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Guo B, Shi Z, Zhang W, Zhao H, He K, Hu X, Gan Y, Shi S, Tian Q. Trajectories of body mass index (BMI) and hypertension risk among middle-aged and elderly Chinese people. J Hum Hypertens 2020; 35:537-545. [PMID: 32581292 DOI: 10.1038/s41371-020-0368-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 05/29/2020] [Accepted: 06/09/2020] [Indexed: 11/09/2022]
Abstract
This study aimed to identify heterogeneity in BMI trajectories and evaluate the impact of BMI trajectories on the risk of hypertension in middle-aged and elderly Chinese people. After data screening, 28, 706 residents' e-health records from 2010 to 2018, including basic personal information, lifestyle and health, were finally included in this population-based longitudinal study. By latent class growth modeling, we identified 12 BMI trajectories: "underweight-increase I (A1)" and "underweight-increase II (A2)"; "normal weight-stable (B1)", "normal weight-decrease (B2)", "normal weight-increase I (B3)" and "normal weight-increase II (B4)"; "overweight-stable (C1)", "overweight-decrease (C2)" and "overweight-increase (C3)"; and "obese-stable I (D1)", "obese-decrease (D2)" and "obese-stable II (D3)". By Cox proportional hazards models, we found that the risk of hypertension in the BMI stable group was lower than that in the BMI increasing trajectory group and higher than that in the BMI decreasing group. For the underweight and normal weight groups, the risk of hypertension was related not only to the magnitude of BMI growth, but also to the rate of growth. For overweight and obesity groups, the risk of hypertension was higher in the high-level stable BMI group than in the low-level stable BMI group. Therefore, for underweight and normal weight people, weight growth and growth rate should be controlled; for overweight and obese people, health education or targeted weight loss exercise should be taken to reduce weight as much as possible to prevent hypertension.
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Affiliation(s)
- Bingxin Guo
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Kexue Avenue 100, Zhengzhou, 450001, Henan, China
| | - Zhan Shi
- Department of Pharmacy, People's Hospital of Zhengzhou, Huanghe Road 33, Zhengzhou, 450003, Henan, China
| | - Wenli Zhang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Kexue Avenue 100, Zhengzhou, 450001, Henan, China
| | - Hao Zhao
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Kexue Avenue 100, Zhengzhou, 450001, Henan, China
| | - Kun He
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Kexue Avenue 100, Zhengzhou, 450001, Henan, China
| | - Xueqi Hu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Kexue Avenue 100, Zhengzhou, 450001, Henan, China
| | - Yuan Gan
- Department of Pharmacy, Fuwai Central China Cardiovascular Hospital, Fuwai Avenue 1, Zhengzhou, 450000, Henan, China
| | - Songhe Shi
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Kexue Avenue 100, Zhengzhou, 450001, Henan, China.
| | - Qingfeng Tian
- Department of Social Medicine and Health Management, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, China
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Batal M, Decelles S. A Scoping Review of Obesity among Indigenous Peoples in Canada. J Obes 2019; 2019:9741090. [PMID: 31281674 PMCID: PMC6589240 DOI: 10.1155/2019/9741090] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 03/15/2019] [Accepted: 03/25/2019] [Indexed: 11/21/2022] Open
Abstract
Indigenous populations in Canada are heavily affected by the burden of obesity, and certain communities, such as First Nations on reserve, are not included in the sampling framework of large national health surveys. A scoping review of ever published original research reporting obesity rates (body mass index ≥ 30), among adult Indigenous peoples in Canada, was conducted to identify studies that help close the Canadian Community Health Survey (CCHS) data gap for obesity prevalence in Indigenous populations in Canada and to make comparisons based on ethnicity, sex, time, and geography. First Nations on reserve with self-reported height and weight had higher rates of obesity (30%-51%) than First Nations off reserve (21%-42%) and non-Indigenous populations (12%-31%) in their respective province or territory, with the exception of Alberta, where rates in First Nations on reserve (30% and 36%) were lower or similar to those reported in First Nations off reserve (38%). First Nations on reserve with predominantly measured height and weight (42%-66%) had higher rates of obesity compared to Inuit in Quebec (28%), Nunavut (33%), and Newfoundland and Labrador (41%), while the rates were similar to those in Inuit in Northwest Territories (49%). Obesity in these large studies conducted among Inuit was based solely on measured height and weight. Studies in First Nations and Inuit alike showed higher prevalence of obesity in women, as well as an increase with time. No recent studies measured the obesity rates for First Nations in Yukon and Northwest Territories and for Métis living in settlements of Northern Alberta. Researchers are encouraged to conduct total diet studies in these regions, and to use existing data to analyze the associations between obesity, road access, latitude, food environment, and traditional food intake, to further inform community planning and development.
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Affiliation(s)
- Malek Batal
- Nutrition Department, Faculty of Medicine, Université de Montréal, 2405 Ch de la Côte Ste-Catherine, Montréal, Québec, Canada H3T 1A8
- WHO Collaborating Centre on Nutrition Changes and Development (TRANSNUT), Nutrition Department, Université de Montréal, Montreal, Canada H3T 1A8
| | - Stéphane Decelles
- WHO Collaborating Centre on Nutrition Changes and Development (TRANSNUT), Nutrition Department, Université de Montréal, Montreal, Canada H3T 1A8
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Aguiar C, MacLeod J, Yip A, Melville S, Légaré JF, Pulinilkunnil T, Kienesberger P, Brunt K, Hassan A. Impact of Obesity on Postoperative Outcomes following cardiac Surgery (The OPOS study): rationale and design of an investigator-initiated prospective study. BMJ Open 2019; 9:e023418. [PMID: 30833313 PMCID: PMC6443054 DOI: 10.1136/bmjopen-2018-023418] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Increasing levels of obesity worldwide have led to a rise in the prevalence of obesity-related complications including cardiovascular risk factors such as diabetes, hypertension and dyslipidaemia. Healthcare providers believe that overweight and obese cardiac surgery patients are more likely to experience adverse postoperative outcomes. The body mass index (BMI) is the primary measure of obesity in clinical practice, without accounting for a patient's level of cardiopulmonary fitness or muscle mass. The objective of this study is to determine whether fitness capacity of obese cardiac surgical patients and biomarkers, alone or in combination, will help identify patients at risk for adverse outcomes when undergoing cardiac surgery. METHODS AND ANALYSIS Patients between the ages of 18 and 75 years undergoing elective cardiac surgery are consented to participate in this prospective observational study. Patients will be invited to participate in measures of obesity, functional capacity and exercise capacity assessments, quality of life questionnaires, and blood and tissue sampling for biomarker analysis. The endpoints evaluated are measures other than BMI that could be predictive of short-term and long-term postoperative outcomes. Clinical outcomes of interest are prolonged ventilation, hospital length of stay, renal failure and all-cause mortality. Biomarkers of interest will largely focus on metabolism (lipids, amino acids) and inflammation (adipokines, cytokines and chemokines). ETHICS AND DISSEMINATION This study has been approved by the institutional review board at the Horizon Health Network. On completion of the study, the results shall be disseminated through conference presentations and publications in peer-reviewed journals. Additionally, the report shall also be diffused more broadly to the general public and the cardiovascular community. TRIAL REGISTRATION NUMBER NCT03248921.
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Affiliation(s)
- Christie Aguiar
- Cardiovascular Research New Brunswick, Saint John Regional Hospital, Saint John, New Brunswick, Canada
| | - Jeffrey MacLeod
- Cardiovascular Research New Brunswick, Saint John Regional Hospital, Saint John, New Brunswick, Canada
| | - Alexandra Yip
- Cardiovascular Research New Brunswick, Saint John Regional Hospital, Saint John, New Brunswick, Canada
| | - Sarah Melville
- Department of Pharmacology, Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada
| | - Jean-Francois Légaré
- Cardiovascular Research New Brunswick, and Department of Cardiac Surgery, Saint John Regional Hospital, Saint John, New Brunswick, Canada
| | - Thomas Pulinilkunnil
- Department of Biochemistry and Molecular Biology, Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada
| | - Petra Kienesberger
- Department of Biochemistry and Molecular Biology, Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada
| | - Keith Brunt
- Department of Pharmacology, Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada
| | - Ansar Hassan
- Cardiovascular Research New Brunswick, and Department of Cardiac Surgery, Saint John Regional Hospital, Saint John, New Brunswick, Canada
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Trajectories of body mass index among Canadian seniors and associated mortality risk. BMC Public Health 2017; 17:929. [PMID: 29202810 PMCID: PMC5715616 DOI: 10.1186/s12889-017-4917-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 11/15/2017] [Indexed: 11/10/2022] Open
Abstract
Background This study aims to characterize the heterogeneity in BMI trajectories and evaluate how different BMI trajectories predict mortality risk in Canadian seniors. Methods Data came from the Canadian National Population Health Survey (NPHS, 1994–2011) and 1480 individuals aged 65–79 years with at least four BMI records were included in this study. Group-based trajectory model was used to identify distinct subgroups of longitudinal trajectories of BMI measured over 19 years for men and women. Cox proportional hazards models were used to examine the association between BMI trajectories and mortality risks. Results Distinct trajectory patterns were found for men and women: ‘Normal Weight-Down’(N-D), ‘Overweight-Normal weight’ (OV-N), ‘Obese I-Down’ (OB I-D), and ‘Obese II- Down’ (OB II-D) for women; and ‘Normal Weight-Down’ (N-D), ‘Overweight-Normal weight’ (OV-N), ‘Overweight-Stable’ (OV-S), and ‘Obese-Stable’ (OB-S) for men. Comparing with OV-N, men in the OV-S group had the lowest mortality risk followed by the N-D (HR = 1.66) and OB-S (HR = 1.98) groups, after adjusting for covariates. Compared with OV-N, women in the OB II-D group with three or more chronic health conditions had higher mortality risk (HR = 1.61); however, women in OB II-D had lower risk (HR = 0.56) if they had less than three conditions. Conclusion The course of BMI over time in Canadian seniors appears to follow one of four different patterns depending on gender. The findings suggest that men who were overweight at age 65 and lost weight over time had the lowest mortality risk. Interestingly, obese women with decreasing BMI have different mortality risks, depending on their chronic health conditions. The findings provide new insights concerning the associations between BMI and mortality risk.
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Hackett FJP, Abonyi S, Dyck RF. Anthropometric indices of First Nations children and youth on first entry to Manitoba/Saskatchewan residential schools-1919 to 1953. Int J Circumpolar Health 2016; 75:30734. [PMID: 27357369 PMCID: PMC4926098 DOI: 10.3402/ijch.v75.30734] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 03/08/2016] [Accepted: 03/18/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND First Nations people are experiencing increasing rates of obesity and type 2 diabetes but no anthropometric information exists from before the 1950s to provide context to these epidemics. OBJECTIVE To compare anthropometric indices of First Nations children and youth on first entering residential schools with historical and contemporary reference groups. METHODS This observational cross-sectional study used archival records from the Department of Indian Affairs to calculate body mass index (BMI), height for age (HA) and weight for age (WA) of all known children and youth undergoing physical examinations on first entering residential schools in Saskatchewan and Manitoba from 1919 to 1953. Proportions of children and youth in each BMI category were determined by age, sex, time period and residential school. Z-scores for HA and WA were determined by age group and sex. Finally, median heights and weights were compared with a non-Indigenous cohort from the 1953 Canadian survey. RESULTS On admission to residential schools, 1,767 First Nations children and youth (847 boys, 920 girls) were more likely to have normal BMIs (79.8%) than Canadian children and youth today (66.5%), but lower rates of overweight/obesity (10.9% vs. 32.0%) and higher rates of underweight (9.3% vs. <2.0%). There was an overall trend of diminishing levels of underweight and increasing levels of overweight/obesity over time. Although 6.6% of boys and 7.9% of girls had HA Z-scores >-2, age-specific median heights tended to be higher than Canadian children and youth in 1953. Under 3% of children and youth had WA Z-scores of >-2. CONCLUSIONS A large majority of First Nations children and youth exhibited normal anthropometric indices on first entering residential schools in Manitoba and Saskatchewan from 1919 to 1953. These historical findings provide an important context to the current epidemics of obesity and type 2 diabetes and suggest that the nutritional conditions in these First Nations children's communities were satisfactory during the residential school era.
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Affiliation(s)
- F J Paul Hackett
- Department of Geography and Planning, University of Saskatchewan, Saskatoon, SK, Canada.,Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Sylvia Abonyi
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, SK, Canada.,Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Roland F Dyck
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, SK, Canada.,Department of Medicine, Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK, Canada;
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Body Mass Index Trajectories among Middle-Aged and Elderly Canadians and Associated Health Outcomes. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2016; 2016:7014857. [PMID: 26925112 PMCID: PMC4748085 DOI: 10.1155/2016/7014857] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Revised: 11/23/2015] [Accepted: 12/13/2015] [Indexed: 11/17/2022]
Abstract
BACKGROUND Whether there is heterogeneity in the development of BMI from middle-age onward is still unknown. The primary aim of this study is to analyze long-term obesity and how BMI trajectories are associated with health outcomes in midlife. METHODS Latent Class Growth Modelling was used to capture the changes in BMI over time. In this study, 3070 individuals from the National Population Health Survey (NPHS), aged 40-55 years at baseline, were included. RESULTS Four BMI trajectory groups, "Normal-Stable" (N-S), "Overweight-Stable" (OV-S), "Obese I-Stable" (OB I-S), and "Obese II-Stable" (OB II-S), were identified. Men, persons of White ancestry, and individuals who had no postsecondary education had higher odds of being in the latter three groups. Moreover, members of the OV-S, OB I-S, and OB II-S groups experienced more asthma, arthritis, hypertension, diabetes, heart disease, cognitive impairment, and reduced self-rated overall health. Individuals in the OB II-S group were at greater risk for back problems, chronic bronchitis or emphysema, and emotional issues when compared to the N-S group. CONCLUSION Understanding different BMI trajectories is important in order to identify people who are at the highest risk of developing comorbidities due to obesity and to establish programs to intervene appropriately.
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Trajectories of Body Mass Index from Young Adulthood to Middle Age among Canadian Men and Women. ACTA ACUST UNITED AC 2015. [DOI: 10.1155/2015/121806] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Knowledge regarding the heterogeneity of BMI trajectories is limited for the Canadian population. Using latent class growth modelling, four distinct BMI trajectories of individuals from young adulthood to middle age were identified for both women and men from the longitudinal data of the National Population Health Survey. The associations between BMI trajectories and the individuals’ sociodemographic characteristics and behavioural factors were also examined. Aboriginal women were found more likely to be in the long-term overweight or obese groups. It reveals that increased years of smoking, drinking, and being physically active were associated with lowering the BMI trajectory in all groups for both women and men, with some exceptions in the long-term normal weight group for men. Increased years of rural living, being employed, and living with low income were associated with raising the BMI trajectory in all groups for women and in some groups for men. Food insecurity was associated with raising the BMI trajectory in each group for both women and men.
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Badley EM, Canizares M, Perruccio AV, Hogg-Johnson S, Gignac MAM. Benefits gained, benefits lost: comparing baby boomers to other generations in a longitudinal cohort study of self-rated health. Milbank Q 2015; 93:40-72. [PMID: 25752350 PMCID: PMC4364431 DOI: 10.1111/1468-0009.12105] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
UNLABELLED POLICY POINTS: Despite beliefs that baby boomers are healthier than previous generations, we found no evidence that the health of baby boomers is substantially different from that of the previous or succeeding cohorts. The effects of increased education, higher income, and lower smoking rates on improving self-rated health were nearly counterbalanced by the adverse effect of increasing body mass index (BMI). Assumptions that baby boomers will require less health care as they age because of better education, more prosperity, and less propensity to smoke may not be realized because of increases in obesity. CONTEXT Baby boomers are commonly believed to be healthier than the previous generation. Using self-rated health (SRH) as an indicator of health status, this study examines the effects of age, period, and birth cohort on the trajectory of health across 4 generations: World War II (born between 1935 and 1944), older baby boomers (born between 1945 and 1954), younger baby boomers (born between 1955 and 1964), and Generation X (born between 1965 and 1974). METHODS We analyzed Canada's longitudinal National Population Health Survey 1994-2010 (n = 8,570 at baseline), using multilevel growth models to estimate the age trajectory of SRH by cohort, accounting for period and incorporating the influence of changes in education, household income, smoking status, and body mass index (BMI) on SRH over time. FINDINGS SRH worsened with increasing age in all cohorts. Cohort differences in SRH were modest (p = 0.034), but there was a significant period effect (p = 0.002). We found marked cohort effects for increasing education, income, and BMI, and decreasing smoking from the youngest to the oldest cohorts, which were much reduced (education and smoking) or removed (income and BMI) once period was taken into account. At the population level, multivariable analysis showed the benefits of increasing education and income and declines in smoking on the trajectory of improving SRH were almost counterbalanced by the effects of increasing BMI (obesity). CONCLUSIONS We found no evidence to support the expectation that baby boomers will age more or less healthily than previous cohorts did. We also found that increasing BMI has likely undermined improvements in health that might have otherwise occurred, with possible implications for the need for health care. Period effects had a more profound effect than birth cohort effects. This suggests that interventions to improve health, such as reducing obesity, can be targeted to the entire, or a major portion of the, population and need not single out particular birth cohorts.
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Affiliation(s)
- Elizabeth M Badley
- Toronto Western Research Institute, University Health Network; Dalla Lana School of Public Health, University of Toronto
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Brauer P, Gorber SC, Shaw E, Singh H, Bell N, Shane AR, Jaramillo A, Tonelli M. Recommendations for prevention of weight gain and use of behavioural and pharmacologic interventions to manage overweight and obesity in adults in primary care. CMAJ 2015; 187:184-195. [PMID: 25623643 PMCID: PMC4330141 DOI: 10.1503/cmaj.140887] [Citation(s) in RCA: 113] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Paula Brauer
- Family Relations and Applied Nutrition (Brauer), University of Guelph, Guelph, Ont.; Public Health Agency of Canada (Connor Gorber, Shane, Jaramillo), Ottawa, Ont.; Department of Family Medicine (Shaw), McMaster University, Hamilton, Ont.; Departments of Internal Medicine and Community Health Sciences (Singh), University of Manitoba, Winnipeg, Man.; Department of Family Medicine (Bell) University of Alberta, Edmonton, Alta.; Department of Medicine, University of Calgary (Tonelli), Calgary, Alta
| | - Sarah Connor Gorber
- Family Relations and Applied Nutrition (Brauer), University of Guelph, Guelph, Ont.; Public Health Agency of Canada (Connor Gorber, Shane, Jaramillo), Ottawa, Ont.; Department of Family Medicine (Shaw), McMaster University, Hamilton, Ont.; Departments of Internal Medicine and Community Health Sciences (Singh), University of Manitoba, Winnipeg, Man.; Department of Family Medicine (Bell) University of Alberta, Edmonton, Alta.; Department of Medicine, University of Calgary (Tonelli), Calgary, Alta
| | - Elizabeth Shaw
- Family Relations and Applied Nutrition (Brauer), University of Guelph, Guelph, Ont.; Public Health Agency of Canada (Connor Gorber, Shane, Jaramillo), Ottawa, Ont.; Department of Family Medicine (Shaw), McMaster University, Hamilton, Ont.; Departments of Internal Medicine and Community Health Sciences (Singh), University of Manitoba, Winnipeg, Man.; Department of Family Medicine (Bell) University of Alberta, Edmonton, Alta.; Department of Medicine, University of Calgary (Tonelli), Calgary, Alta
| | - Harminder Singh
- Family Relations and Applied Nutrition (Brauer), University of Guelph, Guelph, Ont.; Public Health Agency of Canada (Connor Gorber, Shane, Jaramillo), Ottawa, Ont.; Department of Family Medicine (Shaw), McMaster University, Hamilton, Ont.; Departments of Internal Medicine and Community Health Sciences (Singh), University of Manitoba, Winnipeg, Man.; Department of Family Medicine (Bell) University of Alberta, Edmonton, Alta.; Department of Medicine, University of Calgary (Tonelli), Calgary, Alta
| | - Neil Bell
- Family Relations and Applied Nutrition (Brauer), University of Guelph, Guelph, Ont.; Public Health Agency of Canada (Connor Gorber, Shane, Jaramillo), Ottawa, Ont.; Department of Family Medicine (Shaw), McMaster University, Hamilton, Ont.; Departments of Internal Medicine and Community Health Sciences (Singh), University of Manitoba, Winnipeg, Man.; Department of Family Medicine (Bell) University of Alberta, Edmonton, Alta.; Department of Medicine, University of Calgary (Tonelli), Calgary, Alta
| | - Amanda R.E. Shane
- Family Relations and Applied Nutrition (Brauer), University of Guelph, Guelph, Ont.; Public Health Agency of Canada (Connor Gorber, Shane, Jaramillo), Ottawa, Ont.; Department of Family Medicine (Shaw), McMaster University, Hamilton, Ont.; Departments of Internal Medicine and Community Health Sciences (Singh), University of Manitoba, Winnipeg, Man.; Department of Family Medicine (Bell) University of Alberta, Edmonton, Alta.; Department of Medicine, University of Calgary (Tonelli), Calgary, Alta
| | - Alejandra Jaramillo
- Family Relations and Applied Nutrition (Brauer), University of Guelph, Guelph, Ont.; Public Health Agency of Canada (Connor Gorber, Shane, Jaramillo), Ottawa, Ont.; Department of Family Medicine (Shaw), McMaster University, Hamilton, Ont.; Departments of Internal Medicine and Community Health Sciences (Singh), University of Manitoba, Winnipeg, Man.; Department of Family Medicine (Bell) University of Alberta, Edmonton, Alta.; Department of Medicine, University of Calgary (Tonelli), Calgary, Alta
| | - Marcello Tonelli
- Family Relations and Applied Nutrition (Brauer), University of Guelph, Guelph, Ont.; Public Health Agency of Canada (Connor Gorber, Shane, Jaramillo), Ottawa, Ont.; Department of Family Medicine (Shaw), McMaster University, Hamilton, Ont.; Departments of Internal Medicine and Community Health Sciences (Singh), University of Manitoba, Winnipeg, Man.; Department of Family Medicine (Bell) University of Alberta, Edmonton, Alta.; Department of Medicine, University of Calgary (Tonelli), Calgary, Alta
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Tran BX, Ohinmaa A, Kuhle S, Johnson JA, Veugelers PJ. Life course impact of school-based promotion of healthy eating and active living to prevent childhood obesity. PLoS One 2014; 9:e102242. [PMID: 25025581 PMCID: PMC4099303 DOI: 10.1371/journal.pone.0102242] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2013] [Accepted: 06/17/2014] [Indexed: 11/18/2022] Open
Abstract
Background The Alberta Project Promoting active Living and healthy Eating in Schools (APPLE Schools) is a comprehensive school health program that is proven feasible and effective in preventing obesity among school aged children. To support decision making on expanding this program, evidence on its long-term health and economic impacts is particularly critical. In the present study we estimate the life course impact of the APPLE Schools programs in terms of future body weights and avoided health care costs. Method We modeled growth rates of body mass index (BMI) using longitudinal data from the National Population Health Survey collected between 1996–2008. These growth rate characteristics were used to project BMI trajectories for students that attended APPLE Schools and for students who attended control schools (141 randomly selected schools) in the Canadian province of Alberta. Results Throughout the life course, the prevalence of overweight (including obesity) was 1.2% to 2.8% (1.7 on average) less among students attending APPLE Schools relative to their peers attending control schools. The life course prevalence of obesity was 0.4% to 1.4% (0.8% on average) less among APPLE Schools students. If the APPLE Schools program were to be scaled up, the potential cost savings would be $33 to 82 million per year for the province of Alberta, or $150 to 330 million per year for Canada. Conclusions These projected health and economic benefits seem to support broader implementation of school-based health promotion programs.
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Affiliation(s)
- Bach Xuan Tran
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Arto Ohinmaa
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Stefan Kuhle
- Department of Pediatrics, Obstetrics & Gynecology, Dalhousie University, Halifax, NS, Canada
| | - Jeffrey A. Johnson
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Paul J. Veugelers
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
- * E-mail:
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