involved'. Men were more reliant, and women more involved, in changes to dietary practices compared to physical activity. The role of partner involvement in promoting men's behaviour change seemed contingent on men's resoluteness, or their reliance on the partner support. CONCLUSIONS These results highlight how interactions between men's resoluteness/reliance on cohabiting female partners and the partners' involvement impact the extent to which female partners influence men's changes to dietary practices and physical activity following a weight loss intervention. Understanding this interaction could increase the impact of health interventions aimed at one individual's behaviour by considering other family members' roles in facilitating those changes. The typologies developed for this study might contribute towards the development of behaviour change theories within the cohabiting couple context.
Collapse
|
56
|
Fryar CD, Fakhouri TH, Carroll MD, Frenk SM, Ogden CL. The association of nativity/length of residence and cardiovascular disease risk factors in the United States. Prev Med 2020; 130:105893. [PMID: 31715217 PMCID: PMC7340142 DOI: 10.1016/j.ypmed.2019.105893] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 10/03/2019] [Accepted: 11/08/2019] [Indexed: 10/25/2022]
Abstract
Differences by nativity status for cardiovascular disease (CVD) risk factors have been previously reported. Recent research has focused on understanding how other acculturation factors, such as length of residence, affect health behaviors and outcomes. This study examines the association between CVD risk factors and nativity/length of US residence. Using cross-sectional data from 15,965 adults in the 2011-2016 National Health and Nutrition Examination Surveys (analyzed in 2018), prevalence ratios and predicted marginals from logistic regression models are used to estimate associations of CVD risk factors (i.e., hypertension, hypercholesterolemia, diabetes, overweight/obesity and smoking) with nativity/length of residence (<15 years, ≥15 years) in the US. In sex-, age-, education- and race and Hispanic origin- adjusted analyses, a higher percentage of US (50 states and District of Columbia) born adults (86.4%) had ≥1 CVD risk factor compared to non-US born residents in the US <15 years (80.1%) but not ≥15 years (85.1%). Compared to US born counterparts, regardless of length of residence, hypertension overall and smoking among non-Hispanic white and Hispanic adults were lower among non-US born residents. Overweight/obesity overall and diabetes among Hispanic adults were lower among non-US born residents in the US <15 years. In contrast, non-US born non-Hispanic Asian residents in the US <15 years had higher prevalence of diabetes. Non-US born adults were less likely to have most CVD risk factors compared to US born adults regardless of length of residence, although, for smoking and diabetes this pattern differed by race and Hispanic origin.
Collapse
Affiliation(s)
- Cheryl D Fryar
- National Center for Health Statistics, Centers for Disease Control and Prevention, 3311 Toledo Road, Hyattsville, MD 20782, USA.
| | - Tala H Fakhouri
- National Center for Health Statistics, Centers for Disease Control and Prevention, 3311 Toledo Road, Hyattsville, MD 20782, USA.
| | - Margaret D Carroll
- National Center for Health Statistics, Centers for Disease Control and Prevention, 3311 Toledo Road, Hyattsville, MD 20782, USA.
| | - Steven M Frenk
- National Center for Health Statistics, Centers for Disease Control and Prevention, 3311 Toledo Road, Hyattsville, MD 20782, USA.
| | - Cynthia L Ogden
- National Center for Health Statistics, Centers for Disease Control and Prevention, 3311 Toledo Road, Hyattsville, MD 20782, USA.
| |
Collapse
|
57
|
Bschaden A, Rothe S, Schöner A, Pijahn N, Stroebele-Benschop N. Food choice patterns of long-haul truck drivers driving through Germany, a cross sectional study. BMC Nutr 2019; 5:56. [PMID: 32153969 PMCID: PMC7050878 DOI: 10.1186/s40795-019-0326-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 11/14/2019] [Indexed: 12/11/2022] Open
Abstract
Background Long-haul truck drivers are exposed to unfavorable working conditions affecting their health but information on truck drivers travelling through Europe is missing. The study aimed to describe the populations' characteristics and food choice patterns while working compared with eating patterns at home, taking weight status into account. Methods A cross-sectional survey using questionnaires in 12 languages conducted at two truck stops in Germany. Results Among 404 truck drivers of 24 nationalities, only 24% were normal weight while 46% were considered overweight and 30% obese. In regards to their health, more than half reported that they smoked and 32% reported at least one chronic disease. 37% ate their meals often or always at truck stops, while 6% never did so. The most common food items brought from home were fruits (62%) followed by sausages (50.6%), sandwiches (38.7%), self-cooked meals (37%), sweets (35.4%), and raw vegetables (31%). Bivariate analyses revealed differences in food choices during work and at home with more sausages, energy drinks and soft drinks, and canned foods eaten during trips. Fresh vegetables, legumes and fish were more often chosen at home. Available food appliances in trucks appeared to be associated with food choice patterns. Interestingly, food choice patterns and food preparation did not differ significantly across weight categories. Conclusions The working conditions of professional truck drivers make a healthy lifestyle difficult to follow and appear to influence food choices while working. Particular effort should be taken to improve food choice patterns, food preparation and purchasing possibilities during trips.
Collapse
Affiliation(s)
- Andreas Bschaden
- 1Department of Applied Nutritional Psycholoy, Institute of Nutritional Medicine, University of Hohenheim, Fruwirthstr. 12, 70593 Stuttgart, Germany
| | | | - Anja Schöner
- 1Department of Applied Nutritional Psycholoy, Institute of Nutritional Medicine, University of Hohenheim, Fruwirthstr. 12, 70593 Stuttgart, Germany
| | - Nina Pijahn
- 1Department of Applied Nutritional Psycholoy, Institute of Nutritional Medicine, University of Hohenheim, Fruwirthstr. 12, 70593 Stuttgart, Germany
| | - Nanette Stroebele-Benschop
- 1Department of Applied Nutritional Psycholoy, Institute of Nutritional Medicine, University of Hohenheim, Fruwirthstr. 12, 70593 Stuttgart, Germany
| |
Collapse
|
58
|
Modjadji P, Madiba S. The double burden of malnutrition in a rural health and demographic surveillance system site in South Africa: a study of primary schoolchildren and their mothers. BMC Public Health 2019; 19:1087. [PMID: 31399048 PMCID: PMC6689169 DOI: 10.1186/s12889-019-7412-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 07/31/2019] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND In South Africa, the occurrence of the double burden of malnutrition is on the rise at a household level predisposing children and their mothers to negative health outcomes. However, few studies have been conducted at a household level. Therefore, we studied a double burden of malnutrition using child-mother pairs in a rural setting. METHODS A cross-sectional quantitative survey was conducted among 508 child-mother pairs selected from primary schools using a multistage sampling in a rural Dikgale Health and Demographic Site in Limpopo Province, South Africa. Anthropometric measurements of children and mothers, and socio-demographic data were collected. WHO AnthroPlus was used to generate body-mass-index z-scores of children and the BMI was used to indicate overweight and obesity among the mothers. Mann Whitney test was used to compare the means of variables between sexes and age groups, while the prevalence of thinness and overweight/obesity were compared using a chi-square. Multivariate logistic regression with a stepwise backward elimination procedure, controlling for confounding, was used to determine the association between the thinness and overweight/obesity and the covariates. RESULTS Twenty five percent (25%) of the children were thin, 4% were overweight and 1% obese, while mothers were overweight (27.4%) and 42.3% obesity (42.3%) were observed among the mothers. The odds of being thin were higher in boys than in girls (AOR = 1.53, 95%CI: 1.01-2.35). Overweight/obese mothers were more likely to have thin children (AOR = 1.48, 95% CI: 1.01-2.18) and less likely to have overweight/obese children (AOR = 0.18, 95%CI: 0.07-0.46). CONCLUSION A double burden of malnutrition was observed on a household level with thinness among children and overweight/obesity among mothers. A need to address the dual problems of undernutrition and rapidly rising trends of overweight/obesity cannot be over-emphasized.
Collapse
Affiliation(s)
- Perpetua Modjadji
- Department of Public Health, Sefako Makgatho Health Sciences University, School of Health Care Sciences, P O Box 215, Ga-Rankuwa, MEDUNSA, 0204, South Africa.
| | - Sphiwe Madiba
- Department of Public Health, Sefako Makgatho Health Sciences University, School of Health Care Sciences, P O Box 215, Ga-Rankuwa, MEDUNSA, 0204, South Africa
| |
Collapse
|
59
|
Karki A, Shrestha A, Subedi N. Prevalence and associated factors of childhood overweight/obesity among primary school children in urban Nepal. BMC Public Health 2019; 19:1055. [PMID: 31387571 PMCID: PMC6685156 DOI: 10.1186/s12889-019-7406-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 07/30/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Childhood overweight/obesity has become a major public health concern globally because of its adverse health consequences and escalating prevalence. The factors underlying the disease conditions manifested during adulthood commonly originate in childhood. Nepal is going through a transition where under-nutrition co-exists with obesity; however, there is a lack of well-documented information on childhood overweight or obesity in Nepal. This study was carried out to determine the prevalence and associated factors of childhood overweight/obesity among urban primary school children. METHODS A cross-sectional survey was conducted from May to October of 2017. Behavioral data were collected using a structured self-administered questionnaire with parents of children aged 6-13 years old in grades 1-5 studying in private schools of Lalitpur district in Nepal. Study participants were selected using two-stage cluster random sampling from 10 private schools. Height and weight measurements of 575 children were taken and BMI-for-age-sex was calculated using WHO AnthroPlus. Data were analyzed using SPSS version 21. Associated factors were examined using Chi-square tests followed by multivariate logistic regression analyses. RESULTS The study found that out of 575 students, 107 (18.6%) were overweight and 41 (7.1%) were obese. Among 328 male children, 62 (19.0%) were overweight and 35 (10.6%) were obese. Likewise, among 247 female children, 45 (18.2%) were overweight and 6 (2.4%) were obese. Male children (aOR = 2.21, 95% CI: 1.38-3.53), children of mothers with a high school (aOR = 3.13, 95% CI: 1.39-7.12) or university level of education (aOR = 3.09, 95% CI: 1.23-7.70) and children of mothers in a professional field (aOR = 1.34, 95% CI: 1.02-4.05) had a greater likelihood of being overweight/obese. Likewise, students consuming energy-dense less nutrient food (aOR = 2.92, 95% CI: 1.66-5.12), lacking active travel to and from school (aOR = 2.38, 95% CI: 1.12-4.79) and those having sedentary behaviors (aOR = 3.01, 95% CI: 1.20-7.29) were likely to be overweight/obese. CONCLUSIONS More than one-quarter of the children in urban Lalitpur were found to be overweight/obese. High junk food consumption and sedentary activity were found to be significantly associated with childhood overweight/obesity. School health and awareness programs aiming to reduce the intake of energy-dense foods and promote an active lifestyle including active transportation to school among children are imperative. Future studies to objectively measure the type and amount of food intake and physical activity of students are recommended.
Collapse
Affiliation(s)
- Ashmita Karki
- Department of Community Medicine and Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.
| | - Archana Shrestha
- Department of Community Programs, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Narayan Subedi
- Department of Community Medicine and Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| |
Collapse
|
60
|
Schott W, Aurino E, Penny ME, Behrman JR. The double burden of malnutrition among youth: Trajectories and inequalities in four emerging economies. Econ Hum Biol 2019; 34:80-91. [PMID: 31248754 DOI: 10.1016/j.ehb.2019.05.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 05/31/2019] [Accepted: 05/31/2019] [Indexed: 06/09/2023]
Abstract
As part of the nutritional transition, undernutrition is globally declining while changes brought by economic development have ushered in increases in overweight and its related economic costs and health consequences around the world. We examine trajectories in stunting and overweight from age one year to mid-adolescence and from mid-childhood to early adulthood among two cohorts from Ethiopia, India, Peru and Vietnam using data from the Young Lives study. We examine descriptive data and then model trajectories in stunting and overweight status over age. Group-based trajectory analysis with five ages of overweight and stunting for each country-cohort reveals (1) trajectories of catch-up growth for a subset of study children between the ages of 12 and 19 in the older cohort in Ethiopia (20.1% of the cohort), India (20.5%), Peru (16.9%), and Vietnam (14.0%); (2) trajectories of increasing probabilities of stunting as children age from 12 to 22 in the older cohort in India (22.2%) and Peru (30.7%); (3) trajectories of early (childhood) increases in overweight probabilities (younger cohort: India, 3.4%, Peru, 19.4%, and Vietnam, 8.1%), and of later (adolescence) increases in overweight probabilities (older cohort: Ethiopia, 0.5%, India, 6.3%, Peru, 40.9%, and Vietnam, 9.4%). Multinomial logit prediction of membership in trajectory categories reveals that higher wealth quartiles and maternal schooling are protective against high stunting probability trajectory group membership, but higher wealth and urban residence predict high overweight probability trajectory group membership. This evidence suggests a window of opportunity for interventions to reduce stunting and to avert overweight development in adolescence, in addition to the often-emphasized first 1000 days after conception. A life-course approach to policies and programs to target both undernutrition and overweight should be considered.
Collapse
Affiliation(s)
- Whitney Schott
- Population Studies Center, 3718 Locust Walk, University of Pennsylvania, Philadelphia, PA, 19104, USA; A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA, USA.
| | - Elisabetta Aurino
- Department of Management and Centre for Health Economics and Policy Innovations, Imperial College London and Young Lives, University of Oxford, UK.
| | - Mary E Penny
- Instituto de Investigación Nutricional, Av. La Molina 1885, La Molina, Lima, Peru.
| | - Jere R Behrman
- Population Studies Center, 3718 Locust Walk, University of Pennsylvania, Philadelphia, PA, 19104, USA; Economics Department, Ronald O. Perelman Center for Political Science and Economics (PCPSE), 133 South 36th Street, University of Pennsylvania, Philadelphia, PA, 19104-6297, USA.
| |
Collapse
|
61
|
Yaya S, Ghose B. Trend in overweight and obesity among women of reproductive age in Uganda: 1995-2016. Obes Sci Pract 2019; 5:312-323. [PMID: 31452916 PMCID: PMC6700515 DOI: 10.1002/osp4.351] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 05/06/2019] [Accepted: 05/07/2019] [Indexed: 12/28/2022] Open
Abstract
Countries in Sub-Saharan Africa (SSA) are experiencing rising burdens of overweight/obesity and associated non-communicable diseases. As in other developing regions, this epidemiological transition in African countries is believed to be resulting from changes in dietary, sociodemographic structure and lifestyle factors. To date, not much is known about the prevalence and sociodemographic patterns of overweight/obesity in Uganda, especially among women of reproductive age. Therefore, this study aimed to address this research gap by using nationally representative data on women of this age group in Uganda. METHODS This study involved analysis of cross-sectional data on 19,395 women aged between 15 and 49 years from Uganda Demographic and Health Survey for the years 1995-2016. Overweight/obesity was measured using body mass index as per World Health Organization guidelines, and logistic regression methods were used to identify the sociodemographic predictors. RESULTS There has a been significant rise in the prevalence of overweight (9.77% in 1995 vs. 16.21% in 2016) and obesity (1.99% in 1995 vs. 6.21% in 2016) since the first survey in 1995, with the most noticeable increase occurring in the central region that accounted for a combined prevalence of 17.22% in 1995 compared with 37. 21% in 2016. Multivariate analysis showed an increased likelihood of having overweight/obesity among women who live in the urban areas, have primary and above primary education, from non-poor households and users of radio and TV. CONCLUSION During the last two decades, there has been a slow but steady rise in the prevalence of overweight and obesity among women of reproductive age in Uganda. The present findings highlight the need for an enhanced attention on growing overweight/obesity within the broader goal improving maternal and child health in the country.
Collapse
Affiliation(s)
- S. Yaya
- Faculté de MédecineUniversité de ParakouParakouBenin
| | - B. Ghose
- Institute of Nutrition and Food ScienceUniversity of DhakaDhakaBangladesh
| |
Collapse
|
62
|
Grummon AH, Cabana MD, Hecht AA, Alkon A, McCulloch CE, Brindis CD, Patel AI. Effects of a multipronged beverage intervention on young children's beverage intake and weight: a cluster-randomized pilot study. Public Health Nutr 2019; 22:2856-67. [PMID: 31303190 DOI: 10.1017/S1368980019001629] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To evaluate whether a multipronged pilot intervention promoting healthier beverage consumption improved at-home beverage consumption and weight status among young children. DESIGN In this exploratory pilot study, we randomly assigned four childcare centres to a control (delayed-intervention) condition or a 12-week intervention that promoted consumption of healthier beverages (water, unsweetened low- or non-fat milk) and discouraged consumption of less-healthy beverages (juice, sugar-sweetened beverages, high-fat or sweetened milk). The multipronged intervention was delivered via childcare centres; simultaneously targeted children, parents and childcare staff; and included environmental changes, policies and education. Outcomes were measured at baseline and immediately post-intervention and included children's (n 154) at-home beverage consumption (assessed via parental report) and overweight/obese status (assessed via objectively measured height and weight). We estimated intervention impact using difference-in-differences models controlling for children's demographics and classroom. SETTING Two northern California cities, USA, 2013-2014. PARTICIPANTS Children aged 2-5 years and their parents. RESULTS Relative to control group children, intervention group children reduced their consumption of less-healthy beverages from baseline to follow-up by 5·9 ounces/d (95 % CI -11·2, -0·6) (-174·5 ml/d; 95 % CI -331·2, -17·7) and increased their consumption of healthier beverages by 3·5 ounces/d (95 % CI -2·6, 9·5) (103·5 ml/d; 95 % CI -76·9, 280·9). Children's likelihood of being overweight decreased by 3 percentage points (pp) in the intervention group and increased by 3 pp in the control group (difference-in-differences: -6 pp; 95 % CI -15, 3). CONCLUSIONS Our exploratory pilot study suggests that interventions focused comprehensively on encouraging healthier beverage consumption could improve children's beverage intake and weight. Findings should be confirmed in longer, larger studies.
Collapse
|
63
|
Jia J, Yu F, Wei WP, Yang P, Zhang R, Sheng Y, Shi YQ. Relationship between circulating irisin levels and overweight/obesity: A meta-analysis. World J Clin Cases 2019; 7:1444-1455. [PMID: 31363472 PMCID: PMC6656672 DOI: 10.12998/wjcc.v7.i12.1444] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 04/27/2019] [Accepted: 05/02/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Currently, the findings about irisin as a novel myokine related to obesity are inconsistent in overweight/obese people. To our knowledge, no systematic analysis has been conducted to evaluate the relationship between irisin levels and overweight/obesity.
AIM To evaluate the association between circulating irisin levels and overweight/obesity.
METHODS The Cochrane Library, MEDLINE, SCOPUS, and the ISI Web of Science were searched to retrieve all of the studies associated with circulating irisin levels and overweight/obesity. Standard mean difference values and 95% confidence intervals (CI) were estimated and pooled using meta-analysis methodology.
RESULTS A total of 18 studies were included in our meta-analysis containing 1005 cases and 1242 controls. Our analysis showed that the circulating irisin level in overweight/obese people was higher than that in overall healthy controls (random effects MD = 0.63; 95%CI: 0.22-1.05; P = 0.003). In the subgroup analysis by ethnicity, the irisin level was higher in overweight/obesity people than that in controls in Africa (random effects MD = 3.41; 95%CI: 1.23-5.59; P < 0.05) but not in European, Asian, or American populations. In addition, in a subgroup analysis by age, the results showed that obese children exhibited a higher irisin level than controls (random effects MD = 0.86; 95%CI: 0.28-1.43; P < 0.05).
CONCLUSION This meta-analysis provides evidence that circulating irisin is higher in obese individuals compared to healthy controls and it is important to identify the relationship between circulating irisin levels and overweight/obesity in predicting overweight/obesity.
Collapse
Affiliation(s)
- Jue Jia
- Affiliated Hospital of Jiangsu University, Zhenjiang 212001, Jiangsu Province, China
| | - Fan Yu
- Affiliated Hospital of Jiangsu University, Zhenjiang 212001, Jiangsu Province, China
| | - Wei-Ping Wei
- Affiliated Hospital of Jiangsu University, Zhenjiang 212001, Jiangsu Province, China
| | - Ping Yang
- Affiliated Hospital of Jiangsu University, Zhenjiang 212001, Jiangsu Province, China
| | - Ren Zhang
- Department of Library of Jiangsu University, Zhenjiang 212001, Jiangsu Province, China
| | - Yue Sheng
- Affiliated Hospital of Jiangsu University, Zhenjiang 212001, Jiangsu Province, China
| | - Yong-Qin Shi
- Affiliated Hospital of Jiangsu University, Zhenjiang 212001, Jiangsu Province, China
| |
Collapse
|
64
|
Armstrong B, Covington LB, Hager ER, Black MM. Objective sleep and physical activity using 24-hour ankle-worn accelerometry among toddlers from low-income families. Sleep Health 2019; 5:459-465. [PMID: 31171491 DOI: 10.1016/j.sleh.2019.04.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 04/09/2019] [Accepted: 04/22/2019] [Indexed: 01/11/2023]
Abstract
OBJECTIVES Poverty is a risk for short sleep duration and limited physical activity. This study describes sleep, physical activity, and sedentary behavior of Women, Infants, and Children-eligible toddlers and the proportion of toddlers meeting recommendations for sleep and physical activity, and examines associations with body mass index z scores and poverty. PARTICIPANTS/MEASUREMENTS A total of 101 toddlers (12-32 months) from low-income families (62% African American) wore 24-hour ankle accelerometers over 3-7 consecutive days. Concurrent validity for daytime napping was assessed using parent-reported toddler wake/sleep between 08:00 and 20:00 collected using Ecological Momentary Assessment. Logistic regressions predicted odds of meeting guidelines. RESULTS Toddlers averaged 10.56 hours of sleep in 24 hours. All toddlers averaged ≥180 minutes of total activity per day, 38% had ≥60 minutes of moderate/vigorous physical activity per day, 32% of toddlers slept between 11 and 14 hours over 24 hours, and 26% had a bedtime before 9:00 pm. Body mass index z score was not associated with meeting guidelines. Poverty was associated with less than 60 minutes of moderate/vigorous physical activity. CONCLUSIONS Most toddlers were not meeting sleep guidelines. This study provides objective data on sleep and activity among a diverse sample of low-income toddlers. Objective measures of sleep and physical activity facilitate surveillance of children meeting guidelines for sleep and physical activity. Such norms are needed to examine disparities among children from varying racial and economic backgrounds. Future research should examine if meeting guidelines is related to other health indicators.
Collapse
Affiliation(s)
- Bridget Armstrong
- University of Maryland School of Medicine 737 W Lombard St, Baltimore, MD 21201.
| | - Lauren B Covington
- University of Delaware School of Nursing, The Tower at STAR, 5th floor 100 Discovery Blvd, Newark, DE 19713.
| | - Erin R Hager
- University of Maryland School of Medicine 737 W Lombard St, Baltimore, MD 21201.
| | - Maureen M Black
- University of Maryland School of Medicine 737 W Lombard St, Baltimore, MD 21201; RTI International 3040 E Cornwallis Rd, PO Box 12194 Research Triangle Park, NC, United States 27709.
| |
Collapse
|
65
|
Germeroth LJ, Benno MT, Kolko Conlon RP, Emery RL, Cheng Y, Grace J, Salk RH, Levine MD. Trial design and methodology for a non-restricted sequential multiple assignment randomized trial to evaluate combinations of perinatal interventions to optimize women's health. Contemp Clin Trials 2019; 79:111-121. [PMID: 30851434 PMCID: PMC6436999 DOI: 10.1016/j.cct.2019.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 02/26/2019] [Accepted: 03/05/2019] [Indexed: 02/01/2023]
Abstract
Pre-pregnancy overweight/obesity and excessive gestational weight gain (GWG) independently predict negative maternal and child health outcomes. To date, however, interventions that target GWG have not produced lasting improvements in maternal weight or health at 12-months postpartum. Given that interventions solely aimed at addressing GWG may not equip women with the skills needed for postpartum weight management, interventions that address health behaviors over the perinatal period might maximize maternal health in the first postpartum year. Thus, the current study leveraged a sequential multiple assignment randomized trial (SMART) design to evaluate sequences of prenatal (i.e., during pregnancy) and postpartum lifestyle interventions that optimize maternal weight, cardiometabolic health, and psychosocial outcomes at 12-months postpartum. Pregnant women (N = 300; ≤16 weeks pregnant) with overweight/obesity (BMI ≥ 25 kg/m2) are being recruited. Women are randomized to intervention or treatment as usual on two occasions: (1) early in pregnancy, and (2) prior to delivery, resulting in four intervention sequences. Intervention during pregnancy is designed to moderate GWG and introduce skills for management of weight as a chronic condition, while intervention in the postpartum period addresses weight loss. The primary outcome is weight at 12-months postpartum and secondary outcomes include variables of cardiometabolic health and psychosocial well-being. Analyses will evaluate the combination of prenatal and postpartum lifestyle interventions that optimizes maternal weight and secondary outcomes at 12-months postpartum. Optimizing the sequence of behavioral interventions to address specific needs during pregnancy and the first postpartum year can maximize intervention potency and mitigate longer-term cardiometabolic health risks for women.
Collapse
Affiliation(s)
- Lisa J Germeroth
- Department of Psychiatry, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA 15213, USA
| | - Maria T Benno
- Department of Psychiatry, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA 15213, USA
| | - Rachel P Kolko Conlon
- Department of Psychiatry, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA 15213, USA
| | - Rebecca L Emery
- Department of Psychiatry, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA 15213, USA
| | - Yu Cheng
- Department of Statistics, University of Pittsburgh, 1800 Wesley W. Posvar Hall, 230 South Bouquet Street, Pittsburgh, PA 15260, USA
| | - Jennifer Grace
- Department of Psychiatry, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA 15213, USA
| | - Rachel H Salk
- Department of Psychiatry, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA 15213, USA
| | - Michele D Levine
- Department of Psychiatry, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA 15213, USA.
| |
Collapse
|
66
|
Shank LM, Schvey NA, Ekundayo K, Schreiber-Gregory D, Bates D, Maurer D, Spieker E, Stephens M, Tanofsky-Kraff M, Sbrocco T. The relationship between weight stigma, weight bias internalization, and physical health in military personnel with or at high-risk of overweight/obesity. Body Image 2019; 28:25-33. [PMID: 30481680 DOI: 10.1016/j.bodyim.2018.11.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 11/17/2018] [Accepted: 11/17/2018] [Indexed: 12/20/2022]
Abstract
Perceived weight stigma is associated with adverse health indices, such as elevated cortisol, lipid/glucose dysregulation, and poorer self-rated health. This relationship may be particularly relevant for military personnel, given the cultural emphasis on fitness and weight/shape. Therefore, we investigated the relationship between weight stigma and physical health in 117 active duty personnel (66.7% male; 56.4% non-Hispanic White; age: 30.8 ± 7.4 years; BMI: 29.5 ± 2.5 kg/m2). Participants reported weight stigma (general and military-specific), weight bias internalization, and the presence (≥1; n = 55) or absence (n = 62) of medical conditions. Logistic regressions were conducted examining the ability of weight stigma (general or military-specific) and weight bias internalization to predict the presence or absence of medical conditions. General weight stigma was not significantly associated with the presence of a medical condition (p > .05). However, individuals with military-specific weight stigma scores twice that of their peers were over three times more likely (p = .04) to report a medical condition. Weight bias internalization was not significant in any model (ps > .20). Longitudinal studies should prospectively examine the relationship between weight stigma in the military setting and health among service members.
Collapse
Affiliation(s)
- Lisa M Shank
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA; The Henry M. Jackson Foundation for the Advancement of Military Medicine (HJF), 6720A Rockledge Drive #100, Bethesda, MD, 20817, USA.
| | - Natasha A Schvey
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Kendra Ekundayo
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA; The Henry M. Jackson Foundation for the Advancement of Military Medicine (HJF), 6720A Rockledge Drive #100, Bethesda, MD, 20817, USA
| | - Deanna Schreiber-Gregory
- The Henry M. Jackson Foundation for the Advancement of Military Medicine (HJF), 6720A Rockledge Drive #100, Bethesda, MD, 20817, USA; Department of Internal Medicine, USUHS, DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Dawn Bates
- Madigan Army Medical Center, 9040 Jackson Ave, Tacoma, WA, 98431, USA
| | - Douglas Maurer
- Madigan Army Medical Center, 9040 Jackson Ave, Tacoma, WA, 98431, USA
| | - Elena Spieker
- Madigan Army Medical Center, 9040 Jackson Ave, Tacoma, WA, 98431, USA
| | - Mark Stephens
- Department of Family and Community Medicine, Penn State University College of Medicine, 1850 E. Park Avenue, Suite 207 State College, PA, 16803, USA
| | - Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Tracy Sbrocco
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| |
Collapse
|
67
|
Adamska-Patruno E, Ostrowska L, Goscik J, Pietraszewska B, Kretowski A, Gorska M. The relationship between the leptin/ghrelin ratio and meals with various macronutrient contents in men with different nutritional status: a randomized crossover study. Nutr J 2018; 17:118. [PMID: 30593267 PMCID: PMC6309055 DOI: 10.1186/s12937-018-0427-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 12/19/2018] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Hormones, which influence satiety and hunger, play a significant role in body energy balance regulation. Ghrelin is a peptide that plays an important role in short-term appetite regulation, whereas leptin is a factor that controls long-term energy balance and is considered as a satiety hormone. The aim of this study was to evaluate the leptin/ghrelin ratio in a fasting state and after the intake of meals with varying macronutrient contents and to assess the possible differences between normal body weight and overweight/obese men. METHODS We examined 46 healthy adult men (23 with normal body weight and 23 overweight/obese) aged 21-58, who were divided into two groups. In the crossover study, participants received isocaloric (450 kcal) meals with different macronutrient contents: men from the first group received high-carbohydrate (HC) and normo-carbohydrate (NC) meals, and in the second group, participants received high-carbohydrate and high-fat (HF) meals. The ratio of leptin/ghrelin levels was calculated from leptin and total ghrelin serum concentrations in a fasting state and 30, 60, 120, 180 and 240 min after meal intake. One-way ANOVA and Wilcoxon signed-rank tests were carried out. The normality of the variable distribution was checked with the Shapiro-Wilk test, the homogeneity of variances was verified with the Levene test, and the false discovery rate p-value adjustment method was used. RESULTS The leptin/ghrelin ratio was significantly higher in overweight/obese men than individuals with normal body weight in a fasting state, as well as postprandially. We observed trends towards a higher leptin/ghrelin ratio values from the 60 min after HC-meal intake compared to the NC- and HF-meals in normal body weight participants, while in overweight/obese men, we did not note any significant differences dependent on the meal type. CONCLUSIONS We have observed a significantly different postprandial leptin/ghrelin ratio in normal body weight and overweight/obese men, and our results suggest that in men with normal body weight, a greater feeling of satiety may occur after high-carbohydrate meal intake, which was not noted in the overweight/obese individuals.
Collapse
Affiliation(s)
- Edyta Adamska-Patruno
- Clinical Research Centre, Medical University of Bialystok, Sklodowskiej 24A, 15-276, Bialystok, MC, Poland.
| | - Lucyna Ostrowska
- Department of Dietetics and Clinical Nutrition, Medical University of Bialystok, Mieszka I-go 4B, 15-054, Bialystok, Poland
| | - Joanna Goscik
- Clinical Research Centre, Medical University of Bialystok, Sklodowskiej 24A, 15-276, Bialystok, MC, Poland
| | - Barbara Pietraszewska
- Department of Dietetics and Clinical Nutrition, Medical University of Bialystok, Mieszka I-go 4B, 15-054, Bialystok, Poland
| | - Adam Kretowski
- Clinical Research Centre, Medical University of Bialystok, Sklodowskiej 24A, 15-276, Bialystok, MC, Poland.,Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, Sklodowskiej 24A, 15-276, Bialystok, MC, Poland
| | - Maria Gorska
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, Sklodowskiej 24A, 15-276, Bialystok, MC, Poland
| |
Collapse
|
68
|
Feldstein Ewing SW, Claus ED, Hudson KA, Filbey FM, Yakes Jimenez E, Lisdahl KM, Kong AS. Overweight adolescents' brain response to sweetened beverages mirrors addiction pathways. Brain Imaging Behav 2018; 11:925-935. [PMID: 27392791 DOI: 10.1007/s11682-016-9564-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Many adolescents struggle with overweight/obesity, which exponentially increases in the transition to adulthood. Overweight/obesity places youth at risk for serious health conditions, including type 2 diabetes. In adults, neural substrates implicated in addiction (e.g., orbitofrontal cortex (OFC), striatum, amygdala, and ventral tegmental area) have been found to be relevant to risk for overweight/obesity. In this study, we examined three hypotheses to disentangle the potential overlap between addiction and overweight/obesity processing by examining (1) brain response to high vs. low calorie beverages, (2) the strength of correspondence between biometrics, including body mass index (BMI) and insulin resistance, and brain response and (3) the relationship between a measure of food addiction and brain response using an established fMRI gustatory cue exposure task with a sample of overweight/obese youth (M age = 16.46; M BMI = 33.1). Greater BOLD response was observed across the OFC, inferior frontal gyrus (IFG), nucleus accumbens, right amygdala, and additional frontoparietal and temporal regions in neural processing of high vs. low calorie beverages. Further, BMI scores positively correlated with BOLD activation in the high calorie > low calorie contrast in the right postcentral gyrus and central operculum. Insulin resistance positively correlated with BOLD activation across the bilateral middle/superior temporal gyrus, left OFC, and superior parietal lobe. No relationships were observed between measures of food addiction and brain response. These findings support the activation of parallel addiction-related neural pathways in adolescents' high calorie processing, while also suggesting the importance of refining conceptual and neurocognitive models to fit this developmental period.
Collapse
Affiliation(s)
- Sarah W Feldstein Ewing
- Oregon Health & Science University, Mail code: DC7P, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239-3098, USA.
| | - Eric D Claus
- The Mind Research Network, 1101 Yale Blvd. NE, Albuquerque, NM, 87106, USA
| | - Karen A Hudson
- Oregon Health & Science University, Mail code: DC7P, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239-3098, USA
| | - Francesca M Filbey
- Center for BrainHealth, School of Behavioral and Brain Sciences, The University of Texas at Dallas, 2200 West Mockingbird Lane, Dallas, TX, 75235, USA
| | - Elizabeth Yakes Jimenez
- Departments of Individual, Family and Community Education and Family and Community Medicine, University of New Mexico, 1 University of New Mexico, Albuquerque, NM, 87112, USA
| | - Krista M Lisdahl
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, 53211, USA
| | - Alberta S Kong
- Department of Pediatrics, Division of Adolescent Medicine and Department of Family and Community Medicine, University of New Mexico, MSC 10 5590, 1 University of New Mexico, Albuquerque, NM, 87131, USA
| |
Collapse
|
69
|
Verzijl CL, Ahlich E, Lang B, Rancourt D. Body mass index as a moderator of the association between weight status misperception and disordered eating behaviors. Eat Behav 2018; 30:98-103. [PMID: 29990654 DOI: 10.1016/j.eatbeh.2018.06.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Revised: 06/22/2018] [Accepted: 06/26/2018] [Indexed: 11/27/2022]
Abstract
Weight status under-perception is protective against disordered eating behaviors and weight gain; however, it is unclear whether under-perception may confer protection across all weight classes. This work explored body mass index as a moderator of the association between weight status perception accuracy and disordered eating behaviors among adults with overweight or obesity. A total of 572 adults (58.7% female; age M = 39.50, SD = 11.57) with overweight or obesity (body mass index M = 31.50, SD = 6.24) completed a series of online questionnaires assessing uncontrolled, emotional, and restrained eating, eating disorder symptoms, weight status perception, and demographics. Controlling for race/ethnicity, age, and sex, linear and negative binomial regressions were used to test hypotheses. Compared to accurate weight status perception, under-perception was associated with less uncontrolled (p = .003) and restrained eating (p = .002). Under-perception was particularly protective against emotional eating (p = .022) and eating disorder symptoms (p = .017) for individuals of overweight or Class I obesity. In general, weight status under-perception was associated with fewer disordered eating behaviors. The protective effects of under-perception of weight status may be maximized for individuals of overweight or Class I obesity statuses.
Collapse
Affiliation(s)
| | - Erica Ahlich
- Department of Psychology, University of South Florida, Tampa, FL, USA
| | - Brittany Lang
- Department of Psychology, University of South Florida, Tampa, FL, USA
| | - Diana Rancourt
- Department of Psychology, University of South Florida, Tampa, FL, USA.
| |
Collapse
|
70
|
De Meneck F, Victorino de Souza L, Oliveira V, do Franco MC. High irisin levels in overweight/obese children and its positive correlation with metabolic profile, blood pressure, and endothelial progenitor cells. Nutr Metab Cardiovasc Dis 2018; 28:756-764. [PMID: 29858156 DOI: 10.1016/j.numecd.2018.04.009] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Revised: 04/20/2018] [Accepted: 04/23/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS Irisin is involved in the compensatory mechanisms for metabolic regulation and appears to be associated with glucose homeostasis and lipid profile. However, it's possible implications on obesity-associated cardiometabolic complications have not been completely elucidated. This study aimed to investigate the association between irisin level and anthropometric data, metabolic parameters, blood pressure, and endothelial progenitor cells (EPCs) level among children with overweight/obesity. METHODS AND RESULTS This study included 24 children with overweight/obesity (9 girls and 15 boys) and 63 children with normal weight (25 girls and 38 boys). The anthropometric data, blood pressure, blood biochemistry, EPCs and irisin levels were evaluated. Children with overweight/obesity had significantly higher circulating irisin and EPCs levels than those with normal weight (P < 0.001). Additionally, we found that irisin level was positively correlated with BMI (rho = 0.407), waist circumference (rho = 0.449), triglycerides (rho = .334), glucose (rho = 0.226), insulin (rho = 0.533), HOMA (rho = 0.545), and negatively correlated with HDL cholesterol level (rho = -0.218). Importantly, we also found that irisin levels were significantly correlated with systolic (rho = 0.420), diastolic (rho = 0.331) blood pressure and circulating EPCs level (rho = 0.391). CONCLUSION Our study provides evidence that overweight/obese children had elevated circulating levels of both irisin and EPCs and address the gap in the literature with regard to the understanding of the implications of irisin on obesity-related cardiometabolic complications among these children and also highlight the possible involvement of irisin regulation on insulin resistance and endothelial function in childhood overweight and obesity.
Collapse
Affiliation(s)
- F De Meneck
- Division of Translational Medicine, School of Medicine, Federal University of São Paulo, São Paulo, Brazil; Division of Nephrology, School of Medicine, Federal University of São Paulo, São Paulo, Brazil
| | - L Victorino de Souza
- Division of Nephrology, School of Medicine, Federal University of São Paulo, São Paulo, Brazil
| | - V Oliveira
- Division of Nephrology, School of Medicine, Federal University of São Paulo, São Paulo, Brazil
| | - M C do Franco
- Division of Translational Medicine, School of Medicine, Federal University of São Paulo, São Paulo, Brazil; Division of Nephrology, School of Medicine, Federal University of São Paulo, São Paulo, Brazil.
| |
Collapse
|
71
|
Tichá Ľ, Regecová V, Šebeková K, Sedláková D, Hamade J, Podracká Ľ. Prevalence of overweight/obesity among 7-year-old children-WHO Childhood Obesity Surveillance Initiative in Slovakia, trends and differences between selected European countries. Eur J Pediatr 2018; 177:945-53. [PMID: 29663085 DOI: 10.1007/s00431-018-3137-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 03/22/2018] [Accepted: 03/27/2018] [Indexed: 10/17/2022]
Abstract
UNLABELLED The objectives of this study were (1) to assess the prevalence and time trends of overweight/obesity in Slovak children by applying WHO, IOTF, and the national criteria; (2) to compare the prevalence between selected European countries; and (3) to evaluate the central obesity by the waist-to-height ratio. The survey was performed within the WHO European Childhood Obesity Surveillance Initiative. The weight, height, waist, and hip were measured in 2795 children at the age of 7-7.99 years (50.1% boys; 55.5% in rural areas). The prevalence of overweight/obesity was determined using the LMS Growth. In boys, the prevalence of overweight/obesity was 17.1/14.9% according to WHO, 13.8/8.8% according to IOTF, and 9.9/8.8% according to the national criteria. Among girls, the prevalence reached 15.1/11.1%, 12.6/8.1%, and 7.5/9.5%, respectively. These rates corresponded to the average of the European countries. Central obesity was identified in 76.9% of overweight/obese, but also in 5.9% normal-weight subjects. CONCLUSION While overweight has increased by 3% the prevalence of obesity has doubled since 2001. The rise culminated approximately 6 years ago and has not increased since then. The body constitution differences should be considered when comparing the prevalence of overweight/obesity between populations and/or individuals. What is Known: • Knowledge of the prevalence of overweight/obesity is seminal for effective implementation of programs focusing on the reduction of incidence and prevalence of obesity in early childhood. What is New: • The most numerous and representative study on the prevalence of overweight/obesity in 7-year-old children involving 2795 (5%) of peers living in Slovakia. • The prevalence of obesity in Slovakia falls within the range of average rate of the European countries. Central obesity was identified in almost 20% subjects.
Collapse
|
72
|
Pei X, Liu L, Imam MU, Lu M, Chen Y, Sun P, Guo Y, Xu Y, Ping Z, Fu X. Neck circumference may be a valuable tool for screening individuals with obesity: findings from a young Chinese population and a meta-analysis. BMC Public Health 2018; 18:529. [PMID: 29678132 PMCID: PMC5910608 DOI: 10.1186/s12889-018-5448-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 04/12/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Central obesity and overweight/obesity can result in various chronic non-communicable diseases, such as cardiovascular disease, metabolic syndrome, and diabetes mellitus. Waist circumference (WC) and body mass index (BMI) are widely used to measure obesity despite their limitations. For example, WC and BMI cannot be measured in pregnant women and subjects with abdominal ascites or masses. Therefore, this study aims to determine the efficacy of neck circumference (NC) as a tool for screening central obesity and overweight/obesity. METHODS A total of 1169 undergraduates aged 18-25 years were studied by a cross-sectional survey in China, 2016. Questionnaires and physical examinations were used to collect data. Receiver operator characteristic (ROC) curve was performed to determine the best threshold of NC for screening central obesity and overweight/obesity. Meanwhile, a meta-analysis was conducted to estimate the efficacy of NC for screening central obesity and overweight/obesity synthetically. RESULTS NC was moderately correlated with WC and BMI. The ROC analysis showed that 37.1 cm for male and 32.6 cm for female were the best thresholds for central obesity, and 37.4 cm and 32.2 cm for overweight/obesity, respectively. The sensitivity, specificity, area under receiver operating curve (AUC) of central obesity and overweight/obesity were higher. In the meta-analysis, the pooled sensitivity, specificity, AUC and their 95%CI of NC for screening central obesity were 0.72 (0.68~ 0.75), 0.87 (0.74~ 0.94), 0.77 (0.73~ 0.80) for male and 0.73 (0.65~ 0.80), 0.80 (0.71~ 0.86), 0.82 (0.79~ 0.86) for female. For overweight/obesity, the pooled sensitivity, specificity, AUC and corresponding 95%CI were 0.83 (0.70~ 0.91), 0.77 (0.66~ 0.85), 0.86 (0.83~ 0.89) for male and 0.82 (0.71~ 0.90), 0.84 (0.61~ 0.95), 0.89 (0.86~ 0.92) for female. CONCLUSION NC may not be a good tool for screening individuals with central obesity. But it may be a simple and valuable tool for screening individuals with overweight/obesity, especially in females.
Collapse
Affiliation(s)
- Xiaoting Pei
- College of Public Health, Zhengzhou University, No. 100 of Science Avenue, Zhengzhou, 450001, Henan, China
| | - Li Liu
- School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, 450001, China
| | - Mustapha Umar Imam
- Department of Medical Biochemistry, Faculty of Basic Medical Sciences, College of Health Sciences, Usmanu Danfodio University, Sokoto, Nigeria
| | - Ming Lu
- Nursing Department of Jiaozuo People's Hospital, Jiaozuo, 454150, China
| | - Yanzi Chen
- College of Public Health, Zhengzhou University, No. 100 of Science Avenue, Zhengzhou, 450001, Henan, China
| | - Panpan Sun
- College of Public Health, Zhengzhou University, No. 100 of Science Avenue, Zhengzhou, 450001, Henan, China
| | - Yaxin Guo
- School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, 450001, China
| | - Yiping Xu
- College of Public Health, Zhengzhou University, No. 100 of Science Avenue, Zhengzhou, 450001, Henan, China
| | - Zhiguang Ping
- College of Public Health, Zhengzhou University, No. 100 of Science Avenue, Zhengzhou, 450001, Henan, China.
| | - Xiaoli Fu
- College of Public Health, Zhengzhou University, No. 100 of Science Avenue, Zhengzhou, 450001, Henan, China.
| |
Collapse
|
73
|
Mekonnen T, Animaw W, Seyum Y. Overweight/obesity among adults in North-Western Ethiopia: a community-based cross sectional study. Arch Public Health 2018; 76:18. [PMID: 29515803 PMCID: PMC5836379 DOI: 10.1186/s13690-018-0262-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 02/08/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Nowadays adulthood overweight/obesity is an emerging public health problem in developing countries. There is no information on magnitude and contributing factors of adulthood overweight/obesity in Ethiopia, particularly in North West region of the country. Thus, the aim of this study was to assess magnitude and contributing factors of adulthood overweight/obesity in North West region of Ethiopia. METHODS A community-based cross-sectional study was conducted from September1, 2015 to November 30, 2015 in northwest region of Ethiopia particularly Bahir-Dar city and its rural districts. A total of 1484 adult participants were recruited in the study. Stratified multistage followed by systematic random sampling technique was employed to select participants. Overweight/obesity was determined using center for diseases control cutoff points. A multivariable binary logistic regression model was fitted to identify factors associated with overweight/obesity. Adjusted Odds Ratio (AOR) with the corresponding 95% Confidence Interval (CI) was calculated to show the strength of association. RESULTS A total of 1405 adults were participated in the study with a response rate of 94.7%. This study indicated that 11.3 (95% CI: 9.6, 13.1) adults were overweight and obese of which about 9.3% and 2% of adults were overweight and obese, respectively. The higher odds of being Overweight/Obese were noted among urban residents, females and older age. However performing mild to moderate physical activity [AOR = 0.608, 95% CI: 0.37, 0.99] and consumption of fruit and vegetable [AOR = 0.51, 95% CI: 0.34, 0.77] were found to be protective against overweight/obesity. CONCLUSION Though, it was a problem of developed countries adulthood overweight /obesity is emerged as a public health problem among adults in Ethiopia particularly in the study area, northwest region. Hence, preventive interventions focusing on urban residents, females through encouraging Physical activity, fruit and vegetable consumption is essential to prevent emergence of adulthood overweight/obesity.
Collapse
Affiliation(s)
- Teferi Mekonnen
- Bahir Dar University, School of Public Health, Public Health Nutrition Unit, Bahir Dar, Ethiopia
| | - Worku Animaw
- Bahir Dar University, Department of Nursing, Bahir Dar, Ethiopia
| | - Yeshaneh Seyum
- Bahir Dar University, Department of Nursing, Bahir Dar, Ethiopia
| |
Collapse
|
74
|
Chong L, Zhang W, Yu G, Zhang H, Zhu L, Li H, Shao Y, Li C. High-fat-diet induces airway hyperresponsiveness partly through activating CD38 signaling pathway. Int Immunopharmacol 2018; 56:197-204. [PMID: 29414651 DOI: 10.1016/j.intimp.2018.01.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 01/19/2018] [Accepted: 01/22/2018] [Indexed: 01/05/2023]
Abstract
CD38 is a plasma membrane bound multifunctional enzyme. It can be activated by inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-13, inducing calcium responses to agonist in airway smooth muscle cells (ASMC). Previous studies have found that high-fat-diet (HFD) induced obesity exhibited innate airway hyperresponsiveness (AHR). This study aimed to detect the effect of CD38 signaling pathway on the AHR of overweight/obese mice. The HFD-fed mice exhibited a significantly higher baseline airway resistance (Rn), and the increasing rates of Rn responded to increasing doses of methacholine compared with the LFD-fed mice. High-fat-diet increased CD38 expressions both in lung tissues and primary cultured ASMCs. Besides, preincubation with TNF-α led to a higher expression of CD38 protein and increased intracellular calcium in ASMC of the HFD-fed mice. Furthermore, CD38 gene knockdown through transfection of CD38 siRNA decreased the concentration of intracellular calcium. Additionally, the upregulations of CD38 protein and CD38 mRNA were also found in the lung tissues of HFD-fed mice challenged by ovalbumin (OVA). Collectively, our findings demonstrated a role of CD38 signaling pathway on the AHR of obesity and might be a potential therapeutic target for treating difficult-to-control obese asthma phenotype.
Collapse
Affiliation(s)
- Lei Chong
- Institute of Pediatrics, National Key Clinical Specialty of Pediatric Respiratory Medicine, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Weixi Zhang
- Discipline of Pediatric Respiratory Medicine, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Gang Yu
- Discipline of Pediatric Respiratory Medicine, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Hailin Zhang
- Discipline of Pediatric Respiratory Medicine, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Lili Zhu
- Discipline of Pediatric Respiratory Medicine, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Haiyan Li
- Discipline of Pediatric Respiratory Medicine, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Youyou Shao
- Discipline of Pediatric Respiratory Medicine, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Changchong Li
- Discipline of Pediatric Respiratory Medicine, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
| |
Collapse
|
75
|
Thurston IB, Sonneville KR, Milliren CE, Kamody RC, Gooding HC, Richmond TK. Cross-sectional and Prospective Examination of Weight Misperception and Depressive Symptoms Among Youth with Overweight and Obesity. Prev Sci 2017; 18:152-163. [PMID: 27682272 DOI: 10.1007/s11121-016-0714-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This study aims to determine the association between weight misperception (considering oneself average or underweight) and depressive symptoms among youth with overweight/obesity. Linear regression models (adjusted for age, BMI, parental education, percent poverty) were used to examine cross-sectional (wave II, 1996, n = 3898, M age = 15.9, SD = 0.13) and longitudinal (from wave II to IV, 1996-2008/2009, n = 2738, M age = 28.5, SD = 0.06) associations between weight misperception and depressive symptoms (Center for Epidemiologic Studies-Depression Scale) in a subsample of White, Black, Asian, Hispanic, and Multi-racial male and female youth with overweight/obesity participating in the National Longitudinal Study of Adolescent Health. Average BMI was 29.0 (0.16) at wave II and 35.7 (0.23) at wave IV. Thirty-two percent misperceived their weight status as average weight (n = 1151, 30 %) or underweight (n = 99, 3 %). In fully adjusted cross-sectional models, White (β = -1.92, 95 % CI = -2.79, -1.06) and Multi-racial (β = -4.43, 95 % CI = -6.90, -1.95) youth who perceived themselves as average weight had significantly lower depressive symptoms compared to accurate weight-perceivers. In fully adjusted longitudinal models, White youth (β = -0.41, 95 % CI = -0.81, -0.004) who perceived themselves as average weight had significantly lower depressive symptoms 12 years later. Findings suggest that weight misperception may be protective against depression among White adolescents and young adults with overweight/obesity. Clinical and population interventions should consider potential harmful effects of correcting weight misperceptions on the mental health of youth with overweight/obesity.
Collapse
Affiliation(s)
- Idia B Thurston
- Department of Psychology, University of Memphis, 310 Psychology Building, Memphis, TN, 38152, USA.
| | - Kendrin R Sonneville
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Carly E Milliren
- Clinical Research Center, Boston Children's Hospital, Boston, MA, USA
| | - Rebecca C Kamody
- Department of Psychology, University of Memphis, 310 Psychology Building, Memphis, TN, 38152, USA
| | - Holly C Gooding
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Tracy K Richmond
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA
| |
Collapse
|
76
|
Seyed Khoei N, Grindel A, Wallner M, Mölzer C, Doberer D, Marculescu R, Bulmer A, Wagner KH. Mild hyperbilirubinaemia as an endogenous mitigator of overweight and obesity: Implications for improved metabolic health. Atherosclerosis 2017; 269:306-311. [PMID: 29279144 DOI: 10.1016/j.atherosclerosis.2017.12.021] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 12/12/2017] [Accepted: 12/12/2017] [Indexed: 12/26/2022]
Abstract
BACKGROUND AND AIMS Mild endogenous elevation of unconjugated bilirubin (UCB) as seen in Gilbert's syndrome (GS), might mitigate cardiovascular disease (CVD) risk factors including overweight/obesity. This study aimed to determine whether hyperbilirubinaemia is linked to improved anthropometric data and lipid profile. METHODS Our study considered GS and age-/gender-matched healthy controls (n = 248). Additionally, obese female type 2 diabetic patients (DM2) (n = 26) were included as a "disease control group". RESULTS BMI, hip circumference (HC), and lipid profile were significantly lower in GS. UCB was inversely correlated with BMI (p <0 .001), HC as well as with fat mass (FM) and lipid variables (p < 0.05). Moreover, DM2 patients had significantly lower UCB compared to GS and healthy controls. Older GS subjects (≥35 years) had significantly reduced anthropometric data and improved lipid profile. CONCLUSIONS Our results propose that the health promoting potential of mild hyperbilirubinaemia may extend to protection from age-related weight gain and dyslipidaemia.
Collapse
Affiliation(s)
- Nazlisadat Seyed Khoei
- University of Vienna, Faculty of Life Sciences, Department of Nutritional Sciences, Althanstraße 14 (UZA2), 1090, Vienna, Austria
| | - Annemarie Grindel
- University of Vienna, Faculty of Life Sciences, Department of Nutritional Sciences, Althanstraße 14 (UZA2), 1090, Vienna, Austria
| | - Marlies Wallner
- University of Applied Sciences, FH JOANNEUM, Institute of Dietetics and Nutrition, Alte Poststraße 149, 8020, Graz, Austria
| | - Christine Mölzer
- University of Aberdeen, School of Medicine, Medical Sciences and Nutrition, Institute of Medical Sciences, Foresterhill, Ashgrove Road West, AB25 2ZD, Aberdeen, UK
| | - Daniel Doberer
- Medical University of Vienna, Department of Clinical Pharmacology, Vienna General Hospital, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Rodrig Marculescu
- Medical University of Vienna, Clinical Institute of Laboratory Medicine, Vienna General Hospital, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Andrew Bulmer
- School of Medical Science and Menzies Health Institute Queensland, Griffith University, Gold Coast, 4222, Australia
| | - Karl-Heinz Wagner
- University of Vienna, Faculty of Life Sciences, Department of Nutritional Sciences, Althanstraße 14 (UZA2), 1090, Vienna, Austria; Research Platform Active Ageing, University of Vienna, Faculty of Life Sciences, Althanstraße 14 (UZA2), 1090, Vienna, Austria.
| |
Collapse
|
77
|
Brown RF, Thorsteinsson EB, Smithson M, Birmingham CL, Aljarallah H, Nolan C. Can body temperature dysregulation explain the co-occurrence between overweight/obesity, sleep impairment, late-night eating, and a sedentary lifestyle? Eat Weight Disord 2017; 22:599-608. [PMID: 28929462 DOI: 10.1007/s40519-017-0439-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Accepted: 09/04/2017] [Indexed: 12/14/2022] Open
Abstract
PURPOSE Overweight/obesity, sleep disturbance, night eating, and a sedentary lifestyle are common co-occurring problems. There is a tendency for them to co-occur together more often than they occur alone. In some cases, there is clarity as to the time course and evolution of the phenomena. However, specific mechanism(s) that are proposed to explain a single co-occurrence cannot fully explain the more generalized tendency to develop concurrent symptoms and/or disorders after developing one of the phenomena. Nor is there a clinical theory with any utility in explaining the development of co-occurring symptoms, disorders and behaviour and the mechanism(s) by which they occur. Thus, we propose a specific mechanism-dysregulation of core body temperature (CBT) that interferes with sleep onset-to explain the development of the concurrences. METHODS A detailed review of the literature related to CBT and the phenomena that can alter CBT or are altered by CBT is provided. RESULTS Overweight/obesity, sleep disturbance and certain behaviour (e.g. late-night eating, sedentarism) were linked to elevated CBT, especially an elevated nocturnal CBT. A number of existing therapies including drugs (e.g. antidepressants), behavioural therapies (e.g. sleep restriction therapy) and bright light therapy can also reduce CBT. CONCLUSIONS An elevation in nocturnal CBT that interferes with sleep onset can parsimoniously explain the development and perpetuation of common co-occurring symptoms, disorders and behaviour including overweight/obesity, sleep disturbance, late-night eating, and sedentarism. Nonetheless, a significant correlation between CBT and the above symptoms, disorders and behaviour does not necessarily imply causation. Thus, statistical and methodological issues of relevance to this enquiry are discussed including the likely presence of autocorrelation. LEVEL OF EVIDENCE Level V, narrative review.
Collapse
Affiliation(s)
| | - Einar B Thorsteinsson
- School of Behavioural, Cognitive and Social Sciences Psychology, University of New England, Armidale, NSW, 2351, Australia.
| | | | | | | | | |
Collapse
|
78
|
Moss JL, Liu B, Zhu L. Comparing percentages and ranks of adolescent weight-related outcomes among U.S. states: Implications for intervention development. Prev Med 2017; 105:109-115. [PMID: 28888823 PMCID: PMC5653428 DOI: 10.1016/j.ypmed.2017.09.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 07/20/2017] [Accepted: 09/04/2017] [Indexed: 10/18/2022]
Abstract
Understanding statistical differences in states' percentages and ranks of adolescents meeting health behavior guidelines can guide policymaking. Data came from 531,777 adolescents (grades 9-12) who completed the Youth Risk Behavior Surveillance System survey in 2011, 2013, or 2015. We measured the percentage of adolescents in each state that met guidelines for physical activity, fruit and vegetable (F&V) consumption, and healthy weight status. Then we ranked states and calculated the ranks' 95% CI's using a Monte Carlo method with 100,000 simulations. We repeated these analyses stratified by sex (female or male) or race/ethnicity (non-Hispanic white, non-Hispanic black, Hispanic/Latino, or other). Pearson's and Spearman's correlation coefficients examined consistency in the percentages and ranks (respectively) across behaviors and subgroups. Meeting the physical activity and F&V consumption guidelines was relatively rare among adolescents (25.8% [95% CI=25.2%-26.4%] and 8.0% [95% CI=7.6%-8.3%], respectively), while meeting the healthy weight guideline was common (71.5% [95% CI=70.7%-72.3%]). At the state level, percentages of adolescents meeting these guidelines were statistically similar; states' ranks had wide CI's, resulting in considerable overlap (i.e., statistical equivalence). For each behavior, states' percentages and ranks were moderately to highly correlated across adolescent subgroups (Pearson's r=0.33-0.96; Spearman's r=0.42-0.96), but across behaviors, only F&V consumption and healthy weight were correlated (Pearson's r=0.34; Spearman's r=0.37). Adolescents in all states could benefit from initiatives to support cancer prevention behaviors, especially physical activity and F&V consumption. Programs in states that ranked highly on all assessed health behaviors could be adapted for dissemination in lower-performing states.
Collapse
Affiliation(s)
- Jennifer L Moss
- Cancer Prevention Fellowship Program, Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Room 4E514, MSC 9765, Bethesda, MD 20892-9765, USA.
| | - Benmei Liu
- Statistical Research and Applications Branch, Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Room 4E540, MSC 9765, Bethesda, MD 20892-9765, USA.
| | - Li Zhu
- Statistical Research and Applications Branch, Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Room 4E346, MSC 9765, Bethesda, MD 20892-9765, USA.
| |
Collapse
|
79
|
Blunt W, Gill DP, Sibbald SL, Riggin B, Pulford RW, Scott R, Danylchuk K, Gray CM, Wyke S, Bunn C, Petrella RJ. Optimization of the Hockey Fans in Training (Hockey FIT) weight loss and healthy lifestyle program for male hockey fans. BMC Public Health 2017; 17:916. [PMID: 29183291 PMCID: PMC5706169 DOI: 10.1186/s12889-017-4926-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 11/19/2017] [Indexed: 11/15/2022] Open
Abstract
Background The health outcomes of men continue to be poorer than women globally. Challenges in addressing this problem include difficulties engaging men in weight loss programs as they tend to view these programs as contrary to the masculine narrative of independence and self-reliance. Researchers have been turning towards sports fans to engage men in health promotion programs as sports fans are typically male, and tend to have poor health habits. Methods Developed from the highly successful gender-sensitized Football Fans in Training program, Hockey Fans in Training (Hockey FIT) recruited 80 male hockey fans of the London Knights and Sarnia Sting who were overweight or obese into a weekly, 90-minute classroom education and group exercise program held over 12 weeks; a 40-week minimally-supported phase followed. A process evaluation of the Hockey FIT program was completed alongside a pragmatic randomized controlled trial and outcome evaluation in order to fully explore the acceptability of the Hockey FIT program from the perspectives of coaches delivering and participants engaged in the program. Data sources included attendance records, participant focus groups, coach interviews, assessment of fidelity (program observations and post-session coach reflections), and 12-month participant interviews. Results Coaches enjoyed delivering the program and found it simple to deliver. Men valued being among others of similar body shape and similar weight loss goals, and found the knowledge they gained through the program helped them to make and maintain health behaviour changes. Suggested improvements include having more hockey-related information and activities, greater flexibility with timing of program delivery, and greater promotion of technology support tools. Conclusions We confirmed Hockey FIT was an acceptable “gender-sensitized” health promotion program for male hockey fans who were overweight or obese. Minor changes were required for optimization, which will be evaluated in a future definitive trial. Trial registration NCT02396524 (Clinicaltrials.gov). Date of registration: Feb 26, 2015.
Collapse
Affiliation(s)
- Wendy Blunt
- Department of Family Medicine, Centre for Studies in Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Lawson Health Research Institute, London, Ontario, Canada
| | - Dawn P Gill
- Department of Family Medicine, Centre for Studies in Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Lawson Health Research Institute, London, Ontario, Canada.,School of Health Studies, Faculty of Health Sciences, Western University, London, Ontario, Canada.,Graduate Program in Health & Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Shannon L Sibbald
- Department of Family Medicine, Centre for Studies in Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,School of Health Studies, Faculty of Health Sciences, Western University, London, Ontario, Canada.,Graduate Program in Health & Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, Ontario, Canada.,The Schulich Interfaculty Program in Public Health, Schulich School of Medicine and Dentistry, London, Ontario, Canada
| | - Brendan Riggin
- School of Kinesiology, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Roseanne W Pulford
- Department of Family Medicine, Centre for Studies in Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Lawson Health Research Institute, London, Ontario, Canada
| | - Ryan Scott
- School of Health Studies, Faculty of Health Sciences, Western University, London, Ontario, Canada.,Graduate Program in Health & Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Karen Danylchuk
- School of Kinesiology, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Cindy M Gray
- Institute of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Sally Wyke
- Institute of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Christopher Bunn
- Institute of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Robert J Petrella
- Department of Family Medicine, Centre for Studies in Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada. .,Lawson Health Research Institute, London, Ontario, Canada. .,Graduate Program in Health & Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, Ontario, Canada. .,School of Kinesiology, Faculty of Health Sciences, Western University, London, Ontario, Canada. .,Centre for Studies in Family Medicine, Western Centre for Public Health and Family Medicine, 2nd Floor, Western University, 1465 Richmond St, London, ON, N6G 2M1, Canada.
| |
Collapse
|
80
|
Navti LK, Atanga MB, Niba LL. Associations of out of school physical activity, sedentary lifestyle and socioeconomic status with weight status and adiposity of Cameroon children. BMC Obes 2017; 4:35. [PMID: 29152311 PMCID: PMC5678598 DOI: 10.1186/s40608-017-0171-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 10/31/2017] [Indexed: 12/25/2022]
Abstract
BACKGROUND Low physical activity and a sedentary lifestyle are contributing to overweight/obesity in children. This study aims to explore relationships between out of school physical activity, sedentary lifestyle and socioeconomic status indicators with children's weight status and adiposity. METHODS Five hundred twenty-two children of ages 5 to 12 years were randomly selected in a school-based cross sectional study in Bamenda, Cameroon. Weight and height were measured and BMI calculated. These variables were standardized for age and gender. Socioeconomic variables and proxy measures of physical activity and sedentary lifestyle of children were reported by parents using a structured questionnaire. Bivariate and multivariable logistic regression was used to calculate odds ratios.Quantile regression was used to compare median values of triceps skinfold thickness across the different factors. RESULTS In bivariate analysis, physical activity > 4 - 7 times/week was significantly (p = 0.010) associated with a lower prevalence (5.9%) of overweight/obesity. In multivariable analysis, physical activity > twice a week (OR 0.1, 95% CI 0.05 - 0.3), sedentary lifestyle > 3 h/day (OR 2.4, 95% CI 1.2 - 4.3) and being in the high occupation class (OR 4.3, 95% CI 2.2 - 8.1) independently predicted overweight/obesity. With quantile regression, physical activity > 4 - 7 times/week was significantly (p = 0.023) associated with a 1.36 mm decrease in median triceps skinfold thickness, while sedentary lifestyle (> 3 h/day) (p = 0.026) and being in the high occupation class (p = 0.007) were significantly associated with a 1.37 mm and 1.86 mm increase in median triceps skinfold thickness respectively. CONCLUSION Physical activity is inversely related to BMI-defined overweight/obesity and triceps skinfold thickness. Also, a high sedentary lifestyle and a high occupation class were associated with overweight/obesity and had the largest significant relationship with triceps skinfold thickness. There is need to objectively assess physical activity and sedentary lifestyle in our setting, in and out of school. Also longitudinal studies are warranted to understand the influence of cultural and behavioral drivers of physical activity and sedentary lifestyle.
Collapse
Affiliation(s)
- Lifoter K. Navti
- Department of Biochemistry, Catholic University of Cameroon (CATUC), Bamenda, P.O. Box 782, Bamenda, Cameroon
- Nutrition and Health Research Group (NHRG), Bamenda, Cameroon
| | - Mary B. Atanga
- Department of Nursing and Midwifery, University of Bamenda, P.O. Box 39, Bambili, Bamenda, Cameroon
| | - Loveline L. Niba
- Department of Biochemistry, Catholic University of Cameroon (CATUC), Bamenda, P.O. Box 782, Bamenda, Cameroon
- Nutrition and Health Research Group (NHRG), Bamenda, Cameroon
| |
Collapse
|
81
|
Townsend CKM, Miyamoto RES, Antonio M, Zhang G, Paloma D, Basques D, Braun KL, Kaholokula JK. The PILI@Work Program: a translation of the diabetes prevention program to Native Hawaiian-serving worksites in Hawai'i. Transl Behav Med 2017; 6:190-201. [PMID: 27356989 PMCID: PMC4927448 DOI: 10.1007/s13142-015-0383-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
A previously translated Diabetes Prevention Program Lifestyle Intervention (DPP-LI) was adapted for delivery as a worksite-based intervention, called PILI@Work, to address obesity disparities in Native Hawaiians/Pacific Islanders. This study examined the effectiveness of PILI@Work and factors associated with weight loss at post-intervention. Overweight/obese employees of 15 Native Hawaiian-serving organizations received the 3-month component of PILI@Work. Assessments included weight, systolic/diastolic blood pressure, physical activity and functioning, fat intake, locus of weight control, social support, and self-efficacy. Weight, systolic/diastolic blood pressure, physical functioning, physical activity frequency, fat intake, family support, and eating self-efficacy improved from pre- to post-intervention. Regression analysis indicated that worksite type, decreased diastolic blood pressure, increased physical activity, and more internalized locus of weight control were significantly associated with 3-month weight loss. PILI@Work initiated weight loss in Native Hawaiians/Pacific Islanders. DPP-LI translated to worksite settings and tailored for specific populations can be effective for addressing obesity.
Collapse
Affiliation(s)
- Claire K M Townsend
- Department of Native Hawaiian Health, John A Burns School of Medicine, University of Hawai'i at Mānoa, 677 Ala Moana Blvd, Suite 1016, Honolulu, HI, 96813, USA.
| | - Robin E S Miyamoto
- Department of Native Hawaiian Health, John A Burns School of Medicine, University of Hawai'i at Mānoa, 677 Ala Moana Blvd, Suite 1016, Honolulu, HI, 96813, USA
| | - Mapuana Antonio
- Department of Native Hawaiian Health, John A Burns School of Medicine, University of Hawai'i at Mānoa, 677 Ala Moana Blvd, Suite 1016, Honolulu, HI, 96813, USA
| | - Guangxing Zhang
- Office of Biostatistics & Quantitative Health Sciences John A Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, HI, USA
| | - Diane Paloma
- Native Hawaiian Health Program, Queen's Health Systems, Honolulu, HI, USA
| | - DeAnna Basques
- Department of Native Hawaiian Health, John A Burns School of Medicine, University of Hawai'i at Mānoa, 677 Ala Moana Blvd, Suite 1016, Honolulu, HI, 96813, USA
| | - Kathryn L Braun
- Office of Public Health Studies, University of Hawai'i at Mānoa, Honolulu, HI, USA
| | - Joseph Keawe'aimoku Kaholokula
- Department of Native Hawaiian Health, John A Burns School of Medicine, University of Hawai'i at Mānoa, 677 Ala Moana Blvd, Suite 1016, Honolulu, HI, 96813, USA
| |
Collapse
|
82
|
Abstract
The driving force behind the current global type 2 diabetes epidemic is insulin resistance in overweight and obese individuals. Dietary factors, physical inactivity, and sedentary behaviors are the major modifiable risk factors for obesity. Nevertheless, many overweight/obese people do not develop diabetes and lifestyle interventions focused on weight loss and diabetes prevention are often ineffective. Traditionally, chronically elevated blood glucose concentrations have been the hallmark of diabetes; however, many individuals will either remain 'prediabetic' or regress to normoglycemia. Thus, there is a growing need for innovative strategies to tackle diabetes at scale. The emergence of biomarker technologies has allowed more targeted therapeutic strategies for diabetes prevention (precision medicine), though largely confined to pharmacotherapy. Unlike most drugs, lifestyle interventions often have systemic health-enhancing effects. Thus, the pursuance of lifestyle precision medicine in diabetes seems rational. Herein, we review the literature on lifestyle interventions and diabetes prevention, describing the biological systems that can be characterized at scale in human populations, linking them to lifestyle in diabetes, and consider some of the challenges impeding the clinical translation of lifestyle precision medicine.
Collapse
Affiliation(s)
- Pascal M Mutie
- Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Lund University, Skåne University Hospital, SE-205 02, Malmö, Sweden
| | - Giuseppe N Giordano
- Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Lund University, Skåne University Hospital, SE-205 02, Malmö, Sweden
| | - Paul W Franks
- Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Lund University, Skåne University Hospital, SE-205 02, Malmö, Sweden.
- Department of Public Health & Clinical Medicine, Umeå University, Umeå, Sweden.
- Department of Nutrition, Harvard School of Public Health, Boston, MA, USA.
- Oxford Center for Diabetes, Endocrinology & Metabolism, Radcliff Department of Medicine, University of Oxford, Oxford, UK.
| |
Collapse
|
83
|
Xu CX, Zhu HH, Fang L, Hu RY, Wang H, Liang MB, Zhang J, Lu F, He QF, Wang LX, Chen XY, Du XF, Yu M, Zhong JM. Gender disparity in the associations of overweight/obesity with occupational activity, transport to/from work, leisure-time physical activity, and leisure-time spent sitting in working adults: A cross-sectional study. J Epidemiol 2017; 27:401-407. [PMID: 28778528 PMCID: PMC5565757 DOI: 10.1016/j.je.2016.08.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 08/19/2016] [Indexed: 11/25/2022] Open
Abstract
Background The associations of occupational activity (OA), commuting, leisure-time physical activity (LTPA), and sitting with overweight/obesity in working adults are controversial. This study explored these factors with the risk of overall and abdominal overweight/obesity in a Chinese working population and whether these associations differ by gender. Methods A cross-sectional study was conducted. Data analysis was done among 6739 employed participants. Multivariate logistic regression was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for the studied associations. Results For male employees, those with heavy OA had a lower overall (OR 0.76; 95% CI, 0.62–0.93) and abdominal (OR 0.76; 95% CI, 0.62–0.93) overweight/obesity risk than those with light OA. Those with LTPA ≥150 min/week had a lower risk of overall (OR 0.73; 95% CI, 0.56–0.96) and abdominal (OR 0.70; 95% CI, 0.53–0.91) overweight/obesity than those with LTPA <150 min/week. Men with leisure-sitting time <2.5 h/day had a significantly lower risk of abdominal overweight/obesity than those sitting ≥4 h/day (OR 0.80; 95% CI, 0.65–0.99). And men who cycled to/from work had a lower risk of overall (OR 0.69; 95% CI, 0.53–0.90) and abdominal overweight/obesity (OR 0.71; 95% CI, 0.54–0.92) than passive transports. However, the above significant associations disappeared among female employees. Conclusions Heavy OA, cycling to/from work, and LTPA were associated with lower risk of overall or abdominal overweight/obesity in male employees. Reducing leisure sitting time can also help male employees reduce the risk of abdominal overweight/obesity. More research on gender disparity in the risk of overweight and obesity should be done. Physical activity and sitting with overweight/obesity in employees were studied. Heavy occupational activity had a lower overweight/obesity risk. Active LTPA and cycling to work were associated with lower overweight/obesity risk. Reducing leisure sitting time can reduce the risk of abdominal overweight/obesity. The significant results were observed in male employees but not in females.
Collapse
Affiliation(s)
- Chun-Xiao Xu
- Department of Chronic Non-Communicable Diseases Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | | | - Le Fang
- Department of Chronic Non-Communicable Diseases Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China.
| | - Ru-Ying Hu
- Department of Chronic Non-Communicable Diseases Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Hao Wang
- Department of Chronic Non-Communicable Diseases Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Ming-Bin Liang
- Department of Chronic Non-Communicable Diseases Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Jie Zhang
- Department of Chronic Non-Communicable Diseases Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Feng Lu
- Department of Chronic Non-Communicable Diseases Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Qin-Fang He
- Department of Chronic Non-Communicable Diseases Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Li-Xin Wang
- Department of Chronic Non-Communicable Diseases Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Xiang-Yu Chen
- Department of Chronic Non-Communicable Diseases Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Xiao-Fu Du
- Department of Chronic Non-Communicable Diseases Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Min Yu
- Department of Chronic Non-Communicable Diseases Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Jie-Ming Zhong
- Department of Chronic Non-Communicable Diseases Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China.
| |
Collapse
|
84
|
Grazuleviciene R, Petraviciene I, Andrusaityte S, Balseviciene B. Psychosocial stress and obesity among children residing in Kaunas City. Environ Res 2017; 157:37-43. [PMID: 28511079 DOI: 10.1016/j.envres.2017.05.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 05/02/2017] [Accepted: 05/03/2017] [Indexed: 06/07/2023]
Abstract
INTRODUCTION An unfavorable psychosocial environment has been associated with an increased prevalence of obesity among children. However, the available evidence on the association of low socioeconomic status and parent-child relationships with childhood obesity is scarce. The aim of our study was to conduct a simultaneous evaluation of the risks associated with pathological mother-child relationships, education level, and overweight/obesity among 4-6 year-old children. METHODS This cross-sectional study included 1489 mother-child pairs living in Kaunas city, Lithuania. The Parenting Stress Index was measured using the Parent-Child Dysfunctional Interaction subscale. Children's overweight/obesity was defined as the body mass index ≥18kg/m2. Logistic regression models as well as crude and adjusted odds ratios (OR) and their 95% confidence intervals (CI) were used to indicate the strength of the associations between childhood overweight/obesity, maternal education level, and psychosocial stress. RESULTS The percentage of children with overweight/obesity rose with an increasing Parenting Stress Index score. The percentage of children with overweight/obesity in the group of parents with better education and normal mother-child relations was 6.0%, while in the group of less educated parents and pathological mother-child relations, this percentage reached 13.9%. The stratified multivariable model showed that, with reference to the group of better educated parents and normal mother-child relations, lower education level and pathological mother-child relations were statistically significant risk factors for overweight/obesity in 4-6 year-old children, increasing the OR of overweight/obesity (aOR: 2.43; 95% CI: 1.31-4.51). Pathological mother-child relations and maternal smoking mediated the effect of low maternal education level on children's BMI z-scores. CONCLUSION Pathological mother-child relations, lower parental education levels, and smoking may be predictors of children's overweight/obesity. Measures oriented towards health behavior and psychosocial stress management should be encouraged among parents in order to decrease the risk of overweight/obesity in their children.
Collapse
Affiliation(s)
- Regina Grazuleviciene
- Department of Environmental Sciences, Vytauto Didziojo Universitetas, K. Donelaicio str. 58, 44248 Kaunas, Lithuania.
| | - Inga Petraviciene
- Department of Environmental Sciences, Vytauto Didziojo Universitetas, K. Donelaicio str. 58, 44248 Kaunas, Lithuania
| | - Sandra Andrusaityte
- Department of Environmental Sciences, Vytauto Didziojo Universitetas, K. Donelaicio str. 58, 44248 Kaunas, Lithuania
| | - Birute Balseviciene
- Department of Theoretical Psychology, Vytauto Didziojo Universitetas, K. Donelaicio str. 58, 44248 Kaunas, Lithuania
| |
Collapse
|
85
|
Hambidge KM, Krebs NF, Garcés A, Westcott JE, Figueroa L, Goudar SS, Dhaded S, Pasha O, Aziz Ali S, Tshefu A, Lokangaka A, Thorsten VR, Das A, Stolka K, McClure EM, Lander RL, Bose CL, Derman RJ, Goldenberg RL, Bauserman M. Anthropometric indices for non-pregnant women of childbearing age differ widely among four low-middle income populations. BMC Public Health 2017; 18:45. [PMID: 28738791 PMCID: PMC5525260 DOI: 10.1186/s12889-017-4509-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 06/14/2017] [Indexed: 01/08/2023] Open
Abstract
Background Maternal stature and body mass indices (BMI) of non-pregnant women (NPW) of child bearing age are relevant to maternal and offspring health. The objective was to compare anthropometric indices of NPW in four rural communities in low- to low-middle income countries (LMIC). Methods Anthropometry and maternal characteristics/household wealth questionnaires were obtained for NPW enrolled in the Women First Preconception Maternal Nutrition Trial. Body mass index (BMI, kg/m2) was calculated. Z-scores were determined using WHO reference data. Results A total of 7268 NPW participated in Equateur, DRC (n = 1741); Chimaltenango, Guatemala (n = 1695); North Karnataka, India (n = 1823); and Thatta, Sindh, Pakistan (n = 2009). Mean age was 23 y and mean parity 1.5. Median (P25-P75) height (cm) ranged from 145.5 (142.2–148.9) in Guatemala to 156.0 (152.0–160.0) in DRC. Median weight (kg) ranged from 44.7 (39.9–50.3) in India to 52.7 (46.9–59.8) in Guatemala. Median BMI ranged from 19.4 (17.6–21.9) in India to 24.9 (22.3–28.0) in Guatemala. Percent stunted (<−2SD height for age z-score) ranged from 13.9% in DRC to 80.5% in Guatemala; % underweight (BMI <18.5) ranged from 1.2% in Guatemala to 37.1% in India; % overweight/obese (OW, BMI ≥25.0) ranged from 5.7% in DRC to 49.3% in Guatemala. For all sites, indicators for higher SES and higher age were associated with BMI. Lower SES women were underweight more frequently and higher SES women were OW more frequently at all sites. Younger women tended to be underweight, while older women tended to be OW. Conclusions Anthropometric data for NPW varied widely among low-income rural populations in four countries located on three different continents. Global comparisons of anthropometric measurements across sites using standard reference data serve to highlight major differences among populations of low-income rural NPW and assist in evaluating the rationale for and the design of optimal intervention trials. Trial registration ClinicalTrials.gov #NCT01883193 (18 June 2013, retrospectively registered)
Collapse
Affiliation(s)
| | | | - Ana Garcés
- INCAP (Instituto de Nutrición de Centro América y Panamá), Guatemala City, Guatemala
| | | | - Lester Figueroa
- INCAP (Instituto de Nutrición de Centro América y Panamá), Guatemala City, Guatemala
| | | | - Sangappa Dhaded
- KLE University's Jawaharlal Nehru Medical College, Belagavi, Karnataka, India
| | | | | | - Antoinette Tshefu
- Kinshasa School of Public Health, Kinshasa, Democratic Republic of the Congo
| | - Adrien Lokangaka
- Kinshasa School of Public Health, Kinshasa, Democratic Republic of the Congo
| | | | - Abhik Das
- RTI International, Research Triangle Park, NC, USA
| | | | | | | | - Carl L Bose
- University of North Carolina, Chapel Hill, NC, USA
| | | | | | | |
Collapse
|
86
|
Abstract
PURPOSE OF REVIEW Half of states in the USA have legislation requiring that schools conduct body mass index (BMI) screening among students; just under half of these states report results to parents. The effectiveness of school-based BMI screening and reporting in reducing childhood obesity is not established and the practice has raised concerns about the potential for increased weight-based stigmatization. RECENT FINDINGS Recent experimental studies of BMI screening and reporting have not demonstrated a positive impact on students' weight status. However, the language and formatting of BMI reports used in studies to date have been suboptimal and have likely limited the potential effectiveness of the practice. This article reviews the recent literature on school-based BMI screening and reporting and highlights important areas for future inquiry. The present review suggests that evidence to date is not sufficient to support definitive conclusions about the value of school-based BMI screening and reporting as a childhood obesity prevention tool.
Collapse
Affiliation(s)
- Hannah R Thompson
- UC Berkeley School of Public Health, 2115 Milvia Street, 3rd Floor, Berkeley, CA, 94704-1157, USA
| | - Kristine A Madsen
- UC Berkeley School of Public Health, 219 University Hall, #7360, Berkeley, CA, 94720-7360, USA.
| |
Collapse
|
87
|
Byrd DA, Agurs-Collins T, Berrigan D, Lee R, Thompson FE. Racial and Ethnic Differences in Dietary Intake, Physical Activity, and Body Mass Index (BMI) Among Cancer Survivors: 2005 and 2010 National Health Interview Surveys (NHIS). J Racial Ethn Health Disparities 2017; 4:1138-46. [PMID: 28078657 DOI: 10.1007/s40615-016-0319-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 11/10/2016] [Accepted: 11/14/2016] [Indexed: 10/20/2022]
Abstract
INTRODUCTION This paper reports racial/ethnic differences in mean dietary and alcohol intake, physical activity, and body mass index (BMI) among cancer survivors and examines adherence to the American Cancer Society and the US Dietary Guidelines for Americans. METHODS Data are from the cross-sectional 2005 and 2010 National Health Interview Surveys (NHIS). The total sample of cancer survivors (N = 3367) included non-Hispanic Whites (NHW; N = 2698), non-Hispanic Blacks (NHBs; N = 379), and Hispanics (N = 290). We compared mean reported dietary intake, moderate/vigorous physical activity, and BMI among racial/ethnic groups. Predicted marginals and multivariate logistic regression analysis were used to compare prevalence of non-adherence with recommendations among groups. RESULTS Among the three racial/ethnic groups, Hispanics had the highest mean intake of vegetables, fiber, and calcium (p = 0.0003; p < 0.0001; p = 0.001). In the logistic regression model adjusting for sociodemographic covariates, smoking and BMI, Hispanics had lower non-adherence to fiber guidelines (OR = 0.38; CI = 0.24-0.58) than NHWs. NHBs had significantly higher non-adherence to vegetable guidelines (OR = 1.63; CI = 1.07-2.47). NHBs and Hispanics had lower non-adherence with alcohol guidelines than NHWs (OR = 0.35 and 0.38; CI = 0.18-0.69 and 0.19-0.76, respectively). NHBs and Hispanics were more likely to be overweight/obese (OR = 1.66 and 1.57; CI = 1.24-2.23 and CI = 1.11-2.21, respectively). CONCLUSIONS There are racial/ethnic differences in certain health behaviors of cancer survivors. However, non-adherence to guidelines is high in all three racial/ethnic groups. Achieving the recommended guidelines for diet, physical activity, and a healthy BMI is a concern for all cancer survivors, indicating the need for intervention among this growing group of at-risk individuals.
Collapse
|
88
|
Abstract
Gestational diabetes (GDM) is defined as any degree of glucose intolerance with onset during pregnancy and is associated with increased feto-maternal morbidity as well as long-term complications in mothers and offspring. Women detected to have diabetes early in pregnancy receive the diagnosis of overt, non-gestational, diabetes (glucose: fasting > 126 mg/dl, spontaneous > 200 mg/dl or HbA1c > 6.5 % before 20 weeks of gestation). GDM is diagnosed by an oral glucose tolerance test (OGTT) or fasting glucose concentrations (> 92 mg/dl). Screening for undiagnosed type 2 diabetes at the first prenatal visit (Evidence level B) is recommended in women at increased risk using standard diagnostic criteria (high risk: history of GDM or pre-diabetes (impaired fasting glucose or impaired glucose tolerance); malformation, stillbirth, successive abortions or birth weight > 4,500 g in previous pregnancies; obesity, metabolic syndrome, age > 45 years, vascular disease; clinical symptoms of diabetes (e. g. glucosuria)). Performance of the OGTT (120 min; 75 g glucose) may already be indicated in the first trimester in some women but is mandatory between 24 and 28 gestational weeks in all pregnant women with previous non-pathological glucose metabolism (Evidence level B). Based on the results of the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study GDM is defined, if fasting venous plasma glucose exceeds 92 mg/dl or 1 h 180 mg/dl or 2 h 153 mg/dl after glucose loading (OGTT; international consensus criteria). In case of one pathological value a strict metabolic control is mandatory. This diagnostic approach was recently also recommended by the WHO. All women should receive nutritional counseling and be instructed in blood glucose self-monitoring and to increase physical activity to moderate intensity levels- if not contraindicated. If blood glucose levels cannot be maintained in the normal range (fasting < 95 mg/dl and 1 h after meals < 140 mg/dl) insulin therapy should be initiated as first choice. Maternal and fetal monitoring is required in order to minimize maternal and fetal/neonatal morbidity and perinatal mortality. After delivery all women with GDM have to be reevaluated as to their glucose tolerance by a 75 g OGTT (WHO criteria) 6-12 weeks postpartum and every 2 years in case of normal glucose tolerance (Evidence level B). All women have to be instructed about their (sevenfold increased relative) risk of type 2 diabetes at follow-up and possibilities for diabetes prevention, in particular weight management and maintenance/increase of physical activity. Monitoring of the development of the offspring and recommendation of healthy lifestyle of the children and family is recommended.
Collapse
Affiliation(s)
- Alexandra Kautzky-Willer
- Klinische Abteilung für Endokrinologie und Stoffwechsel, Gender Medicine Unit, Universitätsklinik für Innere Medizin III, Medizinische Universität Wien, Wien, Österreich.
| | - Jürgen Harreiter
- Klinische Abteilung für Endokrinologie und Stoffwechsel, Gender Medicine Unit, Universitätsklinik für Innere Medizin III, Medizinische Universität Wien, Wien, Österreich
| | - Dagmar Bancher-Todesca
- Abteilung für Geburtshilfe und feto-maternale Medizin, Universitätsklinik für Frauenheilkunde, Medizinische Universität Wien, Wien, Österreich
| | - Angelika Berger
- Abteilung für Neonatologie, Pädiatrische Intensivmedizin und Neuropädiatrie, Universitätsklinik für Kinder- und Jugendheilkunde, Medizinische Universität Wien, Wien, Österreich
| | - Andreas Repa
- Abteilung für Neonatologie, Pädiatrische Intensivmedizin und Neuropädiatrie, Universitätsklinik für Kinder- und Jugendheilkunde, Medizinische Universität Wien, Wien, Österreich
| | - Monika Lechleitner
- Abteilung für Innere Medizin, Landeskrankenhaus Hochzirl - Natters, Hochzirl, Österreich
| | - Raimund Weitgasser
- Abteilung für Innere Medizin, Privatklinik Wehrle-Diakonissen, Salzburg, Österreich
- Universitätsklinik für Innere Medizin I, Landeskrankenhaus Salzburg - Universitätsklinikum, Paracelsus Medizinische Privatuniversität, Salzburg, Österreich
| |
Collapse
|
89
|
Peng W, Goldsmith R, Berry EM. Demographic and lifestyle factors associated with adherence to the Mediterranean diet in relation to overweight/obesity among Israeli adolescents: findings from the Mabat Israeli national youth health and nutrition survey. Public Health Nutr 2017; 20:883-92. [PMID: 27829478 DOI: 10.1017/S1368980016002779] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To investigate demographic and lifestyle factors associated with adherence to the Mediterranean diet (MD) in Israeli adolescents. DESIGN Cross-sectional. SETTING School-based. SUBJECTS Schoolchildren (n 5268) aged 11-19 years answered self-administered questionnaires on food consumption, eating habits and lifestyle; a subset (n 578) also completed 24 h food recalls. RESULTS Using a modified KIDMED index, 25·5 % of the students had poor, 55·2 % had average and 19·3 % had good MD adherence. Jewish middle-school children had the highest proportion (28·2 %) of poor MD adherence. Olive oil usage, derived from 24 h food recalls, was 18·1 % in Jewish families v. 71·1 % in Arab homes. In Jewish boys, the odds (OR; 95 % CI) of having poor MD adherence was higher in those who watched television/videos/listened to music for ≥2 h/d (1·25; 0·98, 1·58) and those who sometimes/don't read food labels (1·69; 1·31, 2·18). In Jewish girls, the odds for having poor MD adherence was significantly higher in those whose mother's schooling was <12 years (2·06; 1·41, 3·00) and those who sometimes/don't read food labels (1·35; 1·08, 1·69). In Arab boys, watching television/videos/listening to music for ≥2 h/d was significantly associated with poor MD adherence (1·89; 1·16, 3·07). In Arab girls, no aerobic activity or ball games weekly was associated with poor MD adherence (1·38; 0·91, 2·09). CONCLUSIONS Israeli adolescents had overall a high rate of poor MD adherence. Jewish middle-school children were at the highest risk. Interventions aimed at increasing physical activity, reducing sedentary time, improving mother's education and promoting reading of food labels are recommended.
Collapse
|
90
|
Kim TH, Lee EK, Han E. Incremental impact of body mass status with modifiable unhealthy lifestyle behaviors on pharmaceutical expenditure. Res Social Adm Pharm 2016; 12:990-1003. [PMID: 26810936 DOI: 10.1016/j.sapharm.2015.12.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Revised: 12/20/2015] [Accepted: 12/20/2015] [Indexed: 02/02/2023]
Abstract
BACKGROUND Overweight/obesity is a growing health risk in Korea. The impact of overweight/obesity on pharmaceutical expenditure can be larger if individuals have multiple risk factors and multiple comorbidities. The current study estimated the combined effects of overweight/obesity and other unhealthy behaviors on pharmaceutical expenditure. METHODS An instrumental variable quantile regression model was estimated using Korea Health Panel Study data. The current study extracted data from 3 waves (2009, 2010, and 2011). RESULTS The final sample included 7148 person-year observations for adults aged 20 years or older. Overweight/obese individuals had higher pharmaceutical expenditure than their non-obese counterparts only at the upper quantiles of the conditional distribution of pharmaceutical expenditure (by 119% at the 90th quantile and 115% at the 95th). The current study found a stronger association at the upper quantiles among men (152%, 144%, and 150% at the 75th, 90th, and 95th quantiles, respectively) than among women (152%, 150%, and 148% at the 75th, 90th, and 95th quantiles, respectively). The association at the upper quantiles was stronger when combined with moderate to heavy drinking and no regular physical check-up, particularly among males. CONCLUSION The current study confirms that the association of overweight/obesity with modifiable unhealthy behaviors on pharmaceutical expenditure is larger than with overweight/obesity alone. Assessing the effect of overweight/obesity with lifestyle risk factors can help target groups for public health intervention programs.
Collapse
Affiliation(s)
- Tae Hyun Kim
- Graduate School of Public Health and Institute of Health Services Research, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, South Korea
| | - Eui-Kyung Lee
- School of Pharmacy, Sungkyunkwan University, 300 Cheonchoen-dong, Jangan-gu, Suwon, Gyeonggi-do 440-746, South Korea
| | - Euna Han
- College of Pharmacy and Yonsei Institute of Pharmaceutical Sciences, Yonsei University, 162-1 Songdo-Dong, Yeonsu-Gu, Incheon, South Korea.
| |
Collapse
|
91
|
Rachmi CN, Agho KE, Li M, Baur LA. Are stunted young Indonesian children more likely to be overweight, thin, or have high blood pressure in adolescence? Int J Public Health 2016; 62:153-162. [PMID: 27704160 DOI: 10.1007/s00038-016-0905-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Revised: 09/20/2016] [Accepted: 09/24/2016] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVES To determine whether stunted young children are at greater risk of (1) overweight/obesity or thinness, and (2) high blood pressure (HBP) in adolescence. METHODS A secondary data analysis using the Indonesian Family Life Survey waves 1 (1993) to 4 (2007). We generated a 14-year follow-up cohort (1993-2007) and two 7-year cohorts (1993-2000 and 2000-2007) of children aged 2.0-4.9 years. Stunting (HAZ < -2), thinness (BMIZ < -2), and overweight/obesity (BMIZ > +1) were determined based upon the WHO Child Growth Standards. HBP (>90th percentile) was interpreted using the 4th Report on the Diagnosis of HBP in Children and Adolescents. RESULTS 765, 1083, and 1589 children were included in the 14-year cohort, and the two 7-year cohort analyses, respectively. In the 7-year cohorts, early life stunting was inversely associated with overweight/obesity (prevalence ratio 0.32 and 0.38, respectively; P < 0.05), but no significant association was found with the 14-year cohort. There was no significant association between childhood stunting and thinness at adolescence or in the odds/likelihood of having high systolic or diastolic blood pressure. CONCLUSIONS We found no association between early life stunting and overweight/obesity, thinness and HBP in adolescence.
Collapse
Affiliation(s)
- Cut Novianti Rachmi
- Discipline of Child and Adolescent Health, The Children's Hospital at Westmead (University of Sydney Clinical School), Sydney, Australia.
| | | | - Mu Li
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Louise Alison Baur
- Discipline of Child and Adolescent Health, The Children's Hospital at Westmead (University of Sydney Clinical School), Sydney, Australia.,Sydney School of Public Health, The University of Sydney, Sydney, Australia
| |
Collapse
|
92
|
Agrawal S, Agrawal PK. Association Between Body Mass index and Prevalence of Multimorbidity in Low-and Middle-income Countries: A Cross-Sectional Study. ACTA ACUST UNITED AC 2016; 6:73-83. [PMID: 28894693 PMCID: PMC5591643 DOI: 10.5530/ijmedph.2016.2.5] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background Chronic diseases are increasingly becoming a health burden in terms of both morbidity and mortality in low and middle-income countries (LMICs). The role of body mass index (BMI) especially overweight and obesity in the prevalence of multimorbidity, the occurrence of two or more chronic conditions, is understudied in LMICs where two thirds of the world’s obese individuals reside. We estimated the association between BMI and prevalence of chronic non communicable disease multimorbidity in six LMICs. Methods Cross-sectional data of total of 40,166 participants from China (n=13,970), India (10,915), Mexico (2,4 26), Russia (3,892), South Africa (4,000) and Ghana (4,971), aged 18 years and above included in the WHO Study on Global Ageing and adult health (SAGE), 2007–2010 were analyzed. Multimorbidity was measured as the simultaneous presence of two or more of the nine chronic conditions including angina pectoris, arthritis, asthma, chronic lung disease, diabetes mellitus, hypertension, stroke, depression, and vision impairment. Multivariable logistic regression models were fitted to test for associations between overweight/obesity and prevalence of non communicable multimorbidity after adjusting for age, sex, rural/urban residence, education, marital status, occupation, household wealth, tobacco smoking, alcohol drinking, fruits and vegetable intake and health insurance status. Data were analyzed country wise as well as pooled together to give overall LMIC estimates. Results The mean BMI was 24.4 [±7.3SD] in the pooled countries, being as low as 20.8 [±8.0 SD] in India to 23.4 [±6.3 SD] in Ghana, 23.9 [±4.9 SD] in China, 28.4 [±5.4 SD] in Mexico, 28.6 [±6.3 SD] in Russia, to as high as 30.5 [±12.0 SD] in South Africa. The prevalence of overweight was 13% and obesity was 24% in the pooled sample. The prevalence of non communicable disease multimorbidity was 23% in the pooled sample of six countries–the highest being in Russia (50%), followed by Mexico (27%), India (24%), Ghana (23%), South Africa (32%) and China (22%). The prevalence of multimorbidity was 37% among obese population and 27% among overweight population in the pooled sample–highest prevalence was in Russia (59% among obese; 45% among overweight) and lowest in Ghana (28% among obese; 23% among overweight). Being obese (OR:5.78;95%CI:3.55–9.40;p<0.0001) was associated with significantly higher likelihood of having multimorbidity as compared to normal weight category in the pooled sample. The likelihood of multimorbidity among obese were almost ten times higher in Russia (OR:9.90;95%CI:3.90–25.17;p=<0.0001), seven times higher in China (OR:7.06;95%CI:2.47–20.21;p=0.003), six times higher in Ghana (OR:5.61;95%CI:1.21–26.02;p= 0.007) and five times higher in South Africa (OR:4.66;95%CI:2.16–10.08;p=0.005). Non-significant but positive association were also observed in case of India and Mexico. The likelihood of multimorbidity was more than two times higher among overweight population in India (OR:2.33;95%CI:1.35–4.02;p=0.003) and pooled countries (OR:1.47;95%CI:1.05–2.07;p=0.004) while non-significant but positive association were also observed in case of China, Russia, and Ghana. Conclusions The prevalence of non communicable disease multimorbidity in the LMICs is high, one and half times higher in obese than in normal weight individual. Obesity was independently associated with the occurrence of multimorbidity in the six LMICs. These findings may be vital for public health surveillance, prevention and management strategies for non communicable disease multimorbidity in the LMICs.
Collapse
|
93
|
Taylor SR, DeGeeter M, Wilson JA, Leadon KI, Rodgers PT. Preceptor perceptions of fourth year student pharmacists' abilities regarding patient counseling on therapeutic lifestyle changes. Curr Pharm Teach Learn 2016; 8:353-358. [PMID: 30070245 DOI: 10.1016/j.cptl.2016.02.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 02/02/2016] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Advanced pharmacy practice experiences (APPEs) provide an opportunity for students to showcase health and wellness knowledge and skills attained during didactic education. The primary objective of this study was to assess preceptor perceptions of how well pharmacy year four (PY4) students are prepared to provide guideline-based and patient-specific therapeutic lifestyle change (TLC) counseling at onset of an APPE rotation. A secondary objective included assessment of differences in counseling abilities if the preceptor considered the student normal weight versus overweight or obese, or if they were a known smoker. METHODS A questionnaire containing Likert questions about perceptions regarding TLC counseling was distributed electronically in October 2014 to 708 PY4 preceptors from two pharmacy schools. Only preceptors who routinely provided TLC counseling were included in data analysis that were done using descriptive statistics. The project was approved by both universities' institutional review boards. RESULTS The survey was completed by 165 PY4 preceptors (response rate = 23.3%), and 67 met inclusion criteria. Regarding nutrition counseling, a greater percentage of preceptors agreed that students more adequately provided counseling per guidelines (79.1%) versus individual patient needs (62.6%). Preceptors perceived students of normal weight were more likely to provide adequate lifestyle-modification counseling to overweight/obese patients (81%) compared to students that were overweight/obese themselves (69%). Students of normal weight were perceived to be more likely to adequately counsel normal weight patients on lifestyle modifications (81%) compared to students that were overweight/obese (64%). Students who smoked were perceived to adequately counsel about not smoking, though, to a lesser degree than students who were non-smokers. IMPLICATIONS While students are perceived as adequately equipped to provide guideline-based recommendations, there is room for improvement in providing patient-specific counseling. Additionally, it is perceived that student health status related to weight impacts TLC counseling.
Collapse
Affiliation(s)
| | | | | | - Kim I Leadon
- UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Philip T Rodgers
- UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC
| |
Collapse
|
94
|
Rachmi CN, Agho KE, Li M, Baur LA. Stunting coexisting with overweight in 2·0-4·9-year-old Indonesian children: prevalence, trends and associated risk factors from repeated cross-sectional surveys. Public Health Nutr 2016; 19:2698-707. [PMID: 27120968 DOI: 10.1017/S1368980016000926] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective The persistence of undernutrition, along with overweight and obesity, constitute the double burden of malnutrition. The present study aimed to: (i) describe the prevalence and trends of concurrent stunting and overweight in Indonesian children; (ii) identify potentially associated risk factors; and (iii) determine whether stunted children are at greater risk of overweight compared with those of healthy height. Design A secondary data analysis of children aged 2·0–4·9 years in four cross-sectional studies of the Indonesian Family Life Survey. Children’s height and BMI Z-scores were calculated based on the WHO Child Growth Standards (2006). We defined ‘concurrent stunting and overweight’ as height-for-age Z-score <−2 and BMI Z-score >+1. Multivariate generalised linear latent and mixed models were used to determine associated risk factors. Setting Thirteen out of twenty-seven provinces in Indonesia. Subjects Children (n 4101) from four waves of the Indonesian Family Life Survey (1993–2007). Results There were inconsistent trends in the prevalence of concurrent stunting and overweight from waves 1 to 4. Children were more likely to be stunted and overweight when they were in the youngest age group (2·0–2·9 years), were weaned after the age of 6 months, had short-statured mothers or lived in rural areas. Stunted children were significantly more likely to be overweight than healthy-height children (OR>1) but did not differ significantly different across each wave (OR=1·34–2·01). Conclusions Concurrent stunting and overweight occurs in Indonesian children aged 2·0–4·9 years. Current policies and programmes need to be tailored for the management of this phenomenon.
Collapse
|
95
|
Casali ME, Borsari L, Marchesi I, Borella P, Bargellini A. Lifestyle and food habits changes after migration: a focus on immigrant women in Modena (Italy). Ann Ig 2016; 27:748-59. [PMID: 26661916 DOI: 10.7416/ai.2015.2067] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND This study aimed to explore post-migration lifestyle and weight changes in a sample of migrant women recruited in Modena, Italy. Taking into account the importance of the perceived personal susceptibility in improving prevention and treatment seeking behaviors, we further investigated women's self-recognition of overweight/obesity. We also examined the changes in self-perceived quality of life after the arrival in Modena. METHODS A cross-sectional study was conducted among 97 female migrants visiting a family counseling in Modena. Socio-demographic information, post-migration changes in lifestyle, dietary habits and self-perceived quality of life were obtained by administering an anonymous questionnaire, created ad hoc with expert consultation and previously tested in a pilot study. Thereafter blood pressure, height and weight were measured. RESULTS More than half of the sample met criteria for overweight/obesity and 58% reported a weight increase after the arrival in Italy. The increased risk of weight gain after migration was significantly associated with women age, lower education level, African ethnicity and post-migration increased consumption of cheese and snacks/sweets. After applying a conditional multiple logistic regression, ethnicity, age and increased post-migration cheese consumption remained the main predictors of weight gain. More than half of subjects with BMI ≥ 25 Kg/m² were not aware of their own overweight or obesity. Such weight underestimation was more common in African migrants than in other ethnicities. Findings about the perceived quality of life showed an overall improved economic situation, although more than half of women revealed deterioration in their social relationships after migration. CONCLUSIONS Our results are important to identify the gaps in the current migrant populations' health promotion in Modena and suggest that strategies to support female migrants to reinforce good dietary patterns may be the key in preventing unhealthy weight gain. Indeed, understanding immigrant women's culture, beliefs and traditions of their country of origin, as well as food acculturation, is essential to improve the efficiency of these interventions.
Collapse
Affiliation(s)
- M E Casali
- Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - L Borsari
- Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - I Marchesi
- Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - P Borella
- Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - A Bargellini
- Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
| |
Collapse
|
96
|
Meshram II, Vishnu Vardhana Rao M, Sudershan Rao V, Laxmaiah A, Polasa K. Regional variation in the prevalence of overweight/obesity, hypertension and diabetes and their correlates among the adult rural population in India. Br J Nutr 2016; 115:1265-72. [PMID: 26867590 DOI: 10.1017/S0007114516000039] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
A community-based, cross-sectional study was carried out in five regions of India by adopting a multistage random sampling procedure. Information was collected from the participants about socio-demographic particulars such as age, sex, occupation, education, etc. Anthropometric measurements such as height, weight and waist and hip circumferences were measured and three measurements of blood pressure were obtained. Fasting blood sugar was assessed using a Glucometer. Data analysis was done using descriptive statistics, χ(2) test for association and logistic regression analysis. A total of 7531 subjects were covered for anthropometry and blood pressure. The overall prevalence of overweight/obesity and abdominal obesity was 29 and 21%, respectively, and was higher in the Southern region (40% each) as compared with other regions. The prevalence of hypertension was 18 and 16% and diabetes was 9·5% each among men and women, respectively. The risk of hypertension and diabetes was significantly higher among adults from the Southern and Western regions, the among elderly, among overweight/obese individuals and those with abdominal obesity. In conclusion, the prevalence of overweight/obesity and hypertension was higher in the Southern region, whereas diabetes was higher in the Southern and Western regions. Factors such as increasing age, male sex, overweight/obesity, and abdominal obesity were important risk factors for hypertension and diabetes. Appropriate health and nutrition education should be given to the community to control these problems.
Collapse
|
97
|
Dodd JM, Newman A, Moran LJ, Deussen AR, Grivell RM, Yelland LN, Crowther CA, McPhee AJ, Wittert G, Owens JA, Turnbull D, Robinson JS. The effect of antenatal dietary and lifestyle advice for women who are overweight or obese on emotional well-being: the LIMIT randomized trial. Acta Obstet Gynecol Scand 2015; 95:309-18. [PMID: 26618547 DOI: 10.1111/aogs.12832] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 11/24/2015] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Our aim was to evaluate the effect of dietary and lifestyle advice given to women who were overweight or obese during pregnancy on maternal quality of life, anxiety and risk of depression, and satisfaction with care. MATERIAL AND METHODS We conducted a randomized trial, involving pregnant women with body mass index ≥25 kg/m(2) , recruited from maternity units in South Australia. Women were randomized to Lifestyle Advice or Standard Care, and completed questionnaires assessing risk of depression (Edinburgh Postnatal Depression Scale), anxiety (Spielberger State-Trait Anxiety Inventory), and quality of life (SF-36) at trial entry, 28 and 36 weeks' gestation, and 4 months postpartum. Secondary trial outcomes assessed for this analysis were risk of depression, anxiety, maternal quality of life, and satisfaction with care. RESULTS One or more questionnaires were completed by 976 of 1108 (90.8%) women receiving Lifestyle Advice and 957 of 1104 (89.7%) women receiving Standard Care. The risk of depression [adjusted risk ratio 1.01; 95% confidence interval (CI) 0.82-1.24; p = 0.95], anxiety (adjusted risk ratio 1.09; 95% CI 0.93-1.27; p = 0.31), and health-related quality of life were similar between the two groups. Women receiving Lifestyle Advice reported improved healthy food choice [Lifestyle Advice 404 (68.9%) vs. Standard Care 323 (51.8%); p < 0.0001], and exercise knowledge [Lifestyle Advice 444 (75.8%) vs. Standard Care 367 (58.8%); p < 0.0001], and reassurance about their health [Lifestyle Advice 499 (85.3%) vs. Standard Care 485 (77.9%); p = 0.0112], and health of their baby [Lifestyle Advice 527 (90.2%) vs. Standard Care 545 (87.6%); p = 0.0143]. CONCLUSION Lifestyle advice in pregnancy improved knowledge and provided reassurance without negatively impacting well-being.
Collapse
Affiliation(s)
- Jodie M Dodd
- Discipline of Obstetrics and Gynaecology, The Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia.,Women's and Babies Division, Department of Perinatal Medicine, The Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Angela Newman
- Discipline of Obstetrics and Gynaecology, The Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia
| | - Lisa J Moran
- Discipline of Obstetrics and Gynaecology, The Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia
| | - Andrea R Deussen
- Discipline of Obstetrics and Gynaecology, The Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia
| | - Rosalie M Grivell
- Discipline of Obstetrics and Gynaecology, The Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia.,Women's and Babies Division, Department of Perinatal Medicine, The Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Lisa N Yelland
- Discipline of Obstetrics and Gynaecology, The Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia.,Women's and Children's Health Research Institute, North Adelaide, South Australia, Australia.,School of Population Health, University of Adelaide, Adelaide, South Australia, Australia
| | - Caroline A Crowther
- Discipline of Obstetrics and Gynaecology, The Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia
| | - Andrew J McPhee
- Women's and Babies' Division, Department of Neonatal Medicine, The Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Gary Wittert
- School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| | - Julie A Owens
- Discipline of Obstetrics and Gynaecology, The Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia
| | - Deborah Turnbull
- School of Psychology, University of Adelaide, Adelaide, South Australia, Australia
| | - Jeffrey S Robinson
- Discipline of Obstetrics and Gynaecology, The Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia
| | | |
Collapse
|
98
|
Liss DT, Finch EA, Gregory DL, Cooper A, Ackermann RT. Design and participant characteristics for a randomized effectiveness trial of an intensive lifestyle intervention to reduce cardiovascular risk in adults with type 2 diabetes: The I-D-HEALTH study. Contemp Clin Trials 2015; 46:114-121. [PMID: 26611433 DOI: 10.1016/j.cct.2015.11.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 11/17/2015] [Accepted: 11/19/2015] [Indexed: 01/15/2023]
Abstract
Intervening in Diabetes with Healthy Eating, Activity and Linkages To Healthcare (I-D-HEALTH) is a community-based randomized trial evaluating the effectiveness of a group-based adaption of the Look AHEAD intensive lifestyle intervention. Most potentially eligible patients were identified through electronic medical record queries or referral to a diabetes resource hub. Trial enrollees had a usual source of primary care, elevated body mass index (BMI) and type 2 diabetes. I-D-HEALTH participants were randomized to either standard care alone or standard care plus free-of-charge access to a group-based lifestyle intervention (GLI) offered by the YMCA. GLI participation was encouraged, but not required, for the latter group. The primary outcome is percent weight change over 6, 12 and 24months. Secondary outcomes include direct intervention costs and direct medical and non-medical expenditures, as well as changes in systolic blood pressure, hemoglobin A1c and cholesterol. Among 331 I-D-HEALTH participants, 167 were randomized to standard care and 164 to GLI. The mean age (±standard deviation) in each group was 57.1years (±12.2) and 57.6years (±10.5), respectively. Mean BMI was 34.9kg/m(2) (±7.3) among standard care participants and 36.2kg/m(2) (±7.8) among GLI participants. In both groups, approximately one third of participants were non-Hispanic Whites. We detected no significant differences between groups in mean systolic blood pressure, hemoglobin A1c or total cholesterol (P >0.05 for all characteristics above). The I-D-HEALTH study enrolled a diverse sample of adults with diabetes and offers a unique opportunity to evaluate the effectiveness of offering a community-based intensive lifestyle intervention.
Collapse
Affiliation(s)
- David T Liss
- Center for Community Health, Northwestern University Feinberg School of Medicine, Chicago, IL, United States; Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.
| | - Emily A Finch
- Center for Community Health, Northwestern University Feinberg School of Medicine, Chicago, IL, United States; Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Dyanna L Gregory
- Center for Community Health, Northwestern University Feinberg School of Medicine, Chicago, IL, United States; Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Andrew Cooper
- Center for Community Health, Northwestern University Feinberg School of Medicine, Chicago, IL, United States; Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Ronald T Ackermann
- Center for Community Health, Northwestern University Feinberg School of Medicine, Chicago, IL, United States; Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| |
Collapse
|
99
|
Alvarez-Nemegyei J, Buenfil-Rello FA, Pacheco-Pantoja EL. Association between body composition and disease activity in rheumatoid arthritis. A systematic review. ACTA ACUST UNITED AC 2015; 12:190-5. [PMID: 26549160 DOI: 10.1016/j.reuma.2015.09.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Revised: 09/04/2015] [Accepted: 09/16/2015] [Indexed: 01/20/2023]
Abstract
BACKGROUND Reports regarding the association between body composition and inflammatory activity in rheumatoid arthritis (RA) have consistently yielded contradictory results. OBJECTIVE To perform a systematic review on the association between overweight/obesity and inflammatory activity in RA. METHODS FAST approach: Article search (Medline, EBSCO, Cochrane Library), followed by abstract retrieval, full text review and blinded assessment of methodological quality for final inclusion. Because of marked heterogeneity in statistical approach and RA activity assessment method, a meta-analysis could not be done. Results are presented as qualitative synthesis. RESULTS One hundred and nineteen reports were found, 16 of them qualified for full text review. Eleven studies (8,147 patients; n range: 37-5,161) approved the methodological quality filter and were finally included. Interobserver agreement for methodological quality score (ICC: 0.93; 95% CI: 0.82-0.98; P<.001) and inclusion/rejection decision (k 1.00, P>.001) was excellent. In all reports body composition was assessed by BMI; however a marked heterogeneity was found in the method used for RA activity assessment. A significant association between BMI and RA activity was found in 6 reports having larger mean sample size: 1,274 (range: 140-5,161). On the other hand, this association was not found in 5 studies having lower mean sample size: 100 (range: 7-150). CONCLUSIONS The modulation of RA clinical status by body fat mass is suggested because a significant association was found between BMI and inflammatory activity in those reports with a trend toward higher statistical power. The relationship between body composition and clinical activity in RA requires be approached with further studies with higher methodological quality.
Collapse
Affiliation(s)
- José Alvarez-Nemegyei
- Unidad de Investigación, Hospital Regional de Alta Especialidad de la Península de Yucatán, Mérida (Yucatán), México
| | | | | |
Collapse
|
100
|
Mansi I, Frei CR, Wang CP, Mortensen EM. Statins and New-Onset Diabetes Mellitus and Diabetic Complications: A Retrospective Cohort Study of US Healthy Adults. J Gen Intern Med 2015; 30:1599-610. [PMID: 25917657 DOI: 10.1007/s11606-015-3335-1] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Revised: 02/26/2015] [Accepted: 03/27/2015] [Indexed: 12/12/2022]
Abstract
BACKGROUND Statin use is associated with increased incidence of diabetes and possibly with increased body weight and reduced exercise capacity. Data on the long-term effects of these associations in healthy adults, however, are very limited. In addition, the relationship between these effects and diabetic complications has not been adequately studied. OBJECTIVE To examine the association between statin use and new-onset diabetes, diabetic complications, and overweight/obesity in a cohort of healthy adults. RESEARCH DESIGN This was a retrospective cohort study. PARTICIPANTS Subjects were Tricare beneficiaries who were evaluated between October 1, 2003 and March 1, 2012. Patients were divided into statin users and nonusers. INTERVENTION We excluded patients who, at baseline, had a preexisting disease indicative of cardiovascular diseases, any positive element of the Charlson comorbidity index (including diabetes mellitus), or life-limiting chronic diseases. Using 42 baseline characteristics, we generated a propensity score to match statin users and nonusers. MAIN MEASURES Outcomes assessed included new-onset diabetes, diabetic complications, and overweight/obesity. KEY RESULTS A total of 25,970 patients (3982 statin users and 21,988 nonusers) were identified as healthy adults at baseline. Of these, 3351 statins users and 3351 nonusers were propensity score-matched. Statin users had higher odds of new-onset diabetes (odds ratio [OR] 1.87; 95 % confidence interval [95 % CI] 1.67-2.01), diabetes with complications (OR 2.50; 95 % CI 1.88-3.32), and overweight/obesity (OR 1.14; 95 % CI 1.04-1.25). Secondary and sensitivity analyses demonstrated similar findings. CONCLUSIONS Diabetes, diabetic complications, and overweight/obesity were more commonly diagnosed among statin-users than similar nonusers in a healthy cohort of adults. This study demonstrates that short-term clinical trials might not fully describe the risk/benefit of long-term statin use for primary prevention.
Collapse
|