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Bai K, Chen X, Shi Z, He K, Hu X, Song R, Shi W, Tian Q, Shi S. Hypertension modifies the associations of body mass index and waist circumference with all-cause mortality among older Chinese: a retrospective cohort study. BMC Geriatr 2022; 22:441. [PMID: 35590286 PMCID: PMC9118767 DOI: 10.1186/s12877-022-03057-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 04/11/2022] [Indexed: 11/17/2022] Open
Abstract
Background The effect of baseline hypertension status on the BMI–mortality association is still unclear. We aimed to explore the relationships of body mass index (BMI) and waist circumference (WC) with all-cause mortality among older hypertensive and normotensive Chinese individuals. Methods This retrospective cohort study was conducted in Xinzheng, Henan Province, Central China. The data came from the residents’ electronic health records of the Xinzheng Hospital Information System. A total of 77,295 participants (41,357 hypertensive participants and 35,938 normotensive participants) aged ≥ 60 years were included from January 2011 to November 2019. Cox proportional hazard regression model was used to examine the relationships. Results During a mean follow-up of 5.3 years, 10,755 deaths were identified (6,377 in hypertensive participants and 4,378 in normotensive participants). In adjusted models, compared with a BMI of 18.5–24 kg/m2, the hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) of BMI < 18.5, 24–28 and ≥ 28 kg/m2 for mortality in hypertensive participants were 1.074 (0.927–1.244), 0.881 (0.834–0.931) and 0.856 (0.790–0.929), respectively, and 1.444 (1.267–1.646), 0.884 (0.822–0.949) and 0.912 (0.792–1.051), respectively, in normotensive participants. Compared with normal waist circumference, the adjusted HRs and 95% CIs of central obesity for mortality were 0.880 (0.832–0.931) in hypertensive participants and 0.918 (0.846–0.996) in normotensive participants. A sensitivity analysis showed similar associations for both hypertensive and normotensive participants. Conclusion Low BMI and WC were associated with a higher risk of all-cause mortality regardless of hypertension status in older Chinese individuals. The lowest risk of death associated with BMI was in the overweight group in normotensive participants and in the obesity group in hypertensive participants. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03057-9.
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Affiliation(s)
- Kaizhi Bai
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Xuejiao Chen
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Zhan Shi
- Department of Pharmacy, People's Hospital of Zhengzhou, Zhengzhou, Henan, China
| | - Kun He
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Xueqi Hu
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Rui Song
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Wenlong Shi
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Qingfeng Tian
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Songhe Shi
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, China.
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102
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Hermassi S, Hayes LD, Sanal-Hayes NEM, Schwesig R. Differences in Health-Related Physical Fitness and Academic School Performance in Male Middle-School Students in Qatar: A Preliminary Study. Front Psychol 2022; 13:791337. [PMID: 35391970 PMCID: PMC8980685 DOI: 10.3389/fpsyg.2022.791337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 01/24/2022] [Indexed: 11/13/2022] Open
Abstract
This study examined the differences in the level of physical fitness and academic performance among male middle-school children based on different body status categories. A total of 69 male children [age: 12.4 ± 0.7 years; body mass: 58.5 ± 7.2 kg; height: 1.62 ± 0.09 m; and body mass index (BMI): 22.4 ± 3.3 kg/m2] participated and were divided into BMI age-adjusted groups (i.e., lowest, middle, and highest BMI). Height, mass, BMI, stork test of static balance, 10 and 15 m sprint as an indicator for speed, hand-grip strength test, agility T-half test, medicine ball throw (MBT), and the Yo-Yo Intermittent Recovery Test level 1 (Yo-Yo IR1) were assessed. School records were retrieved for grade point averages (GPA) of mathematics, science, and Arabic. We found significant group differences regarding anthropometric (height: ηp2 = 0.24, mass: ηp2 = 0.33, and BMI: ηp2 = 0.66), physical (sprint 10 m: ηp2 = 0.26), and academic (mathematics: ηp2 = 0.19 and science: ηp2 = 0.15) performance parameters. The largest difference (p < 0.001) was observed between the lowest and highest group for the 10 m sprint. All pairwise differences were between the lowest and highest BMI group or the lowest and middle BMI group. No relevant (r > 0.5) correlation between parameters of different dimensions (e.g., anthropometric vs. physical performance parameters) was found. In conclusion, the highest BMI group exhibited similar physical and academic performances than the lowest group. Thus, these data emphasize the importance and appropriateness to engage young Qatari schoolchildren in physical activity as it associates with superior academic performance.
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Affiliation(s)
- Souhail Hermassi
- Physical Education Department, College of Education, Qatar University, Doha, Qatar
| | - Lawrence D Hayes
- Institute of Clinical Exercise and Health Science, School of Health and Life Sciences, University of the West of Scotland, Glasgow, United Kingdom
| | - Nilihan E M Sanal-Hayes
- Institute of Clinical Exercise and Health Science, School of Health and Life Sciences, University of the West of Scotland, Glasgow, United Kingdom
| | - René Schwesig
- Department of Orthopaedic and Trauma Surgery, Martin-Luther-University Halle-Wittenberg, Halle, Germany
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Granlund A, Soares FC, Hjern A, Dahllöf G, Julihn A. Acculturation and 4-year caries increment among children of foreign-born mothers in Sweden: a register-based cohort study. BMC Oral Health 2022; 22:111. [PMID: 35392882 PMCID: PMC8991709 DOI: 10.1186/s12903-022-02130-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 03/11/2022] [Indexed: 11/19/2022] Open
Abstract
Background To study the association of maternal age upon arrival and length of residence in Sweden with the 4-year caries increment in their children between ages 3 and 7 years in relation to the human development index (HDI) of the maternal country of origin. Method This registry-based cohort study included all children born in 2000–2003 who resided in Stockholm County, Sweden, at age 3 years and who were followed up at age 7 (n = 63,931). Negative binomial regressions were used to analyze different models adjusted for sociodemographic factors. Results Children of foreign-born mothers, regardless of the HDI of the maternal country of origin, had a higher risk of caries increment between ages 3 and 7 years than children of Swedish-born mothers. Furthermore, children of mothers who had arrived from a low or medium HDI country had a lower caries increment if their mothers arrived before age 7 compared with after age 7. Nearly half (44%) of the children whose mothers arrived in Sweden at age ≥ 20 years from a low HDI country had a caries increment compared to 22% of the children whose mothers had arrived in Sweden before 7 years of age. Furthermore, children whose mothers were born in a low HDI country and had resided in Sweden ≤ 19 years had approximately 1.5 times higher risk of caries increment compared to children of mothers who had resided in Sweden for more than 20 years. Conclusions Caries increment in the children of foreign-born mothers was associated with the age of their mother when she arrived in Sweden and was lower when the mother had arrived before age 7 years. This indicates an intergenerational effect that carries over to the children and is greater the longer the mother has participated in Swedish dental healthcare.
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Affiliation(s)
- Anna Granlund
- Public Dental Service, Folktandvården Stockholms Län AB, Stockholm, Sweden.,Center for Pediatric Oral Health Research, Stockholm, Sweden
| | - Fernanda Cunha Soares
- Division of Orthodontics and Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Anders Hjern
- Clinical Epidemiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.,Centre for Health Equity Studies (CHESS), Stockholm University, Stockholm, Sweden
| | - Göran Dahllöf
- Center for Pediatric Oral Health Research, Stockholm, Sweden.,Division of Orthodontics and Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.,Center for Oral Health Services and Research, Mid-Norway, Trondheim, Norway
| | - Annika Julihn
- Center for Pediatric Oral Health Research, Stockholm, Sweden. .,Division of Orthodontics and Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden. .,Department of Pediatric Dentistry, Eastmaninstitutet, Folktandvården Stockholms Län AB, Stockholm, Sweden.
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Zheng K, Gao W, Cao W, Lv J, Yu C, Wang S, Huang T, Sun D, Liao C, Pang Y, Pang Z, Yu M, Wang H, Wu X, Dong Z, Wu F, Jiang G, Wang X, Liu Y, Deng J, Lu L, Li L. Education, income, and obesity: A nationwide Chinese twin study. Obesity (Silver Spring) 2022; 30:931-942. [PMID: 35275605 DOI: 10.1002/oby.23390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/20/2021] [Accepted: 12/31/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVE This study aimed to examine the association of socioeconomic status with obesity. METHODS A total of 39,262 twin individuals were included from the Chinese National Twin Registry (CNTR). Generalized estimating equation models for unmatched twin individual analyses and conditional logistic regression for the co-twin matched design were used. Inference about Causation through Examination of FAmiliaL CONfounding (ICE FALCON) was used to explore the evidence of a causal relationship. RESULTS In general estimating equation models, high education level and income were associated with lower risk of obesity (odds ratio [OR] = 0.74 [95% CI: 0.65 to 0.84] and 0.86 [95% CI: 0.77 to 0.96]). In conditional logistic regression analysis, the association with education was significant (OR = 0.50 [95% CI: 0.34 to 0.74]) but the association with income was insignificant (OR = 0.74 [95% CI: 0.48 to 1.15]). From the ICE FALCON analysis, a twin's obesity was associated with the co-twin's education and income. After adjusting for the twin's own education, the association disappeared ( β co - twin ' = -0.10 [95% CI: -0.26 to 0.07]), whereas the twin's obesity was still associated with the co-twin's income but attenuated toward the null ( β co - twin ' = -0.21 [95% CI: -0.36 to -0.06]). CONCLUSIONS Socioeconomic status is negatively associated with obesity. Education may have a causal effect on obesity, whereas the association between income and obesity is confounded by familial factors.
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Affiliation(s)
- Ke Zheng
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Wenjing Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Weihua Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Shengfeng Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Tao Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Dianjianyi Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Chunxiao Liao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Yuanjie Pang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Zengchang Pang
- Qingdao Center for Disease Control and Prevention, Qingdao, China
| | - Min Yu
- Zhejiang Center for Disease Control and Prevention, Hangzhou, China
| | - Hua Wang
- Jiangsu Center for Disease Control and Prevention, Nanjing, China
| | - Xianping Wu
- Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Zhong Dong
- Beijing Center for Disease Control and Prevention, Beijing, China
| | - Fan Wu
- Shanghai Center for Disease Control and Prevention, Shanghai, China
| | - Guohong Jiang
- Tianjin Center for Disease Control and Prevention, Tianjin, China
| | - Xiaojie Wang
- Qinghai Center for Disease Control and Prevention, Xining, China
| | - Yu Liu
- Heilongjiang Center for Disease Control and Prevention, Harbin, China
| | - Jian Deng
- Handan Center for Disease Control and Prevention, Handan, China
| | - Lin Lu
- Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
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105
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Becker N, Mkhonta A, Sibeko LN. The prevalence of overweight/obesity and its association with household food insecurity among women living with HIV in rural Eswatini. BMC Public Health 2022; 22:629. [PMID: 35361183 PMCID: PMC8969360 DOI: 10.1186/s12889-022-13036-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 03/11/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Eswatini is currently afflicted by an extremely high prevalence of HIV (27%) and malnutrition (both under-and over-nutrition). While rates of overweight/obesity in the general adult population have been documented, data on overweight/obesity and associated risk factors among women living with HIV (WLHIV) in Eswatini is limited. This study examines the prevalence of overweight/obesity and associated risk factors, with an emphasis on clarifying the association between household food insecurity and overweight/obesity for WLHIV in rural Eswatini. METHODS This cross-sectional study was conducted among WLHIV (n = 166) in rural communities of Eswatini. Data were collected using an interviewer-administered survey questionnaire between October and November, 2017. Body Mass Index (BMI) was calculated to determine overweight and obesity among study participants. Women with BMI values of 25 kg/m2 or greater were classified as being overweight/obese. Multivariable log-binomial regression models were used to examine associations between household food insecurity and overweight/obesity in our study. RESULTS Nearly a third (32.5%) of the women in our study were overweight and almost a quarter were obese (22.9%). We found significant associations between household food insecurity and overweight/obesity, with women who experienced household food insecurity the most being 0.38 times less likely to be overweight/obese compared to those who experienced household food insecurity the least (ARR: 0.38, 95% CI: 0.2-0.71). In our study sample, women who perceived themselves as being in poor health were less likely to be overweight/obese compared to those who perceived themselves as being in good health (ARR: 0.58, 95% CI: 0.39-0.86). We found significant associations between overweight/obesity and alcohol use, with the risk of overweight/obesity nearly 1.5 times higher among women who consumed alcohol compared to those who did not (ARR: 1.49, 95% CI: 1.07-2.05). CONCLUSIONS The high prevalence of overweight/obesity among food insecure women in poverty stricken communities may pose significant challenges for nutritional health and HIV management. With an increasing prevalence of overweight/obesity in food insecure households, there is a need to re-evaluate current strategies and develop multi-level targeted interventions that include prevention of excessive weight gain among women, particularly those living with HIV in rural Eswatini. HIV programs could include screening to identify individuals at risk for overweight/obesity in this population, and provide nutrition education for weight management for those individuals.
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Affiliation(s)
- Nozipho Becker
- Department of Nutrition, University of Massachusetts, Amherst, USA. .,Department of Food and Nutrition Sciences, University of Eswatini, Luyengo, Kingdom of Eswatini. .,Center for AIDS Prevention Studies, Division of Prevention Science, University of California, San Francisco, USA.
| | - Andile Mkhonta
- grid.12104.360000 0001 2289 8200Department of Food and Nutrition Sciences, University of Eswatini, Luyengo, Kingdom of Eswatini
| | - Lindiwe N. Sibeko
- grid.266683.f0000 0001 2166 5835Department of Nutrition, University of Massachusetts, Amherst, USA
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106
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Obsa MS, Ataro G, Awoke N, Jemal B, Tilahun T, Ayalew N, Woldegeorgis BZ, Azeze GA, Haji Y. Determinants of Dyslipidemia in Africa: A Systematic Review and Meta-Analysis. Front Cardiovasc Med 2022; 8:778891. [PMID: 35284497 PMCID: PMC8904727 DOI: 10.3389/fcvm.2021.778891] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 12/29/2021] [Indexed: 12/18/2022] Open
Abstract
Background Dyslipidemia is a common public health problem in Africa. It has emerged as an important cardiovascular risk factor. It has been steadily increasing due to economic growth, urbanization, and unhealthy dietary pattern. Therefore, it is essential to identify determinants of dyslipidemia to prevent the condition and reduce its long-term sequel. Methods Combinations of search terms with Boolean operators were used to retrieve studies from PubMed, EMBASE, Cochrane Database, Cinahl, Scopus, Mednar, and Google Scholar. The methodological quality of each article was evaluated based on the 2017 Joanna Briggs Institute (JBI) Critical Appraisal checklist for prevalence studies. After evaluation of each study against these criteria, studies with a minimum score of 7 or above out of 9 JBI checklists were included. We included articles presented in the English language. The Cochrane Q test was used to assess the heterogeneity across studies. The visual assessment of publication bias was done by creating a funnel plot. The possible causes of heterogeneity were explored by subgroup analyses. Egger's weighted regression test was used to assess the presence of publication bias. Statistical analyses were done by using the STATA software version 14. Result A total of 24 articles involving 37,902 participants from 10 African countries were included. The overall pooled prevalence of dyslipidemia was 52.8 (95% CI 40.8–64.9). Individuals with a body mass index (BMI) >25.0 kg/m2 and waist circumference (WC) >94 cm were, respectively, 2.36 (95% CI (1.33–4.18), p < 0.001) and 2.33 (95% CI (0.75–0.29) p < 0.001) times more likely to develop dyslipidemia than those with lower values. Furthermore, patients with diabetes mellitus (DM) and hypertension (HTN) were 2.32 (95% CI (0.89–6.05) p < 0.001) and 2.05 (95% CI (1.31–3.21), p < 0.001) times more likely to present with dyslipidemia than non-diabetic patients and those without HTN. Conclusion This study revealed that the prevalence of dyslipidemia is relatively high among study participants in African countries and the independent predictors of dyslipidemia were BMI >25.0 kg/m2, WC > 94 cm, raised blood glucose level, and raised blood pressure. Therefore, there should be a pressing public health measure to prevent, identify, and treat dyslipidemia with the special emphasis on obese, diabetic, and hypertensive patients.
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Affiliation(s)
- Mohammed S Obsa
- College of Health Science and Medicine, Wolaita Soddo University, Wolaita Soddo, Ethiopia
| | - Getu Ataro
- College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
| | - Nefsu Awoke
- College of Health Science and Medicine, Wolaita Soddo University, Wolaita Soddo, Ethiopia
| | - Bedru Jemal
- College of Medicine and Health Science, Dilla University, Dilla, Ethiopia
| | - Tamiru Tilahun
- College of Health Science and Medicine, Wolaita Soddo University, Wolaita Soddo, Ethiopia
| | - Nugusu Ayalew
- Department of Anesthesia, Kotebe Metropolitan University, Addis Ababa, Ethiopia
| | - Beshada Z Woldegeorgis
- College of Health Science and Medicine, Wolaita Soddo University, Wolaita Soddo, Ethiopia
| | - Gedion A Azeze
- College of Health Science and Medicine, Wolaita Soddo University, Wolaita Soddo, Ethiopia
| | - Yusuf Haji
- College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
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107
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Hassan NE, Elshebini S, Hassan N, El hussieny MS, Selim M, Amin DH, Nageeb A, Ibrahim M, Khalil A. Association between Quality of Diets and the Risk of Obesity Complication among a Sample of Egyptian Obese Women. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.7177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Abstract
Background: The fundamental cause of obesity and overweight is an energy imbalance between calories consumed and calories expended. The aim of this study was to identify the awareness of a sample of Egyptian women about eating healthy diet, using Dietary Approaches to Stop Hypertension (DASH) diet as an example.
Methods: This study is a cross-sectional study included 109 Egyptian women random chosen, with age range 25-60 years. Full clinical examinations, anthropometric parameters, dietary recalls, and socioeconomic parameters were recorded. Biochemical analysis was done including serum lipid profile.
Results: Data showed that a large percentage of the participants (56.9%) were consuming a poor-quality diet, while 20.0% were consuming intermediate quality diet. Only 16.5% and 9.2% of them were aware of eating a good and high-quality healthy diet. Data shows that the calories, macronutrients, saturated fatty acids (SFAs), cholesterol and sodium intake among both poor and the intermediate groups were higher, while their intake of the monounsaturated fatty acids (MUFAs), poly unsaturated fatty acids (PUFAs), fiber, important vitamins and the minerals, was significantly low. The mean values of the BMI, body fat %, FFM (Fat Free Mass), waist circumference, visceral fat and LDL-C values showed significant differences between the groups at p≤ 0.05- 0.001, in favor of the good and high groups.
Conclusions: Data of this study revealed that poor quality diet was widespread among studied Egyptian women sample; right food choice was associated with the educational level. So, helping individuals to make the right food choices will help in improve diet quality and health.
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108
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Pradeilles R, Holdsworth M, Olaitan O, Irache A, Osei-Kwasi HA, Ngandu CB, Cohen E. Body size preferences for women and adolescent girls living in Africa: a mixed-methods systematic review. Public Health Nutr 2022; 25:738-759. [PMID: 33593472 PMCID: PMC9991778 DOI: 10.1017/s1368980021000768] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 02/01/2021] [Accepted: 02/10/2021] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To synthesise evidence on body size preferences for females living in Africa and the factors influencing these. DESIGN Mixed-methods systematic review including searches on Medline, CINHAL, ASSIA, Web of Science and PsycINFO (PROSPERO CRD42015020509). A sequential-explanatory approach was used to integrate quantitative and qualitative findings. SETTING Urban and rural Africa. PARTICIPANTS Studies of both sexes providing data on body size preferences for adolescent girls and women aged ≥10 years. RESULTS Seventy-three articles from twenty-one countries were included: fifty quantitative, fifteen qualitative and eight mixed methods. Most studies reported a preference for normal or overweight body sizes. Some studies of adolescent girls/young women indicated a preference for underweight. Factors influencing preferences for large(r) body sizes included: socio-demographic (e.g. education, rural residency), health-related (e.g. current BMI, pubertal status), psycho-social (e.g. avoiding HIV stigma) and socio-cultural factors (e.g. spouse's preference, social standing, cultural norms). Factors influencing preferences for slim(mer) body sizes included: socio-demographic (e.g. higher socioeconomic status, urban residency, younger age), health-related (e.g. health knowledge, being nulliparous), psycho-social (e.g. appearance, body size perception as overweight/obese) and socio-cultural factors (e.g. peer pressure, media). CONCLUSIONS Preference for overweight (not obese) body sizes among some African females means that interventions need to account for the array of factors that maintain these preferences. The widespread preference for normal weight is positive in public health terms, but the valorisation of underweight in adolescent girls/young women may lead to an increase in body dissatisfaction. Emphasis needs to be placed on education to prevent all forms of malnutrition.
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Affiliation(s)
- Rebecca Pradeilles
- School of Sport, Exercise and Health Sciences (SSEHS), Loughborough University, LoughboroughLE11 3TU, UK
| | - Michelle Holdsworth
- UMR MoISA (Montpellier Interdisciplinary Centre on Sustainable Agri-food Systems), (Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD), Montpellier, France
| | | | - Ana Irache
- Warwick Medical School, University of Warwick, Coventry, UK
| | | | - Christian B Ngandu
- MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, University of the Witwatersrand, Johannesburg, South Africa
| | - Emmanuel Cohen
- MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, University of the Witwatersrand, Johannesburg, South Africa
- UMR CNRS-MNHN 7206 « Eco-anthropologie », Musée de l’Homme, Paris, France
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Alliott O, Ryan M, Fairbrother H, van Sluijs E. Do adolescents' experiences of the barriers to and facilitators of physical activity differ by socioeconomic position? A systematic review of qualitative evidence. Obes Rev 2022; 23:e13374. [PMID: 34713548 PMCID: PMC7613938 DOI: 10.1111/obr.13374] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 09/21/2021] [Accepted: 09/21/2021] [Indexed: 12/16/2022]
Abstract
This review aims to systematically identify and synthesize qualitative data on adolescents' experiences of the barriers to and facilitators of physical activity to understand whether these differ by socioeconomic position. Multiple databases (MEDLINE, Web of Science Core Collection, PsycINFO, and ERIC) were searched in August 2020. Duplicate title/abstract and full text screening was conducted. Studies were included if they reported qualitative data collected from adolescents (aged 10-19), a measure of socioeconomic position and focused on physical activity. Studies not published in English or published before 2000 were excluded. Relevant data were extracted and methodological quality assessed (in duplicate). Data were analyzed using Thomas and Harden's methods for the thematic synthesis. Four analytical themes emerged from the 25 included studies: (1) social support, (2) accessibility and the environment, (3) other behaviors and health, and (4) gendered experiences. These themes appeared across socioeconomic groups; however, their narratives varied significantly. For example, provision and access to local facilities was discussed as a facilitator to middle and high socioeconomic adolescents, but was a barrier to low socioeconomic adolescents. These findings can be used to inform how different socioeconomic groups may benefit from, or be disadvantaged by, current interventions.
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Affiliation(s)
- Olivia Alliott
- UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Mairead Ryan
- UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | | | - Esther van Sluijs
- UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
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Atanasova P, Kusuma D, Pineda E, Anjana RM, De Silva L, Hanif AA, Hasan M, Hossain MM, Indrawansa S, Jayamanne D, Jha S, Kasturiratne A, Katulanda P, Khawaja KI, Kumarendran B, Mrida MK, Rajakaruna V, Chambers JC, Frost G, Sassi F, Miraldo M. Food environments and obesity: A geospatial analysis of the South Asia Biobank, income and sex inequalities. SSM Popul Health 2022; 17:101055. [PMID: 35252534 PMCID: PMC8894230 DOI: 10.1016/j.ssmph.2022.101055] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 02/14/2022] [Accepted: 02/21/2022] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION In low-middle income countries (LMICs) the role of food environments on obesity has been understudied. We address this gap by 1) examining the effect of food environments on adults' body size (BMI, waist circumference) and obesity; 2) measuring the heterogeneity of such effects by income and sex. METHODS This cross-sectional study analysed South Asia Biobank surveillance and environment mapping data for 12,167 adults collected between 2018 and 2020 from 33 surveillance sites in Bangladesh and Sri Lanka. Individual-level data (demographic, socio-economic, and health characteristics) were combined with exposure to healthy and unhealthy food environments measured with geolocations of food outlets (obtained through ground-truth surveys) within 300 m buffer zones around participants' homes. Multivariate regression models were used to assess association of exposure to healthy and unhealthy food environments on waist circumference, BMI, and probability of obesity for the total sample and stratified by sex and income. FINDINGS The presence of a higher share of supermarkets in the neighbourhood was associated with a reduction in body size (BMI, β = - 3∙23; p < 0∙0001, and waist circumference, β = -5∙99; p = 0∙0212) and obesity (Average Marginal Effect (AME): -0∙18; p = 0∙0009). High share of fast-food restaurants in the neighbourhood was not significantly associated with body size, but it significantly increased the probability of obesity measured by BMI (AME: 0∙09; p = 0∙0234) and waist circumference (AME: 0∙21; p = 0∙0021). These effects were stronger among females and low-income individuals. INTERPRETATION The results suggest the availability of fast-food outlets influences obesity, especially among female and lower-income groups. The availability of supermarkets is associated with reduced body size and obesity, but their effects do not outweigh the role of fast-food outlets. Policies should target food environments to promote better diets and reduce obesity.
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Affiliation(s)
- Petya Atanasova
- Centre for Health Economics & Policy Innovation, Imperial College Business School, London, UK
| | - Dian Kusuma
- Centre for Health Economics & Policy Innovation, Imperial College Business School, London, UK
| | - Elisa Pineda
- Centre for Health Economics & Policy Innovation, Imperial College Business School, London, UK
- School of Public Health, Imperial College London, London, UK
| | | | | | - Abu A.M. Hanif
- Centre for Non-communicable Diseases and Nutrition, BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Mehedi Hasan
- Centre for Non-communicable Diseases and Nutrition, BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Md Mokbul Hossain
- Centre for Non-communicable Diseases and Nutrition, BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | | | | | | | | | | | | | | | - Malay K. Mrida
- Centre for Non-communicable Diseases and Nutrition, BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | | | - John C. Chambers
- School of Public Health, Imperial College London, London, UK
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Gary Frost
- Faculty of Medicine, Imperial College London, London, UK
| | - Franco Sassi
- Centre for Health Economics & Policy Innovation, Imperial College Business School, London, UK
- Department of Economics and Public Policy, Imperial College Business School, London, UK
| | - Marisa Miraldo
- Centre for Health Economics & Policy Innovation, Imperial College Business School, London, UK
- Department of Economics and Public Policy, Imperial College Business School, London, UK
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Gao M, Wells JC, Johnson W, Li L. Socio-economic disparities in child-to-adolescent growth trajectories in China: Findings from the China Health and Nutrition Survey 1991–2015. THE LANCET REGIONAL HEALTH - WESTERN PACIFIC 2022; 21:100399. [PMID: 35540561 PMCID: PMC9079352 DOI: 10.1016/j.lanwpc.2022.100399] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Backgrounds Socio-economic disparities in growth trajectories of children from low-/middle-income countries are poorly understood, especially those experiencing rapid economic growth. We investigated socio-economic disparities in child growth in recent decades in China. Methods Using longitudinal data on 5095 children/adolescents (7–18 years) from the China Health and Nutrition Survey (1991–2015), we estimated mean height and BMI trajectories by socio-economic position (SEP) and sex for cohorts born in 1981–85, 1986–90, 1991–95, 1996–2000, using random-effects models. We estimated differences between high (urbanization index ≥median, household income per capita ≥median, parental education ≥high school, or occupational classes I–IV) and low SEP groups. Findings Mean height and BMI trajectories have shifted upwards across cohorts. In all cohorts, growth trajectories for high SEP groups were above those for low SEP groups across SEP indicators. For height, socio-economic differences persisted across cohorts (e.g. 3.8cm and 2.9cm in earliest and latest cohorts by urbanization index for boys at 10 year, and 3.6cm and 3.1cm respectively by household income). For BMI, trends were greater in high than low SEP groups, thus socio-economic differences increased across cohorts (e.g. 0.5 to 0.8kg/m2 by urbanization index, 0.4 to 1.1kg/m2 by household income for boys at 10 year). Similar trends were found for stunting and overweight/obesity by SEP. There was no association between SEP indicators and thinness. Interpretation Socio-economic disparities in physical growth persist among Chinese youth. Short stature was associated with lower SEP, but high BMI with higher SEP. Public health interventions should be tailored by SEP, in order to improve children's growth while reducing overweight/obesity. Funding MG is supported by UCL Overseas Research Scholarship and China Scholarship Council for her PhD study. WJ is supported by a UK Medical Research Council (MRC) New Investigator Research Grant (MR/P023347/1) and acknowledges support from the National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, which is a partnership between University Hospitals of Leicester NHS Trust, Loughborough University, and the University of Leicester.
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A preliminary study of body image and depression among adults during COVID-19: A moderation model. Arch Psychiatr Nurs 2022; 36:55-61. [PMID: 35094826 PMCID: PMC8642077 DOI: 10.1016/j.apnu.2021.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 11/10/2021] [Accepted: 11/17/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Since many aspects of functioning can affect body image, the aim of our study was to assess whether the relationship between body image-related negative emotions or depression and body dissatisfaction was moderated by body image-related quality of life and to compare these analyses among participants with various body mass index during COVID-19. SUBJECTS AND METHODS One hundred and thirty-one adults participated in the study. Measurement tools included the Body Image Quality of Life Inventory, the short form of the Situational Inventory of Body-Image Dysphoria, the Beck Depression Inventory-II and the Contour Drawing Scale. RESULTS The effects of body image-related negative emotions or depression on body dissatisfaction is moderated by body image-related quality of life, but only among obese participants. CONCLUSION Treatment of obese patients should focus on improving quality of life related to body image, while managing negative emotions and body dissatisfaction.
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Swarnamali H, Jayawardena R, Michail Chourdakis, Ranasinghe P. Is the proportion of per capita fat supply associated with the prevalence of overweight and obesity? an ecological analysis. BMC Nutr 2022; 8:4. [PMID: 35022072 PMCID: PMC8756625 DOI: 10.1186/s40795-021-00496-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 12/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although it is reported in numerous interventional and observational studies, that a low-fat diet is an effective method to combat overweight and obesity, the relationship at the global population level is not well established. This study aimed to quantify the associations between worldwide per capita fat supply and prevalence of overweight and obesity and further classify this association based on per capita Gross National Income (GNI). METHODS A total of 93 countries from four GNI groups were selected. Country-specific overweight and obesity prevalence data were retrieved from the most recent WHO Global Health Observatory database. Per capita supply of fat and calories were obtained from the United Nations Food and Agricultural Organization database; FAOSTAT, Food Balance Sheet for years 2014-2016. The categorizations of countries were done based on GNI based classification by the World Bank. RESULTS Among the selected countries, the overweight prevalence ranged from 3.9% (India) to 78.8% (Kiribati), while obesity prevalence ranged from 3.6% (Bangladesh) to 46.0% (Kiribati). The highest and the lowest per capita fat supply from total calorie supply were documented in Australia (41.2%) and Madagascar (10.5%) respectively. A significant strong positive correlation was observed between the prevalence of overweight (r = 0.64, p < 0.001) and obesity (r = 0.59, p < 0.001) with per capita fat supply. The lower ends of both trend lines were densely populated by the low- and lower-middle-income countries and the upper ends of both lines were greatly populated by the high-income countries. CONCLUSIONS Per capita fat supply per country is significantly associated with both prevalence of overweight and obesity.
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Affiliation(s)
- Hasinthi Swarnamali
- Health and Wellness Unit, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Ranil Jayawardena
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.,Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - Michail Chourdakis
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, University Campus, 54124, Thessaloniki, Greece
| | - Priyanga Ranasinghe
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
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Abstract
BACKGROUND Few Nigerian studies have examined BMI in people with schizophrenia. The aims of the present study were to assess the prevalence and distribution of obesity in Nigerians with schizophrenia and to examine the clinical correlates of BMI and obesity. METHODS A total of 207 people with schizophrenia met the inclusion criteria and were evaluated for BMI.The Positive and Negative Syndrome Scale (PANSS), Hamilton Depression Rating Scale (HDRS), Social and Occupational Functioning Assessment Scale (SOFAS) were rated for all participants. Anthropometric measures such as weight and height were taken using a standard protocol. RESULTS The prevalence of obesity was 12.6%. The non-obese participants were made up of underweight 24 (11.7%), normal weight 118 (57%) and overweight 38 (18.4%). Compared to non-obese participants, obese participants were older, more educated, more likely to be employed, had higher incomes, lower PANSS score (negative subscale), had fewer female participants, and better social and occupational functioning (p < 0.05). BMI was positively correlated with age and monthly income. In the adjusted model, age, gender and education were independently associated with obesity while only age was associated with BMI. CONCLUSION The present study suggests that unlike in high-income countries, obese patients with schizophrenia in Nigeria have better social and psychological functioning than non-obese patients.
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Affiliation(s)
- Oluyomi Esan
- Department of Psychiatry, University of Ibadan, Ibadan, Nigeria
| | - Arinola Esan
- Department of Medicine, University College Hospital, Ibadan, Nigeria
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Williams DM, Staff M, Bain SC, Min T. Glucagon-like Peptide-1 Receptor Analogues for the Treatment of Obesity. Endocrinology 2022; 18:43-48. [PMID: 35975210 PMCID: PMC9354511 DOI: 10.17925/ee.2022.18.1.43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 01/05/2022] [Indexed: 11/25/2022]
Abstract
There is an increasing prevalence of obesity worldwide, associated with significant morbidity and mortality, which frequently reduces quality of life and life expectancy. Consequently, there is a substantial and growing personal and economic burden necessitating the development of more effective therapies for obesity. Glucagon-like peptide-1 receptor analogues (GLP-1RAs) are licensed for the treatment of type 2 diabetes (T2D), and there is substantial evidence that these drugs not only improve cardiovascular outcomes but also promote weight loss. More recent evidence supports the use of the GLP-1RAs liraglutide and semaglutide in people with obesity without T2D. This article discusses the results of the major cardiovascular outcome trials for GLP-1RAs in people with T2D, the SCALE Obesity and Prediabetes study (Effect of liraglutide on body weight in non-diabetic obese subjects or overweight subjects with co-morbidities: SCALE™ - Obesity and Pre-diabetes; ClinicalTrials.gov identifier: NCT01272219; investigating liraglutide) and the STEP studies (Semaglutide treatment effect in people with obesity; assorted studies; investigating subcutaneous semaglutide). We also highlight the importance of a cost-effective approach to obesity pharmacotherapy. Clinicians should consider the use of GLP-1RAs in people with obesity, especially those with T2D or other obesity-related diseases, such as hypertension and dyslipidaemia. Ongoing trials, as well as clinical and cost-effectiveness appraisals, are anticipated over the next 12 months, and their findings may change the current landscape of obesity pharmacotherapy.
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Affiliation(s)
- David M Williams
- Department of Diabetes and Endocrinology, Singleton Hospital, Swansea Bay University Health Board, Swansea, UK
| | - Matthew Staff
- Department of Diabetes and Endocrinology, Singleton Hospital, Swansea Bay University Health Board, Swansea, UK
| | - Stephen C Bain
- Department of Diabetes and Endocrinology, Singleton Hospital, Swansea Bay University Health Board, Swansea, UK
- Diabetes Research Group, Swansea University Medical School, Swansea University, Swansea, UK
| | - Thinzar Min
- Department of Diabetes and Endocrinology, Singleton Hospital, Swansea Bay University Health Board, Swansea, UK
- Diabetes Research Group, Swansea University Medical School, Swansea University, Swansea, UK
- Department of Diabetes and Endocrinology, Neath Port Talbot Hospital, Swansea Bay University Health Board, Swansea, UK
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Santana DD, Barros EG, Salles-Costa R, Veiga GVD. Changes in prevalence of overweight in adolescents living in areas highly vulnerable to food insecurity. CIENCIA & SAUDE COLETIVA 2021; 26:6189-6198. [PMID: 34910009 DOI: 10.1590/1413-812320212612.26092020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 10/19/2020] [Indexed: 11/21/2022] Open
Abstract
This study ascertained changes, over 5 years, in the prevalence of overweight in adolescents and associations with socio-demographic variables and food insecurity. Two cross-sectional population-based studies were conducted with 511 (2005) and 314 (2010) adolescents resident in Campos Elíseos (Duque de Caxias-RJ). Overweight was evaluated by sex and age specific cut-off points of BMI (weight/height²). The prevalence of food insecurity was investigated using the Brazilian Food Insecurity Scale. Logistic regression was used to determine the association between changes in overweight over time and sex, age, skin colour, and food insecurity. Overweight was found to increase significantly, between 2005 and 2010, in boys who were younger (from 20.1% to 49.5%), black or brown (22.2% to 37.3%), those with per capita income of up to half a minimum wage (13.6% to 32.5%) and those experiencing moderate or severe food insecurity (9.2% to 36.3%). It was concluded that overweight increased significantly in adolescents living in an area of food insecurity, and that younger, black or brown, lower-income adolescents, and those living with moderate and severe food insecurity, were more exposed to that increase.
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Affiliation(s)
- Danilo Dias Santana
- Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro. Av. Carlos Chagas Filho 373, Bloco J, 2º andar, Cidade Universitária. 21941-902 Rio de Janeiro RJ Brasil.
| | - Erica Guimarães Barros
- Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro. Av. Carlos Chagas Filho 373, Bloco J, 2º andar, Cidade Universitária. 21941-902 Rio de Janeiro RJ Brasil.
| | - Rosana Salles-Costa
- Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro. Av. Carlos Chagas Filho 373, Bloco J, 2º andar, Cidade Universitária. 21941-902 Rio de Janeiro RJ Brasil.
| | - Gloria Valeria da Veiga
- Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro. Av. Carlos Chagas Filho 373, Bloco J, 2º andar, Cidade Universitária. 21941-902 Rio de Janeiro RJ Brasil.
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Erkoyun E, Mackenbach JP. Occupational class and educational level inequalities in major cardiovascular risk factors in Turkey: 2008-2016. J Public Health (Oxf) 2021; 43:e584-e592. [PMID: 32617567 DOI: 10.1093/pubmed/fdaa073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 05/07/2020] [Accepted: 05/11/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND We aimed to investigate the magnitude of occupational class (OC) and educational level (EL) inequalities in cardiovascular risk factors in Turkey from 2008 to 2016 and compare these inequalities with neighbouring European countries. METHODS We used the Turkey Health Survey among a representative sample of the Turkish population. We estimated relative index of inequality (RII) for four cardiovascular risk factors (obesity/overweight, hypertension, diabetes, smoking) by OC/EL with an interaction term for survey year and compared selected results with neighbouring countries. RESULTS Men with lower OC and EL smoked more (e.g. RII for EL = 1.40 [1.26-1.55]); however, the remaining risk factors were mostly lower in these groups. Women in lower socio-economic groups smoked less (e.g. RII for EL = 0.36 [0.29-0.44]), however, had higher prevalence of the remaining risk factors. Significant interactions with survey year were only found in a few cases. The pattern of inequalities in Turkey is largely similar to neighbouring countries. CONCLUSIONS Inequalities in cardiovascular risk factors are less systematic in Turkey than in most high-income countries, but ongoing trends suggest that this may change in the future.
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Affiliation(s)
- Erdem Erkoyun
- Department of Public Health, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands
| | - J P Mackenbach
- Department of Public Health, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands
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van der Heijden A, Te Molder H, Huma B, Jager G. To like or not to like: Negotiating food assessments of children from families with a low socioeconomic position. Appetite 2021; 170:105853. [PMID: 34896168 DOI: 10.1016/j.appet.2021.105853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 11/24/2021] [Accepted: 12/06/2021] [Indexed: 11/18/2022]
Abstract
The present study explored how primary school-aged children from families with a low socioeconomic position produce 'likes' and 'dislikes' of foods during everyday family meals, and how these (dis)likes are understood and treated by their parents. It is crucial to understand how food preferences develop in the course of everyday life, as it is known that there are socioeconomic disparities in food preference and consumption, and that children from families with a low socioeconomic position have relatively poorer diets. Deploying an interactional approach to food preference, video recordings of 79 evening meals in families with a low socioeconomic position were analyzed using discursive psychology and conversation analysis. The analysis highlighted that children's food likes and dislikes were treated differently by their parents. While likes were routinely not responded to, agreed with or further elaborated, dislikes were predominantly oriented to as food refusals or treated as inappropriate, or non-genuine claims. Children's food assessments, i.e., likes and dislikes, were often disattended by parents when they appeared to be food preference displays. By contrast, assessments that accomplished social actions like refusals and complaints were more often responded to. The analysis also revealed the importance of distinguishing between assessments about food items in general, that were not currently being eaten, and assessments of food eaten here-and-now. All in all, the study evidences that and how assessment sequences open up interactional spaces where children and parents orient to and negotiate relative rights and responsibilities to know, to assess and to accomplish specific actions. Implications for food preference research are discussed.
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Affiliation(s)
- Amy van der Heijden
- Wageningen University & Research, Division of Human Nutrition and Health, Stippeneng 4, 6708, WE, Wageningen, the Netherlands; Wageningen University & Research, Strategic Communication Group, Hollandseweg 1, 6707, KN, Wageningen, the Netherlands.
| | - Hedwig Te Molder
- VU University Amsterdam, Faculty of Humanities: Language, Literature and Communication, De Boelelaan 1105, 1081, HV, Amsterdam, the Netherlands
| | - Bogdana Huma
- VU University Amsterdam, Faculty of Humanities: Language, Literature and Communication, De Boelelaan 1105, 1081, HV, Amsterdam, the Netherlands
| | - Gerry Jager
- Wageningen University & Research, Division of Human Nutrition and Health, Stippeneng 4, 6708, WE, Wageningen, the Netherlands
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Aiyar A, Dhingra S, Pingali P. Transitioning to an obese India: Demographic and structural determinants of the rapid rise in overweight incidence. ECONOMICS AND HUMAN BIOLOGY 2021; 43:101041. [PMID: 34332246 DOI: 10.1016/j.ehb.2021.101041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 06/29/2021] [Accepted: 07/02/2021] [Indexed: 06/13/2023]
Abstract
India, which has long suffered from undernutrition, has seen a rapid rise in overweight incidence in the last decade and a half. These changes are characterized by significant within-country differences in overweight incidence that vary by gender and regional development levels. In this paper, we provide an integrative framework, linking the income-gradient hypothesis of obesity with biological, obesogenic, and environmental factors to provide an explanation on the emergence of within-country differences in overweight patterns. We utilize measured body mass index (BMI), along with individual- and household-level data of over 800,000 men and women surveyed in the National Family Health Surveys of 2005-06 and 2015-16 to identify correlates of within-country differences in overweight incidence. A decomposition analysis reveals that among women, in addition to increasing access to obesogenic technologies, biological factors are associated with overweight incidence. Among men, obesogenic factors related to technology use and health behaviors are associated with the rise in overweight incidence, but biological factors are not. At lower levels of regional development, overweight incidence is associated with greater access to obesogenic technology such as motorized transport, which reduces physical activity among men at higher rates than women. At higher levels of economic development, obesogenic behaviors, such as watching more television and reducing smoking, are associated with overweight incidence. Our results corroborate the call by public health experts for group-specific policies to stem the rise of overweight incidence in developing countries.
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Affiliation(s)
- Anaka Aiyar
- Department of Economics, University of Nevada, Reno, 1664 N Virginia Avenue, Reno, NV, 89557, United States.
| | - Sunaina Dhingra
- School of Government and Public Policy, O P Jindal Global University, Sonipat, Haryana, 131001, India.
| | - Prabhu Pingali
- Tata-Cornell Institute for Agriculture and Nutrition, Charles H. Dyson School of Applied Economics and Management, Cornell University, 375 Warren Hall, Ithaca, NY, 14853, United States.
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Zuo Q, Band S, Kesavadas M, Madak Erdogan Z. Obesity and Postmenopausal Hormone Receptor-positive Breast Cancer: Epidemiology and Mechanisms. Endocrinology 2021; 162:6370080. [PMID: 34519778 DOI: 10.1210/endocr/bqab195] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Indexed: 12/11/2022]
Abstract
Obesity is a potential risk for several cancers, including postmenopausal, hormone dependent breast cancers. In this review, we summarize recent studies on the impact of obesity on postmenopausal women's health and discuss several mechanisms that were proposed to increase the risk of breast carcinogenesis.
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Affiliation(s)
- Qianying Zuo
- Department of Food Science and Human Nutrition, University of Illinois, Urbana-Champaign, Urbana, IL, USA
| | - Shoham Band
- Department of Food Science and Human Nutrition, University of Illinois, Urbana-Champaign, Urbana, IL, USA
| | - Mrinali Kesavadas
- Department of Food Science and Human Nutrition, University of Illinois, Urbana-Champaign, Urbana, IL, USA
| | - Zeynep Madak Erdogan
- Department of Food Science and Human Nutrition, University of Illinois, Urbana-Champaign, Urbana, IL, USA
- Cancer Center at Illinois, University of Illinois, Urbana-Champaign, Urbana, IL, USA
- Institute for Genomic Biology, University of Illinois, Urbana-Champaign, Urbana, IL, USA
- Division of Nutritional Sciences, University of Illinois, Urbana-Champaign, Urbana, IL, USA
- Department of Biomedical and Translational Sciences, Carle Illinois, College of Medicine, University of Illinois, Urbana-Champaign, Urbana, IL, USA
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Khodarahmi M, Farhangi MA, Khoshro S, Dehghan P. Factors associated with health-related quality of life in women using path analyses: mediation effect of the adiposity traits. BMC Womens Health 2021; 21:395. [PMID: 34819076 PMCID: PMC8611884 DOI: 10.1186/s12905-021-01535-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 11/08/2021] [Indexed: 11/12/2022] Open
Abstract
Background The current work aimed to investigate the mediating role of adiposity traits in the relationship between eating behaviors, sleep quality, socio-demographic factors, and the health-related quality of life in women of reproductive age in northwest of Iran. Methods In the current cross-sectional study, a total of 278 overweight and obese women of reproductive age (20–49 y) were enrolled. Anthropometric assessments were performed. Pittsburgh sleep quality index (PSQI) was used for assessment of sleep quality while Short Form 36 (SF-36) questionnaire was used to measure health-related quality of life (HRQoL). Three-Factor Eating Questionnaire-R18 (TFEQ-R18) was used to measure eating behaviors. Path analysis was used to test the relationships between parameters. Results Age was found to be indirectly and negatively associated with mental component score (MCS) (B = − 0.040; P = 0.049) and physical component score (PCS) (B = − 0.065; P = 0.036) through mediatory effects of obesity. Additionally, education was seen to be indirectly and positively related to MCS (B = 0.529; P = 0.045) and PCS (B = 0.870; P = 0.019), respectively. On the other hand, obesity (B = 0.608; P = 0.018) and PSQI score (B = − 0.240; P = 0.034) had direct associations with MCS. Age (B = − 0.065; P = 0.036) and education (B = 0.870; P = 0.019) were also directly associated with obesity. Conclusions Obesity seemed to mediate the effects of socio-demographic parameters on HRQoL. Poor sleep quality was also related to impairment of HRQoL. Further studies are needed to confirm these results.
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Alao R, Nur H, Fivian E, Shankar B, Kadiyala S, Harris-Fry H. Economic inequality in malnutrition: a global systematic review and meta-analysis. BMJ Glob Health 2021; 6:e006906. [PMID: 34887302 PMCID: PMC8663078 DOI: 10.1136/bmjgh-2021-006906] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 11/17/2021] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE To describe the evidence on global and regional economic inequality in malnutrition, and the associations between economic inequality and malnutrition. METHODS We conducted a systematic review and meta-analysis. Between 1 November 2020 and 22 January 2021, we searched Medline, Embase, Global Health, Eldis, Web of Science and EBSCO Discovery Service. We contacted 39 experts and tracked citations. We included any study reporting a concentration index (CIX) relating economic status and nutritional status and any multilevel study reporting an association between economic inequality and nutritional status. Nutritional status was measured as stunting, wasting, anaemia, or overweight in children (<5 years), or underweight, overweight or obesity, or anaemia in adults (15-49 years). We had no study date or language restriction. Quality was assessed using the Appraisal Tool for Cross-Sectional Studies (AXIS tool). We mapped estimates and pooled them using multilevel random-effects meta-analyses. RESULTS From 6185 results, 91 studies provided 426 CIX (>2.9 million people) and 47 associations (~3.9 million people). Stunting (CIX -0.15 (95% CI -0.19 to -0.11)) and wasting (-0.03 (95% CI -0.05 to -0.02)) are concentrated among poor households. Adult overweight and obesity is concentrated in wealthier households (0.08 (95% CI -0.00 to 0.17)), particularly in South Asia (0.26 (95% CI 0.19 to 0.34)), but not in Europe and Central Asia (-0.02 (95% CI -0.08 to 0.05)) or North America (-0.04 (95% CI -0.10 to 0.03)). We found no association between 0.1 increase in Gini coefficient and adult underweight (OR 1.03 (95% CI 0.94 to 1.12)) or overweight and obesity (0.92 (95% CI 0.80 to 1.05)). CONCLUSIONS There is good evidence that the prevalence of malnutrition varies by levels of absolute economic status. Undernutrition is concentrated in poor households, whereas concentration of overweight and obesity by economic status depends on region, and we lack information on economic inequalities in anaemia and child overweight. In contrast, links between malnutrition and relative economic status are less clear and should not be assumed; robust evidence on causal pathways is needed. PROSPERO REGISTRATION NUMBER CRD42020201572.
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Affiliation(s)
- Rotimi Alao
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Hayaan Nur
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Emily Fivian
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Bhavani Shankar
- Department of Geography, The University of Sheffield, Sheffield, UK
| | - Suneetha Kadiyala
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Helen Harris-Fry
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
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Su Y, Du S, Yang M, Wu J, Lu H, Wang X. Socioeconomic Determinants of Diet Quality on Overweight and Obesity in Adults Aged 40-59 Years in Inner Mongolia: A Cross-Sectional Study. Int J Public Health 2021; 66:1604107. [PMID: 34819829 PMCID: PMC8607545 DOI: 10.3389/ijph.2021.1604107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 10/13/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: This study investigated the relationship of socioeconomic status (SES), diet quality and overweight and obesity in adults aged 40-59 years in Inner Mongolia. Methods: This cross-sectional study was based on the survey of Chronic Disease and Nutrition Monitoring in Adults in Inner Mongolia in 2015. Diet quality was evaluated by the Alternate Mediterranean Diet score (aMeds). SES was measured by household annual income. Generalized estimating equations and path analysis were performed to determine the association of SES, diet quality and overweight and obesity. Results: Among participants, 63.0% had overweight and obesity. In high SES group, 66.4% had overweight and obesity. Higher SES was associated with a higher risk of overweight and obesity (OR = 1.352, 95%CI: 1.020-1.793). And higher aMeds was associated with a lower risk of overweight and obesity (OR = 0.597, 95%CI: 0.419-0.851). There was a positive correlation between SES and the intake of red and processed meat (r = 0.132, p < 0.05). Higher intake of red and processed meat was associated with lower diet quality (β = -0.34). And lower diet quality was associated with a higher risk of overweight and obesity (β = -0.10). Conclusion: In Inner Mongolia, during the period of economic transition, people aged 40-59 years in high SES had poor diet quality, which was related to a higher risk of overweight and obesity.
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Affiliation(s)
- Yuenan Su
- School of Public Health, Inner Mongolia Medical University, Hohhot, China
| | - Sha Du
- School of Public Health, Inner Mongolia Medical University, Hohhot, China
| | - Min Yang
- School of Public Health, Inner Mongolia Medical University, Hohhot, China
| | - Jing Wu
- National Center for Chronic and Non-Communicable Diseases Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Haiwen Lu
- Affiliated Hospital, Inner Mongolia Medical University, Hohhot, China
| | - Xuemei Wang
- School of Public Health, Inner Mongolia Medical University, Hohhot, China
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Wrzosek M, Zawadzka Z, Sawicka A, Bobrowska-Korczak B, Białek A. Impact of Fatty Acids on Obesity-Associated Diseases and Radical Weight Reduction. Obes Surg 2021; 32:428-440. [PMID: 34813039 PMCID: PMC8794933 DOI: 10.1007/s11695-021-05789-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/26/2021] [Accepted: 11/09/2021] [Indexed: 01/21/2023]
Abstract
Purpose Fatty acids (FA), particularly polyunsaturated (PUFA) ones, are involved in the regulation of glycemic control, lipid metabolism, and inflammation. The aim of the study was to assess patient FA profile in relation to obesity, lipid and carbohydrate metabolism disturbances, and weight loss. Materials and Methods The studied group consisted of 51 patients with extreme obesity, 23 of whom achieved radical weight reduction within 1 year after a laparoscopic sleeve gastrectomy (LSG). FA levels were determined using gas chromatography with flame ionization detection. Results Patients with extreme obesity and higher serum PUFA content have lower serum levels of SFA and MUFA (especially myristic, palmitic, lignoceric acids and palmitoleic, oleic acids), as well as lower triglyceride and higher HDL-cholesterol concentrations and it was not influenced by CEPT Taq1B variant. At baseline, the fatty acid profile of patients with type II diabetes differ from patients with dyslipidemia. In patients who had lost weight, significantly lower levels of selected saturated FA and major trans-fatty acid, elaidic, were found. Moreover, the proportion of PUFA was increased. Conclusion In extreme obesity, higher PUFA exert their favorable effects on serum lipids. Significant weight reduction after the bariatric surgery is associated with beneficial changes in the fatty acid profile. Graphical Abstract ![]()
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Affiliation(s)
- Małgorzata Wrzosek
- Department of Biochemistry and Pharmacogenomics, Faculty of Pharmacy, Medical University of Warsaw, 1 Banacha Street, 02-097 Warsaw, Poland
- Centre for Preclinical Research, Medical University of Warsaw, 1 Banacha Street, 02-097 Warsaw, Poland
| | - Zuzanna Zawadzka
- Department of Biochemistry and Pharmacogenomics, Faculty of Pharmacy, Medical University of Warsaw, 1 Banacha Street, 02-097 Warsaw, Poland
| | - Ada Sawicka
- Department of Family Medicine, Internal Medicine and Metabolic Bone Diseases, Center of Postgraduate Medical Education, 00-416, Warsaw, Poland
| | - Barbara Bobrowska-Korczak
- Department of Bromatology, Faculty of Pharmacy, Medical University of Warsaw, 1 Banacha St., 02-097 Warsaw, Poland
| | - Agnieszka Białek
- Institute of Genetics and Animal Biotechnology PAS, Postepu 36A, Jastrzębiec, 05-552 Magdalenka, Poland
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Ahmad A, Saeed M, Ansari IA. Molecular insights on chemopreventive and anticancer potential of carvacrol: Implications from solid carcinomas. J Food Biochem 2021; 45:e14010. [PMID: 34796513 DOI: 10.1111/jfbc.14010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 09/29/2021] [Accepted: 11/01/2021] [Indexed: 12/20/2022]
Abstract
Globally, cancer is one of the deadliest diseases, estimated to cause 9.9 million deaths in 2020. Conventional cancer treatments commonly involve mono-chemotherapy or a combination of radiotherapy and mono-chemotherapy. However, the negative side effects of these approaches have been extensively reported and have prompted the search for new therapeutic drugs. Over the past few years, numerous dietary agents, medicinal plants, and their phytochemicals gained considerable therapeutic importance because of their anticancer, antiviral, anti-inflammatory, and antioxidant activities. Recent years have shown that essential oils possess therapeutic effects against numerous cancers. They are primarily used due to their lesser side effects than standard chemotherapeutic drugs. Carvacrol (CRV) is a phenolic monoterpenoid found in essential oils of oregano, thyme, pepperwort, wild bergamot, and other plants. Numerous anticancer reports of CRV substantiated that the main mechanistic action of CRV involves reduction in the viability of cancer cells and induction of apoptosis via both intrinsic and extrinsic pathways. CRV also obstructs the migration and invasion of cells leading to the suppressed proliferation rate. Furthermore, CRV mediates augmented ROS generation resulting in DNA damage and also halts the progression of cell cycle. Treatment of CRV modulates the expression of apoptotic proteins (Bax, Bad) and molecular targets of various signaling pathways (PI3K/AKT/mTOR, MAPKs, and Notch) in multiple solid carcinomas. Hence, this review aimed to acquire and disseminate the knowledge of chemopreventive and anticancer effects of CRV and the mechanisms of action already described for the compound against numerous cancers, including solid carcinomas, to guide future research. PRACTICAL APPLICATIONS: Development and formulation of phytocompound based anticancer drug agents to counteract the aftereffects of chemotherapeutic drugs is a propitious approach. CRV is a monoterpenoid consisting of a phenolic group obtained from the essential oils of oregano and thyme. These plants are being used as food flavoring spice and as fragrance ingredient in various cosmetic formulations. For the use of CRV as an efficient chemopreventive agent, different therapeutic interactions of CRV along with its targeted pathways and molecules, involved in the regulation of onset and progression of various types of solid carcinomas, need to be studied and explored thoroughly.
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Affiliation(s)
- Afza Ahmad
- Department of Biosciences, Integral University, Lucknow, India
| | - Mohd Saeed
- Department of Biology, College of Sciences, University of Hail, Hail, Saudi Arabia
| | - Irfan A Ansari
- Department of Biosciences, Integral University, Lucknow, India
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Lamb KE, Crawford D, Thornton LE, Shariful Islam SM, Maddison R, Ball K. Educational differences in diabetes and diabetes self-management behaviours in WHO SAGE countries. BMC Public Health 2021; 21:2108. [PMID: 34789208 PMCID: PMC8597224 DOI: 10.1186/s12889-021-12131-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 10/29/2021] [Indexed: 12/03/2022] Open
Abstract
Background Diabetes mellitus represents a substantial global health challenge, with prevalence rising in low- and middle-income countries (LMICs). Although diabetes is known to follow a socioeconomic gradient, patterns in LMICs are unclear. This study examined associations between education and diabetes, and diabetes self-management behaviours, in six LMICs. Methods Cross-sectional data for 31,780 participants from China, Ghana, India, Mexico, Russia, and South Africa from the World Health Organization Study on Global AGEing and adult health (SAGE) study were used. Participants aged ≥50 years completed face-to-face interviews between 2007 and 2010. Participants self-reported diabetes diagnosis, physical activity, sedentary time, fruit and vegetable consumption, any special diet/program for diabetes, whether they were taking insulin for diabetes and number of years of education. Height, weight, waist, and hip circumference were measured. Country-specific survey-weighted log-binomial regression models were fitted to examine associations between the number of years of education and self-reported diabetes diagnosis (primary analysis). In secondary analyses, among those with a self-reported diabetes diagnosis, generalised linear regression models were fitted to examine associations between education and i) physical activity, ii) sedentary time, iii) fruit and vegetable consumption, iv) special diet for diabetes, v) taking insulin, vi) BMI, vii) waist circumference and viii) hip circumference. Results There was strong evidence of an association between years of education and diabetes diagnosis in Ghana (RR = 1.09, 95% CI: 1.06–1.13) and India (RR = 1.09, 95% CI: 1.07–1.12) only. In India, greater years of education was associated with higher leisure physical activity, fruit and vegetable intake, rates following a special diet or taking insulin, but also higher mean BMI, waist and hip circumference. Relationships between education and self-management behaviours were rarely seen in the other countries. Conclusions Associations between education and diabetes, and behavioural self-management (India only) was more evident in the two least developed (Ghana and India) of the WHO SAGE countries, indicating increasing diabetes diagnosis with greater numbers of years of education. The lack of gradients elsewhere may reflect shifting risk from higher to lower educated populations. While there was some suggestion that self-management behaviours were greater with increased education in India, this was not observed in the other countries. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12131-7.
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Affiliation(s)
- Karen E Lamb
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Australia. .,Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia. .,Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia.
| | - David Crawford
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Australia
| | - Lukar E Thornton
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Australia
| | - Sheikh M Shariful Islam
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Australia
| | - Ralph Maddison
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Australia
| | - Kylie Ball
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Australia.
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Buoncristiano M, Williams J, Simmonds P, Nurk E, Ahrens W, Nardone P, Rito AI, Rutter H, Bergh IH, Starc G, Jonsson KR, Spinelli A, Vandevijvere S, Mäki P, Milanović SM, Salanave B, Yardim MS, Hejgaard T, Fijałkowska A, Abdrakhmanova S, Abdurrahmonova Z, Duleva V, Farrugia Sant'Angelo V, García-Solano M, Gualtieri A, Gutiérrez-González E, Huidumac-Petrescu C, Hyska J, Kelleher CC, Kujundžić E, Peterkova V, Petrauskiene A, Pudule I, Sacchini E, Shengelia L, Tanrygulyyeva M, Taxová Braunerová R, Usupova Z, Maruszczak K, Ostojic SM, Spiroski I, Stojisavljević D, Wickramasinghe K, Breda J. Socioeconomic inequalities in overweight and obesity among 6- to 9-year-old children in 24 countries from the World Health Organization European region. Obes Rev 2021; 22 Suppl 6:e13213. [PMID: 34184399 DOI: 10.1111/obr.13213] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 01/12/2021] [Indexed: 01/17/2023]
Abstract
Childhood overweight and obesity have significant short- and long-term negative impacts on children's health and well-being. These challenges are unequally distributed according to socioeconomic status (SES); however, previous studies have often lacked standardized and objectively measured data across national contexts to assess these differences. This study provides a cross-sectional picture of the association between SES and childhood overweight and obesity, based on data from 123,487 children aged 6-9 years in 24 countries in the World Health Organization (WHO) European region. Overall, associations were found between overweight/obesity and the three SES indicators used (parental education, parental employment status, and family-perceived wealth). Our results showed an inverse relationship between the prevalence of childhood overweight/obesity and parental education in high-income countries, whereas the opposite relationship was observed in most of the middle-income countries. The same applied to family-perceived wealth, although parental employment status appeared to be less associated with overweight and obesity or not associated at all. This paper highlights the need for close attention to context when designing interventions, as the association between SES and childhood overweight and obesity varies by country economic development. Population-based interventions have an important role to play, but policies that target specific SES groups are also needed to address inequalities.
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Affiliation(s)
- Marta Buoncristiano
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Julianne Williams
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Philippa Simmonds
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Eha Nurk
- Department of Nutrition Research, National Institute for Health Development, Tallinn, Estonia
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology, BIPS, Bremen, Germany.,Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - Paola Nardone
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health (Istituto Superiore di Sanità), Rome, Italy
| | - Ana Isabel Rito
- WHO/Europe Collaborating Center for Nutrition and Childhood Obesity - Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath, Bath, UK
| | - Ingunn Holden Bergh
- Department of Health and Inequality, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Gregor Starc
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Kenisha Russell Jonsson
- Department of Living Conditions and Lifestyle, Public Health Agency of Sweden, Solna, Sweden
| | - Angela Spinelli
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health (Istituto Superiore di Sanità), Rome, Italy
| | | | - Päivi Mäki
- Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Sanja Musić Milanović
- Croatian Institute of Public Health, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Benoît Salanave
- Departement of Non-Communicable Diseases and Traumatisms, Santé publique France, the French Public Health Agency, Saint Maurice, France.,Nutritional Surveillance and Epidemiology Team (ESEN), University Sorbonne Paris Nord, Bobigny, France
| | | | - Tatjana Hejgaard
- Health Promotion and Inequality, Danish Health Authority, Copenhagen, Denmark
| | - Anna Fijałkowska
- Department of Cardiology, Institute of Mother and Child, Warsaw, Poland
| | - Shynar Abdrakhmanova
- Department of Science and Professional Development, National Center of Public Health of the Ministry of Health of the Republic of Kazakhstan, Almaty, Kazakhstan.,Kazakhstan School of Public Health, Kazakhstan's Medical University, Almaty, Kazakhstan
| | - Zulfiya Abdurrahmonova
- Republican Centre for Nutrition, Ministry of Health and Social Protection of Population, Dushanbe, Tajikistan
| | - Vesselka Duleva
- Department Food and Nutrition, National Centre of Public Health and Analyses, Sofia, Bulgaria
| | | | - Marta García-Solano
- Spanish Agency for Food Safety and Nutrition, Ministry of Consumer Affairs, Madrid, Spain
| | | | | | - Constanta Huidumac-Petrescu
- National Center for Health Assessment and Promotion, National Institute of Public Health, Bucharest, Romania
| | - Jolanda Hyska
- Nutrition and Food Safety Sector, Institute of Public Health, Tirana, Albania
| | - Cecily C Kelleher
- College of Health and Agricultural Sciences, University College Dublin, Dublin, Ireland
| | - Enisa Kujundžić
- Center for Health Ecology, Institute of Public Health, Podgorica, Montenegro
| | - Valentina Peterkova
- Institute of Paediatric Endocrinology, National Medical Research Centre for Endocrinology of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Ausra Petrauskiene
- Department of Preventive Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Iveta Pudule
- Department of Research and Health Statistics, Centre for Disease and Prevention Control, Riga, Latvia
| | - Elena Sacchini
- Health Authority, Ministry of Health, San Marino, San Marino
| | - Lela Shengelia
- Maternal, Child and Reproductive Health, National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia
| | - Maya Tanrygulyyeva
- Scientific Research Institute of Maternal and Child Health, Ashgabat, Turkmenistan
| | | | - Zhamilya Usupova
- Republican Center for Health Promotion and Mass Communication, Ministry of Health of the Kyrgyz Republic, Bishkek, Kyrgyzstan
| | | | - Sergej M Ostojic
- Biomedical Sciences Department, Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Igor Spiroski
- Institute of Public Health, Skopje, North Macedonia.,Faculty of Medicine, SS. Cyril and Methodius University, Skopje, North Macedonia
| | - Dragana Stojisavljević
- Faculty of Medicine, University of Banja Luka, Banja Luka, Bosnia and Herzegovina.,Public Health Institute of Republic of Srpska, Banja Luka, Bosnia and Herzegovina
| | - Kremlin Wickramasinghe
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - João Breda
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
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Bridger Staatz C, Kelly Y, Lacey RE, Blodgett JM, George A, Arnot M, Walker E, Hardy R. Socioeconomic position and body composition in childhood in high- and middle-income countries: a systematic review and narrative synthesis. Int J Obes (Lond) 2021; 45:2316-2334. [PMID: 34315999 PMCID: PMC8528703 DOI: 10.1038/s41366-021-00899-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 05/24/2021] [Accepted: 06/30/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND The relation between socioeconomic position (SEP) and obesity measured by body mass index (BMI), a measure of weight for height, has been extensively reviewed in children, showing consistent associations between disadvantaged SEP and higher BMI in high-income countries (HICs) and lower BMI in middle-income countries (MICs). Fat mass (FM), a more accurate measure of adiposity, and fat-free mass (FFM) are not captured by BMI, but have been shown to track from childhood to adulthood, and be important for cardiovascular health and functional outcomes in later life. It is not clear whether body composition is associated with SEP. We systematically reviewed the association between SEP and body composition in childhood. METHODS A systematic review was carried out following PRISMA guidelines. The protocol was pre-registered with PROSPERO (CRD42019119937). Original studies in the English language, which examined the association between SEP and body composition in childhood, were included. An electronic search of three databases was conducted. Two independent reviewers carried out screening, data extraction and quality assessment. Due to heterogeneity in results, a narrative synthesis was conducted. Heterogeneity in findings according to SEP, sex, body composition measure and country income level was investigated. RESULTS 50 papers were included, the majority from HICs. No papers were from low-income countries. Disadvantage in childhood was associated with greater FM and lower FFM in HICs, but with lower FM and lower FFM in MICs. When measures of FFM indexed to height were used there was no evidence of associations with SEP. In HICs, more studies reported associations between disadvantaged SEP and higher FM among girls comparative to boys. CONCLUSIONS Inequalities in FM are evident in HICs and, in the opposite direction, in MICs and follow similar trends to inequalities for BMI. Inequalities in height are likely important in understanding inequalities in FFM.
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Affiliation(s)
- Charis Bridger Staatz
- Social Research Institute, Institute of Education, University College London, London, UK.
| | - Yvonne Kelly
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Rebecca E Lacey
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Joanna M Blodgett
- Institute of Sport Exercise and Health, Division of Surgery and Interventional Science, Faculty of Medical Sciences, University College London, London, UK
| | - Anitha George
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Megan Arnot
- Department of Anthropology, University College London, London, UK
| | - Emma Walker
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Rebecca Hardy
- Social Research Institute, Institute of Education, University College London, London, UK
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Spatial location, temperature and rainfall diversity affect the double burden of malnutrition among women in Kenya. SSM Popul Health 2021; 16:100939. [PMID: 34660880 PMCID: PMC8503666 DOI: 10.1016/j.ssmph.2021.100939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 09/27/2021] [Accepted: 09/30/2021] [Indexed: 11/22/2022] Open
Abstract
Studies have looked into how environmental and climate covariates affect under-and over-nutrition, but little is known about the spatial distribution of different forms of malnutrition in Kenya and whether there are locations that suffer from double-burden of malnutrition. This research quantifies spatial variations and estimates how climatic and environmental factors affect under-and over-nutrition among women in Kenya. This enables us to determine if the patterns in which these factors affect the malnutrition indicators are similar and whether there are overlaps in the spatial distributions. The study used data from the Demographic and Health Survey, which included cross-sectional data on malnutrition indicators as well as some climate and environmental variables. A multicategorical response variable that classified the women into one of four nutritional classes was generated from the body mass index (BMI) of the women, and a Bayesian geoadditive regression model with an estimate based on the Markov chain Monte Carlo simulation technique was adopted. Findings show that women in Turkana, Samburu, Isiolo, Baringo, Garissa, and West Pokot counties are more likely to be underweight than women in other counties while being overweight is prevalent in Kirinyag'a and Kitui counties. Obesity is prevalent in Kirinyag'a, Lamu, Kiambu, Murang'a, and Taita Taveta counties. The study further shows that as mean temperature and precipitation increase, the likelihood of being underweight reduces. The chances of being underweight are lower among literate women [OR: 0.614; 95% CrI: 0.513,0.739], married women [OR: 0.702; 95% CrI: 0.608,0.819] and those from rich households [OR: 0.617; 95% CrI: 0.489,0.772], which is not the case for overweight and obesity. The generated spatial maps identify hot spots of the double burden of malnutrition that can assist the government and donor agencies in channeling resources efficiently. Low- and middle-income countries have been experiencing double burden of malnutrition. The generated spatial maps identify hot spots of the double burden of malnutrition. Carefully thought-out policy plans are required to curb the challenges of the double burden of malnutrition. Burden of undernutrition has decreased but the cost of being overweight or obese is increasing among women.
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Li W, Li S, Feldman MW. Socioeconomic Status, Institutional Power, and Body Mass Index among Chinese Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010620. [PMID: 34682366 PMCID: PMC8535575 DOI: 10.3390/ijerph182010620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 10/05/2021] [Accepted: 10/06/2021] [Indexed: 11/18/2022]
Abstract
Despite the vast literature on the socioeconomic status (SES) gradient of obesity among adult people, no study has investigated the relationship between institutional power and body mass index. Using national survey data from the “China Labor-force Dynamics Survey 2016” (CLDS 2016), multistage cluster-stratified probability proportional to size (PPS) sampling was employed to select cases from 29 provinces, cities, and autonomous regions in China. This study adopts an institutional approach to explore the influences of SES and institutional power on the state of being overweight or severely overweight (obese) among Chinese adults. It is shown that SES has a non-linear influence on being overweight or obese, higher education has a negative effect on being overweight or obese, income has an inverted U-shaped effect on being overweight or obese, and having a managerial or administrative job has a positive effect on being overweight but less so on obesity. These findings reveal that disparities in health outcome and risks are due to inequality in SES. The work unit is a stronger predictor of adults being overweight or obese than occupation. Working in the public sector has a positive effect on being overweight relative to working in the private sector, and only state institutions and government departments have a positive association with obesity. Our results indicate that institutional structure still has effects on individuals’ life chances in the era of China’s market transition.
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Affiliation(s)
- Weidong Li
- Department of Sociology, School of Philosophy and Government, Shaanxi Normal University, Xi’an 710119, China
- Correspondence:
| | - Shuzhuo Li
- Institute for Population and Development Studies, School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an 710049, China;
| | - Marcus W. Feldman
- Morrison Institute for Population and Resource Studies, Stanford University, Stanford, CA 94305, USA;
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131
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Lin L, Wang HH, Lu C, Chen W, Guo VY. Adverse Childhood Experiences and Subsequent Chronic Diseases Among Middle-aged or Older Adults in China and Associations With Demographic and Socioeconomic Characteristics. JAMA Netw Open 2021; 4:e2130143. [PMID: 34694390 PMCID: PMC8546496 DOI: 10.1001/jamanetworkopen.2021.30143] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Associations between adverse childhood experiences (ACEs) and chronic diseases among middle-aged or older Chinese individuals have not been well documented. In addition, whether demographic and socioeconomic characteristics modify any such associations has been underexplored. OBJECTIVES To examine associations between ACEs and subsequent chronic diseases and to assess whether age, sex, educational level, annual per capita household expenditure level, and childhood economic hardship modify these associations. DESIGN, SETTING, AND PARTICIPANTS This population-based cross-sectional study used data from the China Health and Retirement Longitudinal Study (CHARLS), a survey of residents aged 45 years or older in 28 provinces across China; specifically, the study used data from the CHARLS life history survey conducted from June 1 to December 31, 2014, and a CHARLS follow-up health survey conducted from July 1 to September 30, 2015. The study population included 11 972 respondents aged 45 years or older who had data on at least 1 of 14 specified chronic diseases and information on all 12 of the ACE indicators included in this study. Data analysis was performed from December 1 to 30, 2020. EXPOSURES Any of 12 ACEs (physical abuse, emotional neglect, household substance abuse, household mental illness, domestic violence, incarcerated household member, parental separation or divorce, unsafe neighborhood, bullying, parental death, sibling death, and parental disability), measured by indicators on a questionnaire. The number of ACEs per participant was summed and categorized into 1 of 5 cumulative-score groups: 0, 1, 2, 3, and 4 or more. MAIN OUTCOMES AND MEASURES Hypertension, dyslipidemia, diabetes, heart disease, stroke, chronic lung disease, asthma, liver disease, cancer, digestive disease, kidney disease, arthritis, psychiatric disease, and memory-related disease were defined by self-reported physician diagnoses or in combination with health assessment and medication data. Multimorbidity was defined as the presence of 2 or more of these 14 chronic diseases. Logistic regression models were used to assess associations of the 12 ACEs with the 14 chronic diseases and with multimorbidity. Modification of the associations by demographic and socioeconomic characteristics was assessed by stratified analyses and tests for interaction. RESULTS Of the 11 972 individuals included (mean [SD] age, 59.85 [9.56] years; 6181 [51.6%] were females), 80.9% had been exposed to at least 1 ACE and 18.0% reported exposure to 4 or more ACEs. Compared with those without ACE exposure, participants who experienced 4 or more ACEs had increased risks of dyslipidemia, chronic lung disease, asthma, liver disease, digestive disease, kidney disease, arthritis, psychiatric disease, memory-related disease, and multimorbidity. The estimated odds ratios (ORs) ranged from 1.27 (95% CI, 1.02-1.59) for dyslipidemia to 2.59 (95% CI, 2.16-3.11) for digestive disease. A dose-response association was also observed between the number of ACEs and the risk of most of the chronic diseases (excluding hypertension, diabetes, and cancer) (eg, chronic lung disease for ≥4 ACEs vs none: OR, 2.01; 95% CI, 1.59-2.55; P < .001 for trend) and of multimorbidity (for individuals among the overall study population with ≥4 ACEs vs none: OR, 2.03; 95% CI, 1.70-2.41; P < .001 for trend). The demographic or socioeconomic characteristics of age, sex, educational level, annual per capita household expenditure level, or childhood economic hardship were not shown to significantly modify the associations between ACEs and multimorbidity. CONCLUSIONS AND RELEVANCE In this population-based, cross-sectional study of adults in China, exposure to ACEs was associated with higher risks of chronic diseases regardless of demographic and socioeconomic characteristics during childhood or adulthood. These findings suggest a need to prevent ACEs and a need for a universal life-course public health strategy to reduce potential adverse health outcomes later in life among individuals who experience them.
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Affiliation(s)
- Li Lin
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | | | - Ciyong Lu
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Weiqing Chen
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Vivian Yawei Guo
- School of Public Health, Sun Yat-sen University, Guangzhou, China
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132
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Sociodemographic and Clinical Factors Associated with Severe Obesity in Mexican Adults. Arch Med Res 2021; 53:196-204. [DOI: 10.1016/j.arcmed.2021.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 08/29/2021] [Accepted: 09/21/2021] [Indexed: 01/06/2023]
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133
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YILMAZ B, SOMAY E. Is obesity a problem that threatens oral health in adults? CUKUROVA MEDICAL JOURNAL 2021. [DOI: 10.17826/cumj.950243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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134
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The Impact of Morbid Obesity on the Health Outcomes of Hospital Inpatients: An Observational Study. J Clin Med 2021; 10:jcm10194382. [PMID: 34640400 PMCID: PMC8509550 DOI: 10.3390/jcm10194382] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 09/15/2021] [Accepted: 09/23/2021] [Indexed: 11/16/2022] Open
Abstract
Morbid obesity poses a significant burden on the health-care system. This study determined whether morbid obesity leads to worse health-outcomes in hospitalised patients. This retrospective-study examined nutritional data of all inpatients aged 18-79 years, with a body-mass-index (BMI) ≥ 18.5 kg/m2 admitted over a period of 4 years at two major hospitals in Australia. Patients were divided into 3 groups for comparison: normal/overweight (BMI 18.5-29.9 kg/m2), obese (BMI 30-39.9 kg/m2) and morbidly-obese (BMI ≥ 40 kg/m2). Outcome measures included length-of-hospital-stay (LOS), in-hospital mortality, and 30-day readmissions. Multilevel-mixed-effects regression was used to compare clinical outcomes between the groups after adjustment for potential confounders. Of 16,579 patients, 1004 (6.1%) were classified as morbidly-obese. Morbidly-obese patients had a significantly longer median (IQR) LOS than normal/overweight patients (5 (2, 12) vs. 5 (2, 11) days, p value = 0.012) and obese-patients (5 (2, 12) vs. 5 (2, 10) days, p value = 0.036). After adjusted-analysis, morbidly-obese patients had a higher incidence of a longer LOS than normal/overweight patients (IRR 1.04; 95% CI 1.02-1.07; p value < 0.001) and obese-patients (IRR 1.13; 95% CI 1.11-1.16; p value < 0.001). Other clinical outcomes were similar between the different groups. Morbid obesity leads to a longer LOS in hospitalised patients but does not adversely affect other clinical outcomes.
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135
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Ávila Curiel A, Galindo Gómez C, Juárez Martínez L, García-Guerra A, Del Monte Vega MY, Martínez Domínguez J, Ávila Arcos YMA. Mala nutrición en población escolar mexicana: factores geográficos y escolares asociados. Glob Health Promot 2021; 29:126-135. [PMID: 34558364 DOI: 10.1177/17579759211038381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJETIVOS Determinar prevalencias de mala nutrición [sobrepeso u obesidad (Sp+O) y talla baja (TB)] en población mexicana de 6 a 12 años de edad de nivel básico de primaria, y su asociación con características geográficas (ámbito, marginación y región del país), y de la escuela (tipo, turno y grado). MÉTODOS Con información de 10 528 676 escolares, se estimaron prevalencias (e I.C. 95%), a nivel nacional y por características de interés, y su asociación mediante modelos de regresión logística. RESULTADOS La prevalencia nacional de Sp+O fue 34.4%, 36.5% en ámbito urbano y 40.2% en escuelas privadas. La prevalencia nacional de TB fue 8.7%; en área rural, 13.7% y 28.8% en escuelas tipo indígenas. El Sp+O y la TB se asociaron significativamente con características geográficas y de escuelas. CONCLUSIONES Existe una polarización nutricional en el contexto escolar del país. Es importante continuar con sistemas de monitoreo y vigilancia nutricional.
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Affiliation(s)
- Abelardo Ávila Curiel
- Dirección de Nutrición, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Ciudad de México, México
| | - Carlos Galindo Gómez
- Dirección de Nutrición, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Ciudad de México, México
| | - Liliana Juárez Martínez
- Dirección de Nutrición, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Ciudad de México, México
| | - Armando García-Guerra
- Centro de Investigación en Nutrición y Salud (CINyS), Instituto Nacional de Salud Pública (INSP), Cuernavaca, Morelos, México
| | | | | | - Y Marco Antonio Ávila Arcos
- Dirección de Nutrición, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Ciudad de México, México
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136
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Pradeilles R, Irache A, Wanjohi MN, Holdsworth M, Laar A, Zotor F, Tandoh A, Klomegah S, Graham F, Muthuri SK, Kimani-Murage EW, Coleman N, Green MA, Osei-Kwasi HA, Bohr M, Rousham EK, Asiki G, Akparibo R, Mensah K, Aryeetey R, Bricas N, Griffiths P. Urban physical food environments drive dietary behaviours in Ghana and Kenya: A photovoice study. Health Place 2021; 71:102647. [PMID: 34375838 PMCID: PMC8520917 DOI: 10.1016/j.healthplace.2021.102647] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 06/20/2021] [Accepted: 08/02/2021] [Indexed: 11/26/2022]
Abstract
We identified factors in the physical food environment that influence dietary behaviours among low-income dwellers in three African cities (Nairobi, Accra, Ho). We used Photovoice with 142 males/females (≥13 years). In the neighbourhood environment, poor hygiene, environmental sanitation, food contamination and adulteration were key concerns. Economic access was perceived as a major barrier to accessing nutritionally safe and healthy foods. Home gardening supplemented household nutritional needs, particularly in Nairobi. Policies to enhance food safety in neighbourhood environments are required. Home gardening, food pricing policies and social protection schemes could reduce financial barriers to safe and healthy diets.
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Affiliation(s)
- Rebecca Pradeilles
- School of Sport, Exercise and Health Sciences, Loughborough University, United Kingdom.
| | - Ana Irache
- Warwick Medical School, University of Warwick, Coventry, UK
| | | | - Michelle Holdsworth
- IRD (French National Research Institute for Sustainable Development), NUTRIPASS Unit, Université de Montpellier-IRD, Montpellier, France
| | - Amos Laar
- University of Ghana, Department of Population, Family & Reproductive Health, School of Public Health, Accra, Ghana
| | - Francis Zotor
- Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | - Akua Tandoh
- University of Ghana, Department of Population, Family & Reproductive Health, School of Public Health, Accra, Ghana
| | - Senam Klomegah
- Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | - Fiona Graham
- Population Health Sciences Institute, Newcastle University, United Kingdom
| | | | | | - Nathaniel Coleman
- University of Ghana, Department of Population, Family & Reproductive Health, School of Public Health, Accra, Ghana; Department of Obstetrics and Gynaecology, University of Ghana Medical School, College of Health Sciences, Accra, Ghana
| | - Mark A Green
- Department of Geography and Planning, University of Liverpool, UK
| | | | - Marco Bohr
- School of Art & Design, Nottingham Trent University, UK
| | - Emily K Rousham
- School of Sport, Exercise and Health Sciences, Loughborough University, United Kingdom
| | - Gershim Asiki
- African Population and Health Research Center, Nairobi, Kenya
| | - Robert Akparibo
- Public Health Section, School of Health and Related Research, University of Sheffield, United Kingdom
| | - Kobby Mensah
- Department of Marketing and Entrepreneurship, University of Ghana Business School, Accra, Ghana
| | - Richmond Aryeetey
- University of Ghana, Department of Population, Family & Reproductive Health, School of Public Health, Accra, Ghana
| | - Nicolas Bricas
- UMR MOISA, CIRAD- Agricultural Research & International Cooperation Organization, Montpellier, France
| | - Paula Griffiths
- School of Sport, Exercise and Health Sciences, Loughborough University, United Kingdom
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137
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Zhou M. The shifting income-obesity relationship: Conditioning effects from economic development and globalization. SSM Popul Health 2021; 15:100849. [PMID: 34195348 PMCID: PMC8227802 DOI: 10.1016/j.ssmph.2021.100849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 06/14/2021] [Accepted: 06/14/2021] [Indexed: 11/13/2022] Open
Abstract
The literature has long been debating whether it is high-income or low-income individuals who face higher risks of obesity. In this study I contend that this mixed record about the income-obesity relationship is the result of a failure to account fully for macro-level social contexts. The income-obesity relationship is not uniform in all societies but is conditioned by macro-level social contexts including the society's economic development and involvement in globalization. The 2011 Module on Health and Health Care of the International Social Survey Programme (ISSP) provides an ideal opportunity for testing the complex income-obesity relationship in a cross-country setting. Employing multilevel models with cross-level interactions, this study finds that the shift in the effect of income from obesity-promoting to obesity-depressing is facilitated by both economic development and globalization. Under the combined forces of economic development and globalization, obesity increasingly becomes a burden of the poor in a society and the social distribution of obesity increasingly mirrors existing social inequality. Nevertheless, the economic development and globalization thresholds for shifting into a significant obesity-depressing effect of income are high.
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Affiliation(s)
- Min Zhou
- Department of Sociology, University of Victoria, Cornett Building A359, 3800 Finnerty Road, Victoria, BC, V8W 3P5, Canada
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138
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Goetjes E, Pavlova M, Hongoro C, Groot W. Socioeconomic Inequalities and Obesity in South Africa-A Decomposition Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179181. [PMID: 34501777 PMCID: PMC8430886 DOI: 10.3390/ijerph18179181] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/19/2021] [Accepted: 08/23/2021] [Indexed: 12/30/2022]
Abstract
Background: Prior evidence shows that inequalities are related to overweight and obesity in South Africa. Using data from a recent national study, we examine the socioeconomic inequalities associated with obesity in South Africa and the factors associated with it. Methods: We use quantitative data from the South African National Health and Nutrition Examination Survey (SANHANES-1) carried out in 2012. We estimate the concentration index (CI) to identify inequalities and decompose the CI to explore the determinants of these inequalities. Results: We confirm the existence of pro-rich inequalities associated with obesity in South Africa. The inequalities among males are larger (CI of 0.16) than among women (CI of 0.09), though more women are obese than men. Marriage increases the risk of obesity for women and men, while smoking decreases the risk of obesity among men significantly. Higher education is associated with lower inequalities among females. Conclusions: We recommend policies to focus on promoting a healthy lifestyle, including the individual’s perception of a healthy body size and image, especially among women.
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Affiliation(s)
- Eva Goetjes
- CINCH Health Economics Research Center, Faculty of Business Administration and Economics, University of Duisburg-Essen, Berliner Platz 6–8, 45127 Essen, Germany
- Correspondence:
| | - Milena Pavlova
- Department of Health Services Research, CAPHRI, Maastricht University Medical Centre, Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands; (M.P.); (W.G.)
| | - Charles Hongoro
- Peace and Sustainable Security (PaSS), Developmental, Capable and Ethical State Division, Human Sciences Research Council, 134 Pretorius Street, Private Bag X41, Pretoria 0001, South Africa;
- School of Health Systems and Public Health, University of Pretoria, Private Bag X323, Pretoria 0001, South Africa
| | - Wim Groot
- Department of Health Services Research, CAPHRI, Maastricht University Medical Centre, Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands; (M.P.); (W.G.)
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139
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Li Y, Wang G, Li G. Educational attainment of offspring and obesity among older adults in China. Soc Sci Med 2021; 286:114325. [PMID: 34450393 DOI: 10.1016/j.socscimed.2021.114325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 08/15/2021] [Accepted: 08/17/2021] [Indexed: 10/20/2022]
Abstract
The study focuses on the role of adult offspring's educational attainment in obesity among older adults in China and investigates age and birth cohort heterogeneities in the educational effect. Using the longitudinal data from the 1993-2015 China Health and Nutrition Survey (CHNS), we employed three-level mixed-effects models and conducted sex-stratified analyses to examine the effects of co-resident offspring's education on body mass index (BMI), overweight, waist circumference (WC), and abdominal obesity among older people born before 1956. After controlling for confounding factors, the overall results showed inverted U-shaped educational gradients in BMI-based outcomes for males and positive gradients for females. The effect of education on WC exhibited an inverted U-shaped pattern for both sexes, but no significant effect on abdominal obesity was found among the overall population. However, further analyses of interaction effects indicated considerable age and cohort variations in the educational effects on obesity outcomes. Offspring's schooling was positively associated with obesity among earlier birth cohorts; Among more recent birth cohorts, especially among females, the educational effects were reversed, and disparities in obesity outcomes across education categories strengthened with age. These findings imply that offspring's education appears to gradually exert a protective role against obesity among Chinese older adults in successive cohorts.
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Affiliation(s)
- Yaoyue Li
- School of Social Development and Public Policy, Fudan University, Shanghai, 200433, China.
| | - Guixin Wang
- School of Social Development and Public Policy, Fudan University, Shanghai, 200433, China
| | - Guofeng Li
- School of Statistics, Shandong University of Finance and Economics, Jinan, Shandong, 250014, China
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140
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Sserwanja Q, Mutisya LM, Olal E, Musaba MW, Mukunya D. Factors associated with childhood overweight and obesity in Uganda: a national survey. BMC Public Health 2021; 21:1494. [PMID: 34344336 PMCID: PMC8330108 DOI: 10.1186/s12889-021-11567-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 07/29/2021] [Indexed: 01/19/2023] Open
Abstract
Background Childhood obesity is an emerging public health problem globally. Although previously a problem of high-income countries, overweight and obesity is on the rise in low- and middle-income countries. This paper explores the factors associated with childhood obesity and overweight in Uganda using data from the Uganda Demographic and Health Survey (UDHS) of 2016. Methods We used Uganda Demographic and Health Survey (UDHS) 2016 data of 4338 children less than 5 years. Multistage stratified sampling was used to select study participants and data were collected using validated questionnaires. Overweight and obesity were combined as the primary outcome. Children whose BMI z score was over two were considered as overweight while those with a BMI z score greater than three were considered as obese. We used multivariable logistic regression to determine factors associated with obesity and overweight among children under 5 years of age in Uganda. Results The prevalence of overweight and obesity was 5.0% (217/4338) (95% CI: 4.3–5.6), with overweight at 3.9% (168/4338: 95% CI: 3.2–4.3) and obesity at 1.1% (49/4338: 95% CI: 0.8–1.5). Mother’s nutritional status, sex of the child, and child’s age were associated with childhood obesity and overweight. Boys were more likely to be overweight or obese (aOR = 1.81; 95% CI 1.24 to 2.64) compared to girls. Children who were younger (36 months and below) and those with mothers who were overweight or obese were more likely to have obesity or overweight compared to those aged 49–59 months and those with underweight mothers respectively. Children from the western region were more likely to be overweight or obese compared to those that were from the North. Conclusion The present study showed male sex, older age of the children, nutritional status of the mothers and region of residence were associated with obesity and overweight among children under 5 years of age.
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Affiliation(s)
- Quraish Sserwanja
- Programs Department, GOAL, Arkaweet Block 65 House No, 227, Khartoum, Sudan.
| | - Linet M Mutisya
- Maternal and Child Health Project, Swedish Organization for Global Health, Mayuge, Uganda
| | | | - Milton W Musaba
- Department of Obstetrics and Gynaecology, Busitema University, Mbale, Uganda
| | - David Mukunya
- Department of Community and Public Health, Busitema University, Mbale, Uganda.,Sanyu Africa Research Institute, Mbale, Uganda
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141
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Julihn A, Cunha Soares F, Hjern A, Dahllöf G. Development level of the country of parental origin on dental caries in children of immigrant parents in Sweden. Acta Paediatr 2021; 110:2405-2414. [PMID: 33876448 DOI: 10.1111/apa.15882] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 04/13/2021] [Accepted: 04/15/2021] [Indexed: 11/29/2022]
Abstract
AIM To study the association of parental country of origin-expressed as low-, medium- and high-Human Development Index (HDI) countries-with caries experience in children of immigrant families in Stockholm. METHODS This registry-based cohort study included all children born in 2000-2003 who resided in Stockholm County, Sweden, at age 3 years (n = 83,147) with follow-up at 7 years of age. A logistic regression was performed for the multivariate analysis with adjustments for socio-demographic factors. RESULTS After adjustments, logistic regression analyses revealed that, compared with Swedish children of the same age, the risk of caries was highest when the immigrant parents originated in a medium (OR 4.22 (95% CI 3.99:4.47)) or low (OR 2.80 (95% CI 2.56:3.06)) income country background at age 7 years, but was increased also for high-income country background, OR 1.77 (95% CI 1.52-2.05). Furthermore, the risk of presenting with caries experience at age 7 years increased for all children in the 1st (lowest) household income quintile in the host country Sweden. CONCLUSION This study shows that the developmental level of the parental country of birth as well as the family socioeconomic position in Sweden influence the risk for caries development in their children.
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Affiliation(s)
- Annika Julihn
- Department of Dental Medicine Division of Orthodontics and Pediatric Dentistry Karolinska Institutet Stockholm Sweden
- Department of Pediatric Dentistry Eastman Institute, Public Dental Health Service Stockholm Sweden
- Center for Pediatric Oral Health Research Stockholm Sweden
| | - Fernanda Cunha Soares
- Department of Dental Medicine Division of Orthodontics and Pediatric Dentistry Karolinska Institutet Stockholm Sweden
| | - Anders Hjern
- Clinical Epidemiology Department of Medicine Karolinska Institutet Stockholm Sweden
- Centre for Health Equity Studies (CHESS) Stockholm University Stockholm Sweden
| | - Göran Dahllöf
- Department of Dental Medicine Division of Orthodontics and Pediatric Dentistry Karolinska Institutet Stockholm Sweden
- Center for Pediatric Oral Health Research Stockholm Sweden
- TkMidt‐Center for Oral Health Services and Research Trondheim Norway
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142
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Jomaa L, Hamamji S, Kharroubi S, Diab-El-Harakeh M, Al Zahraa Chokor F, Nasreddine L. Dietary intakes, sources, and determinants of free sugars amongst Lebanese children and adolescents: findings from two national surveys. Eur J Nutr 2021; 60:2655-2669. [PMID: 33389083 DOI: 10.1007/s00394-020-02444-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 11/12/2020] [Indexed: 01/28/2023]
Abstract
PURPOSE To determine the intake levels, dietary sources, and determinants of free sugars (FS) consumption amongst Lebanese children and adolescents. METHODS This study is based on data collected by two national cross-sectional surveys conducted on representative samples of Lebanese children: survey 1 (under-five years (U5) children) (n = 899) and survey 2 (5-18 years-old children) (n = 1133). Multi-component questionnaires were used for data collection. Dietary intakes were assessed using one 24 h dietary recall. Median daily intakes of FS, and percent contribution of various food groups to FS intake were compared between sex and age groups. Logistic regressions were conducted to explore the determinants of high FS intake (> 10% energy intake/d), as per the WHO recommendations. RESULTS Median contribution of FS to daily energy intake was 8.5% in U5 children and 11.9% amongst those aged 5-18 years old. The top contributors to FS in both surveys were sugar-sweetened beverages and biscuits and chocolates. The proportion of children and adolescents exceeding WHO upper limits for FS was estimated at 43 and 62% in survey 1 and survey 2, respectively. Regression models showed females, higher household monthly incomes and higher parental educational levels were associated with significantly lower odds of exceeding the WHO upper limit for FS. CONCLUSION The study showed that a high proportion of Lebanese children and adolescents exceeded the WHO upper limit for FS intake, while also documenting a socioeconomic gradient in FS intake. Findings call for devising food system-based interventions to help reduce FS intake in this nutritionally vulnerable age group.
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Affiliation(s)
- Lamis Jomaa
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Riad El-Solh, PO Box 11-0236, Beirut, 1107-2020, Lebanon
| | - Samer Hamamji
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Riad El-Solh, PO Box 11-0236, Beirut, 1107-2020, Lebanon
| | - Samer Kharroubi
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Riad El-Solh, PO Box 11-0236, Beirut, 1107-2020, Lebanon
| | - Marwa Diab-El-Harakeh
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Riad El-Solh, PO Box 11-0236, Beirut, 1107-2020, Lebanon
| | - Fatima Al Zahraa Chokor
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Riad El-Solh, PO Box 11-0236, Beirut, 1107-2020, Lebanon
| | - Lara Nasreddine
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Riad El-Solh, PO Box 11-0236, Beirut, 1107-2020, Lebanon.
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143
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Biskup M, Macek P, Gozdz S, Terek-Derszniak M, Krol H, Kedzierawski P, Zak M. Two-year follow-up cohort study focused on gender-specific associations between socioeconomic status and body weight changes in overweight and obese middle-aged and older adults. BMJ Open 2021; 11:e050127. [PMID: 34330862 PMCID: PMC8327805 DOI: 10.1136/bmjopen-2021-050127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 07/05/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE As overall spread of obesity in populations is generally acknowledged to result from unhealthy lifestyles rather than individual genetic makeup, this study aimed to gain specific insights into its determinants through assessing the prevalent associations between individual socioeconomic status (SES) and weight loss in overweight and obese men and women. METHODS A prospective, 2-year follow-up study covered 3362 (38.0% men) respondents, aged 43-64 years, body mass index ≥25 kg/m2. Changes in body weight were estimated as a percentage of initial weight. Three categories of changes were defined: gained ≥3%, stable (gained <3% or lost <3%), lost ≥3%. Body weight loss was determined against three categories: lost ≥3 to <5%, lost ≥5 to <10%, lost ≥10%. Select SES variables (ie, gender, age, education, marital status, occupational activity and income) were determined in line with the Health Status Questionnaire. The associations between SES and body weight changes were analysed with the aid of logistic regression models. The results were presented as ORs with 95% CIs. RESULTS Only 18% of the respondents had complied with the medical recommendations on weight loss. Significant differences were encountered between the gender, age and occupational activity variables and the weight loss one. Multifactorial models were used to determine the following gender-specific associations between SES and weight loss. Men with moderate income had significantly higher odds for weight loss (≈75%), as compared with the higher earners, whereas women with low income, occupationally inactive, had significantly higher odds (≈30% and ≈50%, respectively), as compared with the high earners and occupationally active ones. CONCLUSIONS Lower education, male gender, lower income per household, older age and unemployment status were the established factors predisposing to obesity. While aiming to ensure effectiveness of the measures specifically aimed at preventing obesity, population groups deemed most at risk of potential weight gain must prior be identified.
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Affiliation(s)
- Malgorzata Biskup
- Institute of Health Sciences, Collegium Medicum, Jan Kochanowski University, Kielce, Poland
- Department of Rehabilitation, Holycross Cancer Centre, Kielce, Poland
| | - Pawel Macek
- Institute of Health Sciences, Collegium Medicum, Jan Kochanowski University, Kielce, Poland
- Department of Epidemiology and Cancer Control, Holycross Cancer Centre, Kielce, Poland
| | - Stanislaw Gozdz
- Institute of Health Sciences, Collegium Medicum, Jan Kochanowski University, Kielce, Poland
- Clinical Oncology Clinic, Holycross Cancer Centre, Kielce, Poland
| | | | - Halina Krol
- Institute of Health Sciences, Collegium Medicum, Jan Kochanowski University, Kielce, Poland
- Research and Education Department, Holycross Cancer Centre, Kielce, Poland
| | - Piotr Kedzierawski
- Institute of Health Sciences, Collegium Medicum, Jan Kochanowski University, Kielce, Poland
- Radiotherapy Clinic, Holycross Cancer Centre, Kielce, Poland
| | - Marek Zak
- Institute of Health Sciences, Collegium Medicum, Jan Kochanowski University, Kielce, Poland
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144
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Vega-Salas MJ, Caro P, Johnson L, Papadaki A. Socio-economic inequalities in dietary intake in Chile: a systematic review. Public Health Nutr 2021; 25:1-16. [PMID: 34247696 PMCID: PMC9991770 DOI: 10.1017/s1368980021002937] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 06/02/2021] [Accepted: 07/07/2021] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Understanding the socio-economic inequalities in dietary intake is crucial when addressing the socio-economic gradient in obesity rates and non-communicable diseases. We aimed to systematically assess the association between socio-economic position (SEP) and dietary intake in Chile. DESIGN We searched for peer-reviewed and grey literature from inception until 31 December 2019 in PubMed, Scopus, PsycINFO, Web of Sciences and LILACS databases. Observational studies published in English and Spanish, reporting the comparison of at least one dietary factor between at least two groups of different SEP in the general Chilean population, were selected. Two researchers independently conducted data searches, screening and extraction and assessed study quality using an adaptation of the Newcastle Ottawa Quality Assessment Scale. RESULTS Twenty-one articles (from eighteen studies) were included. Study quality was considered low, medium and high for 24, 52 and 24 % of articles, respectively. Moderate-to-large associations indicated lower intake of fruit and vegetables, dairy products and fish/seafood and higher pulses consumption among adults of lower SEP. Variable evidence of association was found for energy intake and macronutrients, in both children and adults. CONCLUSIONS Our findings highlight some socio-economic inequalities in diets in Chile, evidencing an overall less healthy food consumption among the lower SEP groups. New policies to reduce these inequalities should tackle the unequal distribution of factors affecting healthy eating among the lower SEP groups. These findings also provide important insights for developing strategies to reduce dietary inequalities in Chile and other countries that have undergone similar nutritional transitions.
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Affiliation(s)
- María Jesús Vega-Salas
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, 8 Priory Road, BristolBS8 1TZ, UK
| | - Paola Caro
- School for Policy Studies, University of Bristol, Bristol, UK
| | - Laura Johnson
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, 8 Priory Road, BristolBS8 1TZ, UK
| | - Angeliki Papadaki
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, 8 Priory Road, BristolBS8 1TZ, UK
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145
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Needham BL, Straight B, Hilton CE, Olungah CO, Lin J. Family socioeconomic status and child telomere length among the Samburu of Kenya. Soc Sci Med 2021; 283:114182. [PMID: 34225037 DOI: 10.1016/j.socscimed.2021.114182] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/27/2021] [Accepted: 06/25/2021] [Indexed: 01/08/2023]
Abstract
Previous research in high-income countries suggests that children from families with lower socioeconomic status (SES) tend to have shorter telomere length - a biomarker of stress and cell aging - than children from families with greater social and economic resources. However, little is known about predictors of child telomere length in low-income settings. Data for the current study are from a sample of 214 Samburu children aged 1-9 years. The Samburu are semi-nomadic pastoralists who live in the Rift Valley of north-central Kenya. Samburu livelihood is based primarily on livestock, and polygynous marriage is common. Drawing on prior ethnographic research, we measured 14 culturally relevant indicators of family SES, including mother's education, head of household's education, whether the child is currently attending school, household spending, mother's employment history, head of household's employment history, mother's perceived wealth, whether the child lives in a modern house, livestock holdings (total, cows, sheep/goats, and camels), mother's wife number, and whether the child lives in a polygynous household. Telomere length was measured in salivary DNA by the quantitative polymerase chain reaction (qPCR) method. Using latent class analysis, we identified four groups of children that are similar based on the 14 indicators of family SES: Lower SES; Middle SES, Traditional; Middle SES, Modern; and Higher SES. SES classes were not significantly associated with child telomere length. In models examining individual indicators of SES, we found that telomere length was 0.57 standard deviations greater for children who lived in families in the lowest quartile of total livestock holdings compared to those in the highest quartile (b = 0.57, p = 0.03). While additional research is needed to identify the mechanisms underlying this counterintuitive finding, the current study highlights the importance of cultural context in shaping the social gradient in health.
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Affiliation(s)
- Belinda L Needham
- Department of Epidemiology and Center for Social Epidemiology and Population Health, University of Michigan, USA.
| | - Bilinda Straight
- Department of Gender and Women's Studies, Western Michigan University, USA
| | - Charles E Hilton
- Department of Anthropology, University of North Carolina, Chapel Hill, USA
| | | | - Jue Lin
- Department of Biochemistry and Biophysics, University of California, San Francisco, USA
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146
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Impact of Dietary Trajectories on Obesity and Dental Caries in Preschool Children: Findings from the Healthy Smiles Healthy Kids Study. Nutrients 2021; 13:nu13072240. [PMID: 34209914 PMCID: PMC8308427 DOI: 10.3390/nu13072240] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/25/2021] [Accepted: 06/25/2021] [Indexed: 12/15/2022] Open
Abstract
This study examines the impact of longitudinal dietary trajectories on obesity and early childhood caries (ECC) in preschool children in Australia. Mother–infant dyads from the Healthy Smiles Healthy Kids study were interviewed at 4 and 8 months, and 1, 2, and 3 years of age. Children underwent anthropometric and oral health assessments between 3 and 4 years of age. Multivariable logistic regression and negative binomial regression analysis were performed for the prevalence of overweight and obesity, and the number of tooth surfaces with dental caries, respectively. The intake of core, discretionary, and sugary foods showed distinct quadratic (n = 3) trajectories with age. The prevalence of overweight or obesity was 10% (n = 72) and that of early childhood caries (ECC) was 33% (mean decayed, missing, and filled tooth surfaces (dmfs) score: 1.96). Children with the highest trajectories of discretionary foods intake were more likely to be overweight or obese (adjusted OR: 2.51, 95 %CI: 1.16–5.42). Continued breastfeeding beyond 12 months was associated with higher dmfs scores (adjusted IRR: 2.17, 95 %CI: 1.27–3.73). Highest socioeconomic disadvantage was the most significant determinant for overweight or obesity (adjusted OR: 2.86, 95 %CI: 1.11–7.34) and ECC (adjusted IRR: 2.71, 95 %CI: 1.48–4.97). Targeted health promotion interventions should be designed to prevent the incidence of two highly prevalent conditions in preschool children.
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147
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Torrente-Sánchez MJ, Ferrer-Márquez M, Estébanez-Ferrero B, Jiménez-Lasserrotte MDM, Ruiz-Muelle A, Ventura-Miranda MI, Dobarrio-Sanz I, Granero-Molina J. Social Support for People with Morbid Obesity in a Bariatric Surgery Programme: A Qualitative Descriptive Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6530. [PMID: 34204427 PMCID: PMC8297395 DOI: 10.3390/ijerph18126530] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 06/14/2021] [Accepted: 06/15/2021] [Indexed: 12/18/2022]
Abstract
Background-Morbid obesity (MO) is a chronic metabolic disease affecting physical, psychological and social wellbeing. Bariatric surgery is a reliable method for losing weight in the long term, improving the quality of life, body image and social life of people with MO. Current literature recognises the importance of social support in controlling weight and coping with MO. The objective of this study was to describe and understand experiences related to social support for patients with MO included in a bariatric surgery programme. Methods-A qualitative descriptive study, where data collection included thirty-one interviews with people diagnosed with MO involved in a bariatric surgery programme. Results-Three main themes emerged from the analysis: (1) accepting the problem in order to ask for help, (2) the need for close support and (3) professional support: opposing feelings. Conclusions-A partner, family and friends are the key pillars of social support for those with MO included in a bariatric surgery programme. Healthcare professionals gave formal support; the bariatric surgery team provided information, trust and assurance. Nurses provided healthcare 24 h a day, making them the main formal support for people in the bariatric surgery programme.
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Affiliation(s)
| | - Manuel Ferrer-Márquez
- Hospital HLA Mediterráneo, 04007 Almería, Spain; (M.J.T.-S.); (M.F.-M.)
- Hospital Universitario Torrecárdenas, 04009 Almería, Spain;
| | | | - María del Mar Jiménez-Lasserrotte
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 Almería, Spain; (M.d.M.J.-L.); (A.R.-M.); (M.I.V.-M.); (I.D.-S.)
| | - Alicia Ruiz-Muelle
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 Almería, Spain; (M.d.M.J.-L.); (A.R.-M.); (M.I.V.-M.); (I.D.-S.)
| | - María Isabel Ventura-Miranda
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 Almería, Spain; (M.d.M.J.-L.); (A.R.-M.); (M.I.V.-M.); (I.D.-S.)
| | - Iria Dobarrio-Sanz
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 Almería, Spain; (M.d.M.J.-L.); (A.R.-M.); (M.I.V.-M.); (I.D.-S.)
| | - José Granero-Molina
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 Almería, Spain; (M.d.M.J.-L.); (A.R.-M.); (M.I.V.-M.); (I.D.-S.)
- Faculty of Health Sciences, Universidad Autónoma de Chile, Santiago 7500000, Chile
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148
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Maugana VF, Kruger R, Schutte AE, Smith W. Socioeconomic inequalities, modifiable lifestyle risk factors, and retinal vessel calibers: The African-PREDICT Study. Microcirculation 2021; 28:e12714. [PMID: 34008905 DOI: 10.1111/micc.12714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 04/01/2021] [Accepted: 05/11/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Lifestyle risk factors vary between socioeconomic status (SES) groups and may influence cardiovascular function differently. The retinal microvasculature allows for monitoring early changes in cardiovascular health, and therefore, we investigated whether retinal vessel calibers associate differently with modifiable risk factors in different SES groups. METHODS We included 1064 young adults (aged 20-30 years) grouped by low and high SES. The central retinal artery and vein equivalents (CRAE, CRVE) were determined from fundus images captured using the Dynamic Retinal Vessel Analyzer (Imedos Systems GmbH, Jena, Germany). We collected anthropometry, self-reported alcohol consumption, and biochemical data. RESULTS Retinal vessel calibers did not differ between SES groups (p ≥ .80) after adjusting for sex and ethnicity. Unique independent associations were observed in the low SES group, where CRAE (β = 0.08, p = .042) and CRVE (β = .14, p = .001) associated positively with cotinine and body mass index, respectively. In the high SES group, CRAE (β = -0.09, p = .027) associated negatively with alcohol consumption. CONCLUSION At young ages, retinal vessel calibers associated differently with modifiable lifestyle risk factors within each SES group. Our data highlight the importance of detecting adverse lifestyle risk factors among young adults from diverse socioeconomic settings to improve prevention of cardiovascular disease.
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Affiliation(s)
| | - Ruan Kruger
- Hypertension in Africa Research Team (HART, North-West University, Potchefstroom, South Africa.,Medical Research Council: Unit for Hypertension and Cardiovascular Disease, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Aletta Elisabeth Schutte
- Hypertension in Africa Research Team (HART, North-West University, Potchefstroom, South Africa.,Medical Research Council: Unit for Hypertension and Cardiovascular Disease, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa.,School of Population Health, The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Wayne Smith
- Hypertension in Africa Research Team (HART, North-West University, Potchefstroom, South Africa.,Medical Research Council: Unit for Hypertension and Cardiovascular Disease, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
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Marzban M, Nabipour I, Farhadi A, Ostovar A, Larijani B, Darabi AH, Shabankari E, Gholizade M. Association between anemia, physical performance and cognitive function in Iranian elderly people: evidence from Bushehr Elderly Health (BEH) program. BMC Geriatr 2021; 21:329. [PMID: 34030664 PMCID: PMC8142505 DOI: 10.1186/s12877-021-02285-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 05/11/2021] [Indexed: 12/19/2022] Open
Abstract
Background and objectives The present study aimed to investigate the relation between anemia and hemoglobin (Hgb) concentration, physical performance, and cognitive function in a large sample of Iranian elderly population. Methods Data were collected from Bushehr elderly health (BEH) program. A total of 3000 persons aged ≥60 years were selected through multistage random sampling. Hemoglobin values lower than 12 and 13 g/dL were considered as anemia for women and men, respectively. The cognitive function was measured using the Mini-cog test and Category fluency test (CFT), and the physical function was measured using handgrip strength (muscle strength), Relative handgrip strength (RHGS), and 4.57-m usual gait speed. Univariate and adjusted multivariate logistic regression and linear regression with Stata MP (version 15) were run, and a p-value of < 0.05 was used as statistically significant for all analyses. Results Among participants, 7.43% were anemic, and 115 (51.57%) simultaneously had anemia and cognitive disorder. There were significant associations between red blood cell count (RBC), hemoglobin (Hgb), platelet count (PLT), and hematocrit percentage (HCT) with cognitive impairment. Additionally, Hgb concentration was significantly associated with all physical measures (Mean handgrip, Relative handgrip, and usual gait speed) and late recall (mini-cog) among the whole participants. This association remained statistically significant after considering multi-cofounders. In contrast, after stratifying the participants by gender, the association between Hgb concentration and usual gait speed was decreased in both men and women; moreover, Hgb association with cognitive measures (category fluency test and late recall) was no longer significant (all p-values > 0.05). Conclusion There was a cross-sectional and significant association between anemia and functional variables (e.g., Relative and mean handgrip) in Iranian elderly population, whereas Semantic memory, Late recall, and walking were more affected by gender.
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Affiliation(s)
- Maryam Marzban
- Clinical Research Development Center, The Persian Gulf Martyrs, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Iraj Nabipour
- The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Akram Farhadi
- The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran. .,The Persian Gulf Marine Biotechnology Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran.
| | - Afshin Ostovar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Hossein Darabi
- The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Elnaz Shabankari
- Department of Nutrition Science, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Mohamad Gholizade
- The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran.,The Persian Gulf Marine Biotechnology Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
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Tesfaw LM, Muluneh EK. Wealth index and other behavioral and sociodemographic characteristics associated with body mass index in Ethiopia. SAGE Open Med 2021; 9:20503121211016156. [PMID: 34094557 PMCID: PMC8142017 DOI: 10.1177/20503121211016156] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 04/18/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Nowadays, the burden of non-communicable diseases including obesity has been an increasing public health concern. This menace can be monitored using indexing method like body mass index. Studies indicate that socioeconomic indicators such as income, biology, behavior, and demographic factors associated with body mass index. In Ethiopia, few studies associate wealth index with body mass index in people of ages between 15 and 49. This study was aimed to assess the association of body mass index with wealth index, and behavioral and sociodemographic population characteristics. METHODS A cross-sectional population-based study was conducted using the 2016 Ethiopian Demographic and Health Survey population of ages 15-49. A total of 10,245 individuals were considered to detect the effect of socioeconomic, biological, behavioral, and demographic factors on body mass index using logistic regression. RESULTS The prevalence of underweight, overweight, and obesity among men are 23.8%, 6.6%, and 2.0%, respectively, which is lower than that of women (underweight 25.3%, overweight 9.1%, and obesity 2.9%). The poorest men had higher odds of being underweight (adjusted odds ratio = 2.395%; 95% confidence interval = 2.020-3.544) as compared to the richest men. Merchants and government employees have lower odds (adjusted odds ratio = 0.744; 95% confidence interval = 0.588-0.899) compared to men whose occupation is farming and labor, indicating that merchants and government employees are more likely to become overweight and obese compared to men who are farmers and laborers. CONCLUSION It is concluded that wealth index is an important socioeconomic determinant of body mass index among men and women of age 15-49 in Ethiopia. A high prevalence of underweight, and overweight, and obesity is observed, which increases instances of non-communicable diseases. Effects of socioeconomic, biological, behavioral, and demographic indicators on body mass index differed according to sex.
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