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Heo J, Beck AN, Lin SF, Marcelli E, Lindsay S, Karl Finch B. Cohort-based income gradients in obesity among U.S. adults. Am J Hum Biol 2017; 30. [PMID: 29193504 DOI: 10.1002/ajhb.23084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Revised: 08/26/2017] [Accepted: 11/11/2017] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES No studies have focused on socioeconomic disparities in obesity within and between cohorts. Our objectives were to examine income gradients in obesity between birth-cohorts (inter-cohort variations) and within each birth-cohort (intra-cohort variations) by gender and race/ethnicity. METHODS Our sample includes 56,820 white and black adults from pooled, cross-sectional National Health and Nutrition Examination Surveys (1971-2012). We fit a series of logistic hierarchical Age-Period-Cohort models to control for the effects of age and period, simultaneously. Predicted probabilities of obesity by poverty-to-income ratio were estimated and graphed for 5-year cohort groups from 1901-1990. We also stratified this relationship for four gender and racial/ethnic subgroups. RESULTS Obesity disparities due to income were weaker for post-World War I and II generations, specifically the mid-1920s and the mid-1940s to 1950s cohorts, than for other cohorts. In contrast, we found greater income gradients in obesity among cohorts from the 1930s to mid-1940s and mid-1960s to 1970s. Moreover, obesity disparities due to income across cohorts vary markedly by gender and race/ethnicity. White women with higher income consistently exhibited a lower likelihood of obesity than those with lower income since early 1900s cohorts; whereas, black men with higher income exhibited higher risks of obesity than those with lower income in most cohorts. CONCLUSIONS Our findings suggest that strategies that address race and/or gender inequalities in obesity should be cognizant of significant historical factors that may be unique to cohorts. Period-based approaches that ignore life-course experiences captured in significant cohort-based experiences may limit the utility of policies and interventions.
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Affiliation(s)
- Jongho Heo
- JW Lee Center for Global Medicine, Seoul National University College of Medicine, Seoul, 03087, South Korea
| | - Audrey N Beck
- Department of Sociology, San Diego State University, San Diego, California
| | - Shih-Fan Lin
- Graduate School of Public Health, San Diego State University, San Diego, California
| | - Enrico Marcelli
- Department of Sociology, San Diego State University, San Diego, California
| | - Suzanne Lindsay
- Graduate School of Public Health, San Diego State University, San Diego, California
| | - Brian Karl Finch
- Center for Economic and Social Research and Department of Sociology, University of Southern California, Los Angeles, California
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52
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Hernández Vera R, Padró T, Vilahur G, Badimon L. Antithrombotic therapy in obesity. Thromb Haemost 2017; 110:681-8. [DOI: 10.1160/th12-12-0928] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Accepted: 03/11/2013] [Indexed: 12/17/2022]
Abstract
summaryClinical management of obese subjects to reduce their risk of suffering cardiovascular events is complex. Obese patients typically require preventive strategies, life-style modifications, and multi-drug therapy to address obesity-induced co-morbidities. Data regarding the effects of excess weight on the pharmacokinetics of most drugs is scarce as these individuals are often excluded from clinical trials. However, the physiological alterations observed in obese patients and their lower response to some antiplatelet agents and anticoagulants have suggested that dosage regimes need to be adjusted for these subjects. In this review we will briefly discuss platelet alterations that can contributeto increased thrombotic risk, analyse existing data regarding the effects of obesity on drug pharmacokinetics focusing on antiplatelet agents and anticoagulants, and we will describe the beneficial effects of weight loss on thrombosis.
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53
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Yu D, Jordan KP, Bedson J, Englund M, Blyth F, Turkiewicz A, Prieto-Alhambra D, Peat G. Population trends in the incidence and initial management of osteoarthritis: age-period-cohort analysis of the Clinical Practice Research Datalink, 1992-2013. Rheumatology (Oxford) 2017; 56:1902-1917. [PMID: 28977564 PMCID: PMC5850125 DOI: 10.1093/rheumatology/kex270] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Indexed: 12/31/2022] Open
Abstract
Objective To determine recent trends in the rate and management of new cases of OA presenting to primary healthcare using UK nationally representative data. Methods Using the Clinical Practice Research Datalink we identified new cases of diagnosed OA and clinical OA (including OA-relevant peripheral joint pain in those aged over 45 years) using established code lists. For both definitions we estimated annual incidence density using exact person-time, and undertook descriptive analysis and age-period-cohort modelling. Demographic characteristics and management were described for incident cases in each calendar year. Sensitivity analyses explored the robustness of the findings to key assumptions. Results Between 1992 and 2013 the annual age-sex standardized incidence rate for clinical OA increased from 29.2 to 40.5/1000 person-years. After controlling for period effects, the consultation incidence of clinical OA was higher for successive cohorts born after the mid-1950s, particularly women. In contrast, with the exception of hand OA, we observed no increase in the incidence of diagnosed OA: 8.6/1000 person-years in 2004 down to 6.3 in 2013. In 2013, 16.4% of clinical OA cases had an X-ray referral. While NSAID prescriptions fell from 2004, the proportion prescribed opioid analgesia rose markedly (0.1% of diagnosed OA in 1992 to 1.9% in 2013). Conclusion Rising rates of clinical OA, continued use of plain radiography and a shift towards opioid analgesic prescription are concerning. Our findings support the search for policies to tackle this common problem that promote joint pain prevention while avoiding excessive and inappropriate health care.
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Affiliation(s)
- Dahai Yu
- Research Institute for Primary Care & Health Sciences, Keele University, Keele, UK
| | - Kelvin P Jordan
- Research Institute for Primary Care & Health Sciences, Keele University, Keele, UK
| | - John Bedson
- Research Institute for Primary Care & Health Sciences, Keele University, Keele, UK
| | - Martin Englund
- Clinical Epidemiology Unit, Orthopaedics, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
- Clinical Epidemiology Research & Training Unit, Boston University School of Medicine, Boston, MA, USA
| | - Fiona Blyth
- Concord Clinical School, Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia
| | - Aleksandra Turkiewicz
- Clinical Epidemiology Unit, Orthopaedics, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Daniel Prieto-Alhambra
- GREMPAL (Grup de Recerca en Epidemiologia de les Malalties Prevalents de l’Aparell Locomotor), Idiap Jordi Gol Primary Care Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
- Musculoskeletal Pharmaco- and Device Epidemiology, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, UK
| | - George Peat
- Research Institute for Primary Care & Health Sciences, Keele University, Keele, UK
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54
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Social Determinants and Poor Diet Quality of Energy-Dense Diets of Australian Young Adults. Healthcare (Basel) 2017; 5:healthcare5040070. [PMID: 28974029 PMCID: PMC5746704 DOI: 10.3390/healthcare5040070] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 09/26/2017] [Accepted: 09/27/2017] [Indexed: 01/21/2023] Open
Abstract
This research aimed to determine the diet quality and socio-demographic determinants by level of energy-density of diets of Australian young adults. Secondary analysis of the Australian National Nutrition and Physical Activity Survey-2011/2012 for adults aged 18–34 years (n = 2397) was conducted. Diet was assessed by 24-h recalls. Dietary energy-density was calculated as dietary energy/grams of food (kJ/g) and the Healthy-Eating-Index-for-Australians (HEIFA-2013) was used to assess diet quality (highest score = 100). Dietary energy-density was examined with respect to diet quality and sociodemographic determinants including gender, highest tertiary-education attainment, country-of-birth, age, income, and socio-economic-index-for-area (SEIFA). Higher dietary energy-density was associated with lower diet quality scores (β = −3.71, t (2394) = −29.29, p < 0.0001) and included fewer fruits and vegetables, and more discretionary foods. The mean dietary energy-density was 7.7 kJ/g and 7.2 kJ/g for men and women, respectively. Subpopulations most at risk of consuming high energy-dense diets included those with lower education, Australian and English-speaking countries of birth, and men with low income and women from areas of lower socio-economic status. Young adults reporting low energy-dense diets had higher quality diets. Intensive efforts are needed to reduce the high energy-density of young adults’ diets, and should ensure they include populations of lower socio-economic status.
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55
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García-Meseguer MJ, Delicado-Soria A, Serrano-Urrea R. Fiber Patterns in Young Adults Living in Different Environments (USA, Spain, and Tunisia). Anthropometric and Lifestyle Characteristics. Nutrients 2017; 9:nu9091030. [PMID: 28927012 PMCID: PMC5622790 DOI: 10.3390/nu9091030] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 08/14/2017] [Accepted: 09/13/2017] [Indexed: 12/17/2022] Open
Abstract
Benefits of dietary fiber go beyond its effect on chronic diseases associated with development. Consequently, the pattern of fiber intake has been considered an indicator for diet quality. Young adults are especially vulnerable to a food environment that drives an increase in chronic diseases linked to economic development. The aim of this work was to characterize patterns of fiber intake among university students. A cross-sectional study was conducted on a sample of 730 students enrolled at the University of Castilla-La Mancha (Spain), the University of Carthage (Tunisia), and Florida International University (USA). Mean age was 21.2. Food consumption was self-reported in two 24-h recalls. Mean dietary fiber intake was 17.8 g, not reaching the adequate intake. Contrary to expectations, American participants were the highest consumers (p < 0.001), and also exhibited the highest BMI. Cereals, legumes, vegetables and fruit were the main food sources of fiber. Fiber from appetizers, prepared and precooked meals, sauces, spices and condiments accounted for 16.7% in American participants, 7.4% in Spanish participants and 2.6% in Tunisian participants. Total fiber intake increased with energy intake but did not depend on smoking habits and physical activity in any country. It is essential to improve consumers’ interpretation of guidelines on fiber intake.
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Affiliation(s)
- María José García-Meseguer
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Nursing, University of Castilla-La Mancha, Avda. de España, s/n, 02071 Albacete, Spain.
| | - Amalia Delicado-Soria
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Nursing, University of Castilla-La Mancha, Avda. de España, s/n, 02071 Albacete, Spain.
| | - Ramón Serrano-Urrea
- Department of Mathematics, Faculty of Computer Science Engineering, University of Castilla-La Mancha, Avda. de España, s/n, 02071 Albacete, Spain.
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de Ruiter I, Olmedo-Requena R, Sánchez-Cruz JJ, Jiménez-Moleón JJ. Tendencia de la obesidad infantil y el bajo peso por año de nacimiento y edad en España, 1983-2011. Rev Esp Cardiol 2017. [DOI: 10.1016/j.recesp.2016.11.038] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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57
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Canizares M, Hogg-Johnson S, Gignac MAM, Glazier RH, Badley EM. Increasing Trajectories of Multimorbidity Over Time: Birth Cohort Differences and the Role of Changes in Obesity and Income. J Gerontol B Psychol Sci Soc Sci 2017; 73:1303-1314. [DOI: 10.1093/geronb/gbx004] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 01/05/2017] [Indexed: 12/21/2022] Open
Affiliation(s)
- Mayilee Canizares
- Institute of Medical Science Faculty of Medicine, University of Toronto Medical Sciences Building, Canada
- Arthritis Community Research and Evaluation Unit, Krembil Research Institute, Toronto, Canada
| | - Sheilah Hogg-Johnson
- Dalla Lana School of Public Health, University of Toronto, Canada
- Institute for Work and Health, Toronto, Canada
| | - Monique A M Gignac
- Dalla Lana School of Public Health, University of Toronto, Canada
- Institute for Work and Health, Toronto, Canada
| | - Richard H Glazier
- Primary Care & Population Health Research Program, Institute for Clinical Evaluative Science, Toronto, Canada
- Department of Family and Community Medicine, University of Toronto, Canada
| | - Elizabeth M Badley
- Arthritis Community Research and Evaluation Unit, Krembil Research Institute, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Canada
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Socio-Demographic Determinants of Diet Quality in Australian Adults Using the Validated Healthy Eating Index for Australian Adults (HEIFA-2013). Healthcare (Basel) 2017; 5:healthcare5010007. [PMID: 28165394 PMCID: PMC5371913 DOI: 10.3390/healthcare5010007] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 01/20/2017] [Accepted: 01/23/2017] [Indexed: 12/15/2022] Open
Abstract
Diet quality indices have been shown to predict cardiovascular disease, cancer, Type 2 Diabetes, obesity and all-cause mortality. This study aimed to determine the socio-demographics of Australian adults with poor diet quality. Diet quality was assessed for participants of the 2011-2012 National Nutrition and Physical Activity Survey aged 18 years or above (n = 9435), with the validated 11-component Healthy Eating Index for Australians (HEIFA-2013), based on the 2013 Australian Dietary Guidelines. Differences in scores by demographics (ANOVA) and regression models for associations between the HEIFA-2013 score and demographic characteristics were conducted. The mean (SD) HEIFA-2013 score was 45.5 (14.7) out of 100 due to poor intakes of vegetables, fruit, grains, dairy and fat and high intakes of added sugar, sodium and discretionary foods. Lower mean HEIFA-2013 scores (SD) were found for males 43.3 (14.7), young-adults 41.6 (14.2) obese 44.1 (14.3), smokers 40.0 (14.2), low socio-economic status 43.7 (14.9) and Australian country-of-birth 44.2 (14.6) (p < 0.05). The overall diet quality of the Australian population is poor and targeted interventions for young-adults, males, obese and those with lower socio-economic status are recommended.
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59
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Buchanan L, Kelly B, Yeatman H. Exposure to digital marketing enhances young adults' interest in energy drinks: An exploratory investigation. PLoS One 2017; 12:e0171226. [PMID: 28152016 PMCID: PMC5289551 DOI: 10.1371/journal.pone.0171226] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 01/17/2017] [Indexed: 01/01/2023] Open
Abstract
Young adults experience faster weight gain and consume more unhealthy food than any other age groups. The impact of online food marketing on "digital native" young adults is unclear. This study examined the effects of online marketing on young adults' consumption behaviours, using energy drinks as a case example. The elaboration likelihood model of persuasion was used as the theoretical basis. A pre-test post-test experimental research design was adopted using mixed-methods. Participants (aged 18-24) were randomly assigned to control or experimental groups (N = 30 each). Experimental group participants' attitudes towards and intended purchase and consumption of energy drinks were examined via surveys and semi-structured interviews after their exposure to two popular energy drink brands' websites and social media sites (exposure time 8 minutes). Exposure to digital marketing contents of energy drinks improved the experimental group participants' attitudes towards and purchase and consumption intention of energy drinks. This study indicates the influential power of unhealthy online marketing on cognitively mature young adults. This study draws public health attentions to young adults, who to date have been less of a focus of researchers but are influenced by online food advertising.
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Affiliation(s)
- Limin Buchanan
- Early Start Research Institute, School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - Bridget Kelly
- Early Start Research Institute, School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - Heather Yeatman
- Early Start Research Institute, School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia
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60
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de Ruiter I, Olmedo-Requena R, Sánchez-Cruz JJ, Jiménez-Moleón JJ. Trends in Child Obesity and Underweight in Spain by Birth Year and Age, 1983 to 2011. ACTA ACUST UNITED AC 2017; 70:646-655. [PMID: 28153550 DOI: 10.1016/j.rec.2016.12.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Accepted: 11/14/2016] [Indexed: 11/29/2022]
Abstract
INTRODUCTION AND OBJECTIVES The prevalences of child obesity and overweight are increasing worldwide and are a significant public health issue, particularly in terms of long-term cardiovascular risk profiles, which continue into adulthood unless obesity is reversed. Accurately identifying trends and at-risk subgroups is crucial to correctly target public health initiatives. The objective of this study was to examine changes in the prevalences of child obesity and underweight in Spain from 1983 to 2011 taking into consideration both age and birth year. METHODS A series of cross-sectional studies representative of the pediatric population in Spain between 1987 and 2011 was used to calculate the prevalence and trends of excess weight and underweight in girls and boys aged 2 to 14 years per survey year and per birth year. RESULTS The overall prevalence of overweight and obesity remained relatively stable. The prevalence of overweight in boys aged 10 to 14 years increased from 13.9% to 22.2%. The prevalence of obesity in girls aged 2 to 5 years decreased from 30% to 19.8%, whereas the prevalence of underweight in this group increased from 13.7% to 22.6%. CONCLUSIONS Child obesity trends in Spain over the last 2 decades appear to be stable with some fluctuations, but the trends differ depending on age and sex, and have stabilized at too high a level. The prevalence of underweight also appears to have increased and should be considered alongside excess weight when designing and implementing child health and weight measures.
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Affiliation(s)
- Ingrid de Ruiter
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Granada, Granada, Spain.
| | - Rocío Olmedo-Requena
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Granada, Granada, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Instituto de Investigación Biosanitaria de Granada, Complejo Hospitalario Universitario de Granada, Universidad de Granada, Granada, Spain
| | - José Juan Sánchez-Cruz
- CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Instituto de Investigación Biosanitaria de Granada, Complejo Hospitalario Universitario de Granada, Universidad de Granada, Granada, Spain; Escuela Andaluza de Salud Pública, Granada, Spain
| | - José Juan Jiménez-Moleón
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Granada, Granada, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Instituto de Investigación Biosanitaria de Granada, Complejo Hospitalario Universitario de Granada, Universidad de Granada, Granada, Spain
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61
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Munt AE, Partridge SR, Allman-Farinelli M. The barriers and enablers of healthy eating among young adults: a missing piece of the obesity puzzle: A scoping review. Obes Rev 2017; 18:1-17. [PMID: 27764897 DOI: 10.1111/obr.12472] [Citation(s) in RCA: 192] [Impact Index Per Article: 27.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2016] [Revised: 08/18/2016] [Accepted: 09/02/2016] [Indexed: 11/29/2022]
Abstract
Young adults in Western countries are gaining weight faster than their parents and are more likely to gain weight than any other age cohort. Despite this, investigation into the complex young adults' food choice motives, which enable and prevent healthy eating, has not been widely investigated. A scoping review was conducted involving an extensive literature search of four major electronic databases: Medline, Embase, PsychInfo and CINAHL. Data were collected from 34 articles: study descriptions numerically analysed and key findings thematically analysed. The key barriers found included: male apathy towards diet; unhealthy diet of friends and family; expected consumption of unhealthy foods in certain situations; relative low cost of unhealthy foods; lack of time to plan, shop, prepare and cook healthy foods; lack of facilities to prepare, cook and store healthy foods; widespread presence of unhealthy foods; lack of knowledge and skills to plan, shop, prepare and cook healthy foods; lack of motivation to eat healthily (including risk-taking behaviour). The key enablers found included: female interest in a healthy diet; healthy diet of friends and family; support/encouragement of friends and family to eat healthy; desire for improved health; desire for weight management; desire for improved self-esteem; desire for attractiveness to potential partners and others; possessing autonomous motivation to eat healthy and existence and use of self-regulatory skills. This research provides evidence that can be used to tailor interventions for healthy eating and overweight and obesity in this population. However, government intervention in addressing food access, affordability, marketing and taxation remains essential to any significant change.
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Affiliation(s)
- A E Munt
- School of Life and Environmental Sciences, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - S R Partridge
- School of Life and Environmental Sciences, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - M Allman-Farinelli
- School of Life and Environmental Sciences, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
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Grech A, Hebden L, Roy R, Allman-Farinelli M. Are products sold in university vending machines nutritionally poor? A food environment audit. Nutr Diet 2016; 74:185-190. [PMID: 28731640 DOI: 10.1111/1747-0080.12332] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 08/25/2016] [Accepted: 09/19/2016] [Indexed: 11/29/2022]
Abstract
AIM (i) To audit the nutritional composition, promotion and cost of products available from vending machines available to young adults; and (ii) to examine the relationship between product availability and sales. METHODS A cross-sectional analysis of snacks and beverages available and purchased at a large urban university was conducted between March and September 2014. Sales were electronically tracked for nine months. RESULTS A total of 61 vending machines were identified; 95% (n = 864) of the available snacks and 49% of beverages (n = 455) were less-healthy items. The mean (SD) nutrient value of snacks sold was: energy 1173 kJ (437.5), saturated fat 5.36 g (3.6), sodium 251 mg (219), fibre 1.56 g (1.29) and energy density 20.16 kJ/g (2.34) per portion vended. There was a strong correlation between the availability of food and beverages and purchases (R2 = 0.98, P < 0.001). CONCLUSIONS Vending machines market and sell less-healthy food and beverages to university students. Efforts to improve the nutritional quality are indicated and afford an opportunity to improve the diet quality of young adults, a group at risk of obesity.
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Affiliation(s)
- Amanda Grech
- School of Life and Environmental Sciences, The Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Lana Hebden
- School of Life and Environmental Sciences, The Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Rajshri Roy
- School of Life and Environmental Sciences, The Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Margaret Allman-Farinelli
- School of Life and Environmental Sciences, The Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
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63
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Partridge SR, McGeechan K, Bauman A, Phongsavan P, Allman-Farinelli M. Improved confidence in performing nutrition and physical activity behaviours mediates behavioural change in young adults: Mediation results of a randomised controlled mHealth intervention. Appetite 2016; 108:425-433. [PMID: 27818304 DOI: 10.1016/j.appet.2016.11.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Revised: 10/29/2016] [Accepted: 11/02/2016] [Indexed: 12/14/2022]
Abstract
BACKGROUND The burden of weight gain disproportionally affects young adults. Understanding the underlying behavioural mechanisms of change in mHealth nutrition and physical activity interventions designed for young adults is important for enhancing and translating effective interventions. PURPOSE First, we hypothesised that knowledge, self-efficacy and stage-of-change for nutrition and physical activity behaviours would improve, and second, that self-efficacy changes in nutrition and physical activity behaviours mediate the behaviour changes observed in an mHealth RCT for prevention of weight gain. METHODS Young adults, aged 18-35 years at risk of weight gain (n = 250) were randomly assigned to an mHealth-program, TXT2BFiT, consisting of a three-month intensive phase and six-month maintenance phase or to a control group. Self-reported online surveys at baseline, three- and nine-months assessed nutrition and physical activity behaviours, knowledge, self-efficacy and stage-of-change. The mediating effect of self-efficacy was assessed in multiple PROCESS macro-models for three- and nine-month nutrition and physical activity behaviour change. RESULTS Young adults randomised to the intervention increased and maintained knowledge of fruit requirements (P = 0.029) compared to controls. Intervention participants' fruit and takeaway behaviours improved to meet recommendations at nine months, with a greater proportion progressing to action or maintenance stage-of-change (P < 0.001 and P = 0.012 respectively) compared to controls. Intervention participants' vegetable and physical activity behaviours did not meet recommendations, thereby halting progress to action or maintenance stage-of-change. Indirect effects of improved nutrition and physical activity behaviours at three- and nine-months in the intervention group were explained by changes in self-efficacy, accounting for 8%-37% of the total effect. CONCLUSIONS This provides insights into how the mHealth intervention achieved part of its effects and the importance of improving self-efficacy to facilitate improved eating and physical activity behaviours in young adults.
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Affiliation(s)
- Stephanie R Partridge
- School of Life and Environmental Sciences, Charles Perkins Centre, University of Sydney, NSW 2006, Australia.
| | - Kevin McGeechan
- Sydney School of Public Health, Charles Perkins Centre, University of Sydney, NSW 2006, Australia.
| | - Adrian Bauman
- Sydney School of Public Health, Charles Perkins Centre, University of Sydney, NSW 2006, Australia.
| | - Philayrath Phongsavan
- Sydney School of Public Health, Charles Perkins Centre, University of Sydney, NSW 2006, Australia.
| | - Margaret Allman-Farinelli
- School of Life and Environmental Sciences, Charles Perkins Centre, University of Sydney, NSW 2006, Australia.
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Gabet A, Chatignoux E, Ducimetière P, Danchin N, Olié V. Differential trends in myocardial infarction mortality over 1975–2010 in France according to gender: An age-period-cohort analysis. Int J Cardiol 2016; 223:660-664. [PMID: 27567235 DOI: 10.1016/j.ijcard.2016.07.194] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 07/28/2016] [Indexed: 11/15/2022]
Affiliation(s)
- A Gabet
- Department of Chronic Diseases and Injuries, The French Public Health Agency, Saint Maurice, France.
| | - E Chatignoux
- Department of Chronic Diseases and Injuries, The French Public Health Agency, Saint Maurice, France
| | | | - N Danchin
- Department of Cardiology, European Georges-Pompidou Hospital, Assistance Publique Hôpitaux de Paris, Paris-Descartes University, Paris, France
| | - V Olié
- Department of Chronic Diseases and Injuries, The French Public Health Agency, Saint Maurice, France
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Age-period-cohort analyses of obesity prevalence in US adults. Public Health 2016; 141:163-169. [PMID: 27931993 DOI: 10.1016/j.puhe.2016.09.021] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 09/07/2016] [Accepted: 09/12/2016] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Age-period-cohort analysis is a stream of methodologies that decompose the temporal trends for disease risk into three time scales-age, calendar year (period) and year of birth (cohort). This study conducted age-period-cohort analyses of obesity prevalence in US adults. STUDY DESIGN Retrospective data analysis. METHODS We constructed regression models based on anthropometric data from the 1999-2012 National Health and Nutrition Examination Survey to correct for the self-reported height/weight in the 1984-2014 Behavioral Risk Factor Surveillance System (BRFSS). We estimated fixed-effects age-period-cohort models based on the BRFSS data for the overall adult sample (n = 6,093,293) and by sex and race/ethnicity, adjusting for individual characteristics and the BRFSS survey design. RESULTS An inverted U-shaped age effect on obesity and a positive period effect characterized by over-time increase in obesity risk independent of age and cohort influences were identified in the overall sample and subgroups by sex and race/ethnicity. From 1984 to 2014, the adjusted obesity prevalence increased by 21.1 percentage points among US adults, and 20.9, 21.6, 21.0, 26.4 and 20.1 percentage points in men, women, non-Hispanic whites, African Americans and Hispanics, respectively. In contrast, no consistent evidence was found in support of the cohort effect-the adjusted obesity risk was comparable across birth cohorts after accounting for the age and period effects. CONCLUSIONS Shifts in the age distribution and nationwide secular changes may have fuelled the obesity epidemic in the USA over the past decades. Reversing the obesity epidemic may require understanding of the nationwide changes over time that affect weight gain across all population subgroups and promoting universal changes to diet, physical activity and the obesogenic environment.
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Roy R, Rangan A, Hebden L, Yu Louie JC, Tang LM, Kay J, Allman-Farinelli M. Dietary contribution of foods and beverages sold within a university campus and its effect on diet quality of young adults. Nutrition 2016; 34:118-123. [PMID: 28063506 DOI: 10.1016/j.nut.2016.09.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 09/05/2016] [Accepted: 09/24/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Tertiary education institutions have been linked with excessive weight in young adults. However, few data are available on the effect of foods from the university food environment on the diet quality of young adults. The aim of this study was to describe the association of a number of foods and beverages consumed at university food outlets with the diet quality of young adults. METHODS This was a cross-sectional survey in which the 103 university student participants, aged 19 to 24 y, contributed 5 d of dietary data. A purposely designed, validated smartphone application was used to collect the data. Diet quality was assessed by adherence to the 2013 dietary guidelines for food groups and nutrients, and the validated Healthy Eating Index for Australians (HEIFA-2013) was applied. Individual HEIFA-2013 scores were compared with the frequency of food purchase and consumption from university outlets to assess a dose-response effect of the food environment. Comparisons by tertiles of diet quality for body mass index, waist circumference, and takeaway food consumption (university and other) were computed using a one-way analysis of variance and post hoc Tukey test. RESULTS There was a statistically significant difference between the number of university foods and beverages consumed in 5 d and the HEIFA-2013 scores: More on-campus purchases resulted in a poor-quality diet (P = 0.001). As the HEIFA-2013 tertile scores increased, there was a significant decrease in the number of university campus and other takeaway foods consumed; body mass index and waist circumference showed a decrease in trend. CONCLUSIONS Efforts to improve the diet quality of young adults attending university may benefit from approaches to improve the campus food environment.
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Affiliation(s)
- Rajshri Roy
- Discipline of Nutrition and Dietetics, School of Life and Environmental Sciences, Charles Perkins Centre, University of Sydney, Sydney, Australia.
| | - Anna Rangan
- Discipline of Nutrition and Dietetics, School of Life and Environmental Sciences, Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Lana Hebden
- Discipline of Nutrition and Dietetics, School of Life and Environmental Sciences, Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Jimmy Chun Yu Louie
- Discipline of Nutrition and Dietetics, School of Life and Environmental Sciences, Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Lie Ming Tang
- Computer Human Adapted Interaction Research Group, School of Information Technologies, University of Sydney, Sydney, Australia
| | - Judy Kay
- Computer Human Adapted Interaction Research Group, School of Information Technologies, University of Sydney, Sydney, Australia
| | - Margaret Allman-Farinelli
- Discipline of Nutrition and Dietetics, School of Life and Environmental Sciences, Charles Perkins Centre, University of Sydney, Sydney, Australia
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Norman J, Kelly B, Boyland E, McMahon AT. The Impact of Marketing and Advertising on Food Behaviours: Evaluating the Evidence for a Causal Relationship. Curr Nutr Rep 2016. [DOI: 10.1007/s13668-016-0166-6] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Allman-Farinelli M, Partridge SR, McGeechan K, Balestracci K, Hebden L, Wong A, Phongsavan P, Denney-Wilson E, Harris MF, Bauman A. A Mobile Health Lifestyle Program for Prevention of Weight Gain in Young Adults (TXT2BFiT): Nine-Month Outcomes of a Randomized Controlled Trial. JMIR Mhealth Uhealth 2016; 4:e78. [PMID: 27335237 PMCID: PMC4935797 DOI: 10.2196/mhealth.5768] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 04/19/2016] [Accepted: 05/19/2016] [Indexed: 02/06/2023] Open
Abstract
Background The unprecedented rise in obesity among young adults, who have limited interaction with health services, has not been successfully abated. Objective The objective of this study was to assess the maintenance outcomes of a 12-week mHealth intervention on prevention of weight gain in young adults and lifestyle behaviors at 9 months from baseline. Methods A two-arm, parallel, randomized controlled trial (RCT) with subjects allocated to intervention or control 1:1 was conducted in a community setting in Greater Sydney, Australia. From November 2012 to July 2014, 18- to 35-year-old overweight individuals with a body mass index (BMI) of 25-31.99 kg/m2 and those with a BMI ≥ 23 kg/m2 and a self-reported weight gain of ≥ 2 kg in the past 12 months were recruited. A 12-week mHealth program “TXT2BFiT” was administered to the intervention arm. This included 5 coaching calls, 96 text messages, 12 emails, apps, and downloadable resources from the study website. Lifestyle behaviors addressed were intake of fruits, vegetables, sugar-sweetened beverages (SSBs), take-out meals, and physical activity. The control group received 1 phone call to introduce them to study procedures and 4 text messages over 12 weeks. After 12 weeks, the intervention arm received 2 further coaching calls, 6 text messages, and 6 emails with continued access to the study website during 6-month follow-up. Control arm received no further contact. The primary outcome was weight change (kg) with weight measured at baseline and at 12 weeks and self-report at baseline, 12 weeks, and 9 months. Secondary outcomes were change in physical activity (metabolic equivalent of task, MET-mins) and categories of intake for fruits, vegetables, SSBs, and take-out meals. These were assessed via Web-based surveys.
Results Two hundred and fifty young adults enrolled in the RCT. Intervention participants weighed less at 12 weeks compared with controls (model β=−3.7, 95% CI −6.1 to −1.3) and after 9 months (model β=− 4.3, 95% CI − 6.9 to − 1.8). No differences in physical activity were found but all diet behaviors showed that the intervention group, compared with controls at 9 months, had greater odds of meeting recommendations for fruits (OR 3.83, 95% CI 2.10-6.99); for vegetables (OR 2.42, 95% CI 1.32-4.44); for SSB (OR 3.11, 95% CI 1.47-6.59); and for take-out meals (OR 1.88, 95% CI 1.07-3.30). Conclusions Delivery of an mHealth intervention for prevention of weight gain resulted in modest weight loss at 12 weeks with further loss at 9 months in 18- to 35-year-olds. Although there was no evidence of change in physical activity, improvements in dietary behaviors occurred, and were maintained at 9 months. Owing to its scalable potential for widespread adoption, replication trials should be conducted in diverse populations of overweight young adults. Trial Registration Australian and New Zealand Clinical Trials Registry (ANZCTR): ACTRN12612000924853; (Archived by WebCite at http://www.webcitation.org/6i6iRag55)
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Affiliation(s)
- Margaret Allman-Farinelli
- School of Life and Environmental Sciences, Charles Perkins Centre, University of Sydney, University of Sydney, Australia.
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Prevalence and period trends of overweight and obesity in Australian young adults. Eur J Clin Nutr 2016; 70:1083-5. [DOI: 10.1038/ejcn.2016.41] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 01/19/2016] [Accepted: 02/25/2016] [Indexed: 12/25/2022]
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Partridge SR, McGeechan K, Bauman A, Phongsavan P, Allman-Farinelli M. Improved eating behaviours mediate weight gain prevention of young adults: moderation and mediation results of a randomised controlled trial of TXT2BFiT, mHealth program. Int J Behav Nutr Phys Act 2016; 13:44. [PMID: 27039178 PMCID: PMC4818870 DOI: 10.1186/s12966-016-0368-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 03/29/2016] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Explanatory evaluation of interventions for prevention of weight gain is required beyond changes in weight, to determine for whom the intervention works and the underlying mechanisms of change. It was hypothesised that participant characteristics moderate intervention effect on weight change and improved eating and physical activity behaviours during the 3-month program mediate the relationship between intervention and weight. METHODS In our randomised controlled trial, young adults at risk of weight gain (n = 250) were assigned either to an intervention group that received a 3-month mHealth (TXT2BFiT) program with 6-month maintenance or to a control group. Data were collected via online self-report surveys. Hypothesised moderators and mediators of the intervention effect on weight were independently assessed in PROCESS macro models for 3 and 9-month weight change. RESULTS Males (P = 0.01), mid-20s age group (P = 0.04), and higher income earners (P = 0.02) moderated intervention effects on weight change at 3-months and males only at 9-months (P = 0.02). Weight change at 3 (-1.12 kg) and 9-months (-1.38 kg) remained significant when 3-month nutrition and physical activity behaviours were specified as mediators (P <0.01 and P = 0.01 respectively). Indirect paths explained 39% (0.72/1.85 kg) and 40 % (0.92/2.3 kg) of total effect on weight change at 3 and 9-months respectively. Increased vegetable intake by intervention group at 3-months accounted for 19 and 17% and decreased sugar-sweetened beverages accounted for 8 and 13% of indirect weight change effects at 3 and 9-months respectively. CONCLUSIONS TXT2BFiT was effective for both young men and women. Small sustained behavioural changes, including increased vegetable intake and decreased sugar-sweetened beverages consumption significantly mediated the intervention's effects on weight change. Improved eating behaviours and increased physical activity accounted for approximately 40% of the weight change. TRIAL REGISTRATION The trial is registered with the Australian New Zealand Clinical Trials Registry ( ACTRN12612000924853 ).
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Affiliation(s)
- Stephanie R. Partridge
- />School of Life and Environmental Sciences, Charles Perkins Centre, University of Sydney, Sydney, NSW 2006 Australia
| | - Kevin McGeechan
- />Sydney School of Public Health, Charles Perkins Centre, University of Sydney, Sydney, NSW 2006 Australia
| | - Adrian Bauman
- />Sydney School of Public Health, Charles Perkins Centre, University of Sydney, Sydney, NSW 2006 Australia
| | - Philayrath Phongsavan
- />Sydney School of Public Health, Charles Perkins Centre, University of Sydney, Sydney, NSW 2006 Australia
| | - Margaret Allman-Farinelli
- />School of Life and Environmental Sciences, Charles Perkins Centre, University of Sydney, Sydney, NSW 2006 Australia
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Abstract
AbstractObesity in young adults is an increasing health problem in Australia and many other countries. Evidence-based information is needed to guide interventions that reduce the obesity-promoting elements in tertiary-education environments. In a food environmental audit survey, 252 outlets were audited across seven institutions: three universities and four technical and further education institutions campuses. A scoring instrument called the food environment-quality index was developed and used to assess all food outlets on these campuses. Information was collated on the availability, accessibility and promotion of foods and beverages and a composite score (maximum score=148; higher score indicates healthier outlets) was calculated. Each outlet and the overall campus were ranked into tertiles based on their ‘healthiness’. Differences in median scores for each outcome measure were compared between institutions and outlet types using one-way ANOVA with post hoc Scheffe’s testing, χ2 tests, Kruskal–Wallis H test and the Mann–Whitney U test. Binomial logistic regressions were used to compare the proportion of healthy v. unhealthy food categories across different types of outlets. Overall, the most frequently available items were sugar-sweetened beverages (20 % of all food/drink items) followed by chocolates (12 %), high-energy (>600 kJ/serve) foods (10 %), chips (10 %) and confectionery (10 %). Healthy food and beverages were observed to be less available, accessible and promoted than unhealthy options. The median score across all outlets was 72 (interquartile range=7). Tertiary-education food environments are dominated by high-energy, nutrient-poor foods and beverages. Interventions to decrease availability, accessibility and promotion of unhealthy foods are needed.
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Abstract
The origins of the obesogenic environment date back to the early 1980s. This means that young adults i.e., those aged 18 to 35 years, have only ever experienced a food milieu that promotes obesity. Indeed, younger generations are becoming heavier sooner than their parents in developed countries, such as the USA. Young adults demonstrate food consumption patterns and dietary behaviors implicated in an excessive gain of body fat. They are the highest consumers of fast food and sugar-sweetened beverages among adult age groups and the lowest consumers of fruit and vegetables. Younger adults are meal skippers but may consume more energy from snacks than older adults. So that the gains made in stemming obesity in childhood are not undone during young adulthood, prevention programs are needed. This review highlights areas for consideration in planning such programs.
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Affiliation(s)
- Margaret Allman-Farinelli
- School of Molecular Bioscience in the Charles Perkins Centre D17, University of Sydney, Building D17, NSW, Australia, 2006.
| | - Stephanie R Partridge
- School of Molecular Bioscience in the Charles Perkins Centre D17, University of Sydney, Building D17, NSW, Australia, 2006
| | - Rajshri Roy
- School of Molecular Bioscience in the Charles Perkins Centre D17, University of Sydney, Building D17, NSW, Australia, 2006
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Altman CE, Van Hook J, Hillemeier M. What Does Self-rated Health Mean? Changes and Variations in the Association of Obesity with Objective and Subjective Components Of Self-rated Health. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2016; 57:39-58. [PMID: 26811364 PMCID: PMC5191852 DOI: 10.1177/0022146515626218] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
There are concerns about the meaning of self-rated health (SRH) and the factors individuals consider. To illustrate how SRH is contextualized, we examine how the obesity-SRH association varies across age, periods, and cohorts. We decompose SRH into subjective and objective components and use a mechanism-based age-period-cohort model approach with four decades (1970s to 2000s) and five birth cohorts of National Health and Nutrition Examination Survey data (N = 26,184). Obese adults rate their health more negatively than non-obese when using overall SRH with little variation by age, period, or cohort. However, when we decomposed SRH into objective and subjective components, the obesity gap widened with increasing age in objective SRH but narrowed in subjective SRH. Additionally, the gap narrowed for more recently born cohorts for objective SRH but widened for subjective SRH. The results provide indirect evidence that the relationship between obesity and SRH is socially patterned according to exposure to information about obesity and the availability of resources to manage it.
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Lam E, Partridge SR, Allman-Farinelli M. Strategies for successful recruitment of young adults to healthy lifestyle programmes for the prevention of weight gain: a systematic review. Obes Rev 2016; 17:178-200. [PMID: 26663091 DOI: 10.1111/obr.12350] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 09/28/2015] [Accepted: 09/30/2015] [Indexed: 12/12/2022]
Abstract
Recruiting healthy young adults, aged 18-35, to lifestyle programmes for prevention of weight gain is challenging but important given their increasing rates of obesity. This review aimed to examine the success of different recruitment strategies. A systematic literature search identified 26 separate studies using 10 electronic databases. Participant characteristics and efficacy of interventions were well reported in all studies, but reporting of recruitment procedures, costs, times and effectiveness was minimal. Of those reporting recruitment, both active (e.g. face-to-face) and passive (e.g. print-media and mass-mailings) approaches were identified with the latter most frequently employed. Novel strategies such as social media and marketing approaches were identified. Television and radio have potentially high reach but low efficiency with high cost compared with mass-mailings which yield high numbers of participants. Marketing campaigns appeared to be a promising approach. Incentives demonstrated enhanced recruitment. The use of formative research to guide recruitment strategies for interventions is recommended. Reporting of success, cost and timelines for recruitment should be included in reporting of future trials. This first synthesis of recruitment information can be used to inform recruitment frameworks for lifestyle programmes seeking to attract young adults.
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Affiliation(s)
- E Lam
- School of Molecular Bioscience, Charles Perkins Centre, University of Sydney, Sydney, 2006, Australia
| | - S R Partridge
- School of Molecular Bioscience, Charles Perkins Centre, University of Sydney, Sydney, 2006, Australia
| | - M Allman-Farinelli
- School of Molecular Bioscience, Charles Perkins Centre, University of Sydney, Sydney, 2006, Australia
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Partridge SR, Allman-Farinelli M, McGeechan K, Balestracci K, Wong ATY, Hebden L, Harris MF, Bauman A, Phongsavan P. Process evaluation of TXT2BFiT: a multi-component mHealth randomised controlled trial to prevent weight gain in young adults. Int J Behav Nutr Phys Act 2016; 13:7. [PMID: 26785637 PMCID: PMC4717560 DOI: 10.1186/s12966-016-0329-2] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 01/12/2016] [Indexed: 12/22/2022] Open
Abstract
Background TXT2BFiT was one of the first few innovative mHealth programs designed for young adults (18–35 years) with demonstrated efficacy in weight management. However, research is lacking to understand intervention effectiveness, especially in complex, multi-component mHealth programs. This paper investigates participant perceptions of and engagement with the mHealth program components in the TXT2BFiT to understand program effects. Methods Process evaluation data were collected continuously for the study duration. The TXT2BFiT program was a multi-component lifestyle program delivered intensively for 3-month followed by a 6-month maintenance phase. Program components included personalised coaching calls, text messages, emails, smartphone apps and website access. Process evaluation measures included frequency of use of components and frequency for number of components used (online survey data); dose delivered and engagement with program components (researcher logs and web platform reports); frequency, timing and difficulties experienced with program components (online survey data) and overall perceptions of program components (online survey data and semi-structured telephone interviews). Qualitative data analysis was performed using NVivo10. Results Over 80 % of participants completed post-intervention (3-months, intervention, n = 110, control n = 104) and follow-up surveys (9-months, intervention, n = 96, control n = 104). Thirty intervention participants completed semi-structured telephone interviews. Participants reported high use of coaching calls, text messages and emails and no issues in content delivery from these components. These components were described as helping them to achieve their goals. Website and app use and engagement was low for the duration of the program. Participants would prefer incorporation of the self-monitoring apps and website resources into one smartphone application that can be individualised by entry of their personal data. Conclusions Our process evaluation has allowed a comprehensive understanding of use and preference for different program components. The high value placed on the coaching calls is consistent with a desire for personalisation of the mHealth program and even further tailoring of text messages and emails. The findings of this study will be used to revise TXT2BFiT for future users. Trial registration The trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12612000924853).
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Affiliation(s)
- Stephanie R Partridge
- School of Life and Environmental Sciences, Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia.
| | - Margaret Allman-Farinelli
- School of Life and Environmental Sciences, Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia.
| | - Kevin McGeechan
- Sydney School of Public Health, Charles Perkins Centre, University of Sydney, Sydney, NSW, 2006, Australia.
| | - Kate Balestracci
- School of Life and Environmental Sciences, Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia.
| | - Annette T Y Wong
- School of Life and Environmental Sciences, Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia.
| | - Lana Hebden
- School of Life and Environmental Sciences, Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia.
| | - Mark F Harris
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, 2052, Australia.
| | - Adrian Bauman
- Sydney School of Public Health, Charles Perkins Centre, University of Sydney, Sydney, NSW, 2006, Australia.
| | - Philayrath Phongsavan
- Sydney School of Public Health, Charles Perkins Centre, University of Sydney, Sydney, NSW, 2006, Australia.
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Tarabashkina L, Quester P, Crouch R. Exploring the moderating effect of children's nutritional knowledge on the relationship between product evaluations and food choice. Soc Sci Med 2016; 149:145-52. [DOI: 10.1016/j.socscimed.2015.11.046] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 10/27/2015] [Accepted: 11/25/2015] [Indexed: 02/02/2023]
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Cho W, Takeda W, Oh Y, Aiba N, Lee Y. Perceptions and practices of commensality and solo-eating among Korean and Japanese university students: A cross-cultural analysis. Nutr Res Pract 2015; 9:523-9. [PMID: 26425283 PMCID: PMC4575966 DOI: 10.4162/nrp.2015.9.5.523] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 06/22/2015] [Accepted: 07/08/2015] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND/OBJECTIVES Commensality, eating together with others, is a major representation of human sociality. In recent time, environments around commensality have changed significantly due to rapid social changes, and the decline of commensality is perceived as a serious concern in many modern societies. This study employs a cross-cultural analysis of university students in two East Asian countries, and examines cross-cultural variations of perceptions and actual practices of commensality and solo-eating. SUBJECTS/METHODS The analysis was drawn from a free-list survey and a self-administrative questionnaires of university students in urban Korea and Japan. The free-listing survey was conducted with a small cohort to explore common images and meanings of commensality and solo-eating. The self-administrative questionnaire was developed based on the result of the free-list survey, and conducted with a larger cohort to examine reasons and problems of practices and associated behaviors and food intake. RESULTS We found that Korean subjects tended to show stronger associations between solo-eating and negative emotions while the Japanese subjects expressed mixed emotions towards the practice of solo-eating. In the questionnaire, more Korean students reported they prefer commensality and tend to eat more quantities when they eat commensally. In contrast, more Japanese reported that they do not have preference on commensality and there is no notable difference in food quantities when they eat commensally and alone. Compared to the general Korean cohort finding, more proportion of overweight and obese groups of Korean subjects reported that they tend to eat more when they are alone than normal and underweight groups. This difference was not found in the overweight Japanese subjects. CONCLUSION Our study revealed cross-cultural variations of perceptions and practices of commensality and solo-eating in a non-western setting.
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Affiliation(s)
- Wookyoun Cho
- Department of Food and Nutrition, Gachon University, Gyeonggi 461-701, Korea
| | - Wakako Takeda
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Building 62, Mills Road, Acton, ACT, 2601, Australia
| | - Yujin Oh
- Research Evaluation Team, Korea Health Promotion Foundation, Namsan Square, Seoul 100-705, Korea
| | - Naomi Aiba
- Department of Nutrition and Life Science, Kanagawa Institute of Technology, Kanagawa 243-0392, Japan
| | - Youngmee Lee
- Department of Food and Nutrition, Gachon University, Gyeonggi 461-701, Korea
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Roy R, Kelly B, Rangan A, Allman-Farinelli M. Food Environment Interventions to Improve the Dietary Behavior of Young Adults in Tertiary Education Settings: A Systematic Literature Review. J Acad Nutr Diet 2015; 115:1647-81.e1. [DOI: 10.1016/j.jand.2015.06.380] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 06/24/2015] [Indexed: 10/23/2022]
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Adult BMI change and risk of Breast Cancer: National Health and Nutrition Examination Survey (NHANES) 2005-2010. Breast Cancer 2015; 22:648-56. [PMID: 26350490 DOI: 10.1007/s12282-015-0638-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 08/28/2015] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Breast cancer is the second leading cause of cancer mortality among women in the developed world. This study assessed the association between occurrence of breast cancer and body mass index (BMI) change from age 25 to age closest to breast cancer diagnosis while exploring the modifying effects of demographic variables. METHODS The National Health and Nutrition Examination Survey data were used. Women included were ≥50 years, not pregnant and without a diagnosis of any cancer but breast. The total sample included 2895 women (172 with breast cancer and 2723 controls with no breast cancer diagnosis). Multivariate logistic regression was used to estimate the OR and 95 % CIs and interaction evaluated by including an interaction term in the model. RESULTS Women whose BMI increased from normal or overweight to obese compared to those who remained at a normal BMI were found to have a 2 times higher odds (OR = 2.1; 95 % CI 1.11-3.79) of developing breast cancer. No significant association was observed for women who increased to overweight. However, a more pronounced association was observed in non-Hispanic black women (OR = 6.6; 95 % CI 1.68-25.86) and a significant association observed when they increased from normal to overweight (OR = 4.2; 95 % CI 1.02-17.75). CONCLUSIONS Becoming obese after age 25 is associated with increased risk of breast cancer in women over 50 years old, with non-Hispanic black women being at greatest risk.
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Allman-Farinelli MA. Nutrition Promotion to Prevent Obesity in Young Adults. Healthcare (Basel) 2015; 3:809-21. [PMID: 27417798 PMCID: PMC4939558 DOI: 10.3390/healthcare3030809] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2015] [Revised: 08/24/2015] [Accepted: 08/31/2015] [Indexed: 11/24/2022] Open
Abstract
Young adulthood is a vulnerable period for weight gain and the health consequences of becoming obese during this life-stage of serious concern. Some unhealthy dietary habits are typical of young adults in many developed nations encountering the obesity epidemic. These include high sugar-sweetened beverage consumption, lower vegetable intake and greater consumption of foods prepared outside the home including fast foods. Each of these dietary behaviours may place young adults at increased risk for overweight and obesity. Evidence suggests many young adults with unhealthy nutrition behaviours are not considering nor preparing to make changes. To improve their nutrition and health as they progress through the lifecycle requires approaches specifically targeted to this age group. Strategies and programs should include both individual level and population approaches. The evidence base for prevention of weight gain and halting overweight and obesity in young adulthood is currently small with few studies of high quality. Studies modifying food environments in colleges and universities are also of limited quality, but sufficiently promising to conduct further research employing better, more sophisticated, study designs and additionally to include health outcome measures. More research into programs tailored to the needs of young adults is warranted with several studies already underway.
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Freeman B, Kelly B, Vandevijvere S, Baur L. Young adults: beloved by food and drink marketers and forgotten by public health? Health Promot Int 2015; 31:954-961. [PMID: 26276799 DOI: 10.1093/heapro/dav081] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Young adults are a highly desirable target population for energy-dense, nutrient-poor (EDNP) food and beverage marketing. But little research, resources, advocacy and policy action have been directed at this age group, despite the fact that young adults are gaining weight faster than previous generations and other population groups. Factors such as identity development and shifting interpersonal influences differentiate young adulthood from other life stages and influence the adoption of both healthy and unhealthy eating behaviours. EDNP food and beverage marketing campaigns use techniques to normalize brands within young adult culture, in particular through online social media. Young adults must be a priority population in future obesity prevention efforts. Stronger policies to protect young adults from EDNP food and beverage marketing may also increase the effectiveness of policies that are meant to protect younger children. Restrictions on EDNP food and beverage marketing should be extended to include Internet-based advertising and also aim to protect vulnerable young adults.
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Affiliation(s)
- Becky Freeman
- Prevention Research Collaboration, School of Public Health, University of Sydney, Sydney, NSW 2006, Australia
| | - Bridget Kelly
- Early Start Research Institute, School of Health and Society, University of Wollongong, Wollongong, Australia
| | - Stefanie Vandevijvere
- Department of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Louise Baur
- Prevention Research Collaboration, School of Public Health, University of Sydney, Sydney, NSW 2006, Australia.,Discipline of Paediatrics & Child Health, University of Sydney, Sydney, Australia
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82
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Partridge SR, McGeechan K, Hebden L, Balestracci K, Wong AT, Denney-Wilson E, Harris MF, Phongsavan P, Bauman A, Allman-Farinelli M. Effectiveness of a mHealth Lifestyle Program With Telephone Support (TXT2BFiT) to Prevent Unhealthy Weight Gain in Young Adults: Randomized Controlled Trial. JMIR Mhealth Uhealth 2015; 3:e66. [PMID: 26076688 PMCID: PMC4526939 DOI: 10.2196/mhealth.4530] [Citation(s) in RCA: 99] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 05/24/2015] [Indexed: 12/16/2022] Open
Abstract
Background Weight gained in young adulthood often persists throughout later life with associated chronic disease risk. Despite this, current population prevention strategies are not specifically designed for young adults. Objective We designed and assessed the efficacy of an mHealth prevention program, TXT2BFiT, in preventing excess weight gain and improving dietary and physical activity behaviors in young adults at increased risk of obesity and unhealthy lifestyle choices. Methods A two-arm, parallel-group randomized controlled trial was conducted. Subjects and analyzing researchers were blinded. A total of 250 18- to 35-year-olds with a high risk of weight gain, a body mass index (BMI) of 23.0 to 24.9 kg/m2 with at least 2 kg of weight gain in the previous 12 months, or a BMI of 25.0 to 31.9 kg/m2 were randomized to the intervention or control group. In the 12-week intervention period, the intervention group received 8 text messages weekly based on the transtheoretical model of behavior change, 1 email weekly, 5 personalized coaching calls, a diet booklet, and access to resources and mobile phone apps on a website. Control group participants received only 4 text messages and printed dietary and physical activity guidelines. Measured body weight and height were collected at baseline and at 12 weeks. Outcomes were assessed via online surveys at baseline and at 12 weeks, including self-reported weight and dietary and physical activity measures. Results A total of 214 participants—110 intervention and 104 control—completed the 12-week intervention period. A total of 10 participants out of 250 (4.0%)—10 intervention and 0 control—dropped out, and 26 participants (10.4%)—5 intervention and 21 control—did not complete postintervention online surveys. Adherence to coaching calls and delivery of text messages was over 90%. At 12 weeks, the intervention group were 2.2 kg (95% CI 0.8-3.6) lighter than controls (P=.005). Intervention participants consumed more vegetables (P=.009), fewer sugary soft drinks (P=.002), and fewer energy-dense takeout meals (P=.001) compared to controls. They also increased their total physical activity by 252.5 MET-minutes (95% CI 1.2-503.8, P=.05) and total physical activity by 1.3 days (95% CI 0.5-2.2, P=.003) compared to controls. Conclusions The TXT2BFiT low-intensity intervention was successful in preventing weight gain with modest weight loss and improvement in lifestyle behaviors among overweight young adults. The short-term success of the 12-week intervention period shows potential. Maintenance of the behavior change will be monitored at 9 months. Trial Registration Trial Registration: The Australian New Zealand Clinical Trials Registry ACTRN12612000924853; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12612000924853 (Archived by WebCite at http://www.webcitation.org/6Z6w9LlS9).
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Affiliation(s)
- Stephanie R Partridge
- School of Molecular Bioscience, Charles Perkins Centre, University of Sydney, Sydney, Australia
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83
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Efectos de la edad, el periodo de defunción y la cohorte de nacimiento en la mortalidad por enfermedad isquémica del corazón en el sur de España. Rev Esp Cardiol 2015. [DOI: 10.1016/j.recesp.2014.07.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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84
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Taylor AW, Shi Z, Montgomerie A, Dal Grande E, Campostrini S. The use of a chronic disease and risk factor surveillance system to determine the age, period and cohort effects on the prevalence of obesity and diabetes in South Australian adults--2003-2013. PLoS One 2015; 10:e0125233. [PMID: 25923664 PMCID: PMC4414468 DOI: 10.1371/journal.pone.0125233] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 03/23/2015] [Indexed: 11/18/2022] Open
Abstract
Background Age, period and cohort (APC) analyses, using representative, population-based descriptive data, provide additional understanding behind increased prevalence rates. Methods Data on obesity and diabetes from the South Australian (SA) monthly chronic disease and risk factor surveillance system from July 2002 to December 2013 (n = 59,025) were used. Age was the self-reported age of the respondent at the time of the interview. Period was the year of the interview and cohort was age subtracted from the survey year. Cohort years were 1905 to 1995. All variables were treated as continuous. The age-sex standardised prevalence for obesity and diabetes was calculated using the Australia 2011 census. The APC models were constructed with ‘‘apcfit’’ in Stata. Results The age-sex standardised prevalence of obesity and diabetes increased in 2002-2013 from 18.6% to 24.1% and from 6.2% to 7.9%. The peak age for obesity was approximately 70 years with a steady increasing rate from 20 to 70 years of age. The peak age for diabetes was approximately 80 years. There were strong cohort effects and no period effects for both obesity and diabetes. The magnitude of the cohort effect is much more pronounced for obesity than for diabetes. Conclusion The APC analyses showed a higher than expected peak age for both obesity and diabetes, strong cohort effects with an acceleration of risk after 1960s for obesity and after 1940s for diabetes, and no period effects. By simultaneously considering the effects of age, period and cohort we have provided additional evidence for effective public health interventions.
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Affiliation(s)
- Anne W. Taylor
- Population Research & Outcome Studies, Discipline of Medicine, The University of Adelaide, South Australia, Australia
- Ca’ Foscari University, Venice, Italy
- * E-mail:
| | - Zumin Shi
- Population Research & Outcome Studies, Discipline of Medicine, The University of Adelaide, South Australia, Australia
| | - Alicia Montgomerie
- Population Research & Outcome Studies, Discipline of Medicine, The University of Adelaide, South Australia, Australia
| | - Eleonora Dal Grande
- Population Research & Outcome Studies, Discipline of Medicine, The University of Adelaide, South Australia, Australia
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85
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Hebden L, Chan HN, Louie JC, Rangan A, Allman-Farinelli M. You are what you choose to eat: factors influencing young adults' food selection behaviour. J Hum Nutr Diet 2015; 28:401-8. [DOI: 10.1111/jhn.12312] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- L. Hebden
- School of Molecular Bioscience; Faculty of Science; The University of Sydney; Sydney NSW Australia
| | - H. N. Chan
- School of Molecular Bioscience; Faculty of Science; The University of Sydney; Sydney NSW Australia
| | - J. C. Louie
- School of Molecular Bioscience; Faculty of Science; The University of Sydney; Sydney NSW Australia
| | - A. Rangan
- School of Molecular Bioscience; Faculty of Science; The University of Sydney; Sydney NSW Australia
| | - M. Allman-Farinelli
- School of Molecular Bioscience; Faculty of Science; The University of Sydney; Sydney NSW Australia
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86
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Melesse DY, Halli SS, Tate RB. Variations over four decades in body mass index trajectories prior to diagnosis of diabetes mellitus: The Manitoba Follow-up Study, 1948-2007. Canadian Journal of Public Health 2015; 106:e95-100. [PMID: 26125248 DOI: 10.17269/cjph.106.4641] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Revised: 03/19/2015] [Accepted: 01/11/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The aim of the study was to explore the variations in body mass index (BMI) trajectories during the 20 years before diagnosis of type 2 diabetes mellitus (T2DM) over four decades between 1968 and 2007. METHODS Longitudinal measurements of BMI from 437 men, all with a diagnosis of T2DM, were used in the analysis. A mixed method approach was used to fit individual patterns of BMI measurements during the 20 years before diagnosis of T2DM. RESULTS The mean BMI at diagnosis was 26.7 kg/m2 (95% confidence interval, 26.4-27.1). Compared with men whose condition was diagnosed between 1968 and 1977, for men with a diagnosis between 1978 and 2007 the mean BMI about 10 years before diagnosis significantly increased by 0.92 to 1.54 BMI units. Decades also varied in how long there was a persistent increase in BMI during the 20 years before diagnosis. The rate of change in mean BMI among men whose T2DM was diagnosed in the most recent two decades increased by 8.8% to 22.6% during the 10-year interval before diagnosis, but there was no significant difference among men given a diagnosis between 1978 and 1987. The quadratic trend of BMI prior to diagnosis was also significantly affected by age at diagnosis. CONCLUSION The BMI trajectories during the 20 years leading up to T2DM varied by decade of diagnosis. The increase in BMI persisted for much longer among relatively younger men with a diagnosis in more recent decades. Strategies to prevent T2DM, informed by the pattern of BMI trajectories, should be customized to consider a potential age-period effect.
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Affiliation(s)
- Dessalegn Y Melesse
- The Centre for Global Public Health, Department of Community Health Sciences, University of Manitoba.
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87
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Partridge SR, Juan SJH, McGeechan K, Bauman A, Allman-Farinelli M. Poor quality of external validity reporting limits generalizability of overweight and/or obesity lifestyle prevention interventions in young adults: a systematic review. Obes Rev 2015; 16:13-31. [PMID: 25407633 DOI: 10.1111/obr.12233] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 09/09/2014] [Accepted: 09/29/2014] [Indexed: 12/22/2022]
Abstract
Young adulthood is a high-risk life stage for weight gain. Evidence is needed to translate behavioural approaches into community practice to prevent weight gain in young adults. This systematic review assessed the effectiveness and reporting of external validity components in prevention interventions. The search was limited to randomized controlled trial (RCT) lifestyle interventions for the prevention of weight gain in young adults (18-35 years). Mean body weight and/or body mass index (BMI) change were the primary outcomes. External validity, quality assessment and risk of bias tools were applied to all studies. Twenty-one RCTs were identified through 14 major electronic databases. Over half of the studies were effective in the short term for significantly reducing body weight and/or BMI; however, few showed long-term maintenance. All studies lacked full reporting on external validity components. Description of the intervention components and participant attrition rates were reported by most studies. However, few studies reported the representativeness of participants, effectiveness of recruitment methods, process evaluation detail or costs. It is unclear from the information reported how to implement the interventions into community practice. Integrated reporting of intervention effectiveness and enhanced reporting of external validity components are needed for the translation and potential upscale of prevention strategies.
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Affiliation(s)
- S R Partridge
- Discipline of Nutrition and Metabolism, School of Molecular Bioscience, University of Sydney, Sydney, New South Wales, Australia
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88
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Ocaña-Riola R, Mayoral-Cortés JM, Fernández-Ajuria A, Sánchez-Cantalejo C, Martín-Olmedo P, Blanco-Reina E. Age, Period, and Cohort Effects on Mortality From Ischemic Heart Disease in Southern Spain. ACTA ACUST UNITED AC 2014; 68:373-81. [PMID: 25482342 DOI: 10.1016/j.rec.2014.07.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Accepted: 07/11/2014] [Indexed: 10/24/2022]
Abstract
INTRODUCTION AND OBJECTIVES Ischemic heart disease is the leading cause of death and one of the top 4 causes of burden of disease worldwide. The aim of this study was to evaluate age-period-cohort effects on mortality from ischemic heart disease in Andalusia (southern Spain) and in each of its 8 provinces during the period 1981-2008. METHODS A population-based ecological study was conducted. In all, 145 539 deaths from ischemic heart disease were analyzed for individuals aged between 30 and 84 years who died in Andalusia in the study period. A nonlinear regression model was estimated for each sex and geographical area using spline functions. RESULTS There was an upward trend in male and female mortality rate by age from the age of 30 years. The risk of death for men and women showed a downward trend for cohorts born after 1920, decreasing after 1960 with a steep slope among men. Analysis of the period effect showed that male and female death risk first remained steady from 1981 to 1990 and then increased between 1990 and 2000, only to decrease again until 2008. CONCLUSIONS There were similar age-period-cohort effects on mortality in all the provinces of Andalusia and for Andalusia as a whole. If the observed cohort and period effects persist, male and female mortality from ischemic heart disease will continue to decline.
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Affiliation(s)
- Ricardo Ocaña-Riola
- Escuela Andaluza de Salud Pública, Granada, Spain; Instituto de Investigación Biosanitaria de Granada, Granada, Spain.
| | - José María Mayoral-Cortés
- Servicio de Epidemiología y Salud Laboral, Consejería de Salud de la Junta de Andalucía, Seville, Spain
| | - Alberto Fernández-Ajuria
- Escuela Andaluza de Salud Pública, Granada, Spain; Instituto de Investigación Biosanitaria de Granada, Granada, Spain
| | - Carmen Sánchez-Cantalejo
- Escuela Andaluza de Salud Pública, Granada, Spain; Instituto de Investigación Biosanitaria de Granada, Granada, Spain
| | - Piedad Martín-Olmedo
- Escuela Andaluza de Salud Pública, Granada, Spain; Instituto de Investigación Biosanitaria de Granada, Granada, Spain
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89
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Freeman B, Kelly B, Baur L, Chapman K, Chapman S, Gill T, King L. Digital junk: food and beverage marketing on Facebook. Am J Public Health 2014; 104:e56-64. [PMID: 25322294 DOI: 10.2105/ajph.2014.302167] [Citation(s) in RCA: 108] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES We assessed the amount, reach, and nature of energy-dense, nutrient-poor (EDNP) food and beverage marketing on Facebook. METHODS We conducted a content analysis of the marketing techniques used by the 27 most popular food and beverage brand Facebook pages in Australia. We coded content across 19 marketing categories; data were collected from the day each page launched (mean = 3.65 years of activity per page). RESULTS We analyzed 13 international pages and 14 Australian-based brand pages; 4 brands (Subway, Coca-Cola, Slurpee, Maltesers) had both national and international pages. Pages widely used marketing features unique to social media that increase consumer interaction and engagement. Common techniques were competitions based on user-generated content, interactive games, and apps. Four pages included apps that allowed followers to place an order directly through Facebook. Adolescent and young adult Facebook users appeared most receptive to engaging with this content. CONCLUSIONS By using the interactive and social aspects of Facebook to market products, EDNP food brands capitalize on users' social networks and magnify the reach and personal relevance of their marketing messages.
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Affiliation(s)
- Becky Freeman
- Becky Freeman, Simon Chapman, and Lesley King are with the School of Public Health, University of Sydney, New South Wales, Australia. Bridget Kelly is with the School of Health and Society, University of Wollongong, New South Wales. Louise Baur is with the Discipline of Paediatrics and Child Health, University of Sydney, New South Wales. Kathy Chapman is with Health Strategies, Cancer Council New South Wales, Woolloomooloo, Australia. Tim Gill is with the Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, University of Sydney, New South Wales
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90
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Peeters A, Gearon E, Backholer K, Carstensen B. Trends in the skewness of the body mass index distribution among urban Australian adults, 1980 to 2007. Ann Epidemiol 2014; 25:26-33. [PMID: 25453350 DOI: 10.1016/j.annepidem.2014.10.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Revised: 10/06/2014] [Accepted: 10/10/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE We analyzed the changes in the body mass index (BMI) distribution for urban Australian adults between 1980 and 2007. METHODS We used data from participants of six consecutive Australian nation-wide surveys with measured weight and height between 1980 and 2007. We used quantile regression to estimate mean BMI (for percentiles of BMI) and prevalence of severe obesity, modeled by natural splines in age, date of birth, and survey date. RESULTS Since 1980, the right skew in the BMI distribution for Australian adults has increased greatly for men and women, driven by increases in skew associated with age and birth cohort/period. Between 1980 and 2007, the average 5-year increase in BMI was 1 kg/m(2) (0.8) for the 95th percentile of BMI in women (men). The increase in the median was about a third of this, and for the 10th percentile, a fifth of this. We estimated that for the cohort born in 1960 around 31% of men and women were obese by age 50 years compared with 11% of the 1930 birth cohort. CONCLUSIONS There have been large increases in the right skew of the BMI distribution for urban Australian adults between 1980 and 2007, and birth cohort effects suggests similar increases are likely to continue.
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Affiliation(s)
- Anna Peeters
- Obesity and Population Health, Baker IDI Heart and Diabetes Institute, Melbourne, Australia.
| | - Emma Gearon
- Obesity and Population Health, Baker IDI Heart and Diabetes Institute, Melbourne, Australia
| | - Kathryn Backholer
- Obesity and Population Health, Baker IDI Heart and Diabetes Institute, Melbourne, Australia
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91
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Dixon J, Carey G, Strazdins L, Banwell C, Woodman D, Burgess J, Bittman M, Venn D, Sargent G. Contemporary contestations over working time: time for health to weigh in. BMC Public Health 2014; 14:1068. [PMID: 25308889 PMCID: PMC4209053 DOI: 10.1186/1471-2458-14-1068] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 10/02/2014] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Non-communicable disease (NCD) incidence and prevalence is of central concern to most nations, along with international agencies such as the UN, OECD, IMF and World Bank. As a result, the search has begun for 'causes of the cause' behind health risks and behaviours responsible for the major NCDs. As part of this effort, researchers are turning their attention to charting the temporal nature of societal changes that might be associated with the rapid rise in NCDs. From this, the experience of time and its allocation are increasingly understood to be key individual and societal resources for health. The interdisciplinary study outlined in this paper will produce a systematic analysis of the behavioural health dimensions, or 'health time economies' (quantity and quality of time necessary for the practice of health behaviours), that have accompanied labour market transitions of the last 30 years--the period in which so many NCDs have risen sharply. METHODS/DESIGN The study takes a mixed-methods approach to capture and explain the relationships between work time and health behaviours. It combines: longitudinal analysis of temporal organisation of work in Australia, with the goal of establishing associations between labour timescapes and health behaviours and health time economies; an in-depth qualitative investigation of employee experiences of the perceived impact of their labour timescapes on 'health time economies'; and, a stakeholder analysis, will uncover whether, how and why (or why not) stakeholders consider health an important dimension- of work and industrial relations policy, and what efforts are being made to mitigate health impacts of work. DISCUSSION The study posits that time is a key mechanism through which particular forms of labour market policies impact health. The labour market flexibility agenda appears to be operating as a time re-distributive device: it has supported the removal of regulations that governed 'the when' of working time and removed limits over the amount of working time, thus extending by many hours the notion of the 'standard' working week and forcing employees to adapt their shared or social times as well as their time for health.
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Affiliation(s)
- Jane Dixon
- />National Centre for Epidemiology & Population Health, Australian National University, Canberra, Australia
| | - Gemma Carey
- />National Centre for Epidemiology & Population Health, Australian National University, Canberra, Australia
| | - Lyndall Strazdins
- />National Centre for Epidemiology & Population Health, Australian National University, Canberra, Australia
| | - Cathy Banwell
- />National Centre for Epidemiology & Population Health, Australian National University, Canberra, Australia
| | - Dan Woodman
- />Department of Sociology, University of Melbourne, Melbourne, Australia
| | - John Burgess
- />Curtin Business School, Curtin University, Perth, Australia
| | - Michael Bittman
- />School of Behavioural, Cognitive and Social Sciences, University of New England, Armidale, Australia
| | - Danielle Venn
- />National Centre for Epidemiology & Population Health, Australian National University, Canberra, Australia
| | - Ginny Sargent
- />National Centre for Epidemiology & Population Health, Australian National University, Canberra, Australia
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Lo E, Hamel D, Jen Y, Lamontagne P, Martel S, Steensma C, Blouin C, Steele R. Projection scenarios of body mass index (2013-2030) for Public Health Planning in Quebec. BMC Public Health 2014; 14:996. [PMID: 25253196 PMCID: PMC4196088 DOI: 10.1186/1471-2458-14-996] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Accepted: 09/16/2014] [Indexed: 01/22/2023] Open
Abstract
Background Projection analyses can provide estimates of the future health burden of increasing BMI and represent a relevant and useful tool for public health planning. Our study presents long-term (2013–2030) projections of the prevalence and numbers of individuals by BMI category for adult men and women in Quebec. Three applications of projections to estimate outcomes more directly pertinent to public health planning, as well as an in-depth discussion of limits, are provided with the aim of encouraging greater use of projection analyses by public health officers. Methods The weighted compositional regression method is applied to prevalence time series derived from sixteen cross-sectional survey cycles, for scenarios of linear change and deceleration. Estimation of the component of projected change potentially amenable to intervention, future health targets and the projected impact on type 2 diabetes, were done. Results Obesity prevalence in Quebec is projected to rise steadily from 2013 to 2030 in both men (from 18.0-19.4% to 22.2-30.4%) and women (from 15.5-16.3% to 18.2-22.4%). Corresponding projected numbers of obese individuals are (579,000-625,000 to 790,000-1,084,000) in men and (514,000-543,000 to 661,000-816,000) in women. These projected increases are found to be primarily an ‘epidemiologic’ rather than ‘demographic’ phenomenon and thus potentially amenable to public health intervention. Assessment of obesity targets for 2020 illustrates the necessity of using projected rather than current prevalence; for example a targeted 2% drop in obesity prevalence relative to 2013 translates into a 3.6-5.4% drop relative to 2020 projected levels. Type 2 diabetes is projected to increase from 6.9% to 9.2-10.1% in men and from 5.7% to 7.1-7.5% in women, from 2011–2012 to 2030. A substantial proportion of this change (25-44% for men, and 27-43% for women) is attributable to the changing BMI distribution. Conclusions Obesity in Quebec is projected to increase and should therefore continue to be a public health priority. Application of projections to estimate the proportion of change potentially amenable to intervention, feasible health targets, and future chronic disease prevalence are demonstrated. Projection analyses have limitations, but represent a pertinent tool for public health planning. Electronic supplementary material The online version of this article (doi:10.1186/1471-2458-14-996) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ernest Lo
- Institut National de Santé Publique du Québec, 190 blvd Crémazie Est, Montréal, Québec H2P 1E2, Canada.
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Ocaña-Riola R, Blanco-Reina E, Navarro-Moreno E, Mayoral-Cortés JM. Age-period-cohort effects on mortality from cerebrovascular disease in southern Spain. J Stroke Cerebrovasc Dis 2014; 23:2274-82. [PMID: 25081310 DOI: 10.1016/j.jstrokecerebrovasdis.2014.04.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Revised: 03/31/2014] [Accepted: 04/04/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The aim of this article is to evaluate the age-period-cohort effects on mortality from cerebrovascular disease in Andalusia (southern Spain) as a whole and in each of its 8 provinces during the period 1981-2008. METHODS A population-based ecologic study was conducted. In all, 145,867 deaths were analyzed for individuals between the ages of 15 and 84 years who died in Andalusia in the period of study. A nonlinear regression model was estimated for each gender group and geographic area. The effects of age, year of death, and birth cohort were parameterized using spline smoothing functions. RESULTS There is an upward trend in mortality from the age of 25 years. The risk of death was downward for cohorts born after 1896, decreasing after 1970 with steep slope. The analysis of the period effect showed that death rate first declined from 1981 to 1995 and then increased between 1995 and 2000, only to decrease again until 2008. CONCLUSIONS There is a similar age-period-cohort effect on male and female mortality from cerebrovascular disease in all the provinces of Andalusia and for Andalusia as a whole. A significant reduction of male and female mortality has been observed during the last decade.
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Affiliation(s)
- Ricardo Ocaña-Riola
- Escuela Andaluza de Salud Pública, Granada, Spain; Instituto de Investigación Biosanitaria de Granada, Granada, Spain.
| | | | | | - José María Mayoral-Cortés
- Servicio de Epidemiología y Salud Laboral, Consejería de Salud de la Junta de Andalucía, Sevilla, Spain
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Krueger PM, Coleman-Minahan K, Rooks RN. Race/ethnicity, nativity and trends in BMI among U.S. adults. Obesity (Silver Spring) 2014; 22:1739-46. [PMID: 24634406 PMCID: PMC4545289 DOI: 10.1002/oby.20744] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Revised: 02/25/2014] [Accepted: 03/11/2014] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The average BMI is rising even as the U.S. population grows increasingly diverse. Prior research by examining BMI trends in diverse groups including whites, blacks, Chinese, Filipinos, Asian Indians, Mexicans, Puerto Ricans, and Cubans who are U.S. born, recent immigrants, or long-term immigrants was extended. METHODS Cross-sectional data from the 1989 to 2011 waves of the National Health Interview Survey (N = 989,273) have been pooled and linear regression models to examine trends in BMI among U.S. adults have been used. RESULTS Annual increases in BMI are greatest among U.S.-born Puerto Ricans and Mexicans and slowest among foreign born Chinese. Among the U.S. born in 2011, Chinese adults have an average BMI below the threshold for overweight, whereas blacks, Mexicans, and Puerto Ricans have average BMIs in the obese range. Foreign-born adults average lower BMIs than U.S. born adults in most race/ethnic groups, and nativity disparities generally widen over time. BMI increases across calendar periods rather than birth cohorts. CONCLUSION Our results suggest that calendar period interventions may be particularly useful in reversing rising BMIs in the United States. However, interventions must be tailored to different race/ethnic and nativity groups in order to reduce disparities in body mass.
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Affiliation(s)
- Patrick M Krueger
- Department of Health & Behavioral Sciences, University of Colorado Denver, Denver, CO, USA
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95
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Badimon L, Hernández Vera R, Vilahur G. Atherothrombotic risk in obesity. Hamostaseologie 2014; 33:259-68. [PMID: 24190286 DOI: 10.5482/hamo-13-07-0034] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Accepted: 09/02/2013] [Indexed: 12/28/2022] Open
Abstract
A link between obesity and coronary artery disease development has been repeatedly proposed, possibly in part due to the development of a proinflammatory and prothrombotic state in obese subjects. Adipocytes secrete numerous hormones and cytokines (adipokines) which influence gene expression and cell functions in endothelial cells, arterial smooth muscle cells, and monocytes/macrophages favouring the development of an atherosclerotic vulnerable plaque. Moreover, the release of such biologically active molecules also promotes endothelial function impairment, disturbs the haemostatic and fibrinolytic systems, and produces alterations in platelet function affecting the initiation, progression, and stabilization of thrombus formation upon atherosclerotic plaque rupture. In this review we will discuss the pathophysiological mechanisms by which obesity contributes to increase atherothrombosis paying special attention to its effects over thrombosis.
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Affiliation(s)
- L Badimon
- Prof. Lina Badimon, Cardiovascular Research Center, C/ Sant Antoni Mª Claret 167, 08025 Barcelona, Spain, Tel. +34/93/556 58 80; Fax +34/93/556 55 59, E-mail:
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96
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Are Baby Boomers healthier than Generation X? A profile of Australia's working generations using National Health Survey data. PLoS One 2014; 9:e93087. [PMID: 24671114 PMCID: PMC3966866 DOI: 10.1371/journal.pone.0093087] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Accepted: 03/02/2014] [Indexed: 11/19/2022] Open
Abstract
Background To determine differences in sociodemographic and health related characteristics of Australian Baby Boomers and Generation X at the same relative age. Methods The 1989/90 National Health Survey (NHS) for Boomers (1946–1965) and the 2007/08 NHS for Generation Xers (1966–1980) was used to compare the cohorts at the same age of 25–44 years. Generational differences for males and females in education, employment, smoking, physical activity, Body Mass Index (BMI), self-rated health, and diabetes were determined using Z tests. Prevalence estimates and p-values are reported. Logistic regression models examining overweight/obesity (BMI≥25) and diabetes prevalence as the dependent variables, with generation as the independent variable were adjusted for sex, age, education, physical activity, smoking and BMI(diabetes model only). Adjusted odds ratios (OR) and 95% confidence intervals are reported. Results At the same age, tertiary educational attainment was higher among Generation X males (27.6% vs. 15.2% p<0.001) and females (30.0% vs. 10.6% p<0.001). Boomer females had a higher rate of unemployment (5.6% vs. 2.5% p<0.001). Boomer males and females had a higher prevalence of “excellent” self-reported health (35.9% vs. 21.8% p<0.001; 36.3% vs. 25.1% p<0.001) and smoking (36.3% vs. 30.4% p<0.001; 28.3% vs. 22.3% p<0.001). Generation X males (18.3% vs. 9.4% p<0.001) and females (12.7% vs. 10.4% p = 0.015) demonstrated a higher prevalence of obesity (BMI>30). There were no differences in physical activity. Modelling indicated that Generation X were more likely than Boomers to be overweight/obese (OR:2.09, 1.77–2.46) and have diabetes (OR:1.79, 1.47–2.18). Conclusion Self-rated health has deteriorated while obesity and diabetes prevalence has increased. This may impact workforce participation and health care utilization in the future.
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97
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Mendis K, Forster T, Paxton K, Hyland K, Yelverton J, McLean R, Canalese J, Brown A, Steinbeck K. Large and forgotten in rural Australia: assessment, attitudes and possible approaches to losing weight in young adult males. BMC Public Health 2014; 14:243. [PMID: 24612872 PMCID: PMC4008138 DOI: 10.1186/1471-2458-14-243] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Accepted: 02/28/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Young Adult Males (YAMs) in rural Australia are poorly studied with respect to overweight and obesity. Firstly, we explored the feasibility of recruiting 17-25 year old YAMs to obtain baseline data on overweight and obesity rates, socio-demographics, nutrition, exercise and mobile phone usage. Secondly, we explored the views of YAMs with a waist measurement over 94 cm about using mobile phone text messages to promote weight loss and incentives to promote healthy lifestyles. METHODS A two-staged, mixed-methods approach was used to study obesity and overweight issues in Dubbo, a regional city in New South Wales, Australia. In Phase I, socio-demographic, health behaviour and mobile phone usage data were collected using a questionnaire and anthropometric data collected by direct measurement. In Phase II, YAMs' views were explored by focus group discussion using a semi-structured questionnaire. RESULTS Phase I (145 participants): mean Body Mass Index (BMI) 25.06±5.01; mean waist circumference 87.4±15.4 cm. In total, 39.3% were obese (12.4%) or overweight (26.9%) and 24.1% had an increased risk of metabolic complications associated with obesity. 135 (93.1%) owned a mobile phone and sent on average 17±25 text messages per day and received 18±24. Phase II (30 participants): YAMs acknowledged that overweight and obesity was a growing societal concern with many health related implications, but didn't feel this was something that affected them personally at this stage of their lives. Motivation was therefore an issue. YAMs admitted that they would only be concerned about losing weight if something drastic occurred in their lives. Text messages would encourage and motivate them to adopt a healthy lifestyle if they were individually tailored. Gym memberships, not cash payments, seem to be the most favoured incentive. CONCLUSION There is a clear need for an effective health promotion strategy for the almost 40% overweight or obese Dubbo YAMs. The high rate of text message usage makes it feasible to recruit YAMs for a prospective study in which personalized text messages are used to promote healthy behaviours. It may be important to target motivation specifically in any weight-related intervention in this group with incentives such as gym membership vouchers.
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Affiliation(s)
- Kumara Mendis
- School of Rural Health, University of Sydney, Dubbo, Australia
- Bathurst Rural Clinical School, School of Medicine, University of Western Sydney, Bathurst, Australia
| | - Tanya Forster
- School of Rural Health, University of Sydney, Dubbo, Australia
| | - Karen Paxton
- School of Rural Health, University of Sydney, Dubbo, Australia
| | - Karen Hyland
- School of Rural Health, University of Sydney, Dubbo, Australia
| | | | - Rick McLean
- School of Rural Health, University of Sydney, Dubbo, Australia
| | - Joseph Canalese
- School of Rural Health, University of Sydney, Dubbo, Australia
| | - Anthony Brown
- School of Rural Health, University of Sydney, Dubbo, Australia
| | - Katharine Steinbeck
- Sydney Medical School, University of Sydney, Sydney, Australia
- Discipline of Paediatrics & Child Health, Children’s Hospital, Westmead, Australia
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98
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Siopis G, Chey T, Allman-Farinelli M. A systematic review and meta-analysis of interventions for weight management using text messaging. J Hum Nutr Diet 2014; 28 Suppl 2:1-15. [PMID: 24480032 DOI: 10.1111/jhn.12207] [Citation(s) in RCA: 121] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Obesity prevalence continues to increase worldwide, with significant associated chronic disease and health cost implications. Among more recent innovations in health service provision is the use of text messaging for health behaviour change interventions including weight management. This review investigates the efficacy of weight management programmes incorporating text messaging. METHODS Medical and scientific databases were searched from January 1993 to October 2013. Eligibility criteria included randomised controlled trials (RCTs), pseudoRCTs and before and after studies of weight management, among healthy children and adults, that used text messaging and included a nutrition component. Data extraction and quality assessment followed guidelines from PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) and the Evidence Analysis Manual of the American Academy of Nutrition and Dietetics. RESULTS From 512 manuscripts retrieved, 14 met the inclusion criteria (five manuscripts in children and nine in adults). Duration of interventions ranged from 1 to 24 months. Frequency of text messaging was from daily to fortnightly. Six studies in adults were included in a meta-analysis with mean body weight change as the primary outcome. The weighted mean change in body weight in intervention participants was -2.56 kg (95% confidence interval = -3.46 to -1.65) and in controls -0.37 kg (95% confidence interval = -1.22 to 0.48). CONCLUSIONS The small body of evidence indicates that text messaging interventions can promote weight loss. However, lack of long-term results indicate that further efficacy studies are required. Future investigations should elucidate the determinants, such as intervention duration, text message frequency and level of interactivity that maximise the success and cost effectiveness of the delivery medium.
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Affiliation(s)
- G Siopis
- School of Molecular Bioscience, The University of Sydney, Sydney, NSW, Australia
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Predictors of change in weight and waist circumference: 15-year longitudinal study in Australian adults. Eur J Clin Nutr 2014; 68:309-15. [PMID: 24398635 DOI: 10.1038/ejcn.2013.260] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Revised: 10/17/2013] [Accepted: 10/18/2013] [Indexed: 11/08/2022]
Abstract
BACKGROUND/OBJECTIVES This study examines which socio-demographic and lifestyle characteristics are associated with weight and waist circumference (WC) change in a cohort of Australian adults over a 15-year period (1992-2007). Further, it tests the effect of period of birth (birth cohort) on mean weight and WC at two time points, 15 years apart. SUBJECTS/METHODS Up to three repeated measures of weight (n=1437) and WC (n=1317) were used. Self-reported data on socio-demographic and lifestyle characteristics were derived from repeated questionnaires. Multivariable models, stratified by sex, were adjusted for potential confounders. RESULTS Participants born more recently were heavier, on average, than those in the same age group 15 years earlier, but there was no such secular trend in WC. Age at baseline was associated with change in weight and WC, but the pattern was different: participants gained weight up to age 55 years, while WC gain continued to 65 years. In women, higher level of recreational physical activity was associated with lower WC gain (P<0.05). Parity was also associated with WC change in women (P<0.05), but there was no linear trend. CONCLUSIONS Age was the most important factor associated with change in weight and WC in both sexes, apparently reducing the influence of all potential covariates. Among women, physical activity and parity were also associated with change in weight and WC. This study provides longitudinal evidence to support public health efforts that address the continuous increases in average weight and WC of many populations around the world.
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100
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Don't birth cohorts matter? A commentary and simulation exercise on Reither, Hauser, and Yang's (2009) age–period–cohort study of obesity. Soc Sci Med 2014; 101:176-80. [DOI: 10.1016/j.socscimed.2013.09.004] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Accepted: 09/04/2013] [Indexed: 11/21/2022]
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