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Chen P, Jiao J, Xu M, Gao X, Bischak C. Promoting active student travel: A longitudinal study. JOURNAL OF TRANSPORT GEOGRAPHY 2018; 70:265-274. [PMID: 38283393 PMCID: PMC10817717 DOI: 10.1016/j.jtrangeo.2018.06.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
This study investigates the effects of sidewalk modification and bike lane accommodation on students' active travel to schools. The modeling framework assumes that a student's choice for the mode of travel to school is impacted by numerous factors such as neighborhood crime rates, traffic safety, built environment amenities, and socio-demographic factors. A generalized linear model is employed to capture longitudinal changes in the mode share of students who walk or bike to school based on data collected from 53 schools in the city of Seattle, Washington. The modeling results indicate that (1) enhanced sidewalk modifications and bike lane accommodations encourage students walking and biking to school; (2) the implementation of Seattle's student assignment plan helps promote students walking to school possibly due to the change from school choice to neighborhood-based school assignment; (3) the size of the school attendance area is not significantly correlated with students' active travel activities, while the size of school enrollment is negatively associated with walking; (4) in school areas with high employment density, biking to school may be a more attractive option for students; (5) greater crosswalk density may encourage more students to walk to school; (6) the density of bike crashes is negatively associated with students biking to school. In terms of policy implications, transport planners should continually promote walking and biking supportive environments and implement policies to encourage active student travel.
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Affiliation(s)
- Peng Chen
- College of Transportation Engineering, Tongji University, Shanghai, China
| | - Junfeng Jiao
- Urban Information Lab, The University of Texas at Austin, Austin, TX, USA
| | - Mengyuan Xu
- Key Laboratory of Urban Agriculture in Central China, Huazhong Agricultural University, Wuhan, China
| | - Xu Gao
- Department of Statistics, Donald Bren School of Information & Computer Sciences, University of California, Irvine, USA
| | - Chris Bischak
- Urban Information Lab, The University of Texas at Austin, Austin, TX, USA
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Litt JS, Alaimo K, Buchenau M, Villalobos A, Glueck DH, Crume T, Fahnestock L, Hamman RF, Hebert JR, Hurley TG, Leiferman J, Li K. Rationale and design for the community activation for prevention study (CAPs): A randomized controlled trial of community gardening. Contemp Clin Trials 2018; 68:72-78. [PMID: 29563043 PMCID: PMC5963280 DOI: 10.1016/j.cct.2018.03.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 03/02/2018] [Accepted: 03/12/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Engaging in health-promoting behaviors (e.g., healthy fruit- and vegetable-rich diet, physical activity) and living in supportive social and built environments are consistently and significantly associated with reductions in cancer, heart disease, diabetes, and other chronic diseases. Interventions to change diet and physical activity behaviors should aim to educate individuals, change the environments in which people live, work and recreate, improve access, availability, and affordability of healthy foods, and create safe places the facilitate active lifestyles. This trial will assess whether community gardening increases fruit and vegetable consumption and physical activity, improves social support and mental health, and reduces age-associated weight gain and sedentary time among a multi-ethnic, mixed-income population. METHODS/DESIGN A randomized controlled trial of community gardening began in Denver, Colorado in January 2017. Over 3 years, we will recruit 312 consenting participants on Denver Urban Gardens' waitlists and randomize them to garden or remain on the waitlist. At baseline (pre-gardening), harvest time, and post-intervention, study participants will complete three 24-hour dietary recalls, a 7-day activity monitoring period using accelerometry, a health interview and physical anthropometry. DISCUSSION This project addresses health-promoting behaviors among a multi-ethnic, mixed-income adult population in a large metropolitan area. If successful, this trial will provide evidence that community gardening supports and sustains healthy and active lifestyles, which can reduce risk of cancer and other chronic diseases. TRIAL REGISTRATION ClinicalTrials.gov, ID: NCT03089177: Registered on 03/17/17.
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Affiliation(s)
- J S Litt
- Environmental Studies, University of Colorado Boulder, Boulder, CO, United States.
| | - K Alaimo
- Michigan State University, Lansing, MI, United States
| | - M Buchenau
- Denver Urban Gardens, Boulder, CO, United States
| | - A Villalobos
- University of Colorado Boulder, Boulder, CO, United States
| | - D H Glueck
- University of Colorado School of Medicine, Denver, CO, United States
| | - T Crume
- Colorado School of Public Health, Denver, CO, United States
| | - L Fahnestock
- Denver Urban Gardens, Boulder, CO, United States
| | - R F Hamman
- Colorado School of Public Health, Denver, CO, United States
| | - J R Hebert
- University of South Carolina, Charleston, SC, United States
| | - T G Hurley
- University of South Carolina, Charleston, SC, United States
| | - J Leiferman
- Colorado School of Public Health, Denver, CO, United States
| | - K Li
- Environmental Studies, University of Colorado Boulder, Boulder, CO, United States
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Nikiphorou E, Norton S, Young A, Dixey J, Walsh D, Helliwell H, Kiely P. The association of obesity with disease activity, functional ability and quality of life in early rheumatoid arthritis: data from the Early Rheumatoid Arthritis Study/Early Rheumatoid Arthritis Network UK prospective cohorts. Rheumatology (Oxford) 2018; 57:1194-1202. [PMID: 29590474 DOI: 10.1093/rheumatology/key066] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 02/14/2018] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES To examine associations between BMI and disease activity, functional ability and quality of life in RA. METHODS Data from two consecutive, similarly designed UK multicentre RA inception cohorts were used: the Early RA Study (ERAS) and the Early RA Network (ERAN). Recruitment figures/median follow-up for the ERAS and ERAN were 1465/10 years (maximum 25 years), and 1236/6 years (maximum 10 years), respectively. Standard demographic and clinical variables were recorded at baseline and annually. Multilevel piecewise longitudinal models with a change point at 2 years were used with the 28-joint DAS (DAS28), ESR, HAQ and 36-item Short Form Health Survey (SF-36) physical (PCS) and mental (MCS) components as dependent variables. BMI was examined in separate models as both continuous and categorical variables (based on World Health Organization definitions) and up to 5 years from disease onset. RESULTS BMI data from 2386 newly diagnosed RA patients (11 348 measures) showed an increase in BMI of 0.27 U annually (95% CI 0.21, 0.33). Baseline obesity was associated with a significant reduction in the odds of achieving a low year 2 DAS28 [OR 0.52 (95% CI 0.41, 0.650)]. At year 2, HAQ and SF-36 PCS scores were significantly worse but not at year 5 in patients obese at baseline. Obesity at year 2 was associated with higher DAS28 scores at year 2, but not at year 5, and also associated with significantly higher HAQ and SF-36 PCS scores at years 2 and 5. CONCLUSION Obesity prevalence is rising in early RA and associates with worse disease activity, function and health-related quality of life, with a significant negative impact on achieving a low DAS28. The data argue strongly for obesity management to become central to treatment strategies in RA.
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Affiliation(s)
- Elena Nikiphorou
- Academic Rheumatology Department, King's College London, UK.,Rheumatology, Whittington Hospital NHS Trust, London, UK
| | - Sam Norton
- Academic Rheumatology Department, King's College London, UK
| | - Adam Young
- Centre for Lifespan & Chronic Illness Research, University of Hertfordshire, Hatfield, UK
| | - Josh Dixey
- Department of Rheumatology, New Cross Hospital, Wolverhampton, UK
| | - David Walsh
- Arthritis UK Pain Centre, University of Nottingham, Nottingham, UK
| | | | - Patrick Kiely
- Department of Rheumatology, St Georges University Hospitals NHS Foundation Trust, London, UK
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Cui X, Li Y, Yang L, You L, Wang X, Shi C, Ji C, Guo X. Peptidome analysis of human milk from women delivering macrosomic fetuses reveals multiple means of protection for infants. Oncotarget 2018; 7:63514-63525. [PMID: 27566575 PMCID: PMC5325381 DOI: 10.18632/oncotarget.11532] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 08/13/2016] [Indexed: 01/11/2023] Open
Abstract
Breastfeeding is associated with a lower incidence of obesity, diabetes, and cardiovascular disease later in life. While macrosomic infants have a higher risk of developing obesity and other metabolic disorders. Breast milk may contain special nutrients to meet the different growth needs of different infants. Whether mothers make breast milk different to meet the requirement of macrosomic infants is still unknown. Here, we conducted a comparison between mothers delivering macrosomic and non-macrosomic infants in colostrum endogenous peptides. More than 400 peptides, originating from at least 34 protein precursors, were identified by Liquid Chromatography/Mass Spectrometry (LC/MS). Out of these, 29 peptides found to be significant differently expressed (|fold change| ≥ 3, P < 0.01). Blastp analysis revealed 41 peptides may have established biological activities, which exhibit immunomodulating, antibacterial action, antioxidation, opioid agonist and antihypertensive activity. Furthermore, we found that peptide located at β-Casein 24-38 AA has antimicrobial effect against E. coli, Y. enterocolitica and S. aureus. While, κ-Casein 89-109 AA-derived peptide plays as a regulator of preadipocyte proliferation. The profile of endogenous peptides from macrosomic term infants is different from non-macrosomic terms. This different peptide expression potentially has specific physiological function to benefit macrosomic infants. Finally, we believe that our research is a meaningfull finding which may add to the understanding of milk peptide physiological action.
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Affiliation(s)
- Xianwei Cui
- From Nanjing Maternal and Child Health Medical Institute, Nanjing Medical University Affiliated Nanjing Maternal and Child Health Hospital
| | - Yun Li
- From Nanjing Maternal and Child Health Medical Institute, Nanjing Medical University Affiliated Nanjing Maternal and Child Health Hospital
| | - Lei Yang
- From Nanjing Maternal and Child Health Medical Institute, Nanjing Medical University Affiliated Nanjing Maternal and Child Health Hospital
| | - Lianghui You
- From Nanjing Maternal and Child Health Medical Institute, Nanjing Medical University Affiliated Nanjing Maternal and Child Health Hospital
| | - Xing Wang
- From Nanjing Maternal and Child Health Medical Institute, Nanjing Medical University Affiliated Nanjing Maternal and Child Health Hospital
| | - Chunmei Shi
- From Nanjing Maternal and Child Health Medical Institute, Nanjing Medical University Affiliated Nanjing Maternal and Child Health Hospital
| | - Chenbo Ji
- From Nanjing Maternal and Child Health Medical Institute, Nanjing Medical University Affiliated Nanjing Maternal and Child Health Hospital
| | - Xirong Guo
- From Nanjing Maternal and Child Health Medical Institute, Nanjing Medical University Affiliated Nanjing Maternal and Child Health Hospital
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Millstein RA, Quintiliani LM, Sharpe AL. Society of Behavioral Medicine (SBM) position statement: Increasing funding for the NIH OBSSR to promote timely and effective behavioral medicine research. Transl Behav Med 2018; 8:309-312. [PMID: 29506256 DOI: 10.1093/tbm/ibx022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Chronic diseases are a leading cause of morbidity and mortality in the USA. Most chronic diseases have behavioral risk factors that can improve health and quality of life and reduce financial burdens. Improved methods of measurement and behavioral interventions are rapidly progressing. These changes require sufficient funding to maximize effectiveness. The National Institutes of Health (NIH) Office of Behavioral and Social Sciences Research (OBSSR) helps to coordinate and support behavioral and social science research initiatives that are designed to promote public health and reduce chronic disease burden throughout the NIH. OBSSR's budget has not increased for the past 5 years. The goals of this policy paper are to promote awareness of the OBSSR Strategic Plan FY 2017-2021's three priority areas and encourage increased and sustained funding for OBSSR to support these priority areas. Priority area 1 involves improving the quality and integration of behavioral and social science research, which can increase speed of funding natural experiments. Priority area 2 encourages the use and improvement of new technology to create methods and infrastructures to analyze big behavioral data, ensuring that health behavior interventions keep pace with the substantial data generated from new technology. Priority area 3 supports translational research between scientific data and real-world practice, ensuring the delivery of research findings to patients and populations. Adequate and sustained resources are needed to address these priority areas. Without such resources, disparities in health outcomes and the costs of treating preventable chronic diseases will continue to grow. Society of Behavioral Medicine (SBM) recommends and supports an increase for OBSSR's budget.
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Affiliation(s)
- Rachel A Millstein
- Massachusetts General Hospital, Department of Psychiatry, Boston, MA, USA
| | - Lisa M Quintiliani
- Boston University, Department of Medicine, Section of General Internal Medicine, Boston, MA, USA
| | - Angela L Sharpe
- Consortium of Social Science Associations, Washington, DC, USA
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Zhou J, Zhang L, Xuan P, Fan Y, Yang L, Hu C, Bo Q, Wang G, Sheng J, Wang S. The relationship between famine exposure during early life and body mass index in adulthood: A systematic review and meta-analysis. PLoS One 2018; 13:e0192212. [PMID: 29408921 PMCID: PMC5800668 DOI: 10.1371/journal.pone.0192212] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 01/19/2018] [Indexed: 01/01/2023] Open
Abstract
Background Previous epidemiologic studies have reported famine exposure during early life association with overweight or obesity in adulthood, but a consistent perspective has not been established to date. Purpose To determine, by conducting a systematic review and meta-analysis, whether exposure to famine could increase body mass index (BMI) in adult or not, and assess the association between famine exposure and the risk of overweight or obesity. Methods Published articles were systematically searched (until August, 2017) from PubMed, ScienceDirect, Cochrane, and China National Knowledge Infrastructure. Initially, comparing differences in BMI between exposed and non-exposed groups that weight mean difference (WMD) were used. Subsequently, the effect of famine exposure on overweight or obesity risk, which pooled relative risks (RRs), odds ratios (ORs) or hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Result Twenty studies were included in this systematic review and meta-analysis. Compared with non-exposed group, famine exposure group significantly increased the risk of overweight (OR = 1.10, 95% CI: 1.04–1.16) and obesity (OR = 1.15, 95% CI: 1.05–1.24). Sensitivity analyses revealed no significant change in the famine exposure and BMI, the risk of overweight and obesity study when any one study was excluded. Subgroup analyses showed that age, gender, exposure type, study type, continent, famine cause and paper publication date were associated with BMI, the risk of overweight and obesity. Meta-regression analyses suggested that continent, famine cause could partially explain heterogeneity for famine exposure and BMI studies. Conclusion The systematic review and meta-analysis indicates that famine exposure during early life may increase BMI, the risk of overweight and obesity, especially for female, fetal famine exposure or subject age less than 50. Furthermore, famine exposure group the risk of overweight and obesity in cross-sectional studies, Asian studies, famine cause by natural disaster or paper published from 2015 to the present studies are higher than that of non-exposed group.
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Affiliation(s)
- Jielin Zhou
- School of Public Health, Anhui Medical University, Hefei, Anhui, P. R. China
| | - Liangjian Zhang
- School of Public Health, Anhui Medical University, Hefei, Anhui, P. R. China
| | - Peng Xuan
- School of Public Health, Anhui Medical University, Hefei, Anhui, P. R. China
| | - Yong Fan
- School of Public Health, Anhui Medical University, Hefei, Anhui, P. R. China
| | - Linsheng Yang
- School of Public Health, Anhui Medical University, Hefei, Anhui, P. R. China
| | - Chunqiu Hu
- School of Public Health, Anhui Medical University, Hefei, Anhui, P. R. China
| | - Qingli Bo
- School of Public Health, Anhui Medical University, Hefei, Anhui, P. R. China
| | - Guoxiu Wang
- School of Public Health, Anhui Medical University, Hefei, Anhui, P. R. China
| | - Jie Sheng
- School of Public Health, Anhui Medical University, Hefei, Anhui, P. R. China
| | - Sufang Wang
- School of Public Health, Anhui Medical University, Hefei, Anhui, P. R. China
- * E-mail:
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Rhon DI, Clewley D, Young JL, Sissel CD, Cook CE. Leveraging healthcare utilization to explore outcomes from musculoskeletal disorders: methodology for defining relevant variables from a health services data repository. BMC Med Inform Decis Mak 2018; 18:10. [PMID: 29386010 PMCID: PMC5793373 DOI: 10.1186/s12911-018-0588-8] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 01/17/2018] [Indexed: 12/29/2022] Open
Abstract
Background Large healthcare databases, with their ability to collect many variables from daily medical practice, greatly enable health services research. These longitudinal databases provide large cohorts and longitudinal time frames, allowing for highly pragmatic assessment of healthcare delivery. The purpose of this paper is to discuss the methodology related to the use of the United States Military Health System Data Repository (MDR) for longitudinal assessment of musculoskeletal clinical outcomes, as well as address challenges of using this data for outcomes research. Methods The Military Health System manages care for approximately 10 million beneficiaries worldwide. Multiple data sources pour into the MDR from multiple levels of care (inpatient, outpatient, military or civilian facility, combat theater, etc.) at the individual patient level. To provide meaningful and descriptive coding for longitudinal analysis, specific coding for timing and type of care, procedures, medications, and provider type must be performed. Assumptions often made in clinical trials do not apply to these cohorts, requiring additional steps in data preparation to reduce risk of bias. The MDR has a robust system in place to validate the quality and accuracy of its data, reducing risk of analytic error. Details for making this data suitable for analysis of longitudinal orthopaedic outcomes are provided. Results Although some limitations exist, proper preparation and understanding of the data can limit bias, and allow for robust and meaningful analyses. There is the potential for strong precision, as well as the ability to collect a wide range of variables in very large groups of patients otherwise not captured in traditional clinical trials. This approach contributes to the improved understanding of the accessibility, quality, and cost of care for those with orthopaedic conditions. Conclusion The MDR provides a robust pool of longitudinal healthcare data at the person-level. The benefits of using the MDR database appear to outweigh the limitations.
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Affiliation(s)
- Daniel I Rhon
- Center for the Intrepid, Brooke Army Medical Center, 3551 Roger Brooke Drive, San Antonio, TX, 78234, USA.
| | - Derek Clewley
- Baylor University, 3630 Stanley Road, Bldg 2841, Suite 1301; Joint Base San Antonio - Fort Sam Houston, San Antonio, TX, 78234, USA
| | - Jodi L Young
- Division of Physical Therapy, Department of Orthopedics, Duke University, 2200 W. Main Street, Durham, NC, 27701, USA
| | - Charles D Sissel
- Department of Physical Therapy, Arizona School of Health Sciences, 5850 E. Still Circle, Mesa, AZ, 85206, USA
| | - Chad E Cook
- Headquarters, U.S. Army Medical Command, Analysis & Evaluation Division, 3630 Stanley Road; Joint Base San Antonio - Fort Sam Houston, San Antonio, TX, 78234, USA
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Babu GR, Murthy GVS, Ana Y, Patel P, Deepa R, Benjamin-Neelon SE, Kinra S, Reddy KS. Association of obesity with hypertension and type 2 diabetes mellitus in India: A meta-analysis of observational studies. World J Diabetes 2018; 9:40-52. [PMID: 29359028 PMCID: PMC5763039 DOI: 10.4239/wjd.v9.i1.40] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2017] [Revised: 10/09/2017] [Accepted: 11/20/2017] [Indexed: 02/05/2023] Open
Abstract
AIM To perform a meta-analysis of the association of obesity with hypertension and type 2 diabetes mellitus (T2DM) in India among adults.
METHODS To conduct meta-analysis, we performed comprehensive, electronic literature search in the PubMed, CINAHL Plus, and Google Scholar. We restricted the analysis to studies with documentation of some measure of obesity namely; body mass index, waist-hip ratio, waist circumference and diagnosis of hypertension or diagnosis of T2DM. By obtaining summary estimates of all included studies, the meta-analysis was performed using both RevMan version 5 and “metan” command STATA version 11. Heterogeneity was measured by I2 statistic. Funnel plot analysis has been done to assess the study publication bias.
RESULTS Of the 956 studies screened, 18 met the eligibility criteria. The pooled odds ratio between obesity and hypertension was 3.82 (95%CI: 3.39 to 4.25). The heterogeneity around this estimate (I2 statistic) was 0%, indicating low variability. The pooled odds ratio from the included studies showed a statistically significant association between obesity and T2DM (OR = 1.14, 95%CI: 1.04 to 1.24) with a high degree of variability.
CONCLUSION Despite methodological differences, obesity showed significant, potentially plausible association with hypertension and T2DM in studies conducted in India. Being a modifiable risk factor, our study informs setting policy priority and intervention efforts to prevent debilitating complications.
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Affiliation(s)
- Giridhara R Babu
- Public Health Foundation of India, IIPH-H, Bangalore Campus, SIHFW Premises, Beside Leprosy Hospital, Bangalore 560023, India
| | - G V S Murthy
- Indian Institute of Public Health-Hyderabad, Plot # 1, A.N.V.Arcade, Amar Co-op Society, Kavuri Hills, Madhapur, Hyderabad 500033, India
- London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom
| | - Yamuna Ana
- Public Health Foundation of India, IIPH-H, Bangalore Campus, SIHFW Premises, Beside Leprosy Hospital, Bangalore 560023, India
| | - Prital Patel
- Indian School of Business, Hyderabad 500111, India
| | - R Deepa
- Public Health Foundation of India, IIPH-H, Bangalore Campus, SIHFW Premises, Beside Leprosy Hospital, Bangalore 560023, India
| | | | - Sanjay Kinra
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine and University College London Hospital, London WC1E 7HT, United Kingdom
| | - K Srinath Reddy
- Public Health Foundation of India, ISID Campus, 4 Institutional Area Vasant Kunj, New Delhi 110070, India
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Yarar N, Orth UR. Consumer lay theories on healthy nutrition: A Q methodology application in Germany. Appetite 2018; 120:145-157. [DOI: 10.1016/j.appet.2017.08.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 08/16/2017] [Accepted: 08/23/2017] [Indexed: 10/19/2022]
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Han B, Chen Y, Cheng J, Li Q, Zhu C, Chen Y, Xia F, Wang N, Lu Y. Comparison of the Prevalence of Metabolic Disease Between Two Types of Urbanization in China. Front Endocrinol (Lausanne) 2018; 9:665. [PMID: 30483219 PMCID: PMC6240687 DOI: 10.3389/fendo.2018.00665] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 10/25/2018] [Indexed: 12/31/2022] Open
Abstract
Objective: China is experiencing the world's largest urbanization. There are two primary types of urbanization in China: rural-to-urban migration and in situ urbanization, represented by Zhejiang Shangyu (SY) and Jiangsu Nanjing (NJ), respectively. Our aim is to compare changes in the prevalence of metabolic disease between these two types of urbanization in China. Methods: This is a cross-sectional study derived from the SPECT-China 2014 study. This study includes subjects and metabolic parameters from SY and NJ. Furthermore, biochemical and anthropometric indexes were taken into consideration and compared between the areas of interest. Results: The prevalence rates of diabetes, prediabetes and healthy subjects were 6.5, 17.9, and 75.7% in SY and 16.0, 31.0, and 53.0% in NJ, respectively. Industrial and agricultural jobs accounted for 77.9% and 32.0% of employment in SY and NJ, respectively. Fasting plasma glucose (FPG) was higher in SY than in NJ; however, HbA1c was lower in SY than in NJ. There was a significant difference in nonalcoholic fatty liver disease (NAFLD) and healthy subjects between SY and NJ (P < 0.05). Significant differences were also found with respect to body mass index (BMI), waist circumference (WC) and hip circumference (HC) between these two locations (P < 0.001). Logistic regression analysis revealed that the prevalence of prediabetes, diabetes, overweight, obesity and dyslipidemia was higher in NJ than in SY. Conclusions: In situ urbanization has notably changed occupational distribution. The prevalence rates of diabetes, obesity, and NAFLD were increased in rapidly urbanized areas. Thus, more attention should be paid to rapidly urbanizing areas to reduce the prevalence of metabolic disease.
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Zhang D, Cogswell ME, Wang G, Bowman BA. Evidence of Dietary Improvement and Preventable Costs of Cardiovascular Disease. Am J Cardiol 2017; 120:1681-1688. [PMID: 28847593 DOI: 10.1016/j.amjcard.2017.07.068] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 07/13/2017] [Accepted: 07/21/2017] [Indexed: 01/24/2023]
Abstract
We conducted a review to summarize preventable medical costs of cardiovascular disease (CVD) associated with improved diet, as defined by the 2020 Strategic Impact Goal of the American Heart Association. We searched databases of PubMed, Embase, CINAHL and ABI/INFORM to identify population-based studies published from January 1995 to December 2015 on CVD medical costs related to excess intake of salt/sodium or sugar-sweetened beverages, and inadequate intake of fruits and vegetables, fish/fish oils/omega-3 fatty acids, or whole grains/fiber/dietary fiber. Based on the American Heart Association's secondary dietary metrics, we also searched the literature on inadequate intake of nuts and excess intake of processed meat and saturated fat. For each component, we evaluated the CVD cost savings if consumption levels were changed. The cost savings were adjusted into 2013 US dollars. Among 330 studies focusing on diet and economic consequences, 16 studies evaluated CVD costs associated with 1 or more dietary components: salt/sodium (n = 13), fruits and vegetables (n = 1), meat (n = 1), and saturated fat (n = 3). In the United States, reducing individual sodium intake to 2,300 mg/day from the current level could potentially save $1,990.9/person per year for hypertension treatment, based on a simulation study. Increasing consumption of fruits and vegetables from <0.5 cup/day to >1.5 cups/day could save $1,568.0/person per year in treatment costs for CVD, based on a cohort study. Potential CVD cost savings associated with diet improvement are substantial. Interventions for reducing sodium intake and increasing fruit and vegetable consumption could be viable means to alleviate the increasing national medical expenditures.
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Affiliation(s)
- Donglan Zhang
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, Georgia
| | - Mary E Cogswell
- Division for Heart Disease and Stroke Prevention, US Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Guijing Wang
- Division for Heart Disease and Stroke Prevention, US Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.
| | - Barbara A Bowman
- Division for Heart Disease and Stroke Prevention, US Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
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Feeney EL, O'Brien SA, Scannell AG, Markey A, Gibney ER. Suprathreshold measures of taste perception in children - Association with dietary quality and body weight. Appetite 2017; 113:116-123. [DOI: 10.1016/j.appet.2017.02.026] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 01/18/2017] [Accepted: 02/18/2017] [Indexed: 11/16/2022]
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Lo YTC, Wahlqvist ML, Huang YC, Chuang SY, Wang CF, Lee MS. Medical costs of a low skeletal muscle mass are modulated by dietary diversity and physical activity in community-dwelling older Taiwanese: a longitudinal study. Int J Behav Nutr Phys Act 2017; 14:31. [PMID: 28288651 PMCID: PMC5348879 DOI: 10.1186/s12966-017-0487-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 03/05/2017] [Indexed: 12/15/2022] Open
Abstract
Background Age-related loss of skeletal muscle mass (SMM) and function (sarcopenia) are associated with poor health outcomes and an economic burden on health care services. An appropriate diet and physical activity have been proposed for prevention and treatment of sarcopenia. Nevertheless, the effects on medical service utilization and costs remain unclear. This study determined the effects of SMM in conjunction with diet quality and physical activity on medical service utilization and expenditure in community-dwelling older Taiwanese. Methods In total, 1337 participants from the Elderly Nutrition and Health Survey in Taiwan (1999–2000) were enrolled. An SMM index [SMMI, calculated by dividing SMM (kg) by height (m2)] was used as the marker of sarcopenia. Participants with the lowest SMMI quartiles (<11.4 kg/m2 for men and 8.50 kg/m2 for women) comprised the high-risk group, and the remainder comprised the low-risk group. Dietary information (dietary diversity: low and high) and physical activity (low and moderate) were obtained at baseline. Annual medical service utilization and expenditure were calculated from National Health Insurance claims until December 31, 2006. Generalized linear models were used to determine the association between the SMMI and annual medical service utilization and costs in conjunction with dietary diversity or physical activity. Results After 8 follow-up years, regardless of gender, participants in the high-risk group reported significantly more hospitalization (days and expenditure) and total medical expenditure. Participants in the high-risk group who had low dietary diversity made fewer annual outpatient (14%), preventive care (19%), and dental (40%) visits, but exhibited longer hospitalization (102%) than did those who had a low SMMI and high dietary diversity. Similar patterns were observed in the corresponding medical expenditures. The findings were similar when considering physical activity. Being in the low-risk group in conjunction with having high dietary diversity or more physical activity was associated with the lowest annual adjusted mean hospitalization days with expenditure, and also total expenditure. Conclusions A lower SMMI was associated with more hospitalization days and costs. However, high dietary diversity and more physical activity can attenuate the effects of lower SMMI on medical service utilization and expenditure.
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Affiliation(s)
- Yuan-Ting C Lo
- School of Public Health, National Defense Medical Center, 161 Minchuan East Road, Sec. 6, Taipei, 11490, Taiwan, Republic of China
| | - Mark L Wahlqvist
- School of Public Health, National Defense Medical Center, 161 Minchuan East Road, Sec. 6, Taipei, 11490, Taiwan, Republic of China.,Institute of Population Health Sciences, National Health Research Institutes, 35 Keyan Road, Zhunan, Miaoli County, 35053, Taiwan, Republic of China.,Monash Asia Institute, Monash University, Caulfield East, PO Box 197, Melbourne, VIC, 3145, Australia
| | - Yi-Chen Huang
- Graduate Institute of Life Sciences, National Defense Medical Center, 161 Minchuan Road, Sec. 6, Taipei, 11490, Taiwan, Republic of China
| | - Shao-Yuan Chuang
- Institute of Population Health Sciences, National Health Research Institutes, 35 Keyan Road, Zhunan, Miaoli County, 35053, Taiwan, Republic of China
| | - Chi-Fen Wang
- School of Public Health, National Defense Medical Center, 161 Minchuan East Road, Sec. 6, Taipei, 11490, Taiwan, Republic of China
| | - Meei-Shyuan Lee
- School of Public Health, National Defense Medical Center, 161 Minchuan East Road, Sec. 6, Taipei, 11490, Taiwan, Republic of China. .,Monash Asia Institute, Monash University, Caulfield East, PO Box 197, Melbourne, VIC, 3145, Australia. .,Graduate Institute of Life Sciences, National Defense Medical Center, 161 Minchuan Road, Sec. 6, Taipei, 11490, Taiwan, Republic of China.
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64
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Mötteli S, Siegrist M, Keller C. Women's social eating environment and its associations with dietary behavior and weight management. Appetite 2016; 110:86-93. [PMID: 27986538 DOI: 10.1016/j.appet.2016.12.014] [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: 07/18/2016] [Revised: 12/07/2016] [Accepted: 12/12/2016] [Indexed: 01/05/2023]
Abstract
As an unhealthy social eating environment is considered a risk factor for obesity, this study aimed to examine women's regular eating networks and the extent to which diet-related variables were associated with those of their regular eating companions. In Study Part I (N = 579), an egocentric network approach was used to investigate women's perceptions of their eating networks. In Study Part II (N = 262), the participants' most important eating companions responded to a similar survey, and the corresponding answers were matched. The results showed that women shared their meals most frequently with spouses and other family members. Women who dined more often with healthy eaters reported on average a higher diet quality and a lower body mass index (BMI), which were also significant after controlling for individual factors. Study Part II expanded these results by showing that different diet-related factors such as diet quality, eating styles and BMI were correlated between women and their most important eating companions (r = 0.16-0.30, p < 0.05). Moreover, an actor-partner interdependence model revealed that a higher diet quality of the eating companions was associated with a lower BMI in women, controlled for their own eating behavior (b = -0.45, p < 0.05). This study showed similarities and interdependence between women's dietary behavior and body weight and those of their regular eating companions. This might indicate that regular eating networks have a shared understanding of what constitutes a normal diet, which might be an important factor to consider in the promotion of healthy eating.
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Affiliation(s)
- Sonja Mötteli
- Department of Health Sciences and Technology, ETH Zurich, Switzerland.
| | - Michael Siegrist
- Department of Health Sciences and Technology, ETH Zurich, Switzerland
| | - Carmen Keller
- Department of Health Sciences and Technology, ETH Zurich, Switzerland
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65
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Bae YJ, Kim SE, Hong SY, Park T, Lee SG, Choi MS, Sung MK. Time-course microarray analysis for identifying candidate genes involved in obesity-associated pathological changes in the mouse colon. GENES AND NUTRITION 2016; 11:30. [PMID: 27895803 PMCID: PMC5120484 DOI: 10.1186/s12263-016-0547-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 11/07/2016] [Indexed: 01/04/2023]
Abstract
Background Obesity is known to increase the risk of colorectal cancer. However, mechanisms underlying the pathogenesis of obesity-induced colorectal cancer are not completely understood. The purposes of this study were to identify differentially expressed genes in the colon of mice with diet-induced obesity and to select candidate genes as early markers of obesity-associated abnormal cell growth in the colon. Methods C57BL/6N mice were fed normal diet (11% fat energy) or high-fat diet (40% fat energy) and were euthanized at different time points. Genome-wide expression profiles of the colon were determined at 2, 4, 8, and 12 weeks. Cluster analysis was performed using expression data of genes showing log2 fold change of ≥1 or ≤−1 (twofold change), based on time-dependent expression patterns, followed by virtual network analysis. Results High-fat diet-fed mice showed significant increase in body weight and total visceral fat weight over 12 weeks. Time-course microarray analysis showed that 50, 47, 36, and 411 genes were differentially expressed at 2, 4, 8, and 12 weeks, respectively. Ten cluster profiles representing distinguishable patterns of genes differentially expressed over time were determined. Cluster 4, which consisted of genes showing the most significant alterations in expression in response to high-fat diet over 12 weeks, included Apoa4 (apolipoprotein A-IV), Ppap2b (phosphatidic acid phosphatase type 2B), Cel (carboxyl ester lipase), and Clps (colipase, pancreatic), which interacted strongly with surrounding genes associated with colorectal cancer or obesity. Conclusions Our data indicate that Apoa4, Ppap2b, Cel, and Clps are candidate early marker genes associated with obesity-related pathological changes in the colon. Genome-wide analyses performed in the present study provide new insights on selecting novel genes that may be associated with the development of diseases of the colon. Electronic supplementary material The online version of this article (doi:10.1186/s12263-016-0547-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yun Jung Bae
- Division of Food Science and Culinary Arts, Shinhan University, Gyeonggi-do, Republic of Korea
| | - Sung-Eun Kim
- Department of Food and Nutrition, Sookmyung Women's University, 100 Cheongpa-ro 47-gil, Yongsan-gu, Seoul Republic of Korea
| | - Seong Yeon Hong
- Department of Food and Nutrition, Sookmyung Women's University, 100 Cheongpa-ro 47-gil, Yongsan-gu, Seoul Republic of Korea
| | - Taesun Park
- Department of Food and Nutrition, Yonsei University, Seoul, Republic of Korea.,Food and Nutritional Genomics Research Center, Kyungpook National University, Daegu, Republic of Korea
| | - Sang Gyu Lee
- School of Life Science and Biotechnology, Kyungpook National University, Daegu, Republic of Korea
| | - Myung-Sook Choi
- Department of Food Science and Nutrition, Kyungpook National University, Daegu, Republic of Korea.,Food and Nutritional Genomics Research Center, Kyungpook National University, Daegu, Republic of Korea
| | - Mi-Kyung Sung
- Department of Food and Nutrition, Sookmyung Women's University, 100 Cheongpa-ro 47-gil, Yongsan-gu, Seoul Republic of Korea.,Food and Nutritional Genomics Research Center, Kyungpook National University, Daegu, Republic of Korea
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66
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Shrestha N, Pedisic Z, Neil-Sztramko S, Kukkonen-Harjula KT, Hermans V. The Impact of Obesity in the Workplace: a Review of Contributing Factors, Consequences and Potential Solutions. Curr Obes Rep 2016; 5:344-60. [PMID: 27447869 DOI: 10.1007/s13679-016-0227-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
This narrative review summarized findings from previous reviews and the most recently published studies, regarding the following: (1) the association between two occupational risk factors-shift work and sedentary work-and obesity, (2) the effects of obesity on workplace productivity and (3) the effectiveness of workplace interventions aimed at preventing or reducing obesity. Despite some inconsistencies in findings, there is convincing evidence that shift work increases the risk of obesity, while most studies did not show a significant association between sedentary work and obesity. Overweight and obesity were found to be associated with absenteeism, disability pension and overall work impairment, whilst evidence of their relationship with presenteeism, unemployment and early retirement was not consistent. Due to the vast heterogeneity in the types of workplace-based interventions to prevent or treat obesity, no sound conclusions can as yet be drawn about their overall effectiveness and best practice recommendations for their implementation.
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Affiliation(s)
- Nipun Shrestha
- Active Living & Public Health Group, Institute of Sport, Exercise and Active Living (ISEAL), Victoria University, Melbourne, Australia.
| | - Zeljko Pedisic
- Active Living & Public Health Group, Institute of Sport, Exercise and Active Living (ISEAL), Victoria University, Melbourne, Australia
| | | | | | - Veerle Hermans
- Faculty of Psychology &Educational Sciences, Faculty of Medicine & Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
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67
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Song H, Chu Q, Yan F, Yang Y, Han W, Zheng X. Red pitaya betacyanins protects from diet-induced obesity, liver steatosis and insulin resistance in association with modulation of gut microbiota in mice. J Gastroenterol Hepatol 2016; 31:1462-9. [PMID: 26699443 DOI: 10.1111/jgh.13278] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 11/29/2015] [Accepted: 12/16/2015] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIM Growing evidence indicates that gut microbiota contributes to obesity and its related metabolic disorders. Betacyanins possess free radical scavenging and antioxidant activities, suggesting its potential beneficial effects on metabolic diseases. The present study aimed to investigate the metabolic effect of red pitaya (Hylocereus polyrhizus) fruit betacyanins (HPBN) on high-fat diet-fed mice and determine whether the beneficial effects of HPBN are associated with the modulation of gut microbiota. METHODS Thirty-six male C57BL/6J mice were divided into three groups and fed low-fat diet (LFD), high-fat diet (HFD), or high-fat diet plus HPBN of 200 mg/kg for 14 weeks. Sixteen seconds rRNA sequencing was used to analyze the composition of gut microbiota. RESULTS Our results indicated that administration of HPBN reduced HFD-induced body weight gain and visceral obesity and improved hepatic steatosis, adipose hypertrophy, and insulin resistance in mice. Sixteen seconds rRNA sequencing performed on the MiSeq Illumina platform (Illumina, Inc., San Diego, CA, USA) showed that HPBN supplement not only decreased the proportion of Firmicutes and increased the proportion of Bacteroidetes at the phylum level but also induced a dramatic increase in the relative abundance of Akkermansia at the genus level. CONCLUSIONS Red pitaya betacyanins protect from diet-induced obesity and its related metabolic disorders, which is associated with improved inflammatory status and modulation of gut microbiota, especially its ability to decrease the ratio of Firmicutes and Bacteroidetes and increase the relative abundance of Akkermansia. The study suggested a clinical implication of HPBN in the management of obesity, non-alcoholic fatty liver disease, and type 2 diabetes.
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Affiliation(s)
- Haizhao Song
- School of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou, China.,Fuli Institute of Food Science, Zhejiang University, Hangzhou, China
| | - Qiang Chu
- School of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou, China
| | - Fujie Yan
- School of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou, China
| | - Yunyun Yang
- School of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou, China
| | - Wen Han
- School of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou, China
| | - Xiaodong Zheng
- School of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou, China
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68
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Yang Z, Yu Z, Jiang Y, Bai Y, Miller-Kovach K, Zhao W, Foster GD, Chen C. Evaluation of a community-based behavioral weight loss program in Chinese adults: A randomized controlled trial. Obesity (Silver Spring) 2016; 24:1464-70. [PMID: 27240140 DOI: 10.1002/oby.21527] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 03/24/2016] [Accepted: 03/28/2016] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Weight losses between a group of participants assigned to a weight loss program based in the community [i.e., specifically the methodology used by Weight Watchers (WW)] and a Nutrition Education (NE) control group were compared in this study. METHODS In this 6-month trial, 300 participants with overweight or obesity were recruited from Beijing city, China, and randomly assigned to the WW or NE group. Weight, waist circumference, and biochemical parameters were assessed at baseline and 6 months. RESULTS At 6 months, the majority of participants (79% for WW; 89% for NE) completed the study. WW participants lost significantly more weight than the NE group (-4.2 ± 5.6 kg vs. -0.6 ± 3.6 kg). More WW participants lost 5% or 10% of their starting weight [≥5%: 52.0% of WW participants vs. 11.3% of NE participants (odds ratio 8.15, 95% CI: 4.43-14.97)]; [≥10%: 26.0% of WW vs. 3.3% of NE participants (odds ratio 9.39, 95% CI: 3.55-24.83)]. In addition, WW participants reduced waist circumference by 3.9 ± 6.3 cm, while the NE group increased waist circumference by 0.6 ± 5.5 cm. CONCLUSIONS The WW program was associated with clinically significant weight loss, demonstrating its potential value as an intervention strategy, based in the community, for the treatment of obesity in China.
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Affiliation(s)
- Zhengxiong Yang
- International Life Sciences Institute Focal Point in China, Beijing, China
| | - Zhiping Yu
- Department of Nutrition and Dietetics at University of North Florida, Jacksonville, Florida, USA
| | - Yingying Jiang
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yamin Bai
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | | | - Wenhua Zhao
- International Life Sciences Institute Focal Point in China, Beijing, China
| | - Gary D Foster
- Weight Watchers International, Inc, New York, New York, USA
| | - Chunming Chen
- International Life Sciences Institute Focal Point in China, Beijing, China
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69
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Bucher T, Collins C, Diem S, Siegrist M. Adolescents’ perception of the healthiness of snacks. Food Qual Prefer 2016. [DOI: 10.1016/j.foodqual.2016.02.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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70
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Wang X, Wu Y, Zhang X, Zhang M, Huang G. Dietary Changes over 25 Years in Tianjin Residents: Findings from the 1986-1988, 2000-2004, and 2008-2011 Nutrition Surveys. Nutrients 2016; 8:62. [PMID: 26805880 PMCID: PMC4772026 DOI: 10.3390/nu8020062] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Revised: 01/13/2016] [Accepted: 01/14/2016] [Indexed: 01/21/2023] Open
Abstract
In China, the rates of chronic diseases characteristic of countries in nutritional transition have been increasing. However, few studies have examined diet changes in recent decades. We analyzed dietary changes in Tianjin, China. The data in this descriptive, population-based study in ≥18-year-old adults were collected from three surveys from 1986 to 2011. Food consumption and nutrient intake were compared among the three surveys separately for urban and rural areas. Differences in food consumption between urban and rural areas in different periods were also shown. The consumption of cereals, vegetables, and oils decreased, and that of fruits and beans increased in both urban and rural areas. Moreover, the total consumption of animal foods, especially milk, increased (0.01% in 1986–1988; 1.72% in 2008–2011) in rural areas. Although milk consumption also increased in urban areas, consumption of other animal foods decreased (19.33% in 1986–1988; 13.74% in 2008–2011). Meanwhile, cereals consumption rebounded from 22.63% in 2000–2004 to 29.75% in 2008–2011. Moreover, the lack of dairy products and some nutrients, e.g., retinol, calcium, and dietary fiber (<80% of recommended nutrient intake), in the diet persisted in both urban and rural areas. In conclusion, differences in diet between urban and rural areas decreased over time.
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Affiliation(s)
- Xuan Wang
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, 300070 Tianjin, China.
| | - Yuntang Wu
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, 300070 Tianjin, China.
| | - Xumei Zhang
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, 300070 Tianjin, China.
| | - Meilin Zhang
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, 300070 Tianjin, China.
| | - Guowei Huang
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, 300070 Tianjin, China.
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71
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Song H, Han W, Yan F, Xu D, Chu Q, Zheng X. Dietary Phaseolus vulgaris extract alleviated diet-induced obesity, insulin resistance and hepatic steatosis and alters gut microbiota composition in mice. J Funct Foods 2016. [DOI: 10.1016/j.jff.2015.10.022] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
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Tu H, Liao X, Schuller K, Cook A, Fan S, Lan G, Lu Y, Yuan Z, Moore JB, Maddock JE. Insights from an observational assessment of park-based physical activity in Nanchang, China. Prev Med Rep 2015; 2:930-4. [PMID: 26844171 PMCID: PMC4721293 DOI: 10.1016/j.pmedr.2015.08.022] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Internationally, parks have been shown to be an important community asset for physical activity (PA), but little is known about the relationship between park usage and physical activity in China. The purpose of this study was to determine the association between park user characteristics and PA in Nanchang, China. In June 2014, 75,678 people were observed in eight parks over 12 days using SOPARC, a validated systematic observation tool. A logistic regression analysis was used to determine the association between PA and park user characteristics. Most park users were older adults (53.5%) or adults (34.6%). Overall, 55% of park users engaged in moderate-to-vigorous physical activity (MVPA). Fewer women were observed in parks than men, but were 66% more likely to be engaged in MVPA than men. Park users were more likely to be observed in MVPA between 6–9 am and when the temperature was below 30 °C. Chinese park users were more active (55%) than US studies in Tampa (30%), Chicago (49%), and Los Angeles (34%). More research is necessary to identify features of parks that are associated with greater PA so that effective interventions can be developed to promote active park use in Chinese citizens. Park use and physical activity were assessed in 8 parks in Nanchang, China. Children and teenagers were seldom observed in parks. About half of park users were physically active. Temperature but not air quality was related to park use.
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Affiliation(s)
- Hong Tu
- School of Public Health, Nanchang University, China
| | - Xiong Liao
- School of Public Health, Nanchang University, China
| | - Kristyn Schuller
- Department of Public Health Sciences, University of Hawaii at Manoa, United States
| | - Angelie Cook
- Department of Public Health Sciences, University of Hawaii at Manoa, United States
| | - Si Fan
- School of Public Health, Nanchang University, China
| | - Guilian Lan
- School of Public Health, Nanchang University, China
| | - Yuanan Lu
- School of Public Health, Nanchang University, China
- Department of Public Health Sciences, University of Hawaii at Manoa, United States
| | | | - Justin B. Moore
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, United States
| | - Jay E. Maddock
- School of Public Health, Nanchang University, China
- School of Public Health, Texas A&M University, United States
- Corresponding author at: School of Public Health, Texas A&M Health Science Center, MS 1266, 282 SPH Administration Building, College Station, TX 77843-1266, United States. Fax: + 1 979 436 9599.School of Public HealthTexas A&M Health Science Center, MS 1266282 SPH Administration BuildingCollege StationTX77843-1266United States
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Abstract
Sitting too much kills. Epidemiological, physiological and molecular data suggest that sedentary lifestyle can explain, in part, how modernity is associated with obesity, more than 30 chronic diseases and conditions and high healthcare costs. Excessive sitting--sitting disease--is not innate to the human condition. People were designed to be bipedal and, before the industrial revolution, people moved substantially more throughout the day than they do presently. It is encouraging that solutions exist to reverse sitting disease. Work environments, schools, communities and cities can be re-imagined and re-invented as walking spaces, and people thereby offered more active, happier, healthier and more productive lives.
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Affiliation(s)
- James A Levine
- Mayo Clinic, 13400 East Shea Blvd, Scottsdale, AZ, 85259, USA,
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The Frequency of Unhealthy Food Advertising on Mainland Chinese Television (TV) and Children and Adolescents' Risk of Exposure to Them. PLoS One 2015; 10:e0128746. [PMID: 26133984 PMCID: PMC4489874 DOI: 10.1371/journal.pone.0128746] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Accepted: 05/01/2015] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE To conduct an analysis of the frequency of unhealthy food advertising on mainland Chinese television (TV) and children and adolescents' risk of exposure to them. METHODS The frequencies of all types of advertisements (ads) on forty TV channels in mainland China, the exact ad broadcast times, and the name and brand of all snacks and western fast foods advertised were recorded from 0800 hours to 2400 hours on both a weekday and a weekend day in a week. The difference in the frequencies of the diverse types of ads over eight time intervals (each time interval was 2 hours) were compared, and the trends in ad frequencies during the time intervals were described. RESULTS The TV channels broadcast 155 (91-183) (expressed as median [P25-P75]) food ads, 87 (38-123) snack ads, 49 (11-85) beverage ads, and 58 (25-76) ads of snacks suitable for limited consumption (SSLCs) in a day. The proportion of snack ads among food ads (SPF%) was 55.5% (40.3%-71.0%), and the proportion of SSLC ads among snack ads (LPS%) was 67.4% (55.4%-79.3%). The ad frequencies for food, snacks, SSLCs, and beverages demonstrated significant differences among the eight time intervals (all P=0.000). TV channels broadcast the most frequent ads for food, snacks, SSLCs, and beverages during the time interval from 2000 hours to 2200 hours among the eight time intervals. CONCLUSIONS Chinese children and adolescents may be at a high risk of exposure to unhealthy food advertising on TV. Reducing the exposure risk strongly requires multisectoral cooperation.
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Measuring the Eating Habits of Registered Dietitians. TOP CLIN NUTR 2015. [DOI: 10.1097/tin.0000000000000041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Long MW, Gortmaker SL, Ward ZJ, Resch SC, Moodie ML, Sacks G, Swinburn BA, Carter RC, Claire Wang Y. Cost Effectiveness of a Sugar-Sweetened Beverage Excise Tax in the U.S. Am J Prev Med 2015; 49:112-23. [PMID: 26094232 PMCID: PMC8969866 DOI: 10.1016/j.amepre.2015.03.004] [Citation(s) in RCA: 130] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 02/18/2015] [Accepted: 03/03/2015] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Reducing sugar-sweetened beverage consumption through taxation is a promising public health response to the obesity epidemic in the U.S. This study quantifies the expected health and economic benefits of a national sugar-sweetened beverage excise tax of $0.01/ounce over 10 years. METHODS A cohort model was used to simulate the impact of the tax on BMI. Assuming ongoing implementation and effect maintenance, quality-adjusted life-years gained and disability-adjusted life-years and healthcare costs averted were estimated over the 2015-2025 period for the 2015 U.S. POPULATION Costs and health gains were discounted at 3% annually. Data were analyzed in 2014. RESULTS Implementing the tax nationally would cost $51 million in the first year. The tax would reduce sugar-sweetened beverage consumption by 20% and mean BMI by 0.16 (95% uncertainty interval [UI]=0.06, 0.37) units among youth and 0.08 (95% UI=0.03, 0.20) units among adults in the second year for a cost of $3.16 (95% UI=$1.24, $8.14) per BMI unit reduced. From 2015 to 2025, the policy would avert 101,000 disability-adjusted life-years (95% UI=34,800, 249,000); gain 871,000 quality-adjusted life-years (95% UI=342,000, 2,030,000); and result in $23.6 billion (95% UI=$9.33 billion, $54.9 billion) in healthcare cost savings. The tax would generate $12.5 billion in annual revenue (95% UI=$8.92, billion, $14.1 billion). CONCLUSIONS The proposed tax could substantially reduce BMI and healthcare expenditures and increase healthy life expectancy. Concerns regarding the potentially regressive tax may be addressed by reduced obesity disparities and progressive earmarking of tax revenue for health promotion.
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Affiliation(s)
- Michael W Long
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
| | - Steven L Gortmaker
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Zachary J Ward
- Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Stephen C Resch
- Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Marj L Moodie
- Deakin Health Economics, Deakin University, Melbourne, Victoria, Australia
| | - Gary Sacks
- WHO Collaborating Centre for Obesity Prevention, Deakin University, Melbourne, Victoria, Australia
| | - Boyd A Swinburn
- WHO Collaborating Centre for Obesity Prevention, Deakin University, Melbourne, Victoria, Australia; Section of Epidemiology and Biostatistics, the School of Population Health, University of Auckland, New Zealand
| | - Rob C Carter
- Deakin Health Economics, Deakin University, Melbourne, Victoria, Australia
| | - Y Claire Wang
- Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, New York
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77
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Wang MC, Naidoo N, Ferzacca S, Reddy G, Van Dam RM. The role of women in food provision and food choice decision-making in Singapore: a case study. Ecol Food Nutr 2015; 53:658-77. [PMID: 25357270 DOI: 10.1080/03670244.2014.911178] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
As countries develop economically and increasing numbers of women enter the workforce, children are partly being cared for by someone other than their mother. Little is known about the impact of this shift in child-care provider on children's nutrition. This study presents findings from a case study of Singapore, a small country that has experienced phenomenal economic growth. Focus groups were conducted with 130 women of varying educational levels and ethnicities to learn about food decisions in their families. The findings showed that Singaporean working women cook infrequently, families eat out frequently, and children exert considerable influence on food choices. Implications for work-family policies and child health are discussed.
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Affiliation(s)
- May C Wang
- a Department of Community Health Sciences , Fielding School of Public Health, UCLA , Los Angeles , California , USA
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78
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Xu X, Hall J, Byles J, Shi Z. Assessing dietary quality of older Chinese people using the Chinese Diet Balance Index (DBI). PLoS One 2015; 10:e0121618. [PMID: 25811834 PMCID: PMC4374685 DOI: 10.1371/journal.pone.0121618] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2014] [Accepted: 02/02/2015] [Indexed: 11/19/2022] Open
Abstract
Background/Objectives Few studies have applied the Chinese Diet Balance Index (DBI) in evaluating dietary quality for Chinese people. The present cross-sectional study assessed dietary quality based on DBI for older people, and the associated factors, in four socioeconomically distinct regions in China. Methods The China Health and Nutrition Survey (CHNS) involves 2745 older Chinese people, aged 60 or over, from four regions (Northeast, East Coast, Central and West) in 2009. Dietary data were obtained by interviews using 24 hour-recall over three consecutive days. Four indicators: Total Score (TS), Lower Bound Score (LBS), Higher Bound Score (HBS) and Diet Quality Distance (DQD) from DBI were calculated for assessing dietary quality in different aspects. Results 68.9% of older people had different levels of excessive cereals intake. More than 50% of older people had moderate or severe surplus of oil (64.9%) and salt (58.6%). Intake of vegetables and fruit, milk and soybeans, water, and dietary variety were insufficient, especially for milk and soybeans. 80.8% of people had moderate or severe unbalanced diet consumption. The largest differences of DQD scores have been found for people with different education levels and urbanicity levels. People with higher education levels have lower DQD scores (p<0.001), and people living in medium and low urbanicity areas had 2.8 and 8.9 higher DQD scores than their high urbanicity counterparts (p<0.001). Also, significant differences of DQD scores have been found according to gender, marital status, work status and regions (p<0.001). Conclusion DBI can reveal problems of dietary quality for older Chinese people. Rectifying unbalanced diet intake may lead to prevention of non-communicable diseases (NCDs). Dieticians and health care professionals need to increase dissemination and uptake of nutrition education, with interventions targeted at regions of lower socioeconomic status.
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Affiliation(s)
- Xiaoyue Xu
- Priority Research Centre for Gender, Health and Ageing, School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia
- Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia
- * E-mail:
| | - John Hall
- Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia
| | - Julie Byles
- Priority Research Centre for Gender, Health and Ageing, School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia
| | - Zumin Shi
- School of Medicine, University of Adelaide, Adelaide, Australia
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79
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Do older Chinese people's diets meet the Chinese Food Pagoda guidelines? Results from the China Health and Nutrition Survey 2009. Public Health Nutr 2015; 18:3020-30. [PMID: 25697507 DOI: 10.1017/s1368980015000129] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To evaluate dietary intake based on the Chinese Food Pagoda (CFP) and to determine what factors may be associated with adherence to CFP guidelines for older Chinese. DESIGN This cross-sectional population-based study used 24 h recall over three consecutive days to assess dietary intake and adherence to CFP among older Chinese participating in the China Health and Nutrition Survey 2009. SETTING Nine provinces across four diverse regions (Northeast, East Coast, Central and West). SUBJECTS A total of 2745 older Chinese, aged 60-69 years (n 1563) and ≥70 years (n 1182), with dietary data. RESULTS None of the participants reached all ten food group recommendations. More than half of the participants exceeded the recommended amount for grains (63%), oil (62·8%) and salt (55·7%). Ten per cent of the participants consumed dairy, while merely 0·5% met the recommended amount. Average Chinese Food Pagoda Score (CFPS) was 3·3 in men and 3·5 in women, far below the maximum possible score of 10. Women had 0·26 higher CFPS than men (P<0·001; 95% CI 0·16, 0·36). People living in medium and high urbanicity areas had significantly higher scores than those living in low urbanicity areas (P<0·001). Also, there were significant differences in CFPS according to gender, BMI, work status, education level and region. CONCLUSIONS Few older Chinese are meeting the intake of the various food groups based on the recommendations in the CFP guidelines, thus increasing the risk of malnutrition and non-communicable diseases. Action is needed to increase dissemination and uptake of nutrition education, with interventions targeted at socio-economic regions. Moreover, specific dietary guidelines for older Chinese people should be developed.
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80
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Guo Y, Cui JY, Lu H, Klaassen CD. Effect of nine diets on xenobiotic transporters in livers of mice. Xenobiotica 2015; 45:634-41. [PMID: 25566878 DOI: 10.3109/00498254.2014.1001009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
1. Lifestyle diseases are often caused by inappropriate nutrition habits and attempted to be treated by polypharmacotherapy. Therefore, it is important to determine whether differences in diet affect the disposition of drugs. Xenobiotic transporters in the liver are essential in drug disposition. 2. In the current study, mice were fed one of nine diets for 3 weeks. The mRNAs of 23 known xenobiotic transporters in livers of mice were quantified by microarray analysis, and validated by branched DNA assay. The mRNAs of 15 transporters were altered by at least one diet. Diet-restriction (10) and the atherogenic diet (10) altered the expression of the most number of transporters, followed by western diet (8), high-fat diet (4), lab chow (2), high-fructose diet (2) and EFA-deficient diet (2), whereas the low n-3 FA diet had no effect on these transporters. Seven of the 11 xenobiotic transporters in the Slc family, three of four in the Abcb family, two of four in the Abcc family and all three in the Abcg family were changed significantly. 3. This first comprehensive study indicates that xenobiotic transporters are altered by diet, and suggests there are likely diet-drug interactions due to changes in the expression of drug transporters.
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Affiliation(s)
- Ying Guo
- Department of Ethnopharmacology, Institute of Integrated Traditional Chinese and Western Medicine, Xiangya Hospital, Central South University , Changsha , People's Republic of China
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81
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Tafreschi D. The income body weight gradients in the developing economy of China. ECONOMICS AND HUMAN BIOLOGY 2015; 16:115-134. [PMID: 24680912 DOI: 10.1016/j.ehb.2014.02.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Revised: 02/12/2014] [Accepted: 02/13/2014] [Indexed: 06/03/2023]
Abstract
Existing theories predict the income gradient of individual body weight to change sign from positive to negative in process of economic development. However, there are only few empirical studies which test this hypothesis. This paper adds to the literature on that topic by investigating the case of China. Using individual and community data from 1991 to 2009 waves of the China Health and Nutrition Survey regression analyses suggest that after controlling for important confounding factors (1) higher income is positively related to future growth of individuals' BMI in less developed areas (i.e. BMI growth is 0.7-1.5 percentage points higher when comparing the richest with the poorest individuals), but negatively related to BMI growth in more developed areas (i.e. BMI growth is 0.8-1.6 percentage points lower for the richest individuals), and (2) that concentrations of overweight are "trickling down" to lower income ranks as regions become more developed. Moreover, the reversal of the income gradient appears to happen at earlier stages of development for females.
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Affiliation(s)
- Darjusch Tafreschi
- Erasmus School of Economics, Erasmus University, Rotterdam, The Netherlands.
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82
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Carlson SA, Fulton JE, Pratt M, Yang Z, Adams EK. Inadequate physical activity and health care expenditures in the United States. Prog Cardiovasc Dis 2015; 57:315-23. [PMID: 25559060 PMCID: PMC4604440 DOI: 10.1016/j.pcad.2014.08.002] [Citation(s) in RCA: 254] [Impact Index Per Article: 28.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study estimates the percentage of health care expenditures in the non-institutionalized United States (U.S.) adult population associated with levels of physical activity inadequate to meet current guidelines. Leisure-time physical activity data from the National Health Interview Survey (2004-2010) were merged with health care expenditure data from the Medical Expenditure Panel Survey (2006-2011). Health care expenditures for inactive (i.e., no physical activity) and insufficiently active adults (i.e., some physical activity but not enough to meet guidelines) were compared with active adults (i.e., ≥150minutes/week moderate-intensity equivalent activity) using an econometric model. Overall, 11.1% (95% CI: 7.3, 14.9) of aggregate health care expenditures were associated with inadequate physical activity (i.e., inactive and insufficiently active levels). When adults with any reported difficulty walking due to a health problem were excluded, 8.7% (95% CI: 5.2, 12.3) of aggregate health care expenditures were associated with inadequate physical activity. Increasing adults' physical activity to meet guidelines may reduce U.S. health care expenditures.
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Affiliation(s)
- Susan A Carlson
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA; Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA.
| | - Janet E Fulton
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - Michael Pratt
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA; Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Zhou Yang
- Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA
| | - E Kathleen Adams
- Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA
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84
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Haddad L, Cameron L, Barnett I. The double burden of malnutrition in SE Asia and the Pacific: priorities, policies and politics. Health Policy Plan 2014; 30:1193-206. [PMID: 25324529 DOI: 10.1093/heapol/czu110] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2014] [Indexed: 12/30/2022] Open
Abstract
The double burden of malnutrition is defined by the co-existence of serious levels of under- and overnutrition.(1) Nowhere have overweight rates risen as fast as in the regions of South East Asia and the Pacific. The regions are also burdened with high and often stagnant levels of undernutrition. For countries for which data are available, the regions contain nearly half of the individuals, world wide, suffering from a double burden of malnutrition. This article reviews the trends and their consequences and for nine countries in these two regions it reviews the drivers of the problem and attempts to manage it. The article concludes with an analysis of the political challenges and opportunities presented by the double burden and some suggestions for a leadership agenda within the region to address it.
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Affiliation(s)
- Lawrence Haddad
- International Food Policy Research Institute, 2033 K Street, N.W. Washington, DC 20006-1002, USA,
| | | | - Inka Barnett
- Institute of Development studies, Brighton BN19RE, UK
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85
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Skalnaya MG, Tinkov AA, Demidov VA, Serebryansky EP, Nikonorov AA, Skalny AV. Hair toxic element content in adult men and women in relation to body mass index. Biol Trace Elem Res 2014; 161:13-9. [PMID: 25048403 DOI: 10.1007/s12011-014-0082-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 07/15/2014] [Indexed: 11/30/2022]
Abstract
The primary objective of the current study was to estimate the hair toxic metal content in adults in relation to body mass index. A total of 1,229 persons including 719 women and 510 men were examined. All subjects were divided into two age groups: 1 and 2 periods of adulthood. All men and women were also subdivided into groups in relation to their values of body mass index (BMI): underweight, normal weight, overweight and obese. Hair aluminium (Al), beryllium (Be), cadmium (Cd), mercury (Hg), lead (Pb) and tin (Sn) content was evaluated using mass spectrometry with inductively coupled plasma. It has been shown that increase in body weight is accompanied by elevated hair cadmium content in women. At the same time, no significant alteration of hair cadmium concentration was observed in males. Higher values of scalp hair mercury and lead content were observed in men and women with increased body mass index independently of their age. BMI-related elevation of hair tin content was registered only in men of the first period of adulthood. A significant correlation between hair metal content and the values of BMI was observed for mercury independently of the gender of the subjects, whereas BMI values correlated significantly with hair cadmium levels in women and lead and tin levels in men. It has been also estimated that hair cadmium, mercury and lead levels in men exceed the respective values in women.
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Affiliation(s)
- Margarita G Skalnaya
- Russian Society of Trace Elements in Medicine, ANO "Centre for Biotic Medicine", Zemlyanoy Val St. 46, Moscow, Russia, 105064
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86
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Kim HJ, Hwang JT, Kim MJ, Yang HJ, Sung MJ, Kim SH, Park S, Gu EJ, Park Y, Kwon DY. The inhibitory effect of saponin derived from Cheonggukjang on adipocyte differentiation In vitro. Food Sci Biotechnol 2014. [DOI: 10.1007/s10068-014-0175-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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87
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Anterior and posterior cervical fusion in patients with high body mass index are not associated with greater complications. Spine J 2014; 14:1643-53. [PMID: 24388595 DOI: 10.1016/j.spinee.2013.09.054] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Revised: 09/16/2013] [Accepted: 09/28/2013] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Obesity has been associated with adverse surgical outcomes; however, limited information is available regarding the effect of obesity on cervical spinal fusion outcomes. PURPOSE To determine the effect of obesity on complication rates after cervical fusions. STUDY DESIGN/SETTING Retrospective cohort analysis of prospectively collected data on cervical fusion surgeries. PATIENT SAMPLE Patients in the ACS-NSQIP database from 2005 to 2010 undergoing cervical anterior or posterior fusion. OUTCOME MEASURES Primary outcome measures were 30-day postsurgical complications, including mortality, deep-vein thrombosis, pulmonary embolism, septic complications, system-specific complications, and having ≥1 complication overall. Secondary outcomes were time spent in the operating room, blood transfusions, length of stay, and reoperation within 30 days. METHODS Patients undergoing anterior or posterior cervical fusions in the 2005-2010 American College of Surgeons National Surgical Quality Improvement Program were selected using Current Procedural Terminology codes. Anterior cervical fusion patients were categorized into four groups on the basis of body mass index (BMI): nonobese (18.5-29.9 kg/m(2)), obese I (30-34.9 kg/m(2)), obese II (35-39.9 kg/m(2)), and obese III (≥40 kg/m(2)). Posterior cervical patients were categorized into two groups based on the basis of BMI: nonobese (18.5-29.9 kg/m(2)) and obese (≥30 kg/m(2)) due to the smaller sample size. Patients in the obese categories were compared with patients in the nonobese categories by the use of χ(2), Fisher's exact test, Student t test, and analysis of variance. Multivariate linear/logistic regression models were used to adjust for preoperative comorbidities. The authors report no sources of funding or conflicts of interest related to this study. RESULTS Data were available for 3,671 and 400 patients who underwent anterior or posterior cervical fusion, respectively. Obese class III patients only showed a greater incidence of deep-vein thrombosis after anterior fusions on univariate analysis. Obese patients only showed longer mean surgical times and total operating room times after posterior fusions on univariate analysis. On multivariate analyses, these differences did not remain significant. There were also no differences in multivariate analyses for overall and system-specific complication rates, lengths of hospital stay, reoperation rates, and mortality among the obesity groups when compared with the nonobese groups with anterior or posterior cervical fusions. CONCLUSIONS High BMI, regardless of obesity class, does not appear to be associated with increased complications after cervical fusion in the 30-day postoperative period.
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88
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Harmon BE, Adams SA, Scott D, Gladman YS, Ezell B, Hebert JR. Dash of faith: a faith-based participatory research pilot study. JOURNAL OF RELIGION AND HEALTH 2014; 53:747-59. [PMID: 23224838 PMCID: PMC3773027 DOI: 10.1007/s10943-012-9664-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
The Dash of Faith pilot used a community-based participatory research approach to design an experiential dietary intervention based on two African-American churches, one intervention and one comparison. Congregation members identified components that were incorporated into 12 weekly and 4 monthly sessions, with a goal of increasing fruit and vegetable and lowering fat intake. At 2 months, a marginally significant (p = 0.07) increase in fruit and vegetable consumption was observed in the intervention group but was not maintained at study conclusion. We propose that these mixed findings may be attributable, in part, to bias introduced by the participatory nature of the design.
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Affiliation(s)
- Brook E Harmon
- South Carolina Statewide Cancer Prevention and Control Program, Department of Health Promotion, Education, and Behavior, University of South Carolina, 915 Greene Street, Ste 200, Columbia, SC, 20208, USA,
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89
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Kim BS, Song MY, Kim H. The anti-obesity effect of Ephedra sinica through modulation of gut microbiota in obese Korean women. JOURNAL OF ETHNOPHARMACOLOGY 2014; 152:532-539. [PMID: 24556223 DOI: 10.1016/j.jep.2014.01.038] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Revised: 01/30/2014] [Accepted: 01/30/2014] [Indexed: 06/03/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Ephedra sinica (Ma Huang) has been used in traditional Chinese medicine for more than 5000 years for treatment of various conditions, including modern-day obesity. Ephedra has been used as a supplement for weight loss and its effects have been reported. The current study investigated the influence of ephedra on the composition of gut microbiota, and its correlation with weight loss. MATERIALS AND METHODS Clinical data of subjects were measured at pre- and post-intake of ephedra (4g of water extract, roughly equivalent of 24g of crude herb), and analysis of the alteration of gut microbiota was performed simultaneously using 16S rRNA gene based pyrosequencing. RESULTS Body weight (BW), body mass index (BMI), and body fat percentage of subjects were reduced after intake (p<0.05). In correlation analysis, Subdoligranulum, Oscillibacter, and Akkermansia showed an association with changes of BW and BMI (p<0.05). However, the alteration of gut microbiota varied by indigenous microbiota of each subject, and the dissimilarity between microbiota of subjects at pre- and post-intake were different. CONCLUSIONS The influences of gut microbiota are unique according to indigenous microbiota and differences in individual sensitivity to ephedra. Alteration of gut microbiota by ephedra intake showed correlation with loss of BW and BMI.
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Affiliation(s)
- Bong-Soo Kim
- Chunlab Inc., Seoul National University, Seoul 151-742, Republic of Korea
| | - Mi-Young Song
- Department of Rehabilitation Medicine of Korean Medicine, Dongguk University, 707 Seokjang-dong, Gyeonsangbuk-do, Republic of Korea
| | - Hojun Kim
- Department of Rehabilitation Medicine of Korean Medicine, Dongguk University, 814 Siksa-dong, Gyeonggi-do 410-773, Republic of Korea.
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Modelling the vicious circle between obesity and physical activity in children and adolescents using a bivariate probit model with endogenous regressors. J Biosoc Sci 2014; 47:61-74. [PMID: 24423649 DOI: 10.1017/s0021932013000722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The increasing prevalence of obesity in children and adolescents has become one of the most important public health issues around the world. Lack of physical activity is a risk factor for obesity, while being obese could reduce the likelihood of participating in physical activity. Failing to account for the endogeneity between obesity and physical activity would result in biased estimation. This study investigates the relationship between overweight and physical activity by taking endogeneity into consideration. It develops an endogenous bivariate probit model estimated by the maximum likelihood method. The data included 4008 boys and 4197 girls in the 5th-9th grades in Taiwan in 2007-2008. The relationship between overweight and physical activity is significantly negative in the endogenous model, but insignificant in the comparative exogenous model. This endogenous relationship presents a vicious circle in which lower levels of physical activity lead to overweight, while those who are already overweight engage in less physical activity. The results not only reveal the importance of endogenous treatment, but also demonstrate the robust negative relationship between these two factors. An emphasis should be put on overweight and obese children and adolescents in order to break the vicious circle. Promotion of physical activity by appropriate counselling programmes and peer support could be effective in reducing the prevalence of obesity in children and adolescents.
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91
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Sweet SN, Fortier MS, Strachan SM, Blanchard CM, Boulay P. Testing a Longitudinal Integrated Self-Efficacy and Self-Determination Theory Model for Physical Activity Post-Cardiac Rehabilitation. Health Psychol Res 2014; 2:1008. [PMID: 26973926 PMCID: PMC4768554 DOI: 10.4081/hpr.2014.1008] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Revised: 03/11/2013] [Accepted: 03/13/2013] [Indexed: 11/23/2022] Open
Abstract
Self-determination theory and self-efficacy theory are prominent theories in the physical activity literature, and studies have begun integrating their concepts. Sweet, Fortier, Strachan and Blanchard (2012) have integrated these two theories in a cross-sectional study. Therefore, this study sought to test a longitudinal integrated model to predict physical activity at the end of a 4-month cardiac rehabilitation program based on theory, research and Sweet et al.'s cross-sectional model. Participants from two cardiac rehabilitation programs (N=109) answered validated self-report questionnaires at baseline, two and four months. Data were analyzed using Amos to assess the path analysis and model fit. Prior to integration, perceived competence and self-efficacy were combined, and labeled as confidence. After controlling for 2-month physical activity and cardiac rehabilitation site, no motivational variables significantly predicted residual change in 4-month physical activity. Although confidence at two months did not predict residual change in 4-month physical activity, it had a strong positive relationship with 2-month physical activity (β=0.30, P<0.001). The overall model retained good fit indices. In conclusion, results diverged from theoretical predictions of physical activity, but self-determination and self-efficacy theory were still partially supported. Because the model had good fit, this study demonstrated that theoretical integration is feasible.
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Affiliation(s)
- Shane N. Sweet
- School of Psychology, University of Ottawa, Ontario, Canada
| | | | - Shaelyn M. Strachan
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Chris M. Blanchard
- Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Pierre Boulay
- Faculty of Physical Education and Sports, University of Sherbrooke, Sherbrooke, Québec, Canada
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92
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Gordon-Larsen P, Wang H, Popkin BM. Overweight dynamics in Chinese children and adults. Obes Rev 2014; 15 Suppl 1:37-48. [PMID: 24341757 PMCID: PMC3951516 DOI: 10.1111/obr.12121] [Citation(s) in RCA: 136] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Accepted: 09/20/2013] [Indexed: 01/15/2023]
Abstract
China has experienced a transition from a history of undernutrition to a rapid increase in obesity. The China Health and Nutrition Survey, an ongoing longitudinal, household-based survey of urban and rural residents of nine provinces, documents these changes using measured height and weight across 53,298 observations from 18,059 participants collected from 1991 to 2011. Adult overweight (body mass index [BMI] ≥ 25 kg/m(2)) prevalence nearly tripled from 1991 (11.7%) to 2009 (29.2%), with significant cohort and age-related effects (stronger in males). Among youth, quantile regression reveals changes across the BMI distribution. By 2009, approximately 12% of children and adolescents were overweight, and 3% of 7-11-year-olds and 1% of 12-17-year-olds were obese (International Obesity Taskforce BMI 25 and 30 kg/m(2) equivalents, respectively). In 1991-2000, urbanicity was strongly and positively associated with BMI, but in 2000-2011, trends were similar across rural and urban areas. Among women, the burden has shifted to lower educated women (the reverse is true for males, as overweight was higher in men of higher education). Our findings highlight the importance of preventive measures early in the life cycle to reduce weight gain.
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Affiliation(s)
- Penny Gordon-Larsen
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
- Carolina Population Center, University of North Carolina at Chapel Hill
| | - Huijun Wang
- Institute of Nutrition and Food Safety, Chinese Center for Disease Control and Prevention
| | - Barry M. Popkin
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
- Carolina Population Center, University of North Carolina at Chapel Hill
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Schoffman DE, Wilcox S, Baruth M. Association of body mass index with physical function and health-related quality of life in adults with arthritis. ARTHRITIS 2013; 2013:190868. [PMID: 24392226 PMCID: PMC3874331 DOI: 10.1155/2013/190868] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/26/2013] [Revised: 10/04/2013] [Accepted: 10/07/2013] [Indexed: 11/18/2022]
Abstract
Arthritis and obesity, both highly prevalent, contribute greatly to the burden of disability in US adults. We examined whether body mass index (BMI) was associated with physical function and health-related quality of life (HRQOL) measures among adults with arthritis and other rheumatic conditions. We assessed objectively measured BMI and physical functioning (six-minute walk, chair stand, seated reach, walking velocity, hand grip) and self-reported HRQOL (depression, stiffness, pain, fatigue, disability, quality of life-mental, and quality of life, physical) were assessed. Self-reported age, gender, race, physical activity, and arthritis medication use (covariates) were also assessed. Unadjusted and adjusted linear regression models examined the association between BMI and objective measures of functioning and self-reported measures of HRQOL. BMI was significantly associated with all functional (Ps ≤ 0.007) and HRQOL measures (Ps ≤ 0.03) in the unadjusted models. Associations between BMI and all functional measures (Ps ≤ 0.001) and most HRQOL measures remained significant in the adjusted models (Ps ≤ 0.05); depression and quality of life, physical, were not significant. The present analysis of a range of HRQOL and objective measures of physical function demonstrates the debilitating effects of the combination of overweight and arthritis and other rheumatic conditions. Future research should focus on developing effective group and self-management programs for weight loss for people with arthritis and other rheumatic conditions (registered on clinicaltrials.gov: NCT01172327).
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Affiliation(s)
- Danielle E. Schoffman
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 800 Sumter Street, Suite 216, Columbia, SC 29208, USA
| | - Sara Wilcox
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC 29208, USA
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, 1st Floor, 921 Assembly Street, Columbia, SC 29208, USA
| | - Meghan Baruth
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, 1st Floor, 921 Assembly Street, Columbia, SC 29208, USA
- Department of Health Science, Saginaw Valley State University, 7400 Bay Road University Center, MI 48710, USA
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94
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Meng L, Xu H, Liu A, van Raaij J, Bemelmans W, Hu X, Zhang Q, Du S, Fang H, Ma J, Xu G, Li Y, Guo H, Du L, Ma G. The costs and cost-effectiveness of a school-based comprehensive intervention study on childhood obesity in China. PLoS One 2013; 8:e77971. [PMID: 24205050 PMCID: PMC3800134 DOI: 10.1371/journal.pone.0077971] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Accepted: 09/08/2013] [Indexed: 01/22/2023] Open
Abstract
Background The dramatic rise of overweight and obesity among Chinese children has greatly affected the social economic development. However, no information on the cost-effectiveness of interventions in China is available. The objective of this study is to evaluate the cost and the cost-effectiveness of a comprehensive intervention program for childhood obesity. We hypothesized the integrated intervention which combined nutrition education and physical activity (PA) is more cost-effective than the same intensity of single intervention. Methods And Findings: A multi-center randomized controlled trial conducted in six large cities during 2009-2010. A total of 8301 primary school students were categorized into five groups and followed one academic year. Nutrition intervention, PA intervention and their shared common control group were located in Beijing. The combined intervention and its’ control group were located in other 5 cities. In nutrition education group, ‘nutrition and health classes’ were given 6 times for the students, 2 times for the parents and 4 times for the teachers and health workers. "Happy 10" was carried out twice per day in PA group. The comprehensive intervention was a combination of nutrition and PA interventions. BMI and BAZ increment was 0.65 kg/m2 (SE 0.09) and 0.01 (SE 0.11) in the combined intervention, respectively, significantly lower than that in its’ control group (0.82±0.09 for BMI, 0.10±0.11 for BAZ). No significant difference were found neither in BMI nor in BAZ change between the PA intervention and its’ control, which is the same case in the nutrition intervention. The single intervention has a relative lower intervention costs compared with the combined intervention. Labor costs in Guangzhou, Shanghai and Jinan was higher compared to other cities. The cost-effectiveness ratio was $120.3 for BMI and $249.3 for BAZ in combined intervention, respectively. Conclusions The school-based integrated obesity intervention program was cost-effectiveness for children in urban China. Trial Registration Chinese Clinical Trial Registry ChiCTR-PRC-09000402 URL:http://www.chictr.org/cn/
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Affiliation(s)
- Liping Meng
- National Institute for Nutrition and Food Safety, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Haiquan Xu
- National Institute for Nutrition and Food Safety, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ailing Liu
- National Institute for Nutrition and Food Safety, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Joop van Raaij
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Wanda Bemelmans
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Xiaoqi Hu
- National Institute for Nutrition and Food Safety, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qian Zhang
- National Institute for Nutrition and Food Safety, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Songming Du
- National Institute for Nutrition and Food Safety, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hongyun Fang
- National Institute for Nutrition and Food Safety, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jun Ma
- Beijing University Health Science Center, Beijing, China
| | - Guifa Xu
- Shandong University, Jinan, China
| | - Ying Li
- Public Health College, Harbin Medical University, Harbin, China
| | - Hongwei Guo
- School of Public Health, Fudan University, Shanghai, China
| | - Lin Du
- Guangzhou Center for Diseases Prevention and Control, Guangzhou, China
| | - Guansheng Ma
- National Institute for Nutrition and Food Safety, Chinese Center for Disease Control and Prevention, Beijing, China
- * E-mail:
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95
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Thompson AL, Houck KM, Adair L, Gordon-Larsen P, Du S, Zhang B, Popkin B. Pathogenic and obesogenic factors associated with inflammation in Chinese children, adolescents and adults. Am J Hum Biol 2013; 26:18-28. [PMID: 24123588 DOI: 10.1002/ajhb.22462] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Revised: 08/30/2013] [Accepted: 08/31/2013] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES Influenced by pathogen exposure and obesity, inflammation provides a critical biological pathway linking changing environments to the development of cardiometabolic disease. This study tests the relative contribution of obesogenic and pathogenic factors to moderate and acute CRP elevations in Chinese children, adolescents and adults. METHODS Data come from 8795 participants in the China Health and Nutrition Study. Age-stratified multinomial logistic models were used to test the association between illness history, pathogenic exposures, adiposity, health behaviors and moderate (1-10 mg/L in children and 3-10 mg/L in adults) and acute (>10mg/L) CRP elevations, controlling for age, sex and clustering by household. Backward model selection was used to assess which pathogenic and obesogenic predictors remained independently associated with moderate and acute CRP levels when accounting for simultaneous exposures. RESULTS Overweight was the only significant independent risk factor for moderate inflammation in children (RRR 2.10, 95%CI 1.13-3.89). History of infectious (RRR 1.28, 95%CI 1.08-1.52) and non-communicable (RRR 1.37, 95%CI 1.12-1.69) disease, overweight (RRR 1.66, 95%CI 1.45-1.89) and high waist circumference (RRR 1.63, 95%CI 1.42-1.87) were independently associated with a greater likelihood of moderate inflammation in adults while history of infectious disease (RRR 1.87, 95%CI 1.35-2.56) and overweight (RRR 1.40, 95%CI 1.04-1.88) were independently associated with acute inflammation. Environmental pathogenicity was associated with a reduced likelihood of moderate inflammation, but a greater likelihood of acute inflammation in adults. CONCLUSIONS These results highlight the importance of both obesogenic and pathogenic factors in shaping inflammation risk in societies undergoing nutritional and epidemiological transitions.
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Affiliation(s)
- Amanda L Thompson
- Department of Anthropology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, 27599; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, 27516
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96
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Bierl M, Marsh T, Webber L, Brown M, McPherson K, Rtveladze K. Apples and oranges: a comparison of costing methods for obesity. Obes Rev 2013; 14:693-706. [PMID: 23650980 DOI: 10.1111/obr.12044] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2013] [Revised: 03/04/2013] [Accepted: 03/22/2013] [Indexed: 02/01/2023]
Abstract
Obesity has escalated to epidemic proportions over the past 30 years resulting in increased disease burden and healthcare costs. The aim of this paper was to analyse different costing methods for obesity. Several databases have been searched to identify eligible literature estimating obesity cost. These were categorized into databases, patient-attributable fraction (PAF) and modelling studies. Studies from the United States were used to explore effects of study designs on cost outcomes. Our results show that cost outcomes are largely affected by underlying study designs, such as population size, age, cost categories (medical expenditure vs. total costs), length of the data collection and body mass index cut-offs. Three study types are likely to have an impact on reported costs, with modelling studies providing the most conservative estimates. Database studies can help to increase the overall awareness of the economic burden of obesity. PAF studies can make the obesity disease more tangible by drawing connections to diseases. Decision makers need to be aware of the different purposes and weaknesses of the studies when interpreting cost outcomes. Further research is needed to refine the existing methods and provide high-quality data accounting for the complexity of the disease.
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Affiliation(s)
- M Bierl
- Modelling Department, UK Health Forum, London, UK
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97
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Abstract
The gut microbiota has been linked with chronic diseases such as obesity in humans. However, the demonstration of causality between constituents of the microbiota and specific diseases remains an important challenge in the field. In this Opinion article, using Koch's postulates as a conceptual framework, I explore the chain of causation from alterations in the gut microbiota, particularly of the endotoxin-producing members, to the development of obesity in both rodents and humans. I then propose a strategy for identifying the causative agents of obesity in the human microbiota through a combination of microbiome-wide association studies, mechanistic analysis of host responses and the reproduction of diseases in gnotobiotic animals.
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98
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99
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Abstract
OBJECTIVE To estimate the total economic burden of physical inactivity in China. METHOD The costs of physical inactivity combine the medical and non-medical costs of five major Non Communicable Diseases (NCDs) associated with inactivity. The national data from the Chinese Behavioral Risk Factors Surveillance Surveys (2007) and the National Health Service Survey (2003) are used to compute population attributable risks (PARs) of inactivity for each major NCD. Costs specific to inactivity are obtained by multiplying each disease costs by the PAR for each NCD, by incorporating the inactivity effects through overweight and obesity. RESULTS Physical inactivity contributes between 12% and 19% to the risks associated with the five major NCDs in China, namely coronary heart disease, stroke, hypertension, cancer, and type 2 diabetes. Physical inactivity is imposing a substantial economic burden on the country, as it is responsible alone for more than 15% of the medical and non-medical yearly costs of the main NCDs in the country. CONCLUSIONS The high economic burden of physical inactivity implies the need to develop more programs and interventions that address this modifiable behavioral risk, in order to curb the rising NCDs epidemic in China.
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Affiliation(s)
- Juan Zhang
- Division of NCDs Control and Community Health, Chinese Centers for Disease Control and Prevention, China.
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100
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Kun P, Liu Y, Pei X, Luo H. Regional and urban-rural disparities in prevalence of over-weight among old people in China: evidence from four Chinese provinces. J Nutr Health Aging 2013; 17:859-64. [PMID: 24257569 DOI: 10.1007/s12603-013-0343-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE This study is a systematic analysis of regional and local (urban-rural) rates of over-weight among elderly people in China. The primary goal is to update the different trends in over-nutrition by gender and location among elderly Chinese. STUDY DESIGN AND METHODS Data used for this study were obtained from the comprehensive longitudinal data collected in the most recent waves of the China Health and Nutrition Survey in 2000 and 2006. Comparative data on four provinces, two located in the poorer west (Guangxi, Guizhou) and the other two located in the richer east (Jiangsu, Shandong) were selected from the nine provinces of China participating in the survey. The study population included elderly adults aged 60 years or older interviewed during either of the two survey waves. A total of 1996 individuals (998 in 2000 and 998 in 2006) aged 60 years or older made up the sample for the analysis. We compared changes in body mass index (BMI) with changes in the prevalence of over-nutrition across the 6 years. RESULTS The mean BMI values observed ranged from 20.8 kg/m² to 23.2 kg/m². The prevalence of over-weight ranged from 10.5% to 39.0% in both surveys. There were increases in the prevalence of overweight that were greater than the reduction in the prevalence of underweight among Chinese elderly people. Elderly people in the eastern regions and in urban areas were significantly more likely to be overweight compared with those in western regions and rural areas. CONCLUSION This study found that the rates of overweight in elderly Chinese increased overall between 2000 and 2006. China must act quickly to curb continued increases in overweight and the associated economic costs, with particular focus on target groups.
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Affiliation(s)
- P Kun
- Xiaomei Pei, Department of Sociology, School of Humanities and Social Science, Tsinghua University, P.R. China, 100084. E-mail:
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