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Malhotra R, Ostbye T, Riley CM, Finkelstein EA. Young adult weight trajectories through midlife by body mass category. Obesity (Silver Spring) 2013; 21:1923-34. [PMID: 23408493 DOI: 10.1002/oby.20318] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2012] [Accepted: 11/25/2012] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To estimate the expected weight gain through midlife for those in a given BMI category in young adulthood. DESIGN AND METHODS Group-based trajectory modeling and National Longitudinal Survey of Youth 1979 data from 1990 to 2008 were used to quantify weight trajectories through midlife for 10,038 young adult men and women stratified by BMI category. Logistic regression was used to assess the association of trajectory membership with obesity-related conditions (hypertension, diabetes, arthritis) in middle age. RESULTS Annual weight gain averaged 0.53 kg (1.17 lb) across the entire sample. However, there was considerable variation by and within BMI categories. More than 98% of men and 92% of women were on upward-sloping trajectories, generally moving into a higher BMI category by middle age. Those who experienced early and rapid weight gain during young adulthood were most likely to be on a steeper trajectory and had greater risks for obesity-related conditions. CONCLUSION This study points to the health and weight benefits of entering young adulthood with a normal BMI, but further reveals that this is no guarantee of maintaining a healthy weight through midlife. For those who are young adults today, weight maintenance is unlikely to occur without significant environmental or technical innovation.
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Affiliation(s)
- Rahul Malhotra
- Health Services and Systems Research, Duke-NUS Graduate Medical School Singapore, Singapore
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102
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Reis JP, Loria CM, Lewis CE, Powell-Wiley TM, Wei GS, Carr JJ, Terry JG, Liu K. Association between duration of overall and abdominal obesity beginning in young adulthood and coronary artery calcification in middle age. JAMA 2013; 310:280-8. [PMID: 23860986 PMCID: PMC4226407 DOI: 10.1001/jama.2013.7833] [Citation(s) in RCA: 139] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Younger individuals are experiencing a greater cumulative exposure to excess adiposity over their lifetime. However, few studies have determined the consequences of long-term obesity. OBJECTIVE To examine whether the duration of overall and abdominal obesity was associated with the presence and 10-year progression of coronary artery calcification (CAC), a subclinical predictor of coronary heart disease. DESIGN, SETTING, AND PARTICIPANTS Prospective study of 3275 white and black adults aged 18 to 30 years at baseline in 1985-1986 who did not initially have overall obesity (body mass index [BMI] ≥30) or abdominal obesity (men: waist circumference [WC] >102 cm; women: >88 cm) in the multicenter, community-based Coronary Artery Risk Development in Young Adults (CARDIA) study. Participants completed computed tomography scanning for the presence of CAC during the 15-, 20-, or 25-year follow-up examinations. Duration of overall and abdominal obesity was calculated using repeat measurements of BMI and WC, respectively, performed 2, 5, 7, 10, 15, 20, and 25 years after baseline. MAIN OUTCOMES AND MEASURES Presence of CAC was measured by computed tomography at the year 15 (2000-2001), year 20 (2005-2006), or year 25 (2010-2011) follow-up examinations. Ten-year progression of CAC (2000-2001 to 2010-2011) was defined as incident CAC in 2010-2011 or an increase in CAC score of 20 Agatston units or greater. RESULTS During follow-up, 40.4% and 41.0% developed overall and abdominal obesity, respectively. Rates of CAC per 1000 person-years were higher for those who experienced more than 20 years vs 0 years of overall obesity (16.0 vs 11.0, respectively) and abdominal obesity (16.7 vs 11.0). Approximately 25.2% and 27.7% of those with more than 20 years of overall and abdominal obesity, respectively, experienced progression of CAC vs 20.2% and 19.5% of those with 0 years. After adjustment for BMI or WC and potential confounders, the hazard ratios for CAC for each additional year of overall or abdominal obesity were 1.02 (95% CI, 1.01-1.03) and 1.03 (95% CI, 1.02-1.05), respectively. The adjusted odds ratios for CAC progression were 1.04 (95% CI, 1.01-1.06) and 1.04 (95% CI, 1.01-1.07), respectively. Associations were attenuated but largely persisted following additional adjustment for potential intermediate metabolic factors during follow-up. CONCLUSIONS AND RELEVANCE Longer duration of overall and abdominal obesity was associated with subclinical coronary heart disease and its progression through midlife independent of the degree of adiposity. Preventing or at least delaying the onset of obesity in young adulthood may lower the risk of developing atherosclerosis through middle age.
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Affiliation(s)
- Jared P Reis
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, Maryland 20892, USA.
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Nam S. Obesity and asian americans in the United States: systematic literature review. Osong Public Health Res Perspect 2013; 4:187-93. [PMID: 24159554 PMCID: PMC3767102 DOI: 10.1016/j.phrp.2013.06.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Revised: 06/10/2013] [Accepted: 06/17/2013] [Indexed: 11/06/2022] Open
Abstract
Objectives Obesity is one of the most serious health problems in the world today. Asian Americans are usually less overweight and obese than African Americans and Hispanic Americans, but the rate of obesity in Asian Americans is still increasing, especially in younger generations. This research examines Asian American obesity using existing research, as a means of finding the need for greater emphasis on Asian American obesity intervention research. Methods In this research literature review, Asian American obesity using existing research as a means of finding the need for greater emphasis on Asian American obesity intervention research is examined. A systematic review is done in order to find Asian American obesity research, due to the minimal amount of existing studies. In total, there were only nine papers which were not duplicates and which still met the criteria for inclusion, from an initial 106 papers. Results There is very little research on obesity in Asian Americans. Although the rate of obesity among Asian Americans is increasing, there are few related articles, projects, and surveys, and there is little information. There is a need for more specific and in-depth analysis of Asian American obesity. Asian Americans are associated with a lower waist circumference (WC) and BMI, while Hawaiian/Pacific Islanders are associated with a higher WC and BMI. Typically, Asian Americans who were born in the United States (US) tend to be overweight and more obese than those born in foreign countries. Conclusion Based on this literature review, it is concluded that there is a shortage of Asian American obesity research, even though there is an evident need for particular obesity intervention programs that target Asian Americans.
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Affiliation(s)
- Sanggon Nam
- Department of Health Administration, Pfeiffer University, Morrisville, NC, USA
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104
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Reis JP, Hankinson AL, Loria CM, Lewis CE, Powell-Wiley T, Wei GS, Liu K. Duration of abdominal obesity beginning in young adulthood and incident diabetes through middle age: the CARDIA study. Diabetes Care 2013; 36:1241-7. [PMID: 23248193 PMCID: PMC3631861 DOI: 10.2337/dc12-1714] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To examine whether the duration of abdominal obesity determined prospectively using measured waist circumference (WC) is associated with the development of new-onset diabetes independent of the degree of abdominal adiposity. RESEARCH DESIGN AND METHODS The Coronary Artery Risk Development in Young Adults Study is a multicenter, community-based, longitudinal cohort study of 5,115 white and black adults aged 18-30 years in 1985 to 1986. Years spent abdominally obese were calculated for participants without abdominal obesity (WC >102 cm in men and >88 cm in women) or diabetes at baseline (n = 4,092) and was based upon repeat measurements conducted 2, 5, 7, 10, 15, 20, and 25 years later. RESULTS Over 25 years, 392 participants developed incident diabetes. Overall, following adjustment for demographics, family history of diabetes, study center, and time varying WC, energy intake, physical activity, smoking, and alcohol, each additional year of abdominal obesity was associated with a 4% higher risk of developing diabetes [hazard ratio (HR) 1.04 (95% CI 1.02-1.07)]. However, a quadratic model best represented the data. HRs for 0, 1-5, 6-10, 11-15, 16-20, and >20 years of abdominal obesity were 1.00 (referent), 2.06 (1.43-2.98), 3.45 (2.28-5.22), 3.43 (2.28-5.22), 2.80 (1.73-4.54), and 2.91 (1.60-5.29), respectively; P-quadratic < 0.001. CONCLUSIONS Longer duration of abdominal obesity was associated with substantially higher risk for diabetes independent of the degree of abdominal adiposity. Preventing or at least delaying the onset of abdominal obesity in young adulthood may lower the risk of developing diabetes through middle age.
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Affiliation(s)
- Jared P Reis
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD, USA.
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105
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Lloyd L, Miller B. The Impact of Seasonality on Changes in Body Weight and Physical Activity in Mexican-American Women. Women Health 2013; 53:262-81. [DOI: 10.1080/03630242.2013.781095] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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106
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Lim SS, Norman RJ, Davies MJ, Moran LJ. The effect of obesity on polycystic ovary syndrome: a systematic review and meta-analysis. Obes Rev 2013; 14:95-109. [PMID: 23114091 DOI: 10.1111/j.1467-789x.2012.01053.x] [Citation(s) in RCA: 304] [Impact Index Per Article: 27.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Revised: 09/02/2012] [Accepted: 09/13/2012] [Indexed: 12/14/2022]
Abstract
While many women with polycystic ovary syndrome (PCOS) are overweight, obese or centrally obese, the effect of excess weight on the outcomes of PCOS is inconsistent. The review aimed to assess the effects of overweight, obesity and central obesity on the reproductive, metabolic and psychological features of PCOS. MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL) and PSYCINFO were searched for studies reporting outcomes according to body mass index categories or body fat distribution. Data were presented as mean difference or risk ratio (95% confidence interval). This review included 30 eligible studies. Overweight or obese women with PCOS had decreased sex hormone-binding globulin (SHBG), increased total testosterone, free androgen index, hirsutism, fasting glucose, fasting insulin, homeostatic model assessment-insulin resistance index and worsened lipid profile. Obesity significantly worsened all metabolic and reproductive outcomes measured except for hirsutism when compared to normal weight women with PCOS. Overweight women had no differences in total testosterone, hirsutism, total-cholesterol and low-density lipoprotein-cholesterol compared to normal weight women and no differences in SHBG and total testosterone compared to obese women. Central obesity was associated with higher fasting insulin levels. These results suggest that prevention and treatment of obesity is important for the management of PCOS.
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Affiliation(s)
- S S Lim
- The Robinson Institute, University of Adelaide, Adelaide, South Australia, Australia
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107
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Takahashi PY, Sauver JLS, Olson TC, Huber JM, Cha SS, Ebbert JO. Association between underweight and hospitalization, emergency room visits, and mortality among patients in community medical homes. Risk Manag Healthc Policy 2013; 6:1-6. [PMID: 23378790 PMCID: PMC3559084 DOI: 10.2147/rmhp.s39976] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background In older adults, underweight (body mass index [BMI] <18.5) has been associated with increased mortality. This increased mortality risk may be associated with increased health care utilization. We evaluated the relationship between underweight and hospitalization, emergency room visits, and mortality. Methods An analysis of a retrospective cohort study was conducted at a multisite academic primary care medical practice in Minnesota. The patients were ≥60 years of age, impaneled within primary care on January 1, 2011, and had a BMI measurement recorded between January 1, 2011, and December 31, 2011. Individuals were excluded if they refused review of their medical record. The primary measurement was BMI, which was categorized as underweight (BMI < 18.5) or normal and obese (BMI ≥ 18.5). The outcomes were hospitalization, emergency room visits, and mortality in the 2011 calendar year. Associations between underweight and each outcome were calculated using logistic regression. Interactions between underweight and gender were assessed in the logistic regression models. The final results were adjusted for age, gender, comorbid health conditions, and single living status. Results The final cohort included 21,019 patients, of whom 220 (1%) were underweight. Underweight patients had a higher likelihood of hospitalization compared with patients with higher BMI (adjusted odds ratio [OR] 1.64; 95% confidence interval [CI] 1.21–2.22). Underweight patients were also more likely to visit the emergency room (adjusted OR 1.70; 95% CI 1.28–2.25) or to die (adjusted OR 3.64; 95% CI 2.33–5.69). Men with a BMI < 18.5 compared with those having a BMI ≥ 18.5 had the highest odds of hospitalization (OR 3.45; 95% CI 1.59–7.48). Conclusion Underweight older adults, especially men, have higher odds of hospitalization, emergency room visits, and mortality. Future work on underweight might involve improving weight status, which may reduce the risk of hospitalization, emergency room visits, and mortality.
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Affiliation(s)
- Paul Y Takahashi
- Division of Primary Care Internal Medicine, Mayo Clinic, Rochester, MN, USA
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108
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Song YM, Lee K, Sung J, Yang Y. Changes in eating behaviors and body weight in Koreans: The Healthy Twin Study. Nutrition 2013; 29:66-70. [DOI: 10.1016/j.nut.2012.03.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Revised: 03/16/2012] [Accepted: 03/16/2012] [Indexed: 10/28/2022]
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Runfola CD, Von Holle A, Trace SE, Brownley KA, Hofmeier SM, Gagne DA, Bulik CM. Body dissatisfaction in women across the lifespan: results of the UNC-SELF and Gender and Body Image (GABI) studies. EUROPEAN EATING DISORDERS REVIEW 2013; 21:52-9. [PMID: 22949165 PMCID: PMC3745223 DOI: 10.1002/erv.2201] [Citation(s) in RCA: 90] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
To explore age differences in current and preferred silhouette and body dissatisfaction (current - preferred silhouette discrepancy) in women aged 25-89 years using figural stimuli [range: 1 (very small) to 9 (very large)]. Data were abstracted from two online convenience samples (N = 5868). t-tests with permutation-adjusted p-values examined linear associations between mean silhouette scores (current, preferred, discrepancy score) and age with/without stratification by body mass index (BMI). Modal current silhouette was 5; modal preferred silhouette was 4; mean discrepancy score was 1.8. There was no significant association between current silhouette and age, but a positive linear association between preferred silhouette and age remained after stratification by BMI. A significant inverse linear association of silhouette discrepancy score and age was found only prior to stratification by BMI. Body dissatisfaction exists in women across the adult life span and is influenced by BMI.
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Affiliation(s)
- Cristin D. Runfola
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 USA
| | - Ann Von Holle
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 USA
| | - Sara E. Trace
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 USA
| | - Kimberly A. Brownley
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 USA
| | - Sara M. Hofmeier
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 USA
| | - Danielle A. Gagne
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 USA
| | - Cynthia M. Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 USA
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
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Ball K, Cleland V, Salmon J, Timperio AF, McNaughton S, Thornton L, Campbell K, Jackson M, Baur LA, Mishra G, Brug J, Jeffery RW, King A, Kawachi I, Crawford DA. Cohort profile: the resilience for eating and activity despite inequality (READI) study. Int J Epidemiol 2012; 42:1629-39. [PMID: 23255533 DOI: 10.1093/ije/dys165] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The Resilience for Eating and Activity Despite Inequality (READI) cohort was established to address the following two key aims: to investigate the pathways (personal, social and structural) by which socio-economic disadvantage influences lifestyle choices associated with obesity risk (physical inactivity, poor dietary choices) and to explore mechanisms underlying 'resilience' to obesity risk in socio-economically disadvantaged women and children. A total of 4349 women aged 18-46 years and 685 children aged 5-12 years were recruited from 80 socio-economically disadvantaged urban and rural neighbourhoods of Victoria, Australia, and provided baseline (T1: 2007-08) measures of adiposity, physical activity, sedentary and dietary behaviours; socio-economic and demographic factors; and psychological, social and perceived environmental factors that might impact on obesity risk. Audits of the 80 neighbourhoods were undertaken at baseline to provide objective neighbourhood environmental data. Three-year follow-up data (2010-11) have recently been collected from 1912 women and 382 children. Investigators welcome enquiries regarding data access and collaboration.
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Affiliation(s)
- Kylie Ball
- Centre for Physical Activity & Nutrition Research, Deakin University, Melbourne, Victoria, Australia, Menzies Research Institute, Hobart, Tasmania, Australia, Paediatrics & Child Health, Children's Hospital, Westmead & University of Sydney, Sydney, NSW Australia, School of Population Health, University of Queensland, Herston, QLD, Australia, VU University Medical Center, Amsterdam, The Netherlands, Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, MN, USA, School of Medicine, Stanford University, Stanford, CA, USA and School of Public Health, Harvard University, Boston, MA, USA
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Gagne DA, Von Holle A, Brownley KA, Runfola CD, Hofmeier S, Branch KE, Bulik CM. Eating disorder symptoms and weight and shape concerns in a large web-based convenience sample of women ages 50 and above: results of the Gender and Body Image (GABI) study. Int J Eat Disord 2012; 45:832-44. [PMID: 22729743 PMCID: PMC3459309 DOI: 10.1002/eat.22030] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/01/2012] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Limited research exists on eating disorder symptoms and attitudes and weight and shape concerns in women in midlife to older adulthood. We conducted an online survey to characterize these behaviors and concerns in women ages 50 and above. METHOD Participants (n = 1,849) were recruited via the Internet and convenience sampling. RESULTS Eating disorder symptoms, dieting and body checking behaviors, and weight and shape concerns were widely endorsed. Younger age and higher body mass index (BMI) were associated with greater endorsement of eating disorder symptoms, behaviors, and concerns. DISCUSSION Weight and shape concerns and disordered eating behaviors occur in women over 50 and vary by age and BMI. Focused research on disordered eating patterns in this age group is necessary to develop age-appropriate interventions and to meet the developmental needs of an important, growing, and underserved population.
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Affiliation(s)
- Danielle A. Gagne
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC
| | - Ann Von Holle
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC
| | | | | | - Sara Hofmeier
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC
| | | | - Cynthia M. Bulik
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, Department of Nutrition, University of North Carolina, Chapel Hill, NC
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Freedman DS, Khan LK, Serdula MK, Dietz WH, Srinivasan SR, Berenson GS. Racial Differences in the Tracking of Childhood BMI to Adulthood. ACTA ACUST UNITED AC 2012; 13:928-35. [PMID: 15919847 DOI: 10.1038/oby.2005.107] [Citation(s) in RCA: 144] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The possibility that there are racial differences in the patterns of BMI (kilograms per meter squared) change throughout life has not been examined. For example, the high prevalence of obesity among black women could result from a higher prevalence of obesity among black girls or because normal-weight black girls experience larger BMI increases in adolescence or adulthood than do their white counterparts. Therefore, we examined the tracking of childhood BMI into adulthood in a biracial (36% black) sample. RESEARCH METHODS AND PROCEDURES Five- to 14-year-old children (2392) were followed for (mean) 17 years. Childhood overweight was defined as BMI > or = 95th percentile, and adult obesity was defined as BMI > or = 30 kg/m(2). RESULTS The tracking of childhood BMI differed between whites and blacks. Among overweight children, 65% of white girls vs. 84% of black girls became obese adults, and predictive values among boys were 71% (whites) vs. 82% (blacks). These racial differences reflected contrasting patterns in the rate of BMI change. Although the initial BMI of black children was not higher than that of white children, BMI increases with age were larger among black girls and overweight black boys than among their white counterparts. In contrast, relatively thin (BMI < 50th percentile) white boys were more likely to become overweight adults than were their black counterparts. DISCUSSION These findings emphasize the black/white differences in BMI changes with age. Because of the adult health consequences of childhood-onset obesity, early prevention should be given additional emphasis.
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Affiliation(s)
- David S Freedman
- CDC Mailstop K-26, 4770 Buford Highway, Atlanta GA 30341-3717, USA.
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113
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Patterns of weight change and progression to overweight and obesity differ in men and women: implications for research and interventions. Public Health Nutr 2012; 16:1463-75. [PMID: 22939318 DOI: 10.1017/s1368980012003801] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To evaluate long-term patterns of weight change and progression to overweight and obesity during adulthood. DESIGN Prospective study. Changes in mean BMI, waist circumference (WC) and weight were assessed over a mean 26-year follow-up (1971–1975 to 1998–2001). Mean BMI (95% CI) and mean WC (95% CI) of men and women in BMI and age groups were computed. Mean weight change in BMI and age categories was compared using analysis of covariance. SETTING Framingham Heart Study Offspring/Spouse Nutrition Study. SUBJECTS Men and women (n 2394) aged 20–63 years. RESULTS During follow-up, increases in BMI (men: 2?2 kg/m2; women: 3?7 kg/m2) and WC (men: 5?7 cm; women: 15?1 cm) were larger in women than men. BMI gains were greatest in younger adults (20–39 years) and smallest in obese older adults (50–69 years). The prevalence of obesity doubled in men (to 33?2%) and tripled in women (to 26?6 %). Among normal-weight individuals, abdominal obesity developed in women only. The prevalence of abdominal obesity increased 1?8-fold in men (to 53?0%) and 2?4-fold in women (to 71?2 %). Weight gain was greatest in the youngest adults (20–29 years), particularly women. Gains continued into the fifth decade among men and then declined in the sixth decade; in women gains continued into the sixth decade. CONCLUSIONS Patterns of weight change and progression to obesity during adulthood differ in men and women. Preventive intervention strategies for overweight and obesity need to consider age- and sex-specific patterns of changes in anthropometric measures.
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Poobalan AS, Aucott LS, Clarke A, Smith WCS. Physical activity attitudes, intentions and behaviour among 18-25 year olds: a mixed method study. BMC Public Health 2012; 12:640. [PMID: 22892291 PMCID: PMC3490897 DOI: 10.1186/1471-2458-12-640] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Accepted: 07/31/2012] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Young people (18-25 years) during the adolescence/adulthood transition are vulnerable to weight gain and notoriously hard to reach. Despite increased levels of overweight/obesity in this age group, physical activity behaviour, a major contributor to obesity, is poorly understood. The purpose of this study was to explore physical activity (PA) behaviour among 18-25 year olds with influential factors including attitudes, motivators and barriers. METHODS An explanatory mixed method study design, based on health Behaviour Change Theories was used. Those at university/college and in the community, including those Not in Education, Employment or Training (NEET) were included. An initial self reported quantitative questionnaire survey underpinned by the Theory of Planned Behaviour and Social Cognitive Theory was conducted. 1313 questionnaires were analysed. Results from this were incorporated into a qualitative phase also grounded in these theories. Seven focus groups were conducted among similar young people, varying in education and socioeconomic status. Exploratory univariate analysis was followed by multi staged modelling to analyse the quantitative data. 'Framework Analysis' was used to analyse the focus groups. RESULTS Only 28% of 18-25 year olds achieved recommended levels of PA which decreased with age. Self-reported overweight/obesity prevalence was 22%, increasing with age, particularly in males. Based on the statistical modelling, positive attitudes toward PA were strong predictors of physical activity associated with being physically active and less sedentary. However, strong intentions to do exercise, was not associated with actual behaviour. Interactive discussions through focus groups unravelled attitudes and barriers influencing PA behaviour. Doing PA to feel good and to enjoy themselves was more important for young people than the common assumptions of 'winning' and 'pleasing others'. Further this age group saw traditional health promotion messages as 'empty' and 'fear of their future health' was not a motivating factor to change current behaviour. CONCLUSION 18-25 year olds are a difficult group to reach and have low levels of PA. Factors such as, 'enjoyment', 'appearance 'and 'feeling good' were deemed important by this specific age group. A targeted intervention incorporating these crucial elements should be developed to improve and sustain PA levels.
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Affiliation(s)
- Amudha S Poobalan
- Public Health Nutrition Research Group, Division of Applied Health Sciences, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD, UK
| | - Lorna S Aucott
- Public Health Nutrition Research Group, Division of Applied Health Sciences, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD, UK
| | - Amanda Clarke
- School of Health, Community and Education studies, Northumbria University, Coach Lane Campus, Benton, Newcastle upon Tyne, NE7 7XA, UK
| | - W Cairns S Smith
- Public Health Nutrition Research Group, Division of Applied Health Sciences, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD, UK
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The Impact of Surveillance on Weight Change and Predictors of Change in a Population-Based Firefighter Cohort. J Occup Environ Med 2012; 54:961-8. [DOI: 10.1097/jom.0b013e31825296e0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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116
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LeCheminant JD, Merrill RM. Improved health behaviors persist over two years for employees in a worksite wellness program. Popul Health Manag 2012; 15:261-6. [PMID: 22823340 DOI: 10.1089/pop.2011.0083] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This study evaluates whether improvements in health behaviors related to a worksite wellness program persist through 2 years. The program was designed to build behavioral capability and self-efficacy by yielding immediately applicable skills and tools and segmenting the behavior change process into weekly, manageable doses. Analyses are based on 267 individuals employed from 2009 through 2011. Significant improvements were observed in the frequency and volume of exercise, and the consumption of vegetables and fruits over 12 and 24 months. Requests for health coaching significantly increased over the study period. Thus, the type of wellness program evaluated in this study produced sustainable health behaviors through 24 months, which likely will translate into future positive health outcomes and improved employee productivity.
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Affiliation(s)
- James D LeCheminant
- Department of Exercise Science, College of Life Sciences, Brigham Young University, Provo, UT 84602, USA.
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Polotsky HN, Brokhin M, Omry G, Polotsky AJ, Tuttle RM. Iatrogenic hyperthyroidism does not promote weight loss or prevent ageing-related increases in body mass in thyroid cancer survivors. Clin Endocrinol (Oxf) 2012; 76:582-5. [PMID: 22004309 DOI: 10.1111/j.1365-2265.2011.04264.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
CONTEXT Thyroid cancer survivors represent a unique population in which the potential long-term effects of brief periods of intentional thyroid hormone withdrawal and/or prolonged periods of iatrogenic hyperthyroidism on body weight and body mass were evaluated. OBJECTIVES The objectives of this study were to characterize body mass changes over several years in a cohort of thyroid cancer patients with iatrogenic hyperthyroidism and to compare these changes with the expected weight gain in age-matched healthy control populations. We also evaluated the possibility that the method of preparation [thyroid hormone withdrawal (THW) vs recombinant human TSH (rhTSH)] for radioactive iodine remnant ablation may be associated with differences in body mass at the time of the final follow-up. DESIGN/SETTING/PATIENTS/INTERVENTIONS: A retrospective review identified 153 patients with thyroid cancer who underwent total thyroidectomy at one major medical centre. Of the 153 patients, 143 also had radioactive iodine remnant ablation: 70 after THW and 73 after rhTSH. MAIN OUTCOME MEASURES Change in weight and BMI at 1-2 and 3-5 years of follow-up points were examined. Annualized weight variation within the cohort was compared with age-matched population controls expressed in kilogram/year. RESULTS Significant weight gain was noted for the full cohort after 3-5 years of follow-up as compared to baseline (76 ± 21 kg at baseline vs 79 ± 23 kg at 3-5 years of follow-up, P < 0·01), which represented a 3·2% increase. Female and male patients with thyroid cancer experienced 0·46 and 0·94 kg/year gain in weight, respectively, which is similar or somewhat higher than previously published age-matched population controls (ranging from 0·23 to 0·34 kg/year). When expressed as per cent change and comparing the final weight to the pre-operative baseline, the rhTSH group experienced approximately a 1·7% increase in weight compared with the 3·9% increase seen with THW patients (P = 0·02). When expressed as kg/year change, the rhTSH cohort had 0·34 kg/year change compared with the 0·64 kg/year change seen in the thyroid hormone withdrawal patients (P = 0·02). CONCLUSION In otherwise, healthy patients with differentiated thyroid cancer, significant weight gain occurred during the 3-5 years of follow-up despite ongoing thyrotropin suppression. The data suggest that mild iatrogenic hyperthyroidism does not promote weight loss or prevent ageing-related weight gain. Greater weight gain was seen in patients prepared for radioactive remnant ablation with THW than with rhTSH.
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Affiliation(s)
- Hanah N Polotsky
- Department of Medicine, Memorial Sloan Kettering Cancer, New York, NY, USA.
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Turk MW, Sereika SM, Yang K, Ewing LJ, Hravnak M, Burke LE. Psychosocial correlates of weight maintenance among black & white adults. Am J Health Behav 2012; 36:395-407. [PMID: 22370440 DOI: 10.5993/ajhb.36.3.10] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES To investigate (1) weight maintenance among black and white participants and (2) psychosocial correlates (eg, healthy eating barriers, self-efficacy, stress) of weight maintenance 18 months after behavioral weight-loss treatment. METHODS Linear and logistic regression examined weight change and unsuccessful weight maintenance (>5% weight gain) among 107 black and white adults. RESULTS After controlling for socio-demographics, differences in weight maintenance between ethnicities were not generally noted. Healthy eating barriers and stressful life events were associated with weight gain, P<.04. CONCLUSIONS Strategies to cope with stressful events and overcome barriers to eating healthfully are needed for weight maintenance among both ethnicities.
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Gilsing AMJ, Weijenberg MP, Hughes LAE, Ambergen T, Dagnelie PC, Goldbohm RA, Brandt PAVD, Schouten LJ. Longitudinal changes in BMI in older adults are associated with meat consumption differentially, by type of meat consumed. J Nutr 2012; 142:340-9. [PMID: 22223576 DOI: 10.3945/jn.111.146258] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Hypotheses regarding the role of meat consumption in body weight modulation are contradictory. Prospective studies on an association between meat consumption and BMI change are limited. We assessed the association between meat consumption and change in BMI over time in 3902 men and women aged 55-69 y from the Netherlands Cohort Study. Dietary intake was estimated at baseline using a FFQ. BMI was ascertained through baseline self-reported height (1986) and weight (1986, 1992, and 2000). Analyses were based on sex-specific categories of daily total fresh meat, red meat, beef, pork, minced meat, chicken, processed meat, and fish consumption at baseline. Linear mixed effect modeling adjusted for confounders was used to assess longitudinal associations. Significant cross-sectional differences in BMI between quintiles of total meat intake were observed (P-trend < 0.01; both sexes). No association between total fresh meat consumption and prospective BMI change was observed in men (BMI change highest vs. lowest quintile after 14 y: -0.06 kg/m²; P = 0.75) and women (BMI change: 0.26 kg/m²; P = 0.20). Men with the highest intake of beef experienced a significantly lower increase in BMI after 6 and 14 y than those with the lowest intake (BMI change after 14 y 0.60 kg/m²). After 14 y, a significantly higher increase in BMI was associated with higher intakes of pork in women (BMI change highest vs. lowest quintile: 0.47 kg/m²) and chicken in both sexes (BMI change highest vs. lowest category in both men and women: 0.36 kg/m²). The results remained similar when stratifying on median baseline BMI, and age-stratified analyses yielded mixed results. Differential BMI change effects were observed for several subtypes of meat. However, total meat consumption, or factors directly related to total meat intake, was not strongly associated with weight change during the 14-y prospective follow-up in this elderly population.
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Affiliation(s)
- Anne M J Gilsing
- Department of Epidemiology, School for Oncology and Developmental Biology, Maastricht University, Maastricht, Netherlands.
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Ng C, Corey PN, Young TK. Divergent body mass index trajectories between Aboriginal and non-Aboriginal Canadians 1994-2009--an exploration of age, period, and cohort effects. Am J Hum Biol 2012; 24:170-6. [PMID: 22275122 DOI: 10.1002/ajhb.22216] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2011] [Revised: 10/17/2011] [Accepted: 11/22/2011] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES Aboriginal Canadians have a high burden of obesity and obesity-related chronic conditions. Body mass index (BMI) trajectories from 1994 to 2009 were estimated for Aboriginal and non-Aboriginal Canadians using self-reported height and weight data from the National Population Health Survey to explore age, period, and cohort effects of BMI change. METHODS Linear growth curve models were estimated for 311 Aboriginal and 10,967 non-Aboriginal respondents divided into five birth cohorts born in the 1940s, 50s, 60s, 70s, and 80s. RESULTS Overall, Aboriginal Canadians experienced higher rates of BMI increase over the 14-year period. Rate of BMI increase was specifically higher for Aboriginal adults born in the 1960s and 1970s when compared with non-Aboriginal adults. At ages 25, 35, and 45, recent-born cohorts had consistently higher BMIs compared with earlier-born cohorts with magnitudes of differences typically larger in the Aboriginal population. Recent-born cohorts also exhibited steeper BMI trajectories. CONCLUSIONS Cohort effects may be responsible for the divergent BMI trajectories between Aboriginal and non-Aboriginal Canadians born in the 1960s and 1970s. Aboriginal Canadians, particularly of more recent-born cohorts, experienced faster increases in BMI from 1994 to 2009 than non-Aboriginal Canadians, suggesting that prevalence of obesity will continue to rise in this population without intervention.
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Affiliation(s)
- Carmina Ng
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.
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Ailshire JA, House JS. The Unequal Burden of Weight Gain: An Intersectional Approach to Understanding Social Disparities in BMI Trajectories from 1986 to 2001/2002. SOCIAL FORCES; A SCIENTIFIC MEDIUM OF SOCIAL STUDY AND INTERPRETATION 2011; 90:397-423. [PMID: 23413316 PMCID: PMC3570259 DOI: 10.1093/sf/sor001] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
The implications of recent weight gain trends for widening social disparities in body weight in the United States are unclear. Using an intersectional approach to studying inequality, and the longitudinal and nationally representative American's Changing Lives study (19862001/2002), we examine social disparities in body mass index trajectories during a time of rapid weight gain in the United States. Results reveal complex interactive effects of gender, race, socioeconomic position and age, and provide evidence for increasing social disparities, particularly among younger adults. Most notably, among individuals who aged from 25-39 to 45-54 during the study interval, low-educated and low-income black women experienced the greatest increase in BMI, while high-educated and high-income white men experienced the least BMI growth. These new findings highlight the importance of investigating changing disparities in weight intersectionally, using multiple dimensions of inequality as well as age, and also presage increasing BMI disparities in the U.S. adult population.
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Ade JN, Rohrer J, Rea NK. Immigration, income, drinking and obesity in African American adults. J Immigr Minor Health 2011; 13:659-63. [PMID: 21188529 DOI: 10.1007/s10903-010-9431-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The objective of this study was to investigate the relationship between immigration status, income, drinking and overweight and obesity in African American adults residing in the United States using an internet web based survey. Data on 303 adult African American immigrants and non-immigrants was collected using a self-administered web based survey. Respondents were recruited using a snowball sampling technique to obtain a convenience sample. Multiple logistic regression analysis were used to test the independent effects of the immigration status while controlling for confounding effects of demographic, social and behavioral variables. The results of the study showed no significant difference between obesity and immigration status in black adults residing in the US (adjusted odds ration = 1.1095, P = 0.7489). Significance at the P < 0.05 level was demonstrated for obesity and two independent variables: age (OR = 1.0332, P = 0.0298) and days per month consumed more than 5 alcoholic beverages (OR = 1.7735, P = 0.0001). Adult African American immigrants in this study sample were not at risk of being obese due to their immigration status. However, age and days in a month in which more than 5 alcoholic beverages are consumed were significant risk factors for obesity. Primary care providers should be alert for obesity and alcohol consumption in this population.
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Affiliation(s)
- Julius N Ade
- Regional Epidemiologist-Infection Control, New York Sate Department of Health, New York County Health Services Review Organization-MedReview, 199 Water Street, 27th Floor, New York, NY 10038, USA.
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Boggs DA, Palmer JR, Spiegelman D, Stampfer MJ, Adams-Campbell LL, Rosenberg L. Dietary patterns and 14-y weight gain in African American women. Am J Clin Nutr 2011; 94:86-94. [PMID: 21593501 PMCID: PMC3127509 DOI: 10.3945/ajcn.111.013482] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND An inverse association between healthy dietary patterns and weight gain that has been shown in white populations is not evident in the few studies in African Americans, a population at high risk of obesity. OBJECTIVE We prospectively assessed dietary patterns in relation to weight gain in African American women. DESIGN The study included 41,351 women aged 21-54 y at enrollment in 1995 in the Black Women's Health Study. Participants reported dietary intake in 1995 and 2001 and current weight every 2 y through mailed questionnaires. By using factor analysis, 2 major dietary patterns were identified: a "vegetables/fruit" pattern and a "meat/fried foods" pattern. Multivariable mixed linear regression models were used to estimate mean weight gain in 14 y of follow-up according to each dietary pattern. RESULTS Among women who maintained similar dietary patterns in 1995 and 2001, the vegetables/fruit pattern was associated with significantly less weight gain over 14 y (10.88 and 11.94 kg in the highest and lowest quintiles, respectively; P for trend = 0.003), whereas the meat/fried foods pattern was associated with significantly greater weight gain (12.02 and 10.15 kg in the highest and lowest quintiles, respectively; P for trend < 0.001). The associations were stronger among women aged <35 y, whose weight gain was greatest. CONCLUSION These findings are the first to indicate that African American women may be better able to achieve long-term weight maintenance by consuming a diet high in vegetables and fruit and low in red meat and fried foods.
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Affiliation(s)
- Deborah A Boggs
- Slone Epidemiology Center at Boston University, Boston, MA 02215, USA.
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Lindh I, Ellström AA, Milsom I. The long-term influence of combined oral contraceptives on body weight. Hum Reprod 2011; 26:1917-24. [PMID: 21507999 DOI: 10.1093/humrep/der094] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND There is a need to increase our knowledge regarding the influence of combined oral contraceptive (COC) use on individual weight change in the long term. The first aim of this study was to assess the long-term influence of COC's on body weight, and the second aim was to describe body weight increase during the fertile period. METHODS Postal questionnaires regarding weight/height, contraception, reproductive health, smoking and exercise were sent to random samples of 19-year-old women born in 1962 (n= 656) and 1972 (n = 780) resident in the city of Gothenburg, Sweden in 1981 and 1991. The responders were followed longitudinally, and the same women were contacted again every fifth year from 1986-2006 and from 1996-2006, respectively. RESULTS There was no significant difference in weight increase in the women grouped according to use or non-use of COC or duration of COC use. The two cohorts of women were grouped together in a longitudinal analysis and the following factors age, COC use, children, smoking and exercise were included in the model. The only predictor for weight increase was age (P < 0.001), resulting in a gain of 0.45 kg/year. There was no correlation between weight change and COC use or duration of COC use, number of children or exercise. Smokers decreased (P < 0.001) their weight by 1.64 kg per 15 years. Between 19 and 44 years of age, the 62-cohort had successively increased (P < 0.0001) their body weight/BMI by 10.6 kg/3.7. Women from the 72-cohort had a higher (P < 0.05) weight/BMI compared with women of the same age from the 62-cohort. CONCLUSIONS COC use was not found to be a predictor for weight increase in the long term. Body weight/BMI increased by 10.6 kg/3.7 between 19 and 44 years of age in a random sample of Swedish women born in 1962. Women from the 72-cohort had a greater body weight/BMI compared with the 62-cohort.
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Affiliation(s)
- Ingela Lindh
- Department of Obstetrics and Gynecology, Sahlgrenska Academy at Gothenburg University, Sahlgrenska University Hospital, Gothenburg, Sweden
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125
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Walsemann KM, Ailshire JA. BMI Trajectories During the Transition to Older Adulthood: Persistent, Widening, or Diminishing Disparities by Ethnicity and Education? Res Aging 2011; 33:286-311. [PMID: 30089935 DOI: 10.1177/0164027511399104] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Previous research has produced inconsistent results on whether education and ethnic disparities in body mass index (BMI) persist, widen, or diminish over time. The authors investigate how education and ethnicity, independently and conditionally, influence BMI trajectories during the transition to older adulthood. Employing random coefficient modeling, the authors analyzed eight biennial waves of data (1992-2006) from the Health and Retirement Study, a nationally representative longitudinal study of individuals born between 1931 and 1941. After adjusting for health behaviors and health status, education and ethnic disparities in BMI persisted for most groups, but narrowed between high-educated White men and both low-educated Hispanic men and high-educated Black men. As such, the findings generally support the persistent inequality interpretation. Therefore, even though interventions targeted at earlier points in the life course may be effective in reducing BMI disparities in later life, social and health policies directed at reducing obesity among older adults is also warranted.
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Abstract
BACKGROUND With the rising prevalence of childhood obesity over the last several decades, and the call for more family-based intervention research to combat childhood obesity, it is important to examine the extant research on family-based interventions in order to make recommendations and improve future research. OBJECTIVE To conduct a meta-analysis of family-based interventions targeting childhood obesity in the last decade in order to inform the research in the next decade. METHODS A literature review was conducted between December 2009-April 2010. Studies published between the years 2000-2009 that used family-based interventions to treat childhood obesity were included. A total of 20 studies met inclusionary criteria. RESULTS Although results varied by study design, the majority of studies had a moderate to large effect size for change in the target child's BMI (BMI percentile, zBMI, percent overweight) after participating in a family-based intervention. Long-term change varied by study, but the majority of studies produced sustainable change in child BMI, although smaller effect sizes. Change in secondary variables (dietary intake, sugar-sweetened beverage intake, physical activity) were substantially different between studies and are reported as trends. CONCLUSION To date, there is preliminary evidence suggesting that family-based interventions targeting childhood obesity are successful in producing weight loss in the short and long-term. Including families in weight loss treatment of obese children warrants further implementation and study. Limitations with the research, recommendations for future research, and implications for practitioners working with overweight/obese children are discussed.
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Affiliation(s)
- Jerica M. Berge
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN
| | - Jessie C. Everts
- Department of Family Social Science, University of Minnesota, Minneapolis, MN
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Hankinson AL, Daviglus ML, Bouchard C, Carnethon M, Lewis CE, Schreiner PJ, Liu K, Sidney S. Maintaining a high physical activity level over 20 years and weight gain. JAMA 2010; 304:2603-10. [PMID: 21156948 PMCID: PMC3864556 DOI: 10.1001/jama.2010.1843] [Citation(s) in RCA: 188] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CONTEXT Data supporting physical activity guidelines to prevent long-term weight gain are sparse, particularly during the period when the highest risk of weight gain occurs. OBJECTIVE To evaluate the relationship between habitual activity levels and changes in body mass index (BMI) and waist circumference over 20 years. DESIGN, SETTING, AND PARTICIPANTS The Coronary Artery Risk Development in Young Adults (CARDIA) study is a prospective longitudinal study with 20 years of follow-up, 1985-1986 to 2005-2006. Habitual activity was defined as maintaining high, moderate, and low activity levels based on sex-specific tertiles of activity scores at baseline. Participants comprised a population-based multicenter cohort (Chicago, Illinois; Birmingham, Alabama; Minneapolis, Minnesota; and Oakland, California) of 3554 men and women aged 18 to 30 years at baseline. MAIN OUTCOME MEASURES Average annual changes in BMI and waist circumference. RESULTS Over 20 years, maintaining high levels of activity was associated with smaller gains in BMI and waist circumference compared with low activity levels after adjustment for race, baseline BMI, age, education, cigarette smoking status, alcohol use, and energy intake. Men maintaining high activity gained 2.6 fewer kilograms (0.15 BMI units per year; 95% confidence interval [CI], 0.11-0.18 vs 0.20 in the lower activity group; 95% CI, 0.17-0.23), and women maintaining higher activity gained 6.1 fewer kilograms (0.17 BMI units per year; 95% CI, 0.12-0.21 vs 0.30 in the lower activity group; 95% CI, 0.25-0.34). Men maintaining high activity gained 3.1 fewer centimeters in waist circumference (0.52 cm per year; 95% CI, 0.43-0.61 cm vs 0.67 cm in the lower activity group; 95% CI,0.60-0.75 cm) and women maintaining higher activity gained 3.8 fewer centimeters(0.49 cm per year; 95% CI, 0.39-0.58 cm vs 0.67 cm in the lower activity group; 95% CI, 0.60-0.75 cm) [corrected]. CONCLUSION Maintaining high activity levels through young adulthood may lessen weight gain as young adults transition to middle age, particularly in women.
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Affiliation(s)
- Arlene L Hankinson
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Dr, Ste 1400, Chicago, IL 60611, USA.
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Østbye T, Krause KM, Swamy GK, Lovelady CA. Effect of breastfeeding on weight retention from one pregnancy to the next: results from the North Carolina WIC program. Prev Med 2010; 51:368-72. [PMID: 20655944 DOI: 10.1016/j.ypmed.2010.07.017] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2010] [Revised: 06/10/2010] [Accepted: 07/15/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Pregnancy-related weight retention can contribute to obesity, and breastfeeding may facilitate postpartum weight loss. We investigated the effect of breastfeeding on long-term postpartum weight retention. METHODS Using data from the North Carolina Special Supplemental Nutrition Program for Women, Infants, and Children (WIC; 1996-2004), weight retention was assessed in women aged 18 years or older who had more than one pregnancy available for analysis (n=32,920). Using multivariable linear regression, the relationship between duration of breastfeeding after the first pregnancy and change in pre-pregnancy weight from the first pregnancy to the second pregnancy was estimated, controlling for demographic and weight-related covariates. RESULTS Mean time between pregnancies was 2.8 years (standard deviation (SD) 1.5), and mean weight retention from the first to the second pregnancy was 4.9kg (SD 8.7). In covariate-adjusted analyses, breastfeeding for 20 weeks or more resulted in 0.39kg (standard error (SE) 0.18) less weight retention at the beginning of the second pregnancy relative to no breastfeeding (p=0.025). CONCLUSION In this large, racially diverse sample of low-income women, long-term weight retention was lower among those who breastfed for at least 20 weeks.
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Affiliation(s)
- Truls Østbye
- Department of Community and Family Medicine, Duke University Medical Center, Durham, NC 27710, USA.
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Ostbye T, Malhotra R, Landerman LR. Body mass trajectories through adulthood: results from the National Longitudinal Survey of Youth 1979 Cohort (1981-2006). Int J Epidemiol 2010; 40:240-50. [PMID: 20819785 DOI: 10.1093/ije/dyq142] [Citation(s) in RCA: 95] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Most studies describing change in body mass through adulthood model an 'average' trajectory bearing the same functional form in the underlying population. Latent-class growth modelling has revealed the presence of several underlying body mass/obesity trajectory groups among children and adolescents, but has not been applied to capture adult body mass trajectories. We apply the technique to identify adult body mass trajectory groups, risk factors for group membership and (time-varying) modifiers of trajectory level within each group, and assess association between group membership and important health outcomes in midlife. METHODS Body mass trajectory groups, from age 18 to 49 years, were identified using latent-class growth modelling based on the National Longitudinal Survey of Youth 1979 (n = 9681). Role of gender, race/ethnicity and age cohort as risk factors for group membership, and of highest grade of education completed, years of urban living, years in employment, years in poverty and years married as modifiers of trajectory level was evaluated. RESULTS Four trajectory groups, 'normal weight', 'overweight', 'late adulthood obesity' and 'early adulthood obesity' were identified. Males, Blacks and those born later had higher odds of being in the three latter groups. More education and years married lowered the trajectory within each group. The prevalence of most health outcomes was lowest in the 'normal weight' group, somewhat greater in the 'overweight' group, greater again in the 'late adult obesity group' and highest in the 'early adulthood obesity' group. CONCLUSION Regular body mass index screening and monitoring in early adult life may identify a person as belonging to one of these four groups early, and allow the individual and health-care providers opportunities to initiate behavioural or other interventions better tailored to the specific group.
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Affiliation(s)
- Truls Ostbye
- Department of Community and Family Medicine, Duke University Medical Centre, Durham, NC, USA.
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Poobalan AS, Aucott LS, Precious E, Crombie IK, Smith WCS. Weight loss interventions in young people (18 to 25 year olds): a systematic review. Obes Rev 2010; 11:580-92. [PMID: 19874531 DOI: 10.1111/j.1467-789x.2009.00673.x] [Citation(s) in RCA: 106] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
This systematic review assesses weight loss interventions in young adults (18-25 years), who are vulnerable to weight gain. This age group experience critical life course points (leaving home for higher studies or job, pregnancy, cohabitation) and develop/establish lifestyle and behavioural patterns making this an opportune intervention period. Medline, Embase, Cinahl, PsychINFO and Cochrane Library were searched (1980 to March 2008). All trials and cohort studies with control groups that assessed weight loss interventions in this specific age group were included finally identifying 14 studies. Before and after comparison of behavioural/motivational interventions (-2.40 kg; 95% CI -5.4 to 0.6) and combination interventions (-2.96; 95% CI -4.4 to -1.5) consistently showed weight loss. Behavioural/motivational interventions increased self-efficacy, the desire to control weight, boosted self-esteem, and increased satisfaction with body areas and appearance. Interventions also showed improvements in HDL cholesterol, insulin, glucose and maximum oxygen uptake. However, recruitment to participation in interventions was a barrier for this age group with small sample sizes and short-term interventions. There may be gender differences in preference to participation in certain type of interventions. Further research to understand attitudes towards healthy lifestyle and preferences of interventions is needed to develop suitable interventions for this vulnerable age group.
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Affiliation(s)
- A S Poobalan
- Section of Population Health, University of Aberdeen, Aberdeen, UK.
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Kimokoti RW, Newby PK, Gona P, Zhu L, Jasuja GK, Pencina MJ, McKeon-O'Malley C, Fox CS, D'Agostino RB, Millen BE. Diet quality, physical activity, smoking status, and weight fluctuation are associated with weight change in women and men. J Nutr 2010; 140:1287-93. [PMID: 20484553 PMCID: PMC2884329 DOI: 10.3945/jn.109.120808] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2010] [Revised: 01/28/2010] [Accepted: 05/01/2010] [Indexed: 12/20/2022] Open
Abstract
The effect of diet quality on weight change, relative to other body weight determinants, is insufficiently understood. Furthermore, research on long-term weight change in U.S. adults is limited. We evaluated prospectively patterns and predictors of weight change in Framingham Offspring/Spouse (FOS) women and men (n = 1515) aged > or =30 y with BMI > or = 18.5 kg/m2 and without cardiovascular disease, diabetes, and cancer at baseline over a 16-y period. Diet quality was assessed using the validated Framingham Nutritional Risk Score. In women, older age (P < 0.0001) and physical activity (P < 0.05) were associated with lower weight gain. Diet quality interacted with former smoking status (P-interaction = 0.02); former smokers with lower diet quality gained an additional 5.2 kg compared with those with higher diet quality (multivariable-adjusted P-trend = 0.06). Among men, older age (P < 0.0001) and current smoking (P < 0.01) were associated with lower weight gain, and weight fluctuation (P < 0.01) and former smoking status (P < 0.0001) were associated with greater weight gain. Age was the strongest predictor of weight change in both women (partial R(2) = 11%) and men (partial R(2) = 8.6%). Normal- and overweight women gained more than obese women (P < 0.05) and younger adults gained more weight than older adults (P < 0.0001). Patterns and predictors of weight change differ by sex. Age in both sexes and physical activity among women as well as weight fluctuation and smoking status in men were stronger predictors of weight change than diet quality among FOS adults. Women who stopped smoking over follow-up and had poor diet quality gained the most weight. Preventive interventions need to be sex-specific and consider lifestyle factors.
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Affiliation(s)
- Ruth W Kimokoti
- Department of Family Medicine, Boston University School of Medicine, Boston, MA 02118, USA.
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Wang LY, Denniston M, Lee S, Galuska D, Lowry R. Long-term health and economic impact of preventing and reducing overweight and obesity in adolescence. J Adolesc Health 2010; 46:467-73. [PMID: 20413083 DOI: 10.1016/j.jadohealth.2009.11.204] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2009] [Revised: 11/12/2009] [Accepted: 11/13/2009] [Indexed: 10/20/2022]
Abstract
PURPOSE Using data from the 2000 National Medical Expenditure Panel Survey and estimates from published studies, this study projected the long-term health and economic impacts of preventing and reducing overweight and obesity in today's adolescents. METHODS We developed a body mass index progression model to project the impact of a 1% point reduction in both overweight and obese adolescents aged 16-17 years at present on the number of nonoverweight, overweight, and obese adults at age 40 years. We then estimated its impact on the lifetime medical costs and quality-adjusted life years (QALYs) after age 40. Medical costs (in 2007 dollars) and QALYs were discounted to age 17 years. RESULTS A 1% point reduction in both overweight and obese adolescents ages 16-17 years at present could reduce the number of obese adults by 52,821 in the future. As a result, lifetime medical care costs after age 40 years would decrease by $586 million and lifetime QALYs would increase by 47,138. In the worst case scenario, the 1% point reduction would lower medical costs by $463 million and increase QALYs by 34,394; in the best case scenario, it would reduce medical costs by $691 million and increase QALYs by 57,149. CONCLUSIONS Obesity prevention in adolescents goes beyond its immediate benefits; it can also reduce medical costs and increase QALYs substantially in later life. Therefore, it is important to include long-term health and economic benefits when quantifying the impact of obesity prevention in adolescents.
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Affiliation(s)
- Li Y Wang
- Division of Adolescent and School Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
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Tang JW, Kushner RF, Thompson J, Baker DW. Physician counseling of young adults with rapid weight gain: a retrospective cohort study. BMC FAMILY PRACTICE 2010; 11:31. [PMID: 20433703 PMCID: PMC2874787 DOI: 10.1186/1471-2296-11-31] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2009] [Accepted: 04/30/2010] [Indexed: 11/10/2022]
Abstract
BACKGROUND The incidence of weight gain is highest during young adulthood. Our study aims to describe weight gain patterns among young adults and to evaluate physician recognition of and counseling for rapid weight gain. METHODS This retrospective cohort study included patients ages 18-35 at an academic internal medicine clinic between 2004-2008. We conducted chart reviews to determine weight change over time, whether weight gain greater than 3 lbs/year was documented, whether counseling was provided, and whether patients became overweight. We categorized weight gain documentation by location on the problem list, encounter diagnosis, or note text. We categorized counseling as weight-specific or general diet and exercise counseling. We used Chi-square tests to evaluate the relationship between weight change over time and the following variables: gender, diagnosis of weight gain, and counseling for weight gain. Fisher's Exact test was used to test for an association between diagnosis and counseling category. RESULTS The study included 365 patients. Weight gain was greater than 3 lbs/year for 24% (90/365) of patients, of whom 56 (15%) gained 3-5.9 lbs/year, and 34 (9%) gained more than 6 lbs/year. Among patients gaining more than 3 lbs/year, physicians documented weight gain as a problem in only 10% (9/90). Of the 9 patients for whom weight gain was documented, physicians provided weight-specific counseling in three, and general diet and exercise counseling in four. Of the 81 individuals with no documented diagnosis of weight gain, 63% had no documented counseling, but 34% received general diet and exercise counseling. Among patients with over 180 days of follow-up, 8% (10/126) became overweight. CONCLUSIONS Physicians infrequently recognize or counsel for weight gain among young adult patients. Improving identification of patients with rapid weight gain can provide an opportunity for tailored weight-related counseling.
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Affiliation(s)
- Joyce W Tang
- Division of General Internal Medicine, Northwestern University Feinberg School of Medicine, Chicago, USA.
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Kwak L, Kremers SP, Candel MJ, Visscher TL, Brug J, van Baak MA. Changes in skinfold thickness and waist circumference after 12 and 24 months resulting from the NHF-NRG In Balance-project. Int J Behav Nutr Phys Act 2010; 7:26. [PMID: 20370934 PMCID: PMC2858095 DOI: 10.1186/1479-5868-7-26] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2009] [Accepted: 04/07/2010] [Indexed: 11/17/2022] Open
Abstract
Background More knowledge is needed regarding the effectiveness of weight gain prevention programmes. The present study tested the 12-and 24-month effectiveness of the 'Netherlands Research programme weight Gain prevention' (NHF-NRG)-In Balance-project, a worksite-based intervention aimed at the prevention of weight gain. Methods Twelve worksites (n = 553 participants) were matched and assigned to either intervention or control group. The worksites and employees of the intervention group received individual (i.e. pedometer, computer-tailored advice) and environmental (i.e. changes in worksite canteen) interventions, directed at physical activity and food intake over 1-year. Differences between the intervention and control group in changes in body weight, BMI, skinfold thickness and waist circumference at 12 and 24 months were examined using multilevel linear regression analyses adjusting for various baseline characteristics (age, gender, BMI, marital status, education and smoking status). Results A significant greater reduction in skinfold thickness was found in the intervention group than in the control group, both after 12-and 24 months (Unstandardized regression coefficients (B) = -2.52, 95% C.I. -4.58, -0.45; p = 0.018; B = -4.83, 95% C.I. 6.98, -2.67; p < 0.001 respectively). Significant differences were also observed for changes in waist circumferences both at 12 months (B = -1.50, 95% C.I. -2.35, -0.65; p < 0.001) and at 24 months (B = -1.30, 95% C.I. -2.18, -0.42; p = 0.005). No significant changes were observed for weight and BMI. Conclusions The project was effective with regard to changes in skinfold thickness and waist circumference both at 12 and 24 months. It supports the usefulness of worksite-based prevention, especially regarding maintenance of behavioral changes.
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Affiliation(s)
- Lydia Kwak
- Unit for Preventive Nutrition, Department of Biosciences, Karolinska Institutet, Huddinge, Sweden.
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Parker VG, Coles C, Logan BN, Davis L. The LIFE project: a community-based weight loss intervention program for rural African American women. FAMILY & COMMUNITY HEALTH 2010; 33:133-43. [PMID: 20216356 PMCID: PMC2852247 DOI: 10.1097/fch.0b013e3181d594d5] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Obesity continues to be a significant health problem for African American women. While a number of obesity interventions target urban African American women, few target rural ones. The LIFE Project is a 10-week intervention designed to reduce obesity in this rural population. Two different interventions (spiritually based and nonspiritually based) were pilot tested, each utilizing a pretest, posttest design. Results demonstrated that both interventions led to significant reductions in weight, but the spiritually based intervention led to additional improvements. The LIFE Project also demonstrated that churches are appropriate settings to deliver health interventions to these women.
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Affiliation(s)
- Veronica G. Parker
- Professor, School of Nursing, Clemson University Director, Center for Research on Health Disparities, Clemson University Clemson, SC
| | - Charlton Coles
- Agency for Toxic Substances and Disease Registry/Division of Toxicology and Environmental Medicine, Centers for Disease Control and Prevention, Atlanta, GA
| | - Barbara N. Logan
- Professor Emeritus, School of Nursing, Clemson University, Clemson, SC
| | - Leroy Davis
- Executive Director, Center of Excellence in Rural and Minority Health, Voorhees College, Denmark, SC
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Behavioral and cognitive effects of a worksite-based weight gain prevention program: the NHF-NRG in balance-project. J Occup Environ Med 2010; 51:1437-46. [PMID: 19952793 DOI: 10.1097/jom.0b013e3181bd895a] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Examine the effectiveness of the worksite-based weight gain prevention program Netherlands Heart Foundation-Netherlands Research program weight Gain prevention In Balance, with regard to behavioral changes and corresponding cognitive determinants. METHODS A nonrandomized pretest-repeated posttest control group design was applied in 12 worksites. Intervention groups received individual and environmental interventions, directed at physical activity and food intake. Measurements were executed at baseline and after 12 and 24 months. RESULTS Nearly all behaviors in the intervention group improved more than in the control group, even though improvements in behaviors were often too small to reach statistical significance. No positive intervention effects were observed for the cognitive factors. CONCLUSION Differential changes between the intervention and control group were observed for several important dietary and physical activity behaviors. Valuable information is gained regarding the implementation of weight gain prevention programs in worksites.
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Camões M, Lopes C, Oliveira A, Santos AC, Barros H. Overall and central obesity incidence in an urban Portuguese population. Prev Med 2010; 50:50-5. [PMID: 19945478 DOI: 10.1016/j.ypmed.2009.11.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2009] [Revised: 11/05/2009] [Accepted: 11/13/2009] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To provide overall and central obesity incidence estimates by gender, age and educational level in an urban Portuguese population. METHODS As part of the EPIPorto study, 1,621 Porto, Portugal adult residents were evaluated in 1999-2003 and 2005-2008. Overall obesity was defined by a BMI > or = 30.0 kg/m(2) and central obesity by a WC >88.0 cm in women and >102.0 cm in men. Relative risks (RR) and 95% confidence intervals (95% CI) were computed using Poisson regression. Survival analysis was also performed. RESULTS The age-adjusted incidence rates/100 person-years of overall and central obesity were, respectively, 1.70, 95% CI: 1.34-2.19 and 5.97, 95% CI: 5.09-7.03 in women; 1.08, 95% CI: 0.73-1.64 and 2.38, 95% CI: 1.81-3.20 in men. In multivariate analysis, older women presented a higher risk of overall obesity. Moreover, a significant inverse association was found between obesity and education in women (>11 vs. <5 years: RR=0.43, 95% CI: 0.22-0.84, for overall obesity; RR=0.45 95% CI: 0.29-0.69, for central obesity). For overall obesity, 10.1% of women and 5.1% of men became obese during the 5-year study period. Higher proportions were observed regarding central obesity, 29.1% and 11.4% for women and men, respectively. CONCLUSIONS Over time, individuals developed central obesity faster than overall obesity. Our results support that increasing levels of education limit this ongoing development of obesity, particularly among women.
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Affiliation(s)
- Miguel Camões
- Department of Hygiene and Epidemiology, University of Porto Medical School, Alameda Prof. Hernani Monteiro, 4200-319 Porto, Portugal
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Shiffman S, Sweeney CT, Pillitteri JL, Sembower MA, Harkins AM, Wadden TA. Weight management advice: what do doctors recommend to their patients? Prev Med 2009; 49:482-6. [PMID: 19786045 DOI: 10.1016/j.ypmed.2009.09.015] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2009] [Revised: 09/16/2009] [Accepted: 09/21/2009] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To examine the weight management interventions that a broad population of adults reported receiving from physicians and assess what drug-related and behavioral information physicians provided when they prescribe weight loss medications. METHODS A random-digit dialed telephone survey was conducted in 2005-2006 with a representative sample of 3,500 American adults. RESULTS The most frequently reported interventions were having a doctor tell them about the health problems associated with being overweight (48.0%), or suggesting diet and exercise (46.5%). Few respondents reported having been referred to a formal diet program (5.2%), prescribed a weight loss medication (4.0%), recommended a non-prescription weight loss product (1.8%), or recommended stomach bypass surgery (1.5%). The proportion of individuals who reported each intervention increased across levels of body mass index (p<0.001). Of those who reported being prescribed a weight loss medication (n=155), only 29.5% (n=44) reported receiving all six counseling interventions that were assessed. CONCLUSIONS Many overweight patients have not been advised to lose weight, diet, or exercise, and physicians have been particularly reluctant to recommend medications. When physicians do prescribe medications, appropriate counseling too often fails to accompany the prescription. Efforts are needed to increase the involvement of physicians in guiding patients to effective weight management approaches.
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139
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Age, period and cohort effects on body weight and body mass index in adults: The Doetinchem Cohort Study. Public Health Nutr 2009; 12:862-70. [DOI: 10.1017/s1368980008003091] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
AbstractObjectiveTo study the development of body weight with ageing, in a general adult population, taking into account possible period and cohort effects.DesignA prospective cohort study with 11 years of follow-up. At baseline and after 6 and 11 years, body weight and height were measured.SettingThe Doetinchem Cohort Study, consisting of inhabitants of Doetinchem, a town in a rural area of The Netherlands.SubjectsIn total, 4070 healthy men and women aged 20–59 years at baseline.ResultsIncrease in BMI with ageing was less profound based on cross-sectional data than based on longitudinal data. More recent-born cohorts had a higher BMI at a given age than cohorts who were born earlier. Increase in mean BMI with ageing was observed in all age groups and was similar for groups with a different educational level. Highest increase in BMI over 11 years was observed in the youngest group, aged 20–29 years at baseline (2·2 [95 % CL 2·0, 2·3] kg/m2), and lowest increase in the oldest group, aged 50–59 years at baseline (1·1 [1·0, 1·3] kg/m2).ConclusionsFindings of the present study using longitudinal data suggest that increase in BMI with ageing is underestimated in all age groups by studying cross-sectional data only. Further, weight gain is present in all educational levels and does not stop at middle age.
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Strandberg TE, Strandberg AY, Salomaa VV, Pitkälä KH, Tilvis RS, Sirola J, Miettinen TA. Explaining the obesity paradox: cardiovascular risk, weight change, and mortality during long-term follow-up in men. Eur Heart J 2009; 30:1720-7. [PMID: 19429917 DOI: 10.1093/eurheartj/ehp162] [Citation(s) in RCA: 100] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIMS To examine life-long weight trajectories behind the 'obesity paradox', and whether cardiovascular disease (CVD) risk contributes. METHODS AND RESULTS Cardiovascular disease risk and body mass index (BMI) at mean ages of 25, 47 (year 1974), and 73 years (year 2000) were available of a socioeconomically homogenous sample of 1114 men, without chronic diseases and diabetes in 1974. Overweight was defined as BMI > 25 kg/m(2), and 7-year mortality (2000-06) from the mean age of 73 years determined (188 deaths). Between 1974 and 2000, 44.3% (n = 494) were constantly overweight, 31.0% (n = 345) constantly normal weight, 12.2% (n = 136) moved from normal to overweight, and 12.5% (n = 139) moved from overweight to normal. The last group had highest CVD risk in midlife, and in late life more co-morbidities and greatest total mortality (P < 0.001). Adjusted mortality hazard ratio was 2.0 (95% confidence interval, CI 1.3-3.0; constantly normal weight group as referent). The hazard ratio remained similar (1.9, 95% CI 1.2-3.0) after adjustment for prevalent diseases in 2000. CONCLUSION In old age, both normal weight and overweight men are a mixture of individuals with different weight trajectories during their life course. Overweight and high-CVD risk in midlife with subsequent weight decrease predict the worst prognosis in late life.
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Affiliation(s)
- Timo E Strandberg
- Institute of Health Sciences/Geriatrics, University of Oulu and University Hospital, Unit of General Practice, FIN-90014 Oulu, Finland.
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Hill JO. Can a small-changes approach help address the obesity epidemic? A report of the Joint Task Force of the American Society for Nutrition, Institute of Food Technologists, and International Food Information Council. Am J Clin Nutr 2009; 89:477-84. [PMID: 19088151 DOI: 10.3945/ajcn.2008.26566] [Citation(s) in RCA: 228] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The continued rise in obesity rates in most countries suggests that current programs and initiatives designed to combat obesity have not been successful in reversing the obesity epidemic. Obesity rates are increasing because of a gradual weight gain in most populations. There has been little long-term success in treating established obesity through lifestyle change, perhaps because of the large permanent changes in diet and physical activity required to keep weight off. An alternative strategy to address the obesity epidemic involves not focusing on weight loss but promoting small changes in diet and physical activity to initially prevent further weight gain. With the use of this strategy, obesity rates could first be stabilized in most populations and then, over time, decrease gradually. Supporting data show that small reductions in conscious energy intake and increases in physical activity can reduce excessive weight gain. The opportunity exists to use the small-changes approach to bring different stakeholders together to create a national initiative to address the global epidemic of obesity. The Joint Task Force of the American Society for Nutrition, Institute of Food Technologists, and International Food Information Council believe that a small-changes framework, aimed at helping people make conscious small changes in lifestyle behaviors, in combination with efforts by the private sector to gradually "ratchet down" some of the environmental factors that have contributed to excessive energy intake and the declining rates of physical activity, can be successful in reducing obesity rates. Such an initiative would benefit from the support of educational and social marketing campaigns developed with governmental input and support.
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Abstract
AbstractObjectivesTo evaluate the 5-year incidence of obesity in a sample of CVD-free adults and investigate the potential effect of several sociodemographic and lifestyle habits on weight change and obesity incidence in these individuals.MethodsMen (n 1514) and women (n 1528) (>18 years) without any clinical evidence of CVD, living in the Attica area of Greece, were enrolled in the ATTICA study from May 2001 to December 2002. The sampling was random, multistage and included information about various sociodemographic, lifestyle (diet, exercise and smoking), biochemical and clinical characteristics. In 2006, the 5-year follow-up was performed through telephone calls or personal visits. Data from the 1364 participants are analysed in the present work.ResultsThe 5-year incidence of obesity was 21·8 % in men and 11·9 % in women. The ratio of men to women revealed that more men than women developed obesity, while more women than men became overweight during the follow-up period. It was found that men were 1·6 times more likely to develop obesity compared with women; abnormal waist circumference, smoking habits and the presence of hypercholesterolaemia increased the risk for developing obesity, irrespective of age and baseline lifestyle characteristics of the participants. In the multivariate analysis, no association was detected between adherence to a Mediterranean diet and incidence of obesity in initially normal-weight individuals.ConclusionsObesity remains a serious health problem for the Greek population; the alarming rates of excess body weight continue to increase. Preventive measures should be urgently addressed, targeting particularly those with metabolic risk factors.
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143
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Strong KA, Parks SL, Anderson E, Winett R, Davy BM. Weight gain prevention: identifying theory-based targets for health behavior change in young adults. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION 2008; 108:1708-1715. [PMID: 18926139 PMCID: PMC2614557 DOI: 10.1016/j.jada.2008.07.007] [Citation(s) in RCA: 123] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2007] [Accepted: 04/22/2008] [Indexed: 12/21/2022]
Abstract
Young adults attending college are more vulnerable to weight gain than the general population. We sought to identify health behavior change targets related to weight management in college students. Based on the Social Cognitive Theory model for health behavior change, we investigated the health-related lifestyle behaviors and physiological characteristics of this population. Forty-three college students (18.3+/-0.1 years) completed a series of quantitative assessments (eg, body weight and composition, cardiorespiratory fitness, and diet and activity habits) and structured qualitative assessments (ie, structured interview or focus group). Participants were predominantly normal weight (mean body mass index 22.2+/-0.4) and fit (maximal oxygen consumption 50.5+/-1.5 mL/kg/minute). However, healthful eating and physical activity were not considered high priorities, despite having ample free time, high exercise self-efficacy, positive outcome expectations for exercise, and a desire to exercise more. Participants reported that regularly engaging in exercise was difficult. This may have been due to poor planning/time management, satisfaction with body image, lack of accountability, and feelings of laziness. Dietary patterns generally met recommendations but were low in fruits, vegetables, and whole grains. Social support for exercise and healthful dietary habits were important factors associated with health behaviors. Students reported a decline in exercise and dietary habits relative to high school, which may have contributed to college weight gain. Our results suggest that this population may not have adequate self-regulatory skills, such as planning and self-monitoring, to maintain healthful behaviors in the college environment. Food and nutrition professionals working with young adults attending college may use these findings to guide the behavioral therapy component of their weight management medical nutrition therapy goals and outcomes.
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Affiliation(s)
- Kathryn A. Strong
- Department of Human Nutrition, Foods and Exercise, Virginia Tech, Blacksburg, VA 24061, Ph: 540.231.6784, Fax: 540.231.3916
| | - Serena L. Parks
- Department of Human Nutrition, Foods and Exercise, Virginia Tech, Blacksburg, VA 24061, Ph: 540.231.6784, Fax: 540.231.3916
| | - Eileen Anderson
- Department of Psychology, Center for Research in Health Behavior, Virginia Tech, Blacksburg, VA 24061
| | - Richard Winett
- Department of Psychology, Center for Research in Health Behavior, Virginia Tech, Blacksburg, VA 24061
| | - Brenda M. Davy
- Department of Human Nutrition, Foods and Exercise, Virginia Tech, Blacksburg, VA 24061, Ph: 540.231.6784, Fax: 540.231.3916
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Franz CE, Grant MD, Jacobson KC, Kremen WS, Eisen SA, Xian H, Romeis J, Thompson-Brenner H, Lyons MJ. Genetics of body mass stability and risk for chronic disease: a 28-year longitudinal study. Twin Res Hum Genet 2007; 10:537-45. [PMID: 17708694 DOI: 10.1375/twin.10.4.537] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We examined the contributions of genetic and environmental factors to body mass index (BMI) over approximately 28 years. Participants were 693 male, predominantly middle-class, twins (355 monozygotic, 338 dizygotic) from the Vietnam Era Twin Registry. The phenotypic correlation between age 20 and age 48 BMI was 0.52; the genetic correlation was 0.60. Most of the remaining variance at both times was accounted for by nonshared environmental factors. Since genetic factors are not perfectly correlated, this indicates that other genes affect BMI at one or both time points, leaving room for further exploration of the genetics of body mass stability. Mean BMI increased significantly from 22.7 (normal) to 27.8 (overweight). Overweight BMI at age 20 predicted midlife adult onset diabetes (adjusted odds ratio = 4.62, 95% CI 1.91 to 11.18), but not hypertension. Depending on one's vantage point, the results indicate elements of both stability and change in BMI. Very similar phenotypic and genetic correlations were observed over a similar time period in a WW II twin sample, but without the substantial mean increase in BMI. It seems unlikely that different genes influence BMI in the two cohorts. Therefore, we argue that nonshared environmental factors are probably primarily responsible for the secular increase in midlife BMI. Our results also provide prospective evidence that early excess BMI may have serious long-term health consequences, and that this risk is not limited to minorities or adults of lower socioeconomic status.
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Affiliation(s)
- Carol E Franz
- Department of Psychiatry, University of California San Diego, La Jolla, California 92093, United States of America.
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145
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Nemesure B, Wu SY, Hennis A, Leske MC. Nine-year incidence of obesity and overweight in an African-origin population. Int J Obes (Lond) 2007; 32:329-35. [PMID: 17848937 DOI: 10.1038/sj.ijo.0803721] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To provide 9-year incidence estimates for obesity and overweight and describe weight changes over time in an African-origin population. DESIGN A population-based cohort in which participants were examined at baseline and reexamined after 9 years. MEASUREMENTS Obesity and overweight were defined as having body mass indices (BMIs)> or =30 and 25 kg m(-2), respectively. Incidence rates were based on persons without such conditions at baseline and are presented along with 95% confidence intervals. RESULTS Of the 869 men and 921 women at risk at baseline, the 9-year gender-specific incidence rates for obesity were 6.9% (95% confidence interval (5.3, 8.8)) and 13.1% (11.0, 15.5), respectively. The incidence of obesity steadily declined with age, decreasing from 14.4% for those between 40 and 49 years of age to 1.5% for those who were 70 years and older. Overall, the incidence of obesity over 9 years was approximately 10%. The 9-year incidence rate for overweight was 23.3% (20.5, 26.3). Changes in weight over the 9-year period varied by age group. Persons 40-49 years of age at baseline gained, on average, almost 3% of their baseline body weight, whereas persons > or =70 years lost 5% of their body weight in 9 years. CONCLUSIONS This study highlights the high incidence of obesity/overweight in this cohort and suggests that the future public health burden of excess weight and its associated comorbidities may be elevated in this population of African origin. The development of strategies and interventions for the prevention and treatment of obesity/overweight are therefore of primary and immediate importance.
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Affiliation(s)
- B Nemesure
- Department of Preventive Medicine, Stony Brook University School of Medicine, Stony Brook, NY 11794-8036, USA.
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Kwak L, Kremers SPJ, Werkman A, Visscher TLS, van Baak MA, Brug J. The NHF-NRG In Balance-project: the application of Intervention Mapping in the development, implementation and evaluation of weight gain prevention at the worksite. Obes Rev 2007; 8:347-61. [PMID: 17578384 DOI: 10.1111/j.1467-789x.2006.00304.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Very few examples of theory-driven and systematically developed weight gain prevention interventions for adults have been described in the literature. The present paper systematically describes the development, implementation and evaluation framework of a weight gain prevention programme directed at young adults at the worksite, namely the NHF-NRG In Balance-project. It not only can be used as a guide to systematically develop weight gain prevention interventions, but also gives an overview of the current theoretical and empirical knowledge-base in the field of obesity prevention. The outline of the paper follows the Intervention Mapping protocol, which includes a systematic inventory of important health issues, their risk behaviours and determinants of these risk behaviours, and specification of the proximal objectives of the programme directed at both energy intake and energy expenditure. The objectives are translated into behaviour change methods and strategies, which are combined in a stepwise intervention programme, and used for a detailed evaluation plan (process and effect evaluation). The NHF-NRG In Balance-project combines mass media and individually tailored communications with worksite environmental changes to raise awareness, to motivate and to enable energy balance behaviour changes. A quasi-experimental pre-test-multiple post-test control group design was applied in 12 worksites (>500 employees).
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Affiliation(s)
- L Kwak
- Department of Human Biology, Maastricht University, Maastricht, The Netherlands.
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Levine MD, Klem ML, Kalarchian MA, Wing RR, Weissfeld L, Qin L, Marcus MD. Weight gain prevention among women. Obesity (Silver Spring) 2007; 15:1267-77. [PMID: 17495203 PMCID: PMC2531237 DOI: 10.1038/oby.2007.148] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE Women 25 to 45 years old are at risk for weight gain and future obesity. This trial was designed to evaluate the efficacy of two interventions relative to a control group in preventing weight gain among normal or overweight women and to identify demographic, behavioral, and psychosocial factors related to weight gain prevention. RESEARCH METHODS AND PROCEDURES Healthy women (N = 284), ages 25 to 44, with BMI < 30 were randomized to one of three intervention conditions: a clinic-based group, a correspondence course, or an information-only control. Intervention was provided over 2 years, with a follow-up at Year 3. BMI and factors related to eating and weight were assessed yearly. RESULTS Over the 3-year study period, 40% (n = 114) of the women remained at or below baseline body weight (+/-2 lbs), and 60% gained weight (>2 lbs). Intervention had no effect on weight over time. Independently of intervention, women who were older, not actively dieting to lose weight, and who reported less perceived hunger at baseline were more likely to be successful at weight maintenance. Weight maintenance also was associated with increasing dietary restraint (conscious thoughts and purposeful behaviors to control calorie intake) and decreasing dietary disinhibition (the tendency to lose control over eating) over time. DISCUSSION This study raises concern about the feasibility and efficacy of weight gain prevention interventions because most women were interested in weight loss, rather than weight gain prevention, and the interventions had no effect on weight stability. Novel approaches to the prevention of weight gain are needed.
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Affiliation(s)
- Michele D. Levine
- Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Mary Lou Klem
- Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Melissa A. Kalarchian
- Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Rena R. Wing
- Weight Control and Diabetes Research Center, Brown University, Providence, Rhode Island
| | - Lisa Weissfeld
- Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Li Qin
- Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Marsha D. Marcus
- Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
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148
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Truesdale KP, Stevens J, Cai J. Nine-year changes in cardiovascular disease risk factors with weight maintenance in the atherosclerosis risk in communities cohort. Am J Epidemiol 2007; 165:890-900. [PMID: 17259640 PMCID: PMC3234680 DOI: 10.1093/aje/kwk072] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Few studies have focused on the impact of weight maintenance on cardiovascular disease risk factors or addressed whether changes differ by baseline weight status and medication usage. The authors examined these issues using 9 years of follow-up data on 3,235 men and women from the Atherosclerosis Risk in Communities (ARIC) Study who were aged 45-64 years at baseline (1987-1989). In participants not using medications, glucose (3.0 mg/dl, 95% confidence interval (CI): 2.4, 3.5) and triglycerides (10.1 mg/dl, 95% CI: 8.3, 11.9) increased, while total cholesterol (-9.6 mg/dl, 95% CI: -10.6, -8.6), low density lipoprotein cholesterol (-9.9 mg/dl, 95% CI: -10.9, -9.0), and high density lipoprotein cholesterol (-1.7 mg/dl, 95% CI: -2.1, -1.3) decreased. Systolic blood pressure (7.9 mmHg, 95% CI: 7.3, 8.4) increased, but diastolic blood pressure (-1.1 mmHg, 95% CI: -1.4, -0.7) declined. Normal weight (body mass index: 18.5-<25.0 kg/m(2)) participants had smaller increases in glucose compared with obese (body mass index: >/=30.0 kg/m(2)) participants. In contrast, the authors found less favorable changes in total, low density lipoprotein, and high density lipoprotein cholesterol, triglycerides, and diastolic blood pressure among normal weight compared with obese participants who maintained their weight. These patterns were similar across weight status groups regardless of medication usage.
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Affiliation(s)
- Kimberly P Truesdale
- Department of Nutrition, School of Public Health, University of North Carolina, Chapel Hill, NC, USA.
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149
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Hivert MF, Langlois MF, Bérard P, Cuerrier JP, Carpentier AC. Prevention of weight gain in young adults through a seminar-based intervention program. Int J Obes (Lond) 2007; 31:1262-9. [PMID: 17356531 DOI: 10.1038/sj.ijo.0803572] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Prevention would be the ideal public health strategy to face the current obesity epidemic. Adoption of healthy lifestyles during the first years of college or university could prevent the onset of weight gain associated with this period of acquired independence and eventually decrease the incidence of obesity. DESIGN Randomized-controlled trial over a period of 2 years. The subjects received an educational/behavioral intervention (small group seminars) designed to help maintain a healthy lifestyle or no specific intervention (control group). SUBJECTS One-hundred and fifteen non-obese freshmen in a Faculty of Medicine. MEASUREMENTS Anthropometric measurements, physical activity level, fitness level, food intake and lipid profile were recorded at predetermined intervals. RESULTS The control group gained weight, whereas the intervention group lost a slight amount of weight over 2 years. The difference between the two groups was 1.3 kg at the end of the follow-up, the trend of weight gain differing between the two groups during the 2-year intervention period (P=0.04). There was no detectable difference in fitness, physical activity level or total caloric intake between the two groups during follow-up. However, plasma triglyceride levels increased in the control group and decreased in the intervention group (P=0.04). CONCLUSION In this randomized-controlled trial, a small-group seminar educational/behavioral intervention successfully prevents weight gain in normal weight young healthy university students. Such small absolute changes in body composition and lipid profile, if maintained over a prolonged period, could result in significant long-term health benefits for the general population.
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Affiliation(s)
- M-F Hivert
- Department of Medicine, Division of Endocrinology, Faculté de Médecine et des Sciences de la Santé, Centre Hospitalier Universitaire de Sherbrooke, Québec, Canada
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150
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Parikh NI, Pencina MJ, Wang TJ, Lanier KJ, Fox CS, D'Agostino RB, Vasan RS. Increasing trends in incidence of overweight and obesity over 5 decades. Am J Med 2007; 120:242-50. [PMID: 17349447 DOI: 10.1016/j.amjmed.2006.06.004] [Citation(s) in RCA: 131] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2006] [Revised: 05/20/2006] [Accepted: 06/07/2006] [Indexed: 01/22/2023]
Abstract
PURPOSE We evaluated trends in the incidence of overweight and obesity over the past 50 years. METHODS We evaluated trends in the incidence of overweight (25< or =body mass index [BMI] <30 kg/m2), obesity (BMI > or =30 kg/m2) and stage 2 obesity (BMI > or =35 kg/m2) from 1950 to 2000 in Framingham Study participants (n=6798, 54% women). Individuals aged 40-55 years who attended 2 examinations 8 years apart in each decade were eligible. RESULTS The incidences of overweight, obesity, and stage 2 obesity increased across the decades in both sexes (P for trend <.001). For men, the incidence of overweight rose from 21.8% (95% confidence interval [CI], 17.6-26.5) in the 1950s to 35.2% (95% CI, 28.6-42.5) in the 1990s; of obesity from 5.8% (95% CI, 4.4-7.6) to 14.8% (95% CI, 12.2-17.9); and of stage 2 obesity from 0.2% (95% CI, 0.1-0.9) to 5.4% (95% CI, 4.0-7.2). For women, incidence rates of overweight increased from 15.0% (95% CI, 12.3-18.1) to 33.1% (95% CI, 29.0-37.4); of obesity from 3.9% (95% CI, 2.9-5.3) to 14% (95% CI, 11.6-16.7); and of stage 2 obesity from 1.7% (95% CI, 1.1-2.6) to 4.4% (95% CI, 3.2-6.0). Overall, incidence rates of overweight increased 2-fold and that of obesity more than 3-fold over 5 decades, findings that remained robust upon additional adjustment for baseline BMI in each decade. CONCLUSIONS The incidence of overweight and obesity increased progressively over the last 5 decades, suggesting that the rising trend in prevalence is not a recent phenomenon.
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Affiliation(s)
- Nisha I Parikh
- Framingham Heart Study, Framingham, Mass 01702-5803, USA
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