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Seetharaman S, Allen IE, Gadgil M, Srinivasan S, Topor LS, Kanaya AM. Predictors of weight and waist gain in US South Asians: Findings from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study. OBESITY PILLARS 2024; 11:100118. [PMID: 39139780 PMCID: PMC11321434 DOI: 10.1016/j.obpill.2024.100118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 07/01/2024] [Accepted: 07/07/2024] [Indexed: 08/15/2024]
Abstract
Background Weight and waist gain are significant concerns in adulthood. Both weight and waist gain are particularly important among South Asians, known to have an increased risk of developing chronic cardiometabolic complications at any body mass index compared to other racial and ethnic groups. The aim of this study was to investigate factors predicting weight and waist gain in a longitudinal cohort of South Asians living in the US (United States). Methods This was a prospective analysis using data from exam 1 (2010-2013) and exam 2 (2015-2018) of the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study, a prospective cohort study of South Asians (recruited from San Francisco and Chicago), with a mean 4.8 years of follow-up. Results Of 634 participants studied (42.7 % women, mean age 55 years, BMI 25.7 kg/m2, weight 70.4 kg at exam 1), 34.7 % had gained ≥5 % weight and 32.3 % gained ≥5 % waist at exam 2. In the adjusted models, older age, higher number of years of US residence, and having diabetes were associated with lower odds of weight gain; being female and having higher adiponectin were associated with higher odds of weight gain. Being female and being employed full/part time or being retired predicted lower likelihood of waist gain. Being single, separated/divorced, having a higher leptin and a higher C-reactive protein level predicted higher likelihood of waist gain. Conclusions The current study identified several social, demographic, and clinical factors that can serve as targets for obesity interventions among US South Asians. In addition, this study also raises hypotheses about associations of adipokine levels with weight and waist gain.
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Affiliation(s)
- Sujatha Seetharaman
- Division of Pediatric Endocrinology and Diabetes, University of San Francisco, 550 16th St. 4th Floor, Box 0110, San Francisco, CA, 94158, USA
| | - Isabel Elaine Allen
- Department of Epidemiology and Biostatistics, University of California, 550 16th Street, #2431, San Francisco, CA, 94158, USA
| | - Meghana Gadgil
- Division of General Internal Medicine, School of Medicine, University of San Francisco, 1545 Divisadero Street, #311, San Francisco, CA, 94115, USA
| | - Shylaja Srinivasan
- Division of Pediatric Endocrinology and Diabetes, University of San Francisco, 550 16th St. 4th Floor, Box 0110, San Francisco, CA, 94158, USA
| | - Lisa Swartz Topor
- Division of Pediatric Endocrinology and Diabetes, The Warren Alpert School of Medicine of Brown University, 111 Plain Street, 3rd Floor, Providence, RI, 02903, USA
| | - Alka M. Kanaya
- Division of General Internal Medicine, School of Medicine, University of San Francisco, 1545 Divisadero Street, #311, San Francisco, CA, 94115, USA
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2
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Kasher Meron M, Eizenstein S, Cukierman-Yaffe T, Oieru D. Missed diagnosis-a major barrier to patient access to obesity healthcare in the primary care setting. Int J Obes (Lond) 2024; 48:1003-1010. [PMID: 38649487 PMCID: PMC11216998 DOI: 10.1038/s41366-024-01514-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 03/19/2024] [Accepted: 03/20/2024] [Indexed: 04/25/2024]
Abstract
OBJECTIVE To investigate whether individuals with an elevated BMI measurement, for whom a diagnosis of overweight or obesity (OW/OB) is not recorded, are less likely to be offered clinical care for obesity compared to those with a recorded diagnosis. SUBJECTS A retrospective cohort study using the electronic medical record database of Maccabi Healthcare Services (MHS) in Israel. Included were 200,000 adults with BMI ≥ 25 kg/m2 measurement recorded during a primary care visit between 2014 and 2020, and no prior diagnosis of OW/OB or related co-morbidities. METHODS The relationships between a recorded diagnosis of OW/OB and two composite outcomes: 1. A composite of referrals to screening tests for metabolic complications; 2. A composite of weight loss intervention and follow up, were analyzed using multivariate logistic regression models. RESULTS In only 18% of individuals, a diagnosis of OW/OB was recorded. After adjusting for multiple potential confounding factors, individuals who received a recorded diagnosis were 18% more likely to be offered an evaluation for obesity-related metabolic complication, (OR 1.18, 95% CI 1.15-1.21, p < 0.001), and almost twice as likely to be offered intervention and follow up for their excess body weight (OR 1.84, 95% CI 1.76-1.94, p < 0.001) compared to individuals with missed diagnosis. These results persisted after adjusting for inter-physician variability. In addition, male sex, older age, and Arab sector were all associated with lower rates of weight loss intervention and follow up, while young individuals were less likely to be screened for metabolic complications. CONCLUSION Beyond BMI measurement, a recorded diagnosis of OW/OB is associated with statistically and clinically significant higher rates of performance of obesity care and intervention. Undiagnosed OW/OB presents a significant clinical opportunity, as recording a diagnosis of OW/OB would predict improved patient access to obesity healthcare and improved clinical outcomes.
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Affiliation(s)
- Michal Kasher Meron
- Meir Medical Center, Clalit Health Services, Kfar Saba, Israel.
- Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel.
| | - Sapir Eizenstein
- Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Tali Cukierman-Yaffe
- Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel
- Division of Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Tel-HaShomer, Israel
| | - Dan Oieru
- Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel
- Maccabi Healthcare Services, Tel Aviv-Yafo, Israel
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3
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Xin Z, Xu H, Zhang X, Samelson EJ, Kiel DP, Liu CT. Association of bone fracture with 30-year body mass index (BMI) trajectories: findings from the Framingham Heart Study : Bone fracture and 30-year BMI trajectories. Osteoporos Int 2024; 35:1205-1212. [PMID: 38587675 DOI: 10.1007/s00198-024-07068-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 03/14/2024] [Indexed: 04/09/2024]
Abstract
A knowledge gap exists in associating later life's osteoporotic fracture and middle adulthood's BMI trajectories. We observed an association showing those transitioning from overweight to normal weight face a higher fracture risk in late adulthood, emphasizing the potential benefits of maintaining a stable BMI to reduce late-life fractures. PURPOSE Numerous studies on the relationship between obesity and fractures have relied on body mass index (BMI) at a single time point, yielding inconclusive results. This study investigated the association of BMI trajectories over middle adulthood with fracture risk in late adulthood. METHODS This prospective cohort study analyzed 1772 qualified participants from the Framingham Original Cohort Study, with 292 (16.5%) incident fractures during an average of 17.1-year follow-up. We constructed BMI trajectories of age 35-64 years based on latent class mixed modeling and explored their association with the risk of fracture after 65 years using the Cox regression. RESULTS The result showed that compared to the BMI trajectory Group 4 (normal to slightly overweight; see "Methods" for detailed description), Group 1 (overweight declined to normal weight) had a higher all-fracture risk after age 65 (hazard ratio [HR], 2.22, 95% CI, 1.13-4.39). The secondary analysis focusing on lower extremity fractures (pelvis, hip, leg, and foot) showed a similar association pattern. CONCLUSIONS This study suggested that people whose BMI slightly increased from normal weight to low-level overweight during 30 years of middle adulthood confer a significantly lower risk of fracture in later life than those whose BMI declined from overweight to normal weight. This result implies the potentially beneficial effects of avoiding weight loss to normal weight during middle adulthood for overweight persons, with reduced fracture risk in late life.
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Affiliation(s)
- Zihao Xin
- Department of Biostatistics, Boston University School of Public Health, 801 Massachusetts Ave, Third Floor, Boston, MA, 02118, USA
| | - Hanfei Xu
- Department of Biostatistics, Boston University School of Public Health, 801 Massachusetts Ave, Third Floor, Boston, MA, 02118, USA
| | - Xiaoyu Zhang
- Department of Biostatistics, Boston University School of Public Health, 801 Massachusetts Ave, Third Floor, Boston, MA, 02118, USA
| | - Elizabeth J Samelson
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Douglas P Kiel
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Ching-Ti Liu
- Department of Biostatistics, Boston University School of Public Health, 801 Massachusetts Ave, Third Floor, Boston, MA, 02118, USA.
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Loder AKF, van Poppel MNM. Associations of smart device apps with and without a perceived self-efficacy component in a physical activity context with BMI. J Health Psychol 2024:13591053241258254. [PMID: 38898618 DOI: 10.1177/13591053241258254] [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: 06/21/2024] Open
Abstract
Smart device apps can be used to promote physical activity, decrease sedentariness, or increase self-efficacy to get active in college students, possibly reducing their obesity risk. This study assessed associations of college students' smart device use with body mass index (BMI), expecting associations between physical activity parameters and self-efficacy with BMI, moderated by app type. In an online survey, app data of a week from student's devices, weight, height, physical activity, and self-efficacy to get active were collected from 120 students. Apps were categorized "physical activity," "physical activity with a self-efficacy component," or "unrelated." Use time of physical activity apps is not associated with BMI, while self-efficacy app time show negative and unrelated app time positive associations. Self-efficacy may be an important component in app design for obesity risk reduction of college students. Test economy was low, which is why future studies need to concentrate on better data extraction methods.
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Mathur MB, Mathur VS. Toward evidence-based communication on overweight body mass index and mortality. BMC Med 2024; 22:183. [PMID: 38693530 PMCID: PMC11062896 DOI: 10.1186/s12916-024-03402-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 04/24/2024] [Indexed: 05/03/2024] Open
Abstract
BACKGROUND Reducing overweight and obesity has been a longstanding focus of public health messaging and physician-patient interactions. Clinical guidelines by major public health organizations describe both overweight and obesity as risk factors for mortality and other health conditions. Accordingly, a majority of primary care physicians believe that overweight BMI (even without obesity) strongly increases mortality risk. MAIN POINTS The current evidence base suggests that although both obese BMI and underweight BMI are consistently associated with increased all-cause mortality, overweight BMI (without obesity) is not meaningfully associated with increased mortality. In fact, a number of studies suggest modest protective, rather than detrimental, associations of overweight BMI with all-cause mortality. Given this current evidence base, clinical guidelines and physician perceptions substantially overstate all-cause mortality risks associated with the range of BMIs classified as "overweight" but not "obese." Discrepancies between evidence and communication regarding mortality raise the question of whether similar discrepancies exist for other health outcomes. CONCLUSIONS Health communication that inaccurately conveys current evidence may do more harm than good; this applies to communication from health authorities to health practitioners as well as to communication from health practitioners to individual patients. We give three recommendations to better align health communication with the current evidence. First, recommendations to the public and health practitioners should distinguish overweight from obese BMI and at this time should not describe overweight BMI as a risk factor for all-cause mortality. Second, primary care physicians' widespread misconceptions about overweight BMI should be rectified. Third, the evidence basis for other potential risks or benefits of overweight BMI should be rigorously examined and incorporated appropriately into health communication.
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Affiliation(s)
- Maya B Mathur
- Quantitative Sciences Unit and Department of Pediatrics, Stanford University, Porter Drive, Palo Alto, CA, 94304, USA.
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Seetharaman S, Allen I, Gadgil M, Srinivasan S, Topor L, Kanaya A. Predictors of weight and waist gain in US South Asians: Findings from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study. RESEARCH SQUARE 2024:rs.3.rs-4054151. [PMID: 38585953 PMCID: PMC10996820 DOI: 10.21203/rs.3.rs-4054151/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
Background Weight and waist gain are significant concerns in adulthood. Both weight and waist gain are particularly important among South Asians, a high-risk group known to develop chronic cardiometabolic complications at any body mass index compared to other racial and ethnic groups. Objective The aim of this study was to investigate factors predicting weight and waist gain in a longitudinal cohort of US South Asians, a high-risk group for developing obesity-related complications. Methods We used data from Mediators of Atherosclerosis in South Asians Living in America study (MASALA) exam 1 (2010-2013) and exam 2 (2015-2018), with a mean 4.8 years of follow-up. Results Of 634 participants studied (42.7% women, mean age 55 years, BMI 25.7 kg/m2, weight 70.4 kg at exam 1), 34.7% had gained ≥5% weight and 32.3% gained ≥5% waist at exam 2. In the adjusted models, older age, higher number of years of US residence, and having diabetes were associated with lower odds of weight gain; being female and having higher adiponectin were associated with higher odds of weight gain. Being female, employed full or part time, or retired were associated with lower odds of waist gain. Being single, separated/divorced, having a higher leptin and a higher C-reactive protein level were associated with higher odds of waist gain. Conclusions South Asian subgroups with higher risk of weight and/or waist gain may benefit from targeted interventions to improve health outcomes.
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Affiliation(s)
| | | | - Meghana Gadgil
- University of California, San Francisco School of Medicine
| | | | - Lisa Topor
- Warren Alpert Medical School at Brown University
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López-Plaza B, Bermejo LM, Loria-Kohen V, Fernández-Cruz E. [Nutrition in breast cancer genesis]. NUTR HOSP 2023; 40:37-40. [PMID: 37929890 DOI: 10.20960/nh.04953] [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] [Indexed: 11/07/2023] Open
Abstract
Introduction Breast cancer is the most prevalent tumor in women, ranking first in incidence and mortality in many countries. Although the causes of breast cancer are complex and multifactorial, nutritional factors and those related to nutritional status play an important role in the development of the disease. In this way, factors that increase breast cancer risk have been identified, such as weight gain, the amount of adipose tissue, waist circumference, alcohol consumption or the consumption of red meat and processed meat, while other factors have been identified that reduce the risk, such as eating fruits and vegetables. Nutritional factors or factors that depend on the state of nutrition are modifiable and preventable, so they must be considered when designing effective prevention programs.
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Affiliation(s)
- Bricia López-Plaza
- Instituto de Investigación Sanitaria La Paz (IdiPAZ). Hospital Universitario La Paz
| | - Laura M Bermejo
- Departamento de Nutrición y Ciencia de los Alimentos. Facultad de Farmacia. Universidad Complutense de Madrid. Grupo de Investigación VALORNUT-UCM (920030). IdISSC
| | - Viviana Loria-Kohen
- Departamento de Nutrición y Ciencia de los Alimentos. Facultad de Farmacia. Universidad Complutense de Madrid. Grupo de Investigación VALORNUT-UCM (920030)
| | - Edwin Fernández-Cruz
- Instituto de Investigación Sanitaria La Paz (IdiPAZ). Hospital Universitario La Paz. Universidad Autónoma de Madrid
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Hagerman CJ, Stock ML, Post S, Macura Z, Moore PJ, Dodge T, Wirtz PW. The Effects of Implicit Theories on Body Weight Information Avoidance. Exp Psychol 2023; 70:180-191. [PMID: 37830766 DOI: 10.1027/1618-3169/a000585] [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] [Indexed: 10/14/2023]
Abstract
Regular self-weighing is associated with more effective weight control, yet many individuals avoid weight-related information. Implicit theories about weight, or perceptions of how malleable weight is, predict more effortful weight management and may also influence weight-related information avoidance. Participants (N = 209) were randomly assigned to read an article stressing an incremental theory of weight (i.e., weight is malleable), an article stressing an entity theory (i.e., weight is fixed), or to a control condition. We then examined their self-reported preference to avoid their body composition (i.e., body fat, weight, and muscle composition), their willingness to have their body composition measured during the lab visit, and their eating and exercise intentions. There were no notable differences across conditions, but higher self-reported incremental beliefs predicted less self-reported avoidance of body composition. The findings suggest that implicit theories may influence weight-related information avoidance, but a brief manipulation is not powerful enough to create meaningful change.
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Affiliation(s)
- Charlotte J Hagerman
- Department of Psychology, The George Washington University, Washington, DC, USA
- Weight, Eating, and Lifestyle (WELL) Center, Drexel University, Philadelphia, PA, USA
| | - Michelle L Stock
- Department of Psychology, The George Washington University, Washington, DC, USA
| | - Stacy Post
- Department of Psychology, The George Washington University, Washington, DC, USA
| | - Zeljka Macura
- Continuing Education Program Development and Evaluation, American Psychological Association, Washington, DC, USA
| | - Philip J Moore
- Department of Psychology, The George Washington University, Washington, DC, USA
| | - Tonya Dodge
- Department of Psychology, The George Washington University, Washington, DC, USA
| | - Philip W Wirtz
- Department of Psychology, The George Washington University, Washington, DC, USA
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9
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Mottalib MM, Jones-Smith JC, Sheridan B, Beheshti R. Subtyping patients with chronic disease using longitudinal BMI patterns. IEEE J Biomed Health Inform 2023; PP:10.1109/JBHI.2023.3237753. [PMID: 37021857 PMCID: PMC10350469 DOI: 10.1109/jbhi.2023.3237753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Obesity is a major health problem, increasing the risk of various major chronic diseases, such as diabetes, cancer, and stroke. While the role of obesity identified by cross-sectional BMI recordings has been heavily studied, the role of BMI trajectories is much less explored. In this study, we use a machine learning approach to subtype individuals' risk of developing 18 major chronic diseases by using their BMI trajectories extracted from a large and geographically diverse EHR dataset capturing the health status of around two million individuals for a period of six years. We define nine new interpretable and evidence-based variables based on the BMI trajectories to cluster the patients into subgroups using the k-means clustering method. We thoroughly review each cluster's characteristics in terms of demographic, socioeconomic, and physiological measurement variables to specify the distinct properties of the patients in the clusters. In our experiments, the direct relationship of obesity with diabetes, hypertension, Alzheimer's, and dementia has been re-established and distinct clusters with specific characteristics for several of the chronic diseases have been found to be conforming or complementary to the existing body of knowledge.
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10
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Schermer EE, Engelfriet PM, Blokstra A, Verschuren WMM, Picavet HSJ. Healthy lifestyle over the life course: Population trends and individual changes over 30 years of the Doetinchem Cohort Study. Front Public Health 2022; 10:966155. [PMID: 36159268 PMCID: PMC9500162 DOI: 10.3389/fpubh.2022.966155] [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: 06/10/2022] [Accepted: 08/22/2022] [Indexed: 01/24/2023] Open
Abstract
For five health-related lifestyle factors (physical activity, weight, smoking, sleep, and alcohol consumption) we describe both population trends and individual changes over a period of 30 years in the same adult population. Dichotomous indicators (healthy/unhealthy) of lifestyle were analyzed for 3,139 participants measured every 5 years in the Doetinchem Cohort Study (1987-2017). Population trends over 30 years in physical inactivity and "unhealthy" alcohol consumption were flat (i.e., stable); overweight and unhealthy sleep prevalence increased; smoking prevalence decreased. The proportion of the population being healthy on all five lifestyle factors declined from 17% in the round 1 to 10.8% in round 6. Underlying these trends a dynamic pattern of changes at the individual level was seen: sleep duration and physical activity level changed in almost half of the individuals; Body Mass Index (BMI) and alcohol consumption in one-third; smoking in one-fourth. Population trends don't give insight into change at the individual level. In order to be able to gauge the potential for change of health-related lifestyle, it is important to take changes at the individual level into account.
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Affiliation(s)
- Edith E. Schermer
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Peter M. Engelfriet
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Anneke Blokstra
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - W. M. Monique Verschuren
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, Netherlands,Julius Centre for Health Sciences and Primary Care, University Medical Centre, Utrecht, Netherlands
| | - H. Susan J. Picavet
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, Netherlands,*Correspondence: H. Susan J. Picavet
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11
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Ceddia RP, Liu D, Shi F, Crowder MK, Mishra S, Kass DA, Collins S. Increased Energy Expenditure and Protection From Diet-Induced Obesity in Mice Lacking the cGMP-Specific Phosphodiesterase PDE9. Diabetes 2021; 70:2823-2836. [PMID: 34620617 PMCID: PMC8660992 DOI: 10.2337/db21-0100] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 09/28/2021] [Indexed: 11/13/2022]
Abstract
Cyclic nucleotides cAMP and cGMP are important second messengers for the regulation of adaptive thermogenesis. Their levels are controlled not only by their synthesis, but also their degradation. Since pharmacological inhibitors of cGMP-specific phosphodiesterase 9 (PDE9) can increase cGMP-dependent protein kinase signaling and uncoupling protein 1 expression in adipocytes, we sought to elucidate the role of PDE9 on energy balance and glucose homeostasis in vivo. Mice with targeted disruption of the PDE9 gene, Pde9a, were fed nutrient-matched high-fat (HFD) or low-fat diets. Pde9a -/- mice were resistant to HFD-induced obesity, exhibiting a global increase in energy expenditure, while brown adipose tissue (AT) had increased respiratory capacity and elevated expression of Ucp1 and other thermogenic genes. Reduced adiposity of HFD-fed Pde9a -/- mice was associated with improvements in glucose handling and hepatic steatosis. Cold exposure or treatment with β-adrenergic receptor agonists markedly decreased Pde9a expression in brown AT and cultured brown adipocytes, while Pde9a -/- mice exhibited a greater increase in AT browning, together suggesting that the PDE9-cGMP pathway augments classical cold-induced β-adrenergic/cAMP AT browning and energy expenditure. These findings suggest PDE9 is a previously unrecognized regulator of energy metabolism and that its inhibition may be a valuable avenue to explore for combating metabolic disease.
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Affiliation(s)
- Ryan P Ceddia
- Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
- Integrative Metabolism Program, Sanford Burnham Prebys Medical Discovery Institute at Lake Nona, Orlando, FL
| | - Dianxin Liu
- Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
- Integrative Metabolism Program, Sanford Burnham Prebys Medical Discovery Institute at Lake Nona, Orlando, FL
| | - Fubiao Shi
- Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
- Integrative Metabolism Program, Sanford Burnham Prebys Medical Discovery Institute at Lake Nona, Orlando, FL
| | - Mark K Crowder
- Department of Pharmacology, Vanderbilt University, Nashville, TN
| | - Sumita Mishra
- Division of Cardiology, Department of Medicine, Johns Hopkins University and School of Medicine, Baltimore, MD
| | - David A Kass
- Division of Cardiology, Department of Medicine, Johns Hopkins University and School of Medicine, Baltimore, MD
- Department of Biomedical Engineering, Johns Hopkins University and School of Medicine, Baltimore, MD
- Department of Pharmacology and Molecular Sciences, Johns Hopkins University and School of Medicine, Baltimore, MD
| | - Sheila Collins
- Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
- Integrative Metabolism Program, Sanford Burnham Prebys Medical Discovery Institute at Lake Nona, Orlando, FL
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN
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12
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Tasci I, Naharci MI. Intake of Nuts or Nut Products and Weight Gain. Adv Nutr 2021; 12:2035-2036. [PMID: 34595504 PMCID: PMC8483952 DOI: 10.1093/advances/nmab079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - M Ilkin Naharci
- From the University of Health Sciences Turkey, Gulhane Faculty of Medicine and Training and Research Hospital, Department of Internal Medicine, Ankara, Turkey
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13
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Effect of the Lifestyle, Exercise, and Nutrition (LEAN) Study on Long-Term Weight Loss Maintenance in Women with Breast Cancer. Nutrients 2021; 13:nu13093265. [PMID: 34579142 PMCID: PMC8469752 DOI: 10.3390/nu13093265] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 09/17/2021] [Accepted: 09/17/2021] [Indexed: 11/17/2022] Open
Abstract
Lifestyle interventions among breast cancer survivors with obesity have demonstrated successful short-term weight loss, but data on long-term weight maintenance are limited. We evaluated long-term weight loss maintenance in 100 breast cancer survivors with overweight/obesity in the efficacious six-month Lifestyle, Exercise, and Nutrition (LEAN) Study (intervention = 67; usual care = 33). Measured baseline and six-month weights were available for 92 women. Long-term weight data were obtained from electronic health records. We assessed weight trajectories between study completion (2012-2013) and July 2019 using growth curve analyses. Over up to eight years (mean = 5.9, SD = 1.9) of post-intervention follow-up, both the intervention (n = 60) and usual care (n = 32) groups declined in body weight. Controlling for body weight at study completion, the yearly weight loss rate in the intervention and usual care groups was -0.20 kg (-0.2%/year) (95% CI: 0.06, 0.33, p = 0.004) and -0.32 kg (-0.4%/year) (95% CI: 0.12, 0.53, p = 0.002), respectively; mean weight change did not differ between groups (p = 0.31). It was encouraging that both groups maintained their original intervention period weight loss (6% intervention, 2% usual care) and had modest weight loss during long-term follow-up. Breast cancer survivors in the LEAN Study, regardless of randomization, avoided long-term weight gain following study completion.
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Dutton GR, Kinsey AW, Howell CR, Pisu M, Dobelstein AE, Allison DB, Xun P, Levitsky DA, Fontaine K. The daily Self-Weighing for Obesity Management in Primary Care Study: Rationale, design and methodology. Contemp Clin Trials 2021; 107:106463. [PMID: 34082075 PMCID: PMC8429187 DOI: 10.1016/j.cct.2021.106463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 05/18/2021] [Accepted: 05/28/2021] [Indexed: 11/17/2022]
Abstract
Background Daily self-weighing (DSW) may be an effective harm-reduction intervention to disrupt continued weight gain. Self-Weighing for Obesity Management in Primary Care (SWOP) is a 24-month randomized controlled trial in 400 adults with obesity (BMI: kg/m2 ≥ 30) receiving primary care through a clinical network affiliated with an academic medical center. Objective To test DSW as a potentially scalable way to deter age-related weight gain among primary care patients with obesity. Methods Randomized-controlled trial with two conditions: DSW (instruction to weigh daily and provision of a web-enabled digital scale with graphical weight feedback) or Standard Care (receive a monetary gift card equivalent to value of the scale). Both groups receive standardized weight management educational material. SWOP will test the causal effect of assignment to DSW (Aim 1) and adherence to DSW (Aim 2) on weight (primary outcome) and adoption of weight management practices (secondary outcomes), as well as evaluate the cost-effectiveness of DSW compared to standard care (Aim 3). Findings may inform clinical guidelines for weight management by providing evidence that DSW attenuates continued age-related weight gain among adults with obesity. This trial is registered with ClinicalTrials.gov (NCT04044794).
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Affiliation(s)
- Gareth R Dutton
- Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, 1717 11th Avenue South, Birmingham, AL 35205, USA.
| | - Amber W Kinsey
- Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, 1717 11th Avenue South, Birmingham, AL 35205, USA.
| | - Carrie R Howell
- Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, 1717 11th Avenue South, Birmingham, AL 35205, USA.
| | - Maria Pisu
- Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, 1717 11th Avenue South, Birmingham, AL 35205, USA.
| | - Amy E Dobelstein
- Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, 1717 11th Avenue South, Birmingham, AL 35205, USA.
| | - David B Allison
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University-Bloomington, 1025 E. 7th Street, Bloomington, IN 47405, USA.
| | - Pengcheng Xun
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University-Bloomington, 1025 E. 7th Street, Bloomington, IN 47405, USA
| | - David A Levitsky
- Division of Nutritional Sciences, College of Human Ecology, Cornell University, 244 Garden Ave, Ithaca, NY 14853, USA.
| | - Kevin Fontaine
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, 1665 University Boulevard, Birmingham, AL 35233, USA.
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Turner RT, Wong CP, Fosse KM, Branscum AJ, Iwaniec UT. Caloric Restriction and Hypothalamic Leptin Gene Therapy Have Differential Effects on Energy Partitioning in Adult Female Rats. Int J Mol Sci 2021; 22:ijms22136789. [PMID: 34202651 PMCID: PMC8269114 DOI: 10.3390/ijms22136789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 06/04/2021] [Accepted: 06/18/2021] [Indexed: 12/14/2022] Open
Abstract
Dieting is a common but often ineffective long-term strategy for preventing weight gain. Similar to humans, adult rats exhibit progressive weight gain. The adipokine leptin regulates appetite and energy expenditure but hyperleptinemia is associated with leptin resistance. Here, we compared the effects of increasing leptin levels in the hypothalamus using gene therapy with conventional caloric restriction on weight gain, food consumption, serum leptin and adiponectin levels, white adipose tissue, marrow adipose tissue, and bone in nine-month-old female Sprague-Dawley rats. Rats (n = 16) were implanted with a cannula in the 3rd ventricle of the hypothalamus and injected with a recombinant adeno-associated virus, encoding the rat gene for leptin (rAAV-Lep), and maintained on standard rat chow for 18 weeks. A second group (n = 15) was calorically-restricted to match the weight of the rAAV-Lep group. Both approaches prevented weight gain, and no differences in bone were detected. However, calorically-restricted rats consumed 15% less food and had lower brown adipose tissue Ucp-1 mRNA expression than rAAV-Lep rats. Additionally, calorically-restricted rats had higher abdominal white adipose tissue mass, higher serum leptin and adiponectin levels, and higher marrow adiposity. Caloric restriction and hypothalamic leptin gene therapy, while equally effective in preventing weight gain, differ in their effects on energy intake, energy expenditure, adipokine levels, and body composition.
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Affiliation(s)
- Russell T. Turner
- Skeletal Biology Laboratory, School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR 97331, USA; (R.T.T.); (C.P.W.); (K.M.F.)
| | - Carmen P. Wong
- Skeletal Biology Laboratory, School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR 97331, USA; (R.T.T.); (C.P.W.); (K.M.F.)
| | - Kristina M. Fosse
- Skeletal Biology Laboratory, School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR 97331, USA; (R.T.T.); (C.P.W.); (K.M.F.)
| | - Adam J. Branscum
- Biostatistics Program, School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR 97331, USA;
| | - Urszula T. Iwaniec
- Skeletal Biology Laboratory, School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR 97331, USA; (R.T.T.); (C.P.W.); (K.M.F.)
- Correspondence:
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16
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da Silva M, Laaksonen MA, Lissner L, Weiderpass E, Rylander C. Preventable fractions of cancer incidence attributable to 7-years weight gain in the Norwegian Women and Cancer (NOWAC) study. Sci Rep 2021; 11:3800. [PMID: 33589669 PMCID: PMC7884841 DOI: 10.1038/s41598-021-83027-0] [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] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 01/27/2021] [Indexed: 12/24/2022] Open
Abstract
There is a lack of tangible measures for directed public health action to halt the increase in weight and cancer. We estimated the fraction and preventable cases of all and major body fatness-related cancers attributable to 7-years weight gain (≥ 2 kg). We assessed validated self-reported anthropometrics from 44,114 women aged 34-49 years at the enrolment in 1991-1992 and from a second questionnaire in 1998, with follow-up through December 31, 2015. Over 18 years, 3216 body fatness-related cancers and 2041 deaths were reported. Nearly 70% of women experienced weight gain and the average weight change was 4 kg. We observed a substantial proportional impact of weight gain on pancreatic cancer with a population attributable fraction (PAF) of 41.8% (95% CI 8.1-63.1) and a high absolute impact on postmenopausal breast cancer with 4403 preventable cases (95% CI 1064-7299) and a PAF of 16.8% (95% CI 4.1-27.8), and colorectal cancer with 3857 preventable cases (95% CI 1313-5990) and a PAF of 22.6% (95% CI 7.7-35.1). Avoiding weight gain over seven years in middle adulthood could have prevented a considerable proportion of the cancer burden and thousands of cancer cases in women in Norway.
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Affiliation(s)
- Marisa da Silva
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, P.O. Box 6050 Langnes, 9037, Tromsø, Norway.
| | - Maarit A Laaksonen
- Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Lauren Lissner
- School of Public Health and Community Medicine, Section for Epidemiology and Social Medicine (EPSO), Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Elisabete Weiderpass
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Charlotta Rylander
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, P.O. Box 6050 Langnes, 9037, Tromsø, Norway
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17
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Agrawal S, Wojtanowski AC, Tringali L, Foster GD, Finkelstein EA. Financial implications of New York City's weight management initiative. PLoS One 2021; 16:e0246621. [PMID: 33571249 PMCID: PMC7877753 DOI: 10.1371/journal.pone.0246621] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 01/20/2021] [Indexed: 11/18/2022] Open
Abstract
Purpose To estimate potential annual savings in medical expenditures from a subsidized weight management program from the NYC Government perspective. Design Longitudinal observational study. Setting Employees of New York City (NYC) government and enrolled dependents. Sample 14,946 participants with overweight and obesity. Intervention WW (formerly Weight Watchers®) ‘Workshop’ and ‘Digital’ programs. Measures Participation rate, enrollment duration, weight change, and predicted gross and net total and per capita medical expenditure savings and return on investment (ROI). Analysis Participation rate, enrollment duration, weight change, and program costs are based on direct observation. Predicted savings are simulated based on published data relating weight loss to medical expenditure reductions. Results In total, 47% of participating employees and 50% of participating dependents lost weight during the enrollment period. Mean (median) enrollment duration for employees was 7.1 months (7.0) and for dependents was 6.9 months (6.0). Mean (median) weight losses for the employees in ‘Workshops’ and ‘Digital’ was 6.6 lbs (2.80) and 6.3 lbs (0.0). For dependents, weight losses were 7.4 lbs (3.59) and 11.6 lbs (2.0). Per capita and total predicted net savings to NYC Government from employees was estimated to be $120 and $1,486,102 for an ROI of 143%. Including dependents, predicted net savings increases to $1,963,431 for an ROI of 189%. Over 80% of savings came from participants in the Obese III category. Conclusion An evidence-based weight management program has the potential to generate a positive ROI for employers. Future studies should validate these estimates using actual data and more rigorous designs.
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Affiliation(s)
- Sagun Agrawal
- Program in Health Services & Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | | | - Laura Tringali
- WW International (formerly Weight Watchers), New York, NY, United States of America
| | - Gary D. Foster
- WW International (formerly Weight Watchers), New York, NY, United States of America
- Center for Weight and Eating Disorders, Perelman School of Medicine, University of Pennsylvania, Philadelphia PA, United States of America
| | - Eric A. Finkelstein
- Program in Health Services & Systems Research, Duke-NUS Medical School, Singapore, Singapore
- * E-mail:
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18
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Mason TB, Barrington-Trimis J, Leventhal AM. Eating to Cope With the COVID-19 Pandemic and Body Weight Change in Young Adults. J Adolesc Health 2021; 68:277-283. [PMID: 33288456 PMCID: PMC7939108 DOI: 10.1016/j.jadohealth.2020.11.011] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/19/2020] [Accepted: 11/11/2020] [Indexed: 01/11/2023]
Abstract
PURPOSE Life disruptions caused by the novel coronavirus (COVID-19) pandemic are particularly salient for young adults. Some young adults may engage in unhealthy eating practices to cope with social distancing and isolation during the pandemic, which could increase incidental weight gain. The purpose of this study was to examine the association of eating to cope with the pandemic with body weight change in young adults before versus after spread of COVID-19. METHODS Data included the baseline (October/2018-October/2019) and follow-up (May/2020-July/2020) assessments from an ongoing longitudinal cohort recruited from Southern California. A diverse sample of participants (54% Hispanic; age = 19.72[.47] years; N = 1,820) completed online self-report measures of weight at baseline and follow-up and were given a checklist of pandemic coping behaviors including overeating (yes/no) and eating high fat or sugary foods (yes/no) to cope with social distancing and isolation during the pandemic. RESULTS With and without adjusting for confounders, young adults who did versus did not report overeating to cope with the pandemic gained more weight from baseline to follow-up (5.55 vs. 2.54 lbs). Unhealthy food intake to cope with the pandemic was not associated with weight change. Baseline weight moderated the association of eating coping practices with weight change such that individuals with higher baseline weight gained more weight if they engaged in eating to cope behaviors versus not (p's≤.001). CONCLUSIONS Unhealthy eating behavior to cope with the pandemic and corresponding body weight increases may be occurring in young adults. Interventions to promote healthy eating practices in young adults warrant consideration for weight gain prevention during the pandemic.
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Affiliation(s)
- Tyler B Mason
- Department of Preventive Medicine, University of Southern California, Los Angeles, California.
| | | | - Adam M Leventhal
- Department of Preventive Medicine, University of Southern California, Los Angeles, California
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19
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Gaskins AJ, Arvizu M, Mínguez-Alarcón L, Dadd R, Souter I, Chavarro JE. Substantial Weight Gain in Adulthood Is Associated with Lower Probability of Live Birth Following Assisted Reproduction. J Nutr 2021; 151:649-656. [PMID: 33438025 PMCID: PMC7948197 DOI: 10.1093/jn/nxaa371] [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: 07/07/2020] [Revised: 08/21/2020] [Accepted: 10/27/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Overweight and obesity among women have been associated with lower success of assisted reproduction technologies (ARTs). However, the relation of adolescent body weight and adult weight change to ART outcomes is not well understood. OBJECTIVE Our objective was to evaluate the associations of female BMI (in kg/m2) at 18 y and weight change from 18 y to current age with ART outcomes. METHODS We included 486 women in a prospective cohort at the Massachusetts General Hospital Fertility Center (2004-2018) who underwent 863 ART cycles. At study entry, height and weight were measured by research personnel. Women recalled their weight at 18 y. Restricted cubic splines were used to evaluate the associations between BMI at 18 y and weight change since 18 y and ART outcomes adjusting for age, race, education, smoking, and height and accounting for the correlated cycles within women. RESULTS Women had a median (range) BMI of 20.6 (14.8 to 36.4) at 18 y and 23.3 (16.1 to 45.8) at study entry. The median (range) weight change since 18 y was 7.4 kg (-12.1 to 60.1 kg). There was no association between BMI at 18 y and clinical ART outcomes. Long-term weight change had a nonlinear association with live birth such that higher weight gain since 18 y (particularly ≥15 kg) and weight loss were both associated with lower odds of live birth. The negative association between weight change and live birth was stronger in women ≥22.5 kg/m2 at 18 y such that each 10-kg increase was associated with a 30% (6%, 48%) lower odds of live birth. CONCLUSIONS Weight gain in adulthood is negatively associated with ART success, particularly among women who were heavier at 18 y. These results add to the growing literature supporting the benefits of preventing weight gain in adulthood on female fertility.
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Affiliation(s)
| | - Mariel Arvizu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Lidia Mínguez-Alarcón
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Ramace Dadd
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Irene Souter
- Vincent Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Jorge E Chavarro
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA,Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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20
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Takebe N, Tanno K, Ohmomo H, Hangai M, Oda T, Hasegawa Y, Takanashi N, Sasaki R, Shimizu A, Sasaki A, Sakata K, Sasaki M, Ishigaki Y. Weight Gain After 20 Years of Age is Associated with Unfavorable Lifestyle and Increased Prevalence of Metabolic Disorders. Diabetes Metab Syndr Obes 2021; 14:2065-2075. [PMID: 34040401 PMCID: PMC8143959 DOI: 10.2147/dmso.s300250] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 03/12/2021] [Indexed: 12/23/2022] Open
Abstract
PURPOSE It is unclear what kind of modifiable lifestyle factors are associated with long-time weight gain in adulthood. To clarify the lifestyle behavior related to body weight gain since the age of 20 years, we explored the lifestyle risk factor, independently associated with excessive weight gain after 20 years of age as compared to those in subjects with a stable weight, with matching of age, gender, and the current body mass index (BMI). PATIENTS AND METHODS From baseline data of a general population-based cohort study, we designed a cross-sectional analysis collecting individual data of medical health check-ups and a questionnaire related to lifestyle, including amount of sleep, frequency of eating breakfast, average times per day engaged in walking and sitting in the prior year, and smoking habits. These data were compared between the subjects with weight gain ≥10kg (n=3601) and <10kg (n=3601) after age 20, matched by a propensity score model which included current BMI, age and gender. We used multivariable logistic regressions to assess the lifestyle factor's association with high weight gain. RESULTS Participants who gained ≥10 kg were significantly more likely to sleep <5 hours or ≥9 hours per night, skip breakfast, engage in walking <1 hour per day, and sit ≥5 hours per day than those who gained <10kg. Multivariable logistic regressions analyses showed that, with adjusting for potential confounder, the lifestyles with the positive association with high weight gain were skipping breakfast (OR 1.252; 95% CI 1.053-1.489, vs regularly), long sleeping duration (9 hours/day≤ OR 1.613; 95% CI 1.018-2.557 vs 5≤-<7 hours/day), and former smoker (OR 1.163; 95% CI 1.008-1.343 vs never smoker), while walking duration was negatively associated with high weight gain. Furthermore, despite similar current BMI, participants with weight gain ≥10kg had significantly higher values for waist circumference, blood pressure, HbA1c, LDL-C, triglycerides, and hepatic enzyme levels than those with weight gain <10kg. Similarly, the prevalence rates of hypertension, dyslipidemia, metabolic syndrome (MetS), and former smoker were higher in the participants with weight gain ≥10kg. CONCLUSION Major weight gain after 20 years of age was associated with unfavorable lifestyle factors and greater waist circumference, possibly leading to elevated risk for MetS and other non-communicable diseases. These findings highlight the importance of maintaining both weight at age 20 and a favorable lifestyle throughout adulthood.
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Affiliation(s)
- Noriko Takebe
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Iwate Medical University, Yahaba, Japan
- Iwate Tohoku Medical Megabank Organization, Iwate Medical University, Yahaba, Japan
| | - Kozo Tanno
- Iwate Tohoku Medical Megabank Organization, Iwate Medical University, Yahaba, Japan
- Department of Hygiene and Preventive Medicine, Iwate Medical University, Yahaba, Japan
| | - Hideki Ohmomo
- Iwate Tohoku Medical Megabank Organization, Iwate Medical University, Yahaba, Japan
| | - Mari Hangai
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Iwate Medical University, Yahaba, Japan
- Iwate Tohoku Medical Megabank Organization, Iwate Medical University, Yahaba, Japan
| | - Tomoyasu Oda
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Iwate Medical University, Yahaba, Japan
| | - Yutaka Hasegawa
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Iwate Medical University, Yahaba, Japan
- Iwate Tohoku Medical Megabank Organization, Iwate Medical University, Yahaba, Japan
| | - Nobuyuki Takanashi
- Iwate Tohoku Medical Megabank Organization, Iwate Medical University, Yahaba, Japan
- Department of Hygiene and Preventive Medicine, Iwate Medical University, Yahaba, Japan
| | - Ryohei Sasaki
- Iwate Tohoku Medical Megabank Organization, Iwate Medical University, Yahaba, Japan
- Department of Human Sciences, Center for Liberal Arts and Sciences, Iwate Medical University, Yahaba, Japan
| | - Atsushi Shimizu
- Iwate Tohoku Medical Megabank Organization, Iwate Medical University, Yahaba, Japan
| | - Akira Sasaki
- Department of Surgery, Iwate Medical University, Yahaba, Japan
| | - Kiyomi Sakata
- Iwate Tohoku Medical Megabank Organization, Iwate Medical University, Yahaba, Japan
- Department of Hygiene and Preventive Medicine, Iwate Medical University, Yahaba, Japan
| | - Makoto Sasaki
- Iwate Tohoku Medical Megabank Organization, Iwate Medical University, Yahaba, Japan
| | - Yasushi Ishigaki
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Iwate Medical University, Yahaba, Japan
- Iwate Tohoku Medical Megabank Organization, Iwate Medical University, Yahaba, Japan
- Correspondence: Yasushi Ishigaki Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Iwate Medical University, 2-1-1 Idai-Dori, Yahaba, Iwate, 028-3695, JapanTel +81 19 613 7111Fax +81 19 907 8270 Email
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21
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Hanttu A, Kauppinen KJ, Kivelä P, Ollgren J, Jousilahti P, Liitsola K, Koponen P, Sutinen J. Prevalence of obesity and disturbances in glucose homeostasis in HIV-infected subjects and general population - missed diagnoses of diabetes? HIV Med 2020; 22:244-253. [PMID: 33169536 PMCID: PMC7983891 DOI: 10.1111/hiv.13009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2020] [Indexed: 12/27/2022]
Abstract
Objectives Comparative data on glucose disorders using fasting blood samples between people living with HIV (PLWH) and the general population are lacking. The objective of this study was to compare the prevalence and risk factors of obesity and disturbances in glucose homeostasis between PLWH treated with modern antiretroviral therapy and the general population. Methods Adjusted prevalence of obesity, features of insulin resistance (triglyceride:high‐density lipoprotein cholesterol ratio and alanine aminotransferase), impaired fasting glucose (IFG), diabetes mellitus (DM) and combined dysglycaemia (presence of IFG or DM) were determined using fasting blood samples among 1041 PLWH and 7047 subjects representing the general population. Results People living with HIV had a lower prevalence of obesity [18.2%, 95% confidence interval (CI): 15.1–21.2 vs. 23.9%, 95% CI: 22.4–25.4], but a higher prevalence of insulin resistance and IFG (20.0%, 95% CI: 16.6–23.4 vs. 9.8%, 95% CI: 8.7–10.8) than the general population. Fasting glucose concentration was higher, but glycated haemoglobin (HbA1c) was lower, among PLWH. Prevalence of dysglycaemia for a given body mass index (BMI) was higher in PLWH than in the general population. The prevalence of DM did not differ between PLWH (13.2%, 95% CI: 10.2–15.9) and the general population (14.5%, 95% CI: 13.6–15.4). Conclusions The prevalence of obesity was lower, but the risk of dysglycaemia for a given BMI was significantly higher, among PLWH, highlighting the importance of prevention and treatment of obesity among HIV‐infected subjects. Regardless of the increased prevalence of insulin resistance and IFG, DM was surprisingly not more common among PLWH, raising concern about the under‐diagnosis of DM, possibly due to low sensitivity of HbA1c in this patient population.
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Affiliation(s)
- A Hanttu
- Department of Infectious Diseases, Inflammation Center, Helsinki University Hospital, Helsinki, Finland.,University of Helsinki, Helsinki, Finland
| | - K J Kauppinen
- Department of Infectious Diseases, Inflammation Center, Helsinki University Hospital, Helsinki, Finland.,University of Helsinki, Helsinki, Finland
| | - P Kivelä
- Department of Infectious Diseases, Inflammation Center, Helsinki University Hospital, Helsinki, Finland.,University of Helsinki, Helsinki, Finland
| | - J Ollgren
- Department of Infectious Disease Surveillance and Control, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - P Jousilahti
- Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - K Liitsola
- Department of Health Security, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - P Koponen
- Public Health Evaluation and Projection Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - J Sutinen
- Department of Infectious Diseases, Inflammation Center, Helsinki University Hospital, Helsinki, Finland.,University of Helsinki, Helsinki, Finland
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22
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De Rubeis V, Andreacchi AT, Sharpe I, Griffith LE, Keown‐Stoneman CDG, Anderson LN. Group‐based trajectory modeling of body mass index and body size over the life course: A scoping review. Obes Sci Pract 2020. [PMCID: PMC7909593 DOI: 10.1002/osp4.456] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Background Group‐based trajectory modeling has been applied to identify distinct trajectories of growth across the life course. Objectives of this study were to describe the methodological approaches for group‐based modeling of growth across the life course and to summarize outcomes across studies. Methods A scoping review with a systematic search of Medline, EMBASE, CINAL, and Web of Science was conducted. Studies that used a group‐based procedure to identify trajectories on any statistical software were included. Data were extracted on trajectory methodology, measures of growth, and association with outcomes. Results A total of 59 studies were included, and most were published from 2013 to 2020. Body mass index was the most common measure of growth (n = 43). The median number of identified trajectories was 4 (range: 2–9). PROC TRAJ in SAS was used by 33 studies, other procedures used include TRAJ in STATA, lcmm in R, and Mplus. Most studies evaluated associations between growth trajectories and chronic disease outcomes (n = 22). Conclusions Group‐based trajectory modeling of growth in adults is emerging in epidemiologic research, with four distinct trajectories observed somewhat consistently from all studies. Understanding life course growth trajectories may provide further insight for population health interventions.
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Affiliation(s)
- Vanessa De Rubeis
- Department of Health Research Methods, Evidence, and Impact McMaster University Hamilton Ontario Canada
| | - Alessandra T. Andreacchi
- Department of Health Research Methods, Evidence, and Impact McMaster University Hamilton Ontario Canada
| | - Isobel Sharpe
- Department of Health Research Methods, Evidence, and Impact McMaster University Hamilton Ontario Canada
| | - Lauren E. Griffith
- Department of Health Research Methods, Evidence, and Impact McMaster University Hamilton Ontario Canada
| | - Charles D. G. Keown‐Stoneman
- Applied Health Research Centre Li Ka Shing Knowledge Institute St. Michael's Hospital University of Toronto Toronto Ontario Canada
- Division of Biostatistics Dalla Lana School of Public Health University of Toronto Toronto Ontario Canada
| | - Laura N. Anderson
- Department of Health Research Methods, Evidence, and Impact McMaster University Hamilton Ontario Canada
- Child Health Evaluative Sciences The Hospital for Sick Children Research Institute Toronto Ontario Canada
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23
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Hammami N, Chaurasia A, Bigelow P, Leatherdale ST. Gender differences in the longitudinal association between multilevel latent classes of chronic disease risk behaviours and body mass index in adolescents. HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION IN CANADA-RESEARCH POLICY AND PRACTICE 2020; 40:259-266. [PMID: 32909936 DOI: 10.24095/hpcdp.40.9.01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Few studies have assessed the relationship between chronic disease risk behaviours and body mass index (BMI) in a longitudinal, sex/gender-specific context. This study used gender-specific analyses to assess the extent to which chronic disease risk behaviour latent classes are associated with BMI and weight status at follow-up. METHODS Longitudinal data from 4510 students in Grades 9 to 12, tracked from 2013- 2015, who participated in the COMPASS study were used to assess gender differences in the lagged association between previously determined latent classes (of physical activity and substance use) with BMI using multilevel mixed-effects models. Our multilevel regression models assessed the association between two latent classes, active experimenters and inactive non-using youth, with BMI when stratified by gender. RESULTS Male inactive non-substance-using youth were associated with a 0.29 higher continuous BMI (95% CI: 0.057, 0.53) and odds of overweight/obesity increased by 72% (OR = 1.72, 95% CI: 1.2, 2.4) for binary BMI at follow-up relative to active youth who experiment with substance use. No significant associations were detected in females. CONCLUSION Over time, physical activity has a protective role on BMI in male youth. Both substance use and physical inactivity should be addressed in obesity prevention efforts. Gender stratification in analyses is also important since females and males have different contributing factors to increases in BMI.
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Affiliation(s)
- Nour Hammami
- Institute for Health and Social Policy, McGill University, Montréal, Quebec, Canada
| | - Ashok Chaurasia
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Philip Bigelow
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Scott T Leatherdale
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
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Switching to Integrase Inhibitors Unlinked to Weight Increase in Perinatally HIV-Infected Young Adults and Adolescents: A 10-Year Observational Study. Microorganisms 2020; 8:microorganisms8060864. [PMID: 32521616 PMCID: PMC7356820 DOI: 10.3390/microorganisms8060864] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 05/26/2020] [Accepted: 06/04/2020] [Indexed: 12/17/2022] Open
Abstract
An unexpected increase in weight gain has recently been reported in the course of integrase strand transfer inhibitors (INSTI) treatment. The possibility of this effect in people who are perinatally infected with HIV (PHIV) and thus exposed to lifelong therapy needs to be explored. This is a retrospective multicenter case-control study. Adults with PHIV followed between 2010 and 2019 in two outpatient services in Northern Italy were included if they had at least two weight measures in two successive years of observation. Patients were considered as cases if they were switched to INSTI (INSTI group), or controls if they were never exposed to INSTI (non-INSTI group). The date of the switch in cases was considered to be the baseline (T0), while it was randomly selected in controls. Mixed effect models were used to assess the weight changes in INSTI and non-INSTI groups. A total of 66 participants, 50.0% women, 92.4% Caucasian, were included. Median follow-up was 9 years (range 2–10): 4 years (range 1–8) before and 3 (range 1–9) after-T0. Mean age at the last study visit was 27.3 (±4.8) years, and mean CD4+ T-cells were 820.8 (±323.6) cells/mm3. Forty-five patients were switched to INSTI during the study, while 21 remained in the non-INSTI group. The INSTI group experienced a mean increase (pre-post T0) in bodyweight of 0.28 kg/year (95% CI − 0.29; 0.85, p = 0.338), while in the non-INSTI group, the mean increase was 0.36 kg/year (95% CI − 0.47; 1.20, p = 0.391), without a significant difference between groups (p for interaction between time and treatment regimen = 0.868). Among patients on INSTI, the weight gain after T0 was higher than pre-T0, amounting to +0.28 kg/year (95% CI − 0.29; 0.85), although this difference did not reach significance (p = 0.337). PHIV switched to an INSTI-based regimen did not experience an excessive weight gain compared to those who were treated with a non-INSTI based regimen in our cohort.
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Lee M, Lauren BN, Zhan T, Choi J, Klebanoff M, Abu Dayyeh B, Taveras EM, Corey K, Kaplan L, Hur C. The cost-effectiveness of pharmacotherapy and lifestyle intervention in the treatment of obesity. Obes Sci Pract 2020; 6:162-170. [PMID: 32313674 PMCID: PMC7156872 DOI: 10.1002/osp4.390] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 10/29/2019] [Accepted: 11/12/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The Food and Drug Administration has approved several pharmacotherapies for the treatment of obesity. This study assesses the cost-effectiveness of six pharmacotherapies and lifestyle intervention for people with mild obesity (body mass indices [BMIs] 30 to 35). METHODS A microsimulation model was constructed to compare seven weight loss strategies plus no treatment: intensive lifestyle intervention, orlistat, phentermine, phentermine/topiramate, lorcaserin, liraglutide, and semaglutide. Weight loss, quality-of-life scores, and costs were estimated using clinical trials and other published literature. Endpoints included costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs) with a willingness-to-pay (WTP) threshold of $100 000/QALY. Results were analysed at 1-, 3-, and 5-year time horizons. RESULTS At each of the three follow-up periods, phentermine was the cost-effective strategy, with ICERs of $46 258/QALY, $20 157/QALY, and $17 880/QALY after 1, 3, and 5 years, respectively. Semaglutide was the most effective strategy in the 3- and 5-year time horizons, with total QALYs of 2.224 and 3.711, respectively. However, the ICERs were prohibitively high at $1 437 340/QALY after 3 years and $576 931/QALY after 5 years. Deterministic and probabilistic sensitivity analyses indicated these results were robust. CONCLUSIONS Phentermine is the cost-effective pharmacologic weight-loss strategy. Although semaglutide is the most effective, it is not cost-effective because of its high price.
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Affiliation(s)
- Minyi Lee
- Gastroenterology DivisionMassachusetts General HospitalBostonMassachusetts
- Institute for Technology AssessmentMassachusetts General HospitalBostonMassachusetts
| | - Brianna N. Lauren
- Department of General MedicineColumbia University Irving Medical CenterNew YorkNew York
- Healthcare Innovation Research and EvaluationColumbia University Irving Medical CenterNew YorkNew York
| | - Tiannan Zhan
- Gastroenterology DivisionMassachusetts General HospitalBostonMassachusetts
- Institute for Technology AssessmentMassachusetts General HospitalBostonMassachusetts
| | - Jin Choi
- Department of General MedicineColumbia University Irving Medical CenterNew YorkNew York
- Healthcare Innovation Research and EvaluationColumbia University Irving Medical CenterNew YorkNew York
| | - Matthew Klebanoff
- Gastroenterology DivisionMassachusetts General HospitalBostonMassachusetts
- Institute for Technology AssessmentMassachusetts General HospitalBostonMassachusetts
- Yale School of MedicineNew HavenConnecticut
| | - Barham Abu Dayyeh
- Division of Gastroenterology and HepatologyMayo ClinicRochesterMinnesota
| | - Elsie M. Taveras
- Department of PediatricsMassachusetts General HospitalBostonMassachusetts
| | - Kathleen Corey
- Gastroenterology DivisionMassachusetts General HospitalBostonMassachusetts
- Harvard Medical SchoolBostonMassachusetts
| | - Lee Kaplan
- Gastroenterology DivisionMassachusetts General HospitalBostonMassachusetts
- Harvard Medical SchoolBostonMassachusetts
| | - Chin Hur
- Department of General MedicineColumbia University Irving Medical CenterNew YorkNew York
- Healthcare Innovation Research and EvaluationColumbia University Irving Medical CenterNew YorkNew York
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Wing RR, Russell GB, Tate DF, Espeland MA, LaRose JG, Gorin AA, Lewis CE, Jelalian E, Perdue LH, Bahnson J, Polzien K, Robichaud EF. Examining Heterogeneity of Outcomes in a Weight Gain Prevention Program for Young Adults. Obesity (Silver Spring) 2020; 28:521-528. [PMID: 32030910 PMCID: PMC7042032 DOI: 10.1002/oby.22720] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 10/23/2019] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study aimed to characterize young adults who experienced significant weight gains (> 10%) over 3 years in a weight gain prevention program. METHODS Secondary data analysis from the Study of Novel Approaches to Weight Gain Prevention (SNAP), a randomized trial comparing two self-regulation interventions and a control arm in young adults (18-35 years; BMI 21-30.9 kg/m2 ), was used. Large Gainers (≥ 10% of their body weight; n = 48), Small Gainers (2.6%-9.9%; n = 149), and Weight Stable participants (± 2.5%; n = 143) were compared on dimensions affecting weight gain. RESULTS Differences in weight gain among the three groups were significant by year 1 and subsequently increased. Those who became Large Gainers were heavier at baseline and further below their highest weight, and they reported more weight cycling than Weight Stable, with Small Gainers intermediate. Neither study arm nor pregnancy explained weight change differences among the three groups. Large Gainers reported more depressive symptoms than Weight Stable at years 1 and 2. Large Gainers were less likely to weigh themselves at least weekly at 4 months, before differences in weight gain emerged, and at years 1 and 2. CONCLUSIONS Large Gainers (representing almost 10% of participants) could be identified early by greater weight issues at baseline and lower use of weight gain prevention strategies.
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Affiliation(s)
- Rena R. Wing
- Alpert Medical School of Brown University, Miriam Hospital, Providence, Rhode Island
| | | | - Deborah F. Tate
- Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill
| | | | - Jessica Gokee LaRose
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine Richmond
| | - Amy A. Gorin
- Department of Psychological Sciences, University of Connecticut, Storrs
| | - Cora E. Lewis
- Department of Medicine, University of Alabama at Birmingham, Birmingham
| | - Elissa Jelalian
- Alpert Medical School of Brown University, Miriam Hospital, Providence, Rhode Island
| | | | - Judy Bahnson
- Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Kristen Polzien
- Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill
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Wing RR, Espeland MA, Tate DF, Perdue LH, Bahnson J, Polzien K, Robichaud EF, LaRose JG, Gorin AA, Lewis CE, Jelalian E. Weight Gain Over 6 Years in Young Adults: The Study of Novel Approaches to Weight Gain Prevention Randomized Trial. Obesity (Silver Spring) 2020; 28:80-88. [PMID: 31858732 PMCID: PMC6927481 DOI: 10.1002/oby.22661] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 08/21/2019] [Indexed: 02/04/2023]
Abstract
OBJECTIVE The study objective was to determine whether two self-regulation interventions that reduced 3-year weight gain in young adults remain effective at 6 years. METHODS A randomized trial was conducted in two academic settings in 599 young adults, aged 18 to 35 years, with normal weight or overweight; 504 (84%) reconsented for a 6-year extension (Study of Novel Approaches to Weight Gain Prevention-Extended [SNAP-E]) with ongoing intervention and assessments. Weight gain over 6 years was compared for all assigned to Control, Large Changes (LC; lose 5-10 pounds initially), and Small Changes (SC; make small daily changes in intake and activity). RESULTS Weight change from baseline to 6 years did not differ significantly among the three groups (Control = 3.9 kg, SC = 4.1 kg, and LC = 2.8 kg). However, there was a significant age-by-treatment interaction (P = 0.002). Among those < 25 years old, weight gain from baseline to 6 years averaged 7.3 kg in the Control group and was reduced by almost 50% in LC and SC. LC also significantly reduced mean weight gain (area under the curve) over 6 years compared with Control or SC. CONCLUSIONS Although the interventions did not reduce weight gain at 6 years for the full cohort, they were effective in those < 25 years old. Future efforts should focus on young adults aged 18 to 24.9 and test more intensive interventions with more diverse participants.
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Affiliation(s)
- Rena R. Wing
- Alpert Medical School of Brown University, Miriam Hospital, Providence, Rhode Island
| | | | - Deborah F. Tate
- Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill
| | | | - Judy Bahnson
- Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Kristen Polzien
- Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill
| | | | - Jessica Gokee LaRose
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine Richmond
| | - Amy A. Gorin
- Department of Psychological Sciences, University of Connecticut, Storrs
| | - Cora E. Lewis
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham
| | - Elissa Jelalian
- Alpert Medical School of Brown University, Miriam Hospital, Providence, Rhode Island
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Kushner RF, Batsis JA, Butsch WS, Davis N, Golden A, Halperin F, Kidambi S, Machineni S, Novick M, Port A, Rubino DM, Saunders KH, Shapiro Manning L, Soleymani T, Kahan S. Weight History in Clinical Practice: The State of the Science and Future Directions. Obesity (Silver Spring) 2020; 28:9-17. [PMID: 31858735 DOI: 10.1002/oby.22642] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Accepted: 07/29/2019] [Indexed: 02/06/2023]
Abstract
Eliciting a weight history can provide clinically important information to aid in treatment decision-making. This view is consistent with the life course perspective of obesity and the aim of patient-centered care, one of six domains of health care quality. However, thus far, the value and practicality of including a weight history in the clinical assessment and treatment of patients with obesity have not been systematically explored. For these reasons, the Clinical Committee of The Obesity Society established a task force to review and assess the available evidence to address five key questions. It is concluded that weight history is an essential component of the medical history for patients presenting with overweight or obesity, and there are strong and emerging data that demonstrate the importance of life stage, duration of exposure to obesity, maximum BMI, and group-based trajectory modeling in predicting risk for increased morbidity and mortality. Consideration of these and other patient-specific factors may improve risk stratification and clinical decision-making for screening, counseling, and management. Recommendations are provided for the key elements that should be included in a weight history, and several needs for future clinical research are outlined.
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Affiliation(s)
- Robert F Kushner
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - John A Batsis
- Geisel School of Medicine at Dartmouth, Section of General Internal Medicine-3M, Dartmouth-Hitchcock Medical Center, The Dartmouth Institute, Lebanon, New Hampshire, USA
| | - W Scott Butsch
- Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Nicola Davis
- Chronic Diseases and Prevention, Office of Population Health, NYC Health + Hospitals, New York, New York, USA
| | - Angela Golden
- NP Obesity Treatment Clinic, Flagstaff, Arizona, USA
| | - Florencia Halperin
- Center for Weight Management and Metabolic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Srividya Kidambi
- Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Sriram Machineni
- Division of Endocrinology and Metabolism, Department of Medicine, UNC School of Medicine, Chapel Hill, North Carolina, USA
| | - Marsha Novick
- Department of Pediatrics, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Ava Port
- Department of Medicine, Division of Endocrinology, Diabetes and Nutrition, University of Maryland, College Park, Maryland, USA
| | - Domenica M Rubino
- Washington Center for Weight Management and Research, Arlington, Virgnia, USA
| | - Katherine H Saunders
- Division of Endocrinology, Diabetes & Metabolism, Comprehensive Weight Control Center, Weill Cornell Medicine, New York, New York, USA
| | - Linda Shapiro Manning
- Clinical Development and Medical Affairs-Metabolism, Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, Connecticut, USA
| | | | - Scott Kahan
- National Center for Weight and Wellness, Johns Hopkins Bloomberg School of Public Health, Washington, DC, USA
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Shafran SD, Di Perri G. Response to Noe, Oldenbuettel and Jaeger. HIV Med 2019; 21:e12-e13. [PMID: 31852020 DOI: 10.1111/hiv.12835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- S D Shafran
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - G Di Perri
- Clinic of Infectious Diseases, University of Turin, Turin, Italy
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Pope ZC, Barr-Anderson DJ, Lewis BA, Pereira MA, Gao Z. Use of Wearable Technology and Social Media to Improve Physical Activity and Dietary Behaviors among College Students: A 12-Week Randomized Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3579. [PMID: 31557812 PMCID: PMC6801802 DOI: 10.3390/ijerph16193579] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 09/17/2019] [Accepted: 09/19/2019] [Indexed: 01/03/2023]
Abstract
College students demonstrate poor physical activity (PA) and dietary behaviors. We evaluated the feasibility of a combined smartwatch and theoretically based, social media-delivered health education intervention versus a comparison on improving college students' health behaviors/outcomes. Thirty-eight students (28 female; Xage = 21.5 ± 3.4 years) participated in this two-arm, randomized 12-week pilot trial (2017-2018). Participants were randomized into: (a) experimental: Polar M400 use and twice-weekly social cognitive theory- and self-determination theory-based Facebook-delivered health education intervention; or (b) comparison: enrollment only in separate, but content-identical, Facebook intervention. Primary outcomes pertained to intervention feasibility. Secondary outcomes included accelerometer-estimated PA, physiological/psychosocial outcomes, and dietary behaviors. Intervention adherence was high (~86%), with a retention of 92.1%. Participants implemented health education tips 1-3 times per week. We observed experimental and comparison groups to have 4.2- and 1.6-min/day increases in moderate-to-vigorous PA (MVPA), respectively, at six weeks-partially maintained at 12 weeks. In both groups, similarly decreased body weight (experimental = -0.6 kg; comparison = -0.5 kg) and increased self-efficacy, social support, and intrinsic motivation were observed pre- and post-intervention. Finally, we observed small decreases in daily caloric consumption over time (experimental = -41.0 calories; comparison = -143.3). Both interventions were feasible/of interest to college students and demonstrated initial effectiveness at improving health behaviors/outcomes. However, smartwatch provision may not result in an additional benefit.
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Affiliation(s)
- Zachary C Pope
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, 1300 S. 2nd St., Suite 300, Minneapolis, MN 55455, USA.
| | - Daheia J Barr-Anderson
- School of Kinesiology, University of Minnesota, 1900 University Ave. S.E., Minneapolis, MN 55455, USA.
| | - Beth A Lewis
- School of Kinesiology, University of Minnesota, 1900 University Ave. S.E., Minneapolis, MN 55455, USA.
| | - Mark A Pereira
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, 1300 S. 2nd St., Suite 300, Minneapolis, MN 55455, USA.
| | - Zan Gao
- School of Kinesiology, University of Minnesota, 1900 University Ave. S.E., Minneapolis, MN 55455, USA.
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Wischik DL, Magny-Normilus C, Whittemore R. Risk Factors of Obesity in Veterans of Recent Conflicts: Need for Diabetes Prevention. Curr Diab Rep 2019; 19:70. [PMID: 31368008 PMCID: PMC7530827 DOI: 10.1007/s11892-019-1191-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE OF REVIEW To identify factors associated with obesity in veterans of the recent, Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND) war conflicts. RECENT FINDINGS Over 44% OEF/OIF/OND veterans are obese (BMI > 30 kg/m2), which exceeds the national obesity prevalence rate of 39% in people younger than 45. Obesity increases morbidity, risk for type 2 diabetes (T2D), and mortality as well as decreases quality of life. A scoping review method was used to identify factors associated with obesity in young veterans. Military exposures, such as multiple deployments and exposure to combat, contribute to challenges in re-integration to civilian life in all veterans. Factors that contribute to increased risk for obesity include changes in eating patterns/eating disorders, changes in physical activity, physical disability, and psychological comorbidity. These conditions can contribute to a rapid weight gain trajectory, changes in metabolism, and obesity. Young veterans face considerable challenges related to obesity risk. Further research is needed to better understand young veterans' experiences and health needs in order to adapt or expand existing programs and improve access, engagement, and metabolic outcomes in this vulnerable population.
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Affiliation(s)
| | | | - Robin Whittemore
- Yale School of Nursing, 400 West Campus Drive, Orange, CT, 06477, USA
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Jones PR, Ekelund U. Physical Activity in the Prevention of Weight Gain: the Impact of Measurement and Interpretation of Associations. Curr Obes Rep 2019; 8:66-76. [PMID: 30905041 DOI: 10.1007/s13679-019-00337-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE OF REVIEW To what extent do different methods of physical activity measurement and statistical analysis influence the reported associations between physical activity and weight gain? RECENT FINDINGS The obesity epidemic has led to a focus on lifestyle approaches to the prevention of weight gain. Physical activity is one such approach. A number of studies have reported beneficial associations between higher levels of physical activity and weight gain at the population level. However, limitations of physical activity measurement and analytical models in some of these studies are likely to have resulted in overestimation of the strength of association. Understanding the limitations of assessment methods and analytical models used in epidemiological research should facilitate more realistic appraisal for physical activity to prevent weight gain at the population level and inform approaches to future research.
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Affiliation(s)
- Paul Remy Jones
- Department of Sports Medicine, Norwegian School of Sport Sciences, Ullevål Stadion, PO Box 4014, 0806, Oslo, Norway.
| | - Ulf Ekelund
- Department of Sports Medicine, Norwegian School of Sport Sciences, Ullevål Stadion, PO Box 4014, 0806, Oslo, Norway
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Karunasinghe N, Symes E, Gamage A, Wang A, Murray P, Zhu S, Goudie M, Masters J, Ferguson LR. Interaction between leukocyte aldo-keto reductase 1C3 activity, genotypes, biological, lifestyle and clinical features in a prostate cancer cohort from New Zealand. PLoS One 2019; 14:e0217373. [PMID: 31125365 PMCID: PMC6534310 DOI: 10.1371/journal.pone.0217373] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 05/02/2019] [Indexed: 12/26/2022] Open
Abstract
Introduction Aldo-keto reductase 1C3 (AKR1C3) is known for multiple functions including its catalytic activity towards producing extra-testicular androgen. The present study is towards understanding interaction between biological, lifestyle and genetic impacts of AKR1C3 and their influence on clinical factors in a prostate cancer (PC) cohort from New Zealand (NZ). Method Characteristics of 516 PC patients were collected from the Auckland Regional Urology Facility, NZ. These men were genotyped for the AKR1C3 rs12529 single nucleotide polymorphism (SNP). The leukocyte AKR1C3 activity was measured in a sub-cohort. Variability of leukocyte AKR1C3 activity between biological, lifestyle and clinical features as well as correlation between biological and clinical features were assessed with and without genetic stratification. Results The leukocyte AKR1C3 activity was associated with age at diagnosis (0.51 vs 0.34 μM coumberol units for >69y vs ≤69y, P = 0.03); and with anatomic stage/prognostic grouping among the AKR1C3 rs12529 CC genotype carriers (0.50 vs 28 μM coumberol units among low- and high-risk groups respectively, P = 0.02). Significant correlation between leukocyte AKR1C3 activity and age at PC diagnosis was also observed (correlation coefficient 0.20 and P = 0.02). Ever- smoking impacted both age and PSA at PC diagnosis among AKR1C3 rs12529 GG and CG genotype carriers respectively. Age at diagnosis significantly correlated with PSA at diagnosis in the main (correlation coefficient 0.29, and P<0.001) and sub-cohorts (correlation coefficient 0.24, and P = 0.01); and those carrying the AKR1C3 rs12529 CG and GG genotypes in both the main (correlation coefficient 0.30, and P<0.001 and correlation coefficient 0.35, and P<0.001 respectively) and sub-cohorts (correlation coefficient 0.43, and P<0.001 and correlation coefficient 0.39, and P = 0.06 respectively); but not with those carrying the CC genotype. Conclusions Age dependent PSA thresholds in PC screening could have been valid only in men carrying the AKR1C3 rs12529 CG and GG genotypes in this NZ cohort.
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Affiliation(s)
- Nishi Karunasinghe
- Auckland Cancer Society Research Centre (ACSRC), Faculty of Medical and Health Sciences (FM&HS), The University of Auckland, Auckland, New Zealand
- * E-mail:
| | - Eva Symes
- Auckland Cancer Society Research Centre (ACSRC), Faculty of Medical and Health Sciences (FM&HS), The University of Auckland, Auckland, New Zealand
| | - Amy Gamage
- Auckland Cancer Society Research Centre (ACSRC), Faculty of Medical and Health Sciences (FM&HS), The University of Auckland, Auckland, New Zealand
| | - Alice Wang
- Auckland Cancer Society Research Centre (ACSRC), Faculty of Medical and Health Sciences (FM&HS), The University of Auckland, Auckland, New Zealand
| | - Pam Murray
- Auckland Cancer Society Research Centre (ACSRC), Faculty of Medical and Health Sciences (FM&HS), The University of Auckland, Auckland, New Zealand
| | - Shuotun Zhu
- Auckland Cancer Society Research Centre (ACSRC), Faculty of Medical and Health Sciences (FM&HS), The University of Auckland, Auckland, New Zealand
| | - Megan Goudie
- Urology Department, Auckland City Hospital, Auckland, New Zealand
| | - Jonathan Masters
- Urology Department, Auckland City Hospital, Auckland, New Zealand
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Williams SG, McDermott R, Fruh S, Graves R, Hall H, Wright T, Swanzy D, Carter C. Nursing Student Satisfaction With Daily Life: A Holistic Approach. J Nurs Educ 2018; 57:751-755. [PMID: 30512113 PMCID: PMC6578587 DOI: 10.3928/01484834-20181119-09] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 09/06/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND Nursing school, clinical, and academic life challenges most students' satisfaction with daily life. This study sought to examine associations between undergraduate nursing students' satisfaction with daily life and body mass index (BMI), self-weight perception, and intake of 18 commonly consumed food and beverages over the past 30 days. METHOD A cross-sectional, correlational, online study facilitated data collection from 215 nursing students. RESULTS One unit increase in satisfaction with daily life predicted a modest 36% decrease in the odds of being overweight/obese. One unit increase in satisfaction with daily life predicted a 106% increase in the odds of being in the about the right weight category. Approximately 44.9% of the nursing students were in the overweight, obese, or extremely obese categories. CONCLUSION Healthy nutrition and normal BMI, with a positive self-weight perception, before nurses enter the workforce may have lifelong benefits. Nursing faculty can provide motivation, a supportive environment, and tools to instill a culture of health and wellness. [J Nurs Educ. 2018;57(12):751-755.].
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Elmer J, Jones BL, Nagin DS. Using the Beta distribution in group-based trajectory models. BMC Med Res Methodol 2018; 18:152. [PMID: 30477430 PMCID: PMC6258307 DOI: 10.1186/s12874-018-0620-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 11/15/2018] [Indexed: 12/03/2022] Open
Abstract
Background We demonstrate an application of Group-Based Trajectory Modeling (GBTM) based on the beta distribution. It is offered as an alternative to the normal distribution for modeling continuous longitudinal data that are poorly fit by the normal distribution even with censoring. The primary advantage of the beta distribution is the flexibility of the shape of the density function. Methods GBTM is a specialized application of finite mixture modeling designed to identify clusters of individuals who follow similar trajectories. Like all finite mixture models, GBTM requires that the distribution of the data composing the mixture be specified. To our knowledge this is the first demonstration of the use of the beta distribution in GBTM. A case study of a beta-based GBTM analyzes data on the neurological activity of comatose cardiac arrest patients. Results The case study shows that the summary measure of neurological activity, the suppression ratio, is not well fit by the normal distribution but due to the flexibility of the shape of the beta density function, the distribution of the suppression ratio by trajectory appears to be well matched by the estimated beta distribution by group. Conclusions The addition of the beta distribution to the already available distributional alternatives in software for estimating GBTM is a valuable augmentation to extant distributional alternatives.
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Affiliation(s)
- Jonathan Elmer
- Department of Emergency Medicine, Critical Care Medicine and Neurology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Bobby L Jones
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Daniel S Nagin
- Heinz College, Carnegie Mellon University, Pittsburgh, PA, 15206, USA.
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Štefan L, Sporiš G, Krističević T. Are lower levels of physical activity and self-rated fitness associated with higher levels of psychological distress in Croatian young adults? A cross-sectional study. PeerJ 2018; 6:e4700. [PMID: 29736338 PMCID: PMC5935075 DOI: 10.7717/peerj.4700] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 04/13/2018] [Indexed: 11/21/2022] Open
Abstract
Background Although previous evidence has shown that physical activity and physical fitness lower the level of psychological distress, little is known of simultaneous associations between of physical activity and physical fitness and with psychological distress, especially in young adults. Therefore, the main purpose of the present study was to explore both separate and simultaneous association between physical activity and physical fitness with psychological distress. Methods Participants in this cross-sectional study were 2,100 university students (1,041 men and 1,059 women) chosen from eight faculties in the city of Zagreb. Physical activity, physical fitness and psychological distress were assessed using structured questionnaires. The associations were examined using logistic regression analysis. Results After adjusting for gender, body-mass index, self-rated health, material status, binge drinking, chronic disease/s and sleep quality, “insufficient” physical activity (OR = 2.60; 95% CI [1.92–3.52]) and “lower” levels of physical fitness (tertile 2; OR = 1.94; 95% CI [1.25–3.01] and tertile 1; OR = 2.59; 95% CI [1.65–4.08]) remained associated with “high” psychological distress. When physical activity and physical fitness were entered simultaneously into the model, “insufficient” physical activity (OR = 2.35; 95% CI [1.72–3.21]) and “lower” levels of physical fitness (tertile 2; OR = 1.77; 95% CI [1.24–2.77] and tertile 1; OR = 2.00; 95% CI [1.26–3.20]) remained associated with “high” psychological distress. Conclusion Our study shows that both “insufficient” physical activity and “lower” levels of physical fitness are associated with “high” psychological distress, even after adjusting for numerous covariates. Therefore, special policies aiming to increase the levels of physical activity and fitness are warranted.
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Affiliation(s)
- Lovro Štefan
- Department of General and Applied Kinesiology, Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia
| | - Goran Sporiš
- Department of General and Applied Kinesiology, Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia
| | - Tomislav Krističević
- Department of Sports Kinesiology, Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia
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Lee SE, Han K, Kang YM, Kim SO, Cho YK, Ko KS, Park JY, Lee KU, Koh EH. Trends in the prevalence of metabolic syndrome and its components in South Korea: Findings from the Korean National Health Insurance Service Database (2009-2013). PLoS One 2018; 13:e0194490. [PMID: 29566051 PMCID: PMC5864027 DOI: 10.1371/journal.pone.0194490] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 03/05/2018] [Indexed: 12/15/2022] Open
Abstract
Background The prevalence of metabolic syndrome has markedly increased worldwide. However, studies in the United States show that it has remained stable or slightly declined in recent years. Whether this applies to other countries is presently unclear. Objectives We examined the trends in the prevalence of metabolic syndrome and its components in Korea. Methods The prevalence of metabolic syndrome and its components was estimated in adults aged >30 years from the Korean National Health Insurance Service data from 2009 to 2013. The revised National Cholesterol Education Program criteria were used to define metabolic syndrome. Results Approximately 10 million individuals were analyzed annually. The age-adjusted prevalence of metabolic syndrome increased from 28.84% to 30.52%, and the increasing trend was more prominent in men. Prevalence of hypertriglyceridemia, low HDL-cholesterol, and impaired fasting plasma glucose significantly increased. However, the prevalence of hypertension decreased in both genders. The prevalence of abdominal obesity decreased in women over 50 years-of-age but significantly increased in young women and men (<50 years). Conclusions The prevalence of metabolic syndrome is still increasing in Korea. Trends in each component of metabolic syndrome are disparate according to the gender, or age groups. Notably, abdominal obesity among young adults increased significantly; thus, interventional strategies should be implemented particularly for this age group.
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Affiliation(s)
- Seung Eun Lee
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyungdo Han
- Department of Biostatistics, The Catholic University of Korea, Seoul, Korea
| | - Yu Mi Kang
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seon-Ok Kim
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yun Kyung Cho
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyung Soo Ko
- Department of Internal Medicine, Cardiovascular and Metabolic Disease Center, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Joong-Yeol Park
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ki-Up Lee
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Eun Hee Koh
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- * E-mail:
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Goldschmidt AB, Wall MM, Choo THJ, Evans EW, Jelalian E, Larson N, Neumark-Sztainer D. Fifteen-year Weight and Disordered Eating Patterns Among Community-based Adolescents. Am J Prev Med 2018; 54:e21-e29. [PMID: 29132950 PMCID: PMC5736404 DOI: 10.1016/j.amepre.2017.09.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 08/24/2017] [Accepted: 09/07/2017] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The current study aims to characterize weight-change trajectories and their concomitant associations with prospectively measured dieting and other disordered eating behaviors among initially nonoverweight adolescents during the transition to adulthood. METHODS A population-based sample (n=1,091) self-reported their height/weight, dieting, unhealthy weight-control behaviors, and binge eating at 5-year intervals between 1998/1999 and 2013/2014, spanning early/middle adolescence through middle/late young adulthood. Data were analyzed in 2016/2017. RESULTS Groups were categorized as those who were never overweight (n=562), were overweight during at least one measurement point and gained weight more rapidly (n=246) or gradually (n=238) than their peers, or were overweight during at least one measurement point but returned to nonoverweight status by middle/late young adulthood (n=45). Thus, nearly half of adolescents became overweight during the transition to adulthood. Those who were never overweight had the lowest rates of dieting (males: F[9, 1,314]=2.54, p=0.0069, females: F[9, 1,927]=3.02, p=0.0014) and unhealthy weight-control behaviors (males: F[9, 1,313]=3.30, p=0.0005, females: F[9, 1,927]=3.02, p=0.0014), whereas some of these behaviors tended to track with weight gain in rapid and gradual weight gainers. CONCLUSIONS Although adolescents who are already overweight are most frequently targeted for weight-gain prevention and early intervention programs, results suggest that healthy lifestyle interventions could also benefit individuals who may be perceived as low risk for overweight in adulthood by nature of being nonoverweight in adolescence. Dieting and unhealthy weight-control behaviors tended to be associated with weight gain, suggesting that they are ineffective in addition to being potentially harmful.
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Affiliation(s)
- Andrea B Goldschmidt
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, The Miriam Hospital/Weight Control and Diabetes Research Center, Providence, Rhode Island.
| | - Melanie M Wall
- Department of Biostatistics, Columbia University, New York, New York
| | - Tse-Hwei J Choo
- Department of Biostatistics, Columbia University, New York, New York
| | - E Whitney Evans
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, The Miriam Hospital/Weight Control and Diabetes Research Center, Providence, Rhode Island
| | - Elissa Jelalian
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, The Miriam Hospital/Weight Control and Diabetes Research Center, Providence, Rhode Island
| | - Nicole Larson
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
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da Silva M, Weiderpass E, Licaj I, Rylander C. Factors Associated with High Weight Gain and Obesity Duration: The Norwegian Women and Cancer (NOWAC) Study. Obes Facts 2018; 11:381-392. [PMID: 30308488 PMCID: PMC6257091 DOI: 10.1159/000492002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 07/10/2018] [Indexed: 01/15/2023] Open
Abstract
AIM To identify factors associated with high weight gain and obesity duration in a representative sample of Norwegian women. METHODS 66,618 Norwegian women aged 34-70 years at baseline were included in the analysis. Baseline and follow-up questionnaires completed in 1991-2011 provided information on height, weight as well as sociodemographic, lifestyle and reproductive factors. We assessed the association with multivariable logistic regression. RESULTS Women gained on average 0.5 kg/year (95% CI 0.5-0.5 kg/year) during 6 years of follow-up, and 3.5% maintained in obesity during 13 years of follow-up. The factors with strongest association with high weight gain (≥10 kg) were smoking cessation (cessation vs. no change, OR = 4.39, 95% CI 3.91-4.94) and decreased physical activity level (decrease vs. no change, OR = 2.40, 95% CI 2.21-2.61). Low physical activity level (high vs. low, OR = 0.17, 95% CI 0.14-0.20), higher than median age at menarche (over median vs. median or under median, OR = 0.36, 95% CI 0.31-0.41), and less than 10 years of education (>12 years vs. <10 years, OR = 0.44, 95% CI 0.37-0.51) were strongly associated with obesity duration. CONCLUSION The modifiable factor with the strongest association with adverse weight development and potential for prevention was low or decreased physical activity level.
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Affiliation(s)
- Marisa da Silva
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- *Marisa da Silva, Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, P.O. Box 6050 Langnes, 9037 Tromsø, Norway,
| | - Elisabete Weiderpass
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland
| | - Idlir Licaj
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- Clinical Research Department, Centre François Baclesse, Caen, France
| | - Charlotta Rylander
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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Isaman DJM, Rothberg AE. Weight Mobility and Obesity in a Representative Sample of the US Adult Population. Int J Endocrinol 2018; 2018:4561213. [PMID: 29983711 PMCID: PMC6015688 DOI: 10.1155/2018/4561213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 05/20/2018] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Despite the attention given to the prevalence of obesity, surprisingly little is known about the incidence or reduction of obesity. We report the 1-year incidence and remission of obesity in a representative sample of the US population. METHODS Individuals from the Medical Expenditure Panel Survey (MEPS) panel 17 were classified into standard obesity categories at enrollment and one year later. Incidence rates were calculated by age. RESULTS Although the overall prevalence of obesity remained nearly constant, remission rates from obesity (stratified by age) ranged from 11 to 27% while incidence rates ranged from 6 to 16%. For almost all age levels, the proportion of individuals leaving an obese or overweight state was greater than or equal to the proportion who progressed to a more severe level of overweight or obesity. Overall, 36% of adults lost at least 2.5 kg/m2 in the one-year period; only 8% gained 2.5 kg/m2 or more. Individuals less than 25 years of age had higher rates of leaving overweight (23% versus <16%) and obesity (27% versus 24%) classifications than people of other ages. CONCLUSIONS Prevalence rates of obesity are well documented in the United States, but incidence is understudied. Public health efforts that target young people with overweight or obesity may yield the greatest benefit.
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Affiliation(s)
| | - Amy E. Rothberg
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
- Department of Human Nutrition, University of Michigan, Ann Arbor, MI, USA
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41
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Development of multivariable models to predict change in Body Mass Index within a clinical trial population of psychotic individuals. Sci Rep 2017; 7:14738. [PMID: 29116126 PMCID: PMC5677086 DOI: 10.1038/s41598-017-15137-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 10/18/2017] [Indexed: 12/20/2022] Open
Abstract
Many antipsychotics promote weight gain, which can lead to non-compliance and relapse of psychosis. By developing models that accurately identify individuals at greater risk of weight gain, clinicians can make informed treatment decisions and target intervention measures. We examined clinical, genetic and expression data for 284 individuals with psychosis derived from a previously published randomised controlled trial (IMPACT). These data were used to develop regression and classification models predicting change in Body Mass Index (BMI) over one year. Clinical predictors included demographics, anthropometrics, cardiac and blood measures, diet and exercise, physical and mental health, medication and BMI outcome measures. We included genetic polygenic risk scores (PRS) for schizophrenia, bipolar disorder, BMI, waist-hip-ratio, insulin resistance and height, as well as gene co-expression modules generated by Weighted Gene Co-expression Network Analysis (WGCNA). The best performing predictive models for BMI and BMI gain after one year used clinical data only, which suggests expression and genetic data do not improve prediction in this cohort.
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Silventoinen K, Jelenkovic A, Sund R, Yokoyama Y, Hur YM, Cozen W, Hwang AE, Mack TM, Honda C, Inui F, Iwatani Y, Watanabe M, Tomizawa R, Pietiläinen KH, Rissanen A, Siribaddana SH, Hotopf M, Sumathipala A, Rijsdijk F, Tan Q, Zhang D, Pang Z, Piirtola M, Aaltonen S, Öncel SY, Aliev F, Rebato E, Hjelmborg JB, Christensen K, Skytthe A, Kyvik KO, Silberg JL, Eaves LJ, Cutler TL, Ordoñana JR, Sánchez-Romera JF, Colodro-Conde L, Song YM, Yang S, Lee K, Franz CE, Kremen WS, Lyons MJ, Busjahn A, Nelson TL, Whitfield KE, Kandler C, Jang KL, Gatz M, Butler DA, Stazi MA, Fagnani C, D’Ippolito C, Duncan GE, Buchwald D, Martin NG, Medland SE, Montgomery GW, Jeong HU, Swan GE, Krasnow R, Magnusson PKE, Pedersen NL, Dahl Aslan AK, McAdams TA, Eley TC, Gregory AM, Tynelius P, Baker LA, Tuvblad C, Bayasgalan G, Narandalai D, Spector TD, Mangino M, Lachance G, Burt SA, Klump KL, Harris JR, Brandt I, Nilsen TS, Krueger RF, McGue M, Pahlen S, Corley RP, Huibregtse BM, Bartels M, van Beijsterveldt CEM, Willemsen G, Goldberg JH, Rasmussen F, Tarnoki AD, Tarnoki DL, Derom CA, Vlietinck RF, Loos RJF, Hopper JL, Sung J, Maes HH, Turkheimer E, Boomsma DI, Sørensen TIA, Kaprio J. Differences in genetic and environmental variation in adult BMI by sex, age, time period, and region: an individual-based pooled analysis of 40 twin cohorts. Am J Clin Nutr 2017; 106:457-466. [PMID: 28679550 PMCID: PMC5525120 DOI: 10.3945/ajcn.117.153643] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 06/08/2017] [Indexed: 12/20/2022] Open
Abstract
Background: Genes and the environment contribute to variation in adult body mass index [BMI (in kg/m2)], but factors modifying these variance components are poorly understood.Objective: We analyzed genetic and environmental variation in BMI between men and women from young adulthood to old age from the 1940s to the 2000s and between cultural-geographic regions representing high (North America and Australia), moderate (Europe), and low (East Asia) prevalence of obesity.Design: We used genetic structural equation modeling to analyze BMI in twins ≥20 y of age from 40 cohorts representing 20 countries (140,379 complete twin pairs).Results: The heritability of BMI decreased from 0.77 (95% CI: 0.77, 0.78) and 0.75 (95% CI: 0.74, 0.75) in men and women 20-29 y of age to 0.57 (95% CI: 0.54, 0.60) and 0.59 (95% CI: 0.53, 0.65) in men 70-79 y of age and women 80 y of age, respectively. The relative influence of unique environmental factors correspondingly increased. Differences in the sets of genes affecting BMI in men and women increased from 20-29 to 60-69 y of age. Mean BMI and variances in BMI increased from the 1940s to the 2000s and were greatest in North America and Australia, followed by Europe and East Asia. However, heritability estimates were largely similar over measurement years and between regions. There was no evidence of environmental factors shared by co-twins affecting BMI.Conclusions: The heritability of BMI decreased and differences in the sets of genes affecting BMI in men and women increased from young adulthood to old age. The heritability of BMI was largely similar between cultural-geographic regions and measurement years, despite large differences in mean BMI and variances in BMI. Our results show a strong influence of genetic factors on BMI, especially in early adulthood, regardless of the obesity level in the population.
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Affiliation(s)
- Karri Silventoinen
- Departments of Social Research and .,Osaka University Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Aline Jelenkovic
- Departments of Social Research and,Department of Genetics, Physical Anthropology, and Animal Physiology, University of the Basque Country, Leioa, Spain
| | - Reijo Sund
- Departments of Social Research and,Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Yoshie Yokoyama
- Department of Public Health Nursing, Osaka City University, Osaka, Japan
| | - Yoon-Mi Hur
- Department of Education, Mokpo National University, Jeonnam, South Korea
| | - Wendy Cozen
- Department of Preventive Medicine, Keck School of Medicine,,Norris Comprehensive Cancer Center, and
| | - Amie E Hwang
- Department of Preventive Medicine, Keck School of Medicine
| | - Thomas M Mack
- Department of Preventive Medicine, Keck School of Medicine,,Norris Comprehensive Cancer Center, and
| | - Chika Honda
- Osaka University Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Fujio Inui
- Osaka University Graduate School of Medicine, Osaka University, Osaka, Japan;,Faculty of Health Science, Kio University, Nara, Japan
| | - Yoshinori Iwatani
- Osaka University Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Mikio Watanabe
- Osaka University Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Rie Tomizawa
- Osaka University Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Kirsi H Pietiläinen
- Obesity Research Unit, Research Programs Unit, University of Helsinki, Helsinki, Finland;,Endocrinology, Abdominal Center, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Aila Rissanen
- Obesity Research Unit, Research Programs Unit, University of Helsinki, Helsinki, Finland;,Endocrinology, Abdominal Center, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Sisira H Siribaddana
- Institute of Research and Development, Battaramulla, Sri Lanka;,Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - Matthew Hotopf
- National Institute for Health Research Mental Health Biomedical Research Centre, South London and Maudsley National Health Service Foundation Trust, Institute of Psychiatry Psychology and Neuroscience
| | - Athula Sumathipala
- Institute of Research and Development, Battaramulla, Sri Lanka;,Research Institute for Primary Care and Health Sciences, School for Primary Care Research, Faculty of Health, Keele University, Staffordshire, United Kingdom
| | - Fruhling Rijsdijk
- Medical Research Council Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, and
| | - Qihua Tan
- Unit of Epidemiology, Biostatistics, and Biodemography, Departments of Public Health and
| | - Dongfeng Zhang
- Department of Public Health, Qingdao University Medical College, Qingdao, China
| | - Zengchang Pang
- Department of Noncommunicable Diseases Prevention, Qingdao Centers for Disease Control and Prevention, Qingdao, China
| | - Maarit Piirtola
- Departments of Social Research and,Institute for Molecular Medicine, Helsinki, Finland
| | - Sari Aaltonen
- Departments of Social Research and,Public Health, and
| | - Sevgi Y Öncel
- Department of Statistics, Faculty of Arts and Sciences, Kırıkkale University, Kırıkkale, Turkey
| | - Fazil Aliev
- Faculty of Business, Karabuk University, Karabuk, Turkey;,Departments of Psychology and,African American Studies
| | - Esther Rebato
- Department of Genetics, Physical Anthropology, and Animal Physiology, University of the Basque Country, Leioa, Spain
| | | | - Kaare Christensen
- The Danish Twin Registry,,Departments of Clinical Biochemistry and Pharmacology and Clinical Genetics, and
| | | | - Kirsten O Kyvik
- Clinical Research, University of Southern Denmark, Odense, Denmark;,Odense Patient Data Explorative Network, Odense University Hospital, Odense, Denmark
| | - Judy L Silberg
- Department of Human and Molecular Genetics, Virginia Institute for Psychiatric and Behavioral Genetics, and
| | - Lindon J Eaves
- Department of Human and Molecular Genetics, Virginia Institute for Psychiatric and Behavioral Genetics, and
| | - Tessa L Cutler
- The Australian Twin Registry, Centre for Epidemiology and Biostatistics, University of Melbourne, Melbourne, Victoria, Australia
| | - Juan R Ordoñana
- Department of Human Anatomy and Psychobiology, University of Murcia, Murcia, Spain;,Biomedical Research Institute of Murcia (IMIB)-Arrixaca, Murcia, Spain
| | - Juan F Sánchez-Romera
- Department of Human Anatomy and Psychobiology, University of Murcia, Murcia, Spain;,Biomedical Research Institute of Murcia (IMIB)-Arrixaca, Murcia, Spain
| | - Lucia Colodro-Conde
- Department of Human Anatomy and Psychobiology, University of Murcia, Murcia, Spain;,Quantitative Genetics Laboratory and
| | - Yun-Mi Song
- Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Sarah Yang
- Department of Epidemiology, School of Public Health, and,Institute of Health and Environment, Seoul National University, Seoul, South Korea
| | - Kayoung Lee
- Department of Family Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Carol E Franz
- Department of Psychiatry, University of California, San Diego, CA
| | - William S Kremen
- Department of Psychiatry, University of California, San Diego, CA;,US Department of Veterans Affairs San Diego Center of Excellence for Stress and Mental Health, La Jolla, CA
| | | | | | - Tracy L Nelson
- Department of Health and Exercise Sciences, Colorado School of Public Health, Colorado State University, Aurora, CO
| | | | | | - Kerry L Jang
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada; Departments of
| | - Margaret Gatz
- Department of Psychology, University of Southern California, Los Angeles, CA;,Medical Epidemiology and Biostatistics and
| | - David A Butler
- Health and Medicine Division, National Academies of Sciences, Engineering, and Medicine, Washington, DC
| | - Maria A Stazi
- Italian National Institute of Health National Center for Epidemiology, Surveillance, and Health Promotion, Rome, Italy
| | - Corrado Fagnani
- Italian National Institute of Health National Center for Epidemiology, Surveillance, and Health Promotion, Rome, Italy
| | - Cristina D’Ippolito
- Italian National Institute of Health National Center for Epidemiology, Surveillance, and Health Promotion, Rome, Italy
| | - Glen E Duncan
- Washington State Twin Registry, Health Sciences, Washington State University, Spokane, WA
| | - Dedra Buchwald
- Washington State Twin Registry, Health Sciences, Washington State University, Spokane, WA
| | - Nicholas G Martin
- Genetic Epidemiology Department, Queensland Institute of Medical Research Berghofer Medical Research Institute, Brisbane, Australia
| | - Sarah E Medland
- Genetic Epidemiology Department, Queensland Institute of Medical Research Berghofer Medical Research Institute, Brisbane, Australia
| | - Grant W Montgomery
- Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
| | - Hoe-Uk Jeong
- Department of Education, Mokpo National University, Jeonnam, South Korea
| | - Gary E Swan
- Department of Medicine, Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA
| | - Ruth Krasnow
- Center for Health Sciences, SRI International, Menlo Park, CA
| | | | | | - Anna K Dahl Aslan
- Medical Epidemiology and Biostatistics and,Institute of Gerontology and Aging Research Network, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Tom A McAdams
- Medical Research Council Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, and
| | - Thalia C Eley
- Medical Research Council Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, and
| | - Alice M Gregory
- Department of Psychology, Goldsmiths, University of London, London, United Kingdom
| | - Per Tynelius
- Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Laura A Baker
- Department of Psychology, University of Southern California, Los Angeles, CA
| | - Catherine Tuvblad
- Department of Psychology, University of Southern California, Los Angeles, CA;,School of Law, Psychology, and Social Work, Örebro University, Örebro, Sweden
| | | | - Danshiitsoodol Narandalai
- Healthy Twin Association of Mongolia, Ulaanbaatar, Mongolia;,Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Timothy D Spector
- Department of Twin Research and Genetic Epidemiology, King’s College London, London, United Kingdom
| | - Massimo Mangino
- Department of Twin Research and Genetic Epidemiology, King’s College London, London, United Kingdom;,National Institute for Health Research Biomedical Research Centre at Guy’s and St. Thomas’ Foundation Trust, London, United Kingdom
| | - Genevieve Lachance
- Department of Twin Research and Genetic Epidemiology, King’s College London, London, United Kingdom
| | | | | | | | | | | | - Robert F Krueger
- Department of Psychology, University of Minnesota, Minneapolis, MN
| | - Matt McGue
- Department of Psychology, University of Minnesota, Minneapolis, MN
| | - Shandell Pahlen
- Department of Psychology, University of Minnesota, Minneapolis, MN
| | - Robin P Corley
- Institute for Behavioral Genetics, University of Colorado, Boulder, Colorado
| | - Brooke M Huibregtse
- Institute for Behavioral Genetics, University of Colorado, Boulder, Colorado
| | - Meike Bartels
- Department of Biological Psychology, VU University Amsterdam, Amsterdam, Netherlands
| | | | - Gonneke Willemsen
- Department of Biological Psychology, VU University Amsterdam, Amsterdam, Netherlands
| | - Jack H Goldberg
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA
| | - Finn Rasmussen
- Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Adam D Tarnoki
- Department of Radiology, Semmelweis University, Budapest, Hungary;,Hungarian Twin Registry, Budapest, Hungary
| | - David L Tarnoki
- Department of Radiology, Semmelweis University, Budapest, Hungary;,Hungarian Twin Registry, Budapest, Hungary
| | - Catherine A Derom
- Centre of Human Genetics, University Hospitals Leuven, Leuven, Belgium;,Department of Obstetrics and Gynaecology, Ghent University Hospitals, Ghent, Belgium
| | | | - Ruth JF Loos
- Charles Bronfman Institute for Personalized Medicine, Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - John L Hopper
- Department of Epidemiology, School of Public Health, and,The Australian Twin Registry, Centre for Epidemiology and Biostatistics, University of Melbourne, Melbourne, Victoria, Australia
| | - Joohon Sung
- Department of Epidemiology, School of Public Health, and,Institute of Health and Environment, Seoul National University, Seoul, South Korea
| | - Hermine H Maes
- Departments of Human and Molecular Genetics and Psychiatry, Massey Cancer Center, Virginia Commonwealth University, Richmond, VA
| | - Eric Turkheimer
- Department of Psychology, University of Virginia, Charlottesville, VA
| | - Dorret I Boomsma
- Department of Biological Psychology, VU University Amsterdam, Amsterdam, Netherlands
| | - Thorkild IA Sørensen
- Section on Metabolic Genetics, Novo Nordisk Foundation Centre for Basic Metabolic Research, Copenhagen, Denmark;,Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; and,Department of Clinical Epidemiology, Bispebjerg and Frederiksberg Hospitals, Copenhagen, Denmark
| | - Jaakko Kaprio
- Public Health, and,Institute for Molecular Medicine, Helsinki, Finland
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Chao AM, Jastreboff AM, White MA, Grilo CM, Sinha R. Stress, cortisol, and other appetite-related hormones: Prospective prediction of 6-month changes in food cravings and weight. Obesity (Silver Spring) 2017; 25:713-720. [PMID: 28349668 PMCID: PMC5373497 DOI: 10.1002/oby.21790] [Citation(s) in RCA: 98] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 01/13/2017] [Accepted: 01/16/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To examine whether baseline chronic stress, morning cortisol, and other appetite-related hormones (leptin, ghrelin, and insulin) predict future weight gain and food cravings in a naturalistic, longitudinal, 6-month follow-up study. METHODS A prospective community cohort of 339 adults (age 29.1 ± 9.0 years; BMI = 26.7 ± 5.4 kg/m2 ; 56.9% female; 70.2% white) completed assessments at baseline and 6-month follow-up. Fasting blood draws were used to assess cortisol and other appetite-related hormone levels at baseline. At baseline and follow-up, body weight was measured, and the Cumulative Adversity Interview and Food Craving Inventory were administered. Data were analyzed using linear mixed models adjusting for demographic and clinical covariates. RESULTS Over the 6-month period, 49.9% of the sample gained weight. Food cravings and chronic stress decreased over 6 months (Ps < 0.05). However, after adjusting for covariates, individuals with higher baseline total ghrelin had significantly higher food cravings at 6 months (P = 0.04). Furthermore, higher cortisol, insulin, and chronic stress were each predictive of greater future weight gain (Ps < 0.05). CONCLUSIONS These results suggest that ghrelin plays a role in increased food cravings and reward-driven eating behaviors. Studies are needed that examine the utility of stress reduction methods for normalizing disrupted cortisol responses and preventing future weight gain.
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Affiliation(s)
- Ariana M. Chao
- University of Pennsylvania School of Nursing, Philadelphia, PA
- University of Pennsylvania Center for Weight and Eating Disorders at the Perelman School of Medicine, Philadelphia, PA
- Corresponding Author: Ariana M. Chao; 418 Curie Blvd, Philadelphia, PA 19104; ; Phone: 215-746-7183
| | - Ania M. Jastreboff
- Department of Internal Medicine, Section of Endocrinology, Yale University School of Medicine, New Haven, CT
- Department of Pediatrics, Section of Endocrinology, Yale University School of Medicine, New Haven, CT
| | - Marney A. White
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
- Yale School of Public Health, New Haven, CT
| | - Carlos M. Grilo
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
- Department of Psychology, Yale University, New Haven, CT
- National Center on Addiction and Substance Abuse, New York, NY
| | - Rajita Sinha
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
- Yale Stress Center, New Haven, CT
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Wilkinson L, Pacanowski CR, Levitsky D. Three-Year Follow-Up of Participants from a Self-Weighing Randomized Controlled Trial. J Obes 2017; 2017:4956326. [PMID: 29104805 PMCID: PMC5625756 DOI: 10.1155/2017/4956326] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 07/19/2017] [Indexed: 11/18/2022] Open
Abstract
Frequent self-weighing is associated with weight loss maintenance. Several years ago, we investigated frequent self-weighing's effect on weight loss and found the participants lost a significant amount of weight. Three years after this trial's end, participants were contacted for an update on their weight and self-weighing frequency. Weight change and self-weighing frequency since the end of the study were assessed. We hypothesized that participants who maintained frequent self-weighing behavior would have maintained their weight loss. Out of 98 participants enrolled in the RCT, 37% (n = 36) participated in this follow-up study. Total weight loss during the trial for the follow-up participants was 12.7 ± 19.4 lbs (p < 0.001). Three years after intervention, participants regained 0.9 ± 4.34 lbs, a value that was not statistically different from zero (p = 0.75). This did not differ by gender (p = 0.655). Over 75% of these participants continued to weigh themselves at least once a week. Frequent self-weighing may be an effective, low-cost strategy for weight loss maintenance. Future research should further investigate the role of self-weighing in long-term weight gain prevention.
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Affiliation(s)
- Lua Wilkinson
- Division of Nutritional Sciences, University of Alabama, Birmingham, Birmingham, AL, USA
| | - Carly R. Pacanowski
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE, USA
| | - David Levitsky
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
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Kruseman M, Schmutz N, Carrard I. Long-Term Weight Maintenance Strategies Are Experienced as a Burden by Persons Who Have Lost Weight Compared to Persons with a lifetime Normal, Stable Weight. Obes Facts 2017; 10:373-385. [PMID: 28810238 PMCID: PMC5644938 DOI: 10.1159/000478096] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 06/07/2017] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE To assess dietary intake, eating patterns, physical activity and eating behaviors, and to explore strategies and perceptions of the experience of weight maintenance in weight loss maintainers (weight loss maintenance (WLM) ≥ 10% weight loss maintained for ≥1 year) and in matched controls with a lifetime stable normal weight. METHODS Volunteers (32) were recruited by a snowball procedure in this cross-sectional, mixed-methods study. Diet, physical activity, and eating behaviors were assessed with validated questionnaires. Strategies and experiences were investigated during interviews. Descriptive coding, thematic analysis (qualitative data) as well as descriptive analysis and t-tests (quantitative data) were performed. RESULTS Both groups had similar energy and macronutrient consumption. Those in the WLM group reported higher levels of exercise and scored higher on several dimensions of eating disorders. Four themes - 'food choices,' 'quantities and portion control,' 'physical activity', and 'burden' - emerged from the qualitative data. Both groups used similar weight maintenance strategies, but those in the WLM group experienced a higher burden, expressing effortful control which contrasted with the control group's confidence in their internal cues. CONCLUSION Our results show an additional burden related with maintaining weight loss compared to keeping a stable normal weight. They provide evidence to devise interventions that will address the difficulty of regulating intake.
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Affiliation(s)
- Maaike Kruseman
- *Prof. Dr. Maaike Kruseman, Department of Nutrition and Dietetics, HES-SO University of Applied Sciences Western Switzerland, Rue des Caroubiers 25, 1227 Carouge, Switzerland,
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46
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Ford ND, Martorell R, Mehta NK, Ramirez-Zea M, Stein AD. Life-Course Body Mass Index Trajectories Are Predicted by Childhood Socioeconomic Status but Not Exposure to Improved Nutrition during the First 1000 Days after Conception in Guatemalan Adults. J Nutr 2016; 146:2368-2374. [PMID: 27655759 PMCID: PMC5086792 DOI: 10.3945/jn.116.236075] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 08/12/2016] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Latin America has experienced increases in obesity. Little is known about the role of early life factors on body mass index (BMI) gain over the life course. OBJECTIVE The objective of this research was to examine the role of early life factors [specifically, nutrition supplementation during the first 1000 d (from conception to 2 y of age) and childhood household socioeconomic status (SES)] on the pattern of BMI gain from birth or early childhood through midadulthood by using latent class growth analysis. METHODS Study participants (711 women, 742 men) who were born in 4 villages in Guatemala (1962-1977) were followed prospectively since participating in a randomized nutrition supplementation trial as children. Sex-specific BMI latent class trajectories were derived from 22 possible measures of height and weight from 1969 to 2004. To characterize early life determinants of BMI latent class membership, we used logistic regression modeling and estimated the difference-in-difference (DD) effect of nutrition supplementation during the first 1000 d. RESULTS We identified 2 BMI latent classes in women [low (57%) and high (43%)] and 3 classes in men [low (38%), medium (47%), and high (15%)]. Nutrition supplementation during the first 1000 d after conception was not associated with BMI latent class membership (DD test: P > 0.15 for men and women), whereas higher SES was associated with increased odds of high BMI latent class membership in both men (OR: 1.98; 95% CI: 1.09, 3.61) and women (OR: 1.62; 95% CI: 1.07, 2.45) for the highest relative to the lowest tertile. CONCLUSIONS In a cohort of Guatemalan men and women, nutrition supplementation provided during the first 1000 d was not significantly associated with higher BMI trajectory. Higher childhood household SES was associated with increased odds of high BMI latent class membership relative to the poorest households. The pathways through which this operates still need to be explored.
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Affiliation(s)
- Nicole D Ford
- Nutrition and Health Sciences Program, Laney Graduate School, and
| | - Reynaldo Martorell
- Nutrition and Health Sciences Program, Laney Graduate School, and,Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA; and
| | - Neil K Mehta
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA; and
| | - Manuel Ramirez-Zea
- Institute of Nutrition of Central America and Panama Research Center for the Prevention of Chronic Diseases (CIIPEC), Guatemala City, Guatemala
| | - Aryeh D Stein
- Nutrition and Health Sciences Program, Laney Graduate School, and .,Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA; and
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47
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Godino JG, Merchant G, Norman GJ, Donohue MC, Marshall SJ, Fowler JH, Calfas KJ, Huang JS, Rock CL, Griswold WG, Gupta A, Raab F, Fogg BJ, Robinson TN, Patrick K. Using social and mobile tools for weight loss in overweight and obese young adults (Project SMART): a 2 year, parallel-group, randomised, controlled trial. Lancet Diabetes Endocrinol 2016; 4:747-755. [PMID: 27426247 PMCID: PMC5005009 DOI: 10.1016/s2213-8587(16)30105-x] [Citation(s) in RCA: 99] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 05/21/2016] [Accepted: 05/24/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Few weight loss interventions are evaluated for longer than a year, and even fewer employ social and mobile technologies commonly used among young adults. We assessed the efficacy of a 2 year, theory-based, weight loss intervention that was remotely and adaptively delivered via integrated user experiences with Facebook, mobile apps, text messaging, emails, a website, and technology-mediated communication with a health coach (the SMART intervention). METHODS In this parallel-group, randomised, controlled trial, we enrolled overweight or obese college students (aged 18-35 years) from three universities in San Diego, CA, USA. Participants were randomly assigned (1:1) to receive either the intervention (SMART intervention group) or general information about health and wellness (control group). We used computer-based permuted-block randomisation with block sizes of four, stratified by sex, ethnicity, and college. Participants, study staff, and investigators were masked until the intervention was assigned. The primary outcome was objectively measured weight in kg at 24 months. Differences between groups were evaluated using linear mixed-effects regression within an intention-to-treat framework. Objectively measured weight at 6, 12, and 18 months was included as a secondary outcome. The trial is registered with ClinicalTrials.gov, number NCT01200459. FINDINGS Between May 18, 2011, and May 17, 2012, 404 individuals were randomly assigned to the intervention (n=202) or control (n=202). Participants' mean (SD) age was 22·7 (3·8) years. 284 (70%) participants were female and 125 (31%) were Hispanic. Mean (SD) body-mass index at baseline was 29·0 (2·8) kg/m(2). At 24 months, weight was assessed in 341 (84%) participants, but all 404 were included in analyses. Weight, adjusted for sex, ethnicity, and college, was not significantly different between the groups at 24 months (-0·79 kg [95% CI -2·02 to 0·43], p=0·204). However, weight was significantly less in the intervention group compared with the control group at 6 months (-1·33 kg [95% CI -2·36 to -0·30], p=0·011) and 12 months (-1·33 kg [-2·30 to -0·35], p=0·008), but not 18 months (-0·67 kg [95% CI -1·69 to 0·35], p=0·200). One serious adverse event in the intervention group (gallstones) could be attributable to rapid and excessive weight loss. INTERPRETATION Social and mobile technologies did not facilitate sustained reductions in weight among young adults, although these approaches might facilitate limited short-term weight loss. FUNDING The National Heart, Lung, and Blood Institute of the National Institutes of Health (U01 HL096715).
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Affiliation(s)
- Job G Godino
- Center for Wireless and Population Health Systems, University of California, San Diego, La Jolla, CA, USA; Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA, USA
| | - Gina Merchant
- Center for Wireless and Population Health Systems, University of California, San Diego, La Jolla, CA, USA; Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA, USA
| | - Gregory J Norman
- Center for Wireless and Population Health Systems, University of California, San Diego, La Jolla, CA, USA; Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA, USA
| | - Michael C Donohue
- Department of Neurology, University of Southern California, Los Angeles, CA, USA
| | - Simon J Marshall
- Center for Wireless and Population Health Systems, University of California, San Diego, La Jolla, CA, USA; Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA, USA
| | - James H Fowler
- Center for Wireless and Population Health Systems, University of California, San Diego, La Jolla, CA, USA; Division of Global Public Health, University of California, San Diego, La Jolla, CA, USA; Department of Political Science, University of California, San Diego, La Jolla, CA, USA
| | - Karen J Calfas
- Center for Wireless and Population Health Systems, University of California, San Diego, La Jolla, CA, USA; Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA, USA
| | - Jeannie S Huang
- Center for Wireless and Population Health Systems, University of California, San Diego, La Jolla, CA, USA; Division of Pediatric Gastroenterology, University of California, San Diego, La Jolla, CA, USA
| | - Cheryl L Rock
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA, USA
| | - William G Griswold
- Center for Wireless and Population Health Systems, University of California, San Diego, La Jolla, CA, USA
| | - Anjali Gupta
- Center for Wireless and Population Health Systems, University of California, San Diego, La Jolla, CA, USA; Department of Development, Aging, and Regeneration, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA, USA
| | - Fredric Raab
- Center for Wireless and Population Health Systems, University of California, San Diego, La Jolla, CA, USA
| | - B J Fogg
- Behavior Design Laboratory, Human Sciences and Technologies Advanced Research Institute, Stanford University, Stanford, CA, USA
| | - Thomas N Robinson
- Stanford Solutions Science Laboratory, Department of Pediatrics, Stanford University, Stanford, CA, USA
| | - Kevin Patrick
- Center for Wireless and Population Health Systems, University of California, San Diego, La Jolla, CA, USA; Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA, USA.
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Kumpulainen SM, Heinonen K, Salonen MK, Andersson S, Wolke D, Kajantie E, Eriksson JG, Raikkonen K. Childhood cognitive ability and body composition in adulthood. Nutr Diabetes 2016; 6:e223. [PMID: 27525818 PMCID: PMC5022144 DOI: 10.1038/nutd.2016.30] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 07/01/2016] [Accepted: 07/05/2016] [Indexed: 12/31/2022] Open
Abstract
Background: Childhood cognitive ability has been identified as a novel risk factor for adulthood overweight and obesity as assessed by adult body mass index (BMI). BMI does not, however, distinguish fat-free and metabolically harmful fat tissue. Hence, we examined the associations between childhood cognitive abilities and body fat percentage (BF%) in young adulthood. Methods: Participants of the Arvo Ylppö Longitudinal Study (n=816) underwent tests of general reasoning, visuomotor integration, verbal competence and language comprehension (M=100; s.d.=15) at the age of 56 months. At the age of 25 years, they underwent a clinical examination, including measurements of BF% by the InBody 3.0 eight-polar tactile electrode system, weight and height from which BMI (kg m−2) was calculated and waist circumference (cm). Results: After adjustments for sex, age and BMI-for-age s.d. score at 56 months, lower general reasoning and visuomotor integration in childhood predicted higher BMI (kg m−2) increase per s.d. unit decrease in cognitive ability (−0.32, 95% confidence interval −0.60,−0.05; −0.45, −0.75,−0.14, respectively) and waist circumference (cm) increase per s.d. unit decrease in cognitive ability (−0.84, −1.56,−0.11; −1.07,−1.88,−0.26, respectively) in adulthood. In addition, lower visuomotor integration predicted higher BF% per s.d. unit decrease in cognitive ability (−0.62,−1.14,−0.09). Associations between general reasoning and BMI/waist were attenuated when adjusted for smoking, alcohol consumption, intake of fruits and vegetables and physical activity in adulthood, and all associations, except for visuomotor integration and BMI, were attenuated when adjusted for parental and/or own attained education and/or birth weight. Conclusions: Of the measured childhood cognitive abilities, only lower visuomotor integration was associated with BF% in adulthood. This challenges the view that cognitive ability, at least when measured in early childhood, poses a risk for adiposity in adulthood, as characterized by higher BF%.
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Affiliation(s)
- S M Kumpulainen
- Institute of Behavioral Sciences, University of Helsinki, Helsinki, Finland
| | - K Heinonen
- Institute of Behavioral Sciences, University of Helsinki, Helsinki, Finland
| | - M K Salonen
- National Institute for Health and Welfare, Helsinki, Finland.,Folkhälsan Research Unit, Helsinki, Finland
| | - S Andersson
- Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - D Wolke
- Department of Psychology, University of Warwick, Coventry, UK
| | - E Kajantie
- National Institute for Health and Welfare, Helsinki, Finland.,Institute for Health and Welfare, Oulu, Finland
| | - J G Eriksson
- Folkhälsan Research Unit, Helsinki, Finland.,Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
| | - K Raikkonen
- Institute of Behavioral Sciences, University of Helsinki, Helsinki, Finland
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49
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Hohenadel MG, Baier LJ, Piaggi P, Muller YL, Hanson RL, Krakoff J, Thearle MS. The impact of genetic variants on BMI increase during childhood versus adulthood. Int J Obes (Lond) 2016; 40:1301-9. [PMID: 27076275 DOI: 10.1038/ijo.2016.53] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 02/04/2016] [Accepted: 02/21/2016] [Indexed: 01/13/2023]
Abstract
BACKGROUND Genetic variants that predispose individuals to obesity may have differing influences during childhood versus adulthood, and additive effects of such variants are likely to occur. Our ongoing studies to identify genetic determinants of obesity in American Indians have identified 67 single-nucleotide polymorphisms (SNPs) that reproducibly associate with maximum lifetime non-diabetic body mass index (BMI). This study aimed to identify when, during the lifetime, these variants have their greatest impact on BMI increase. SUBJECTS/METHODS A total of 5906 Native Americans of predominantly Pima Indian heritage with repeated measures of BMI between the ages of 5 and 45 years were included in this study. The association between each SNP with the rates of BMI increase during childhood (5-19 years) and adulthood (20-45 years) were assessed separately. The significant SNPs were used to calculate a cumulative allelic risk score (ARS) for childhood and adulthood, respectively, to assess the additive effect of these variants within each period of life. RESULTS The majority of these SNPs (36 of 67) were associated with rate of BMI increase during childhood (P-value range: 0.00004-0.05), whereas only nine SNPs were associated with rate of BMI change during adulthood (P-value range: 0.002-0.02). These 36 SNPs associated with childhood BMI gain likely had a cumulative effect as a higher childhood-ARS associated with rate of BMI change (β=0.032 kg m(-2) per year per risk allele, 95% confidence interval: 0.027-0.036, P<0.0001), such that at age 19 years, individuals with the highest number of risk alleles had a BMI of 10.2 kg m(-2) greater than subjects with the lowest number of risk alleles. CONCLUSIONS Overall, our data indicates that genetic polymorphisms associated with lifetime BMI may influence the rate of BMI increase during different periods in the life course. The majority of these polymorphisms have a larger impact on BMI during childhood, providing further evidence that prevention of obesity will need to begin early in life.
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Affiliation(s)
- M G Hohenadel
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ, USA
| | - L J Baier
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ, USA
| | - P Piaggi
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ, USA
| | - Y L Muller
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ, USA
| | - R L Hanson
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ, USA
| | - J Krakoff
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ, USA
| | - M S Thearle
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ, USA
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50
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Hwang Y, Lee KE, Park YJ, Kim SJ, Kwon H, Park DJ, Cho B, Choi HC, Kang D, Park SK. Annual Average Changes in Adult Obesity as a Risk Factor for Papillary Thyroid Cancer: A Large-Scale Case-Control Study. Medicine (Baltimore) 2016; 95:e2893. [PMID: 26945379 PMCID: PMC4782863 DOI: 10.1097/md.0000000000002893] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
We evaluated the association between weight change in middle-aged adults and papillary thyroid cancer (PTC) based on a large-scale case-control study. Our study included data from 1551 PTC patients (19.3% men and 80.7% women) who underwent thyroidectomy at the 3 general hospitals in Korea and 15,510 individually matched control subjects. The subjects' weight history, epidemiologic information, and tumor characteristics confirmed after thyroidectomy were analyzed. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were determined for the annual average changes in weight and obesity indicators (body mass index (BMI), body surface area, and body fat percentage (BF%) in subjects since the age of 35 years. Subjects with a total weight gain ≥10 kg after age 35 years were more likely to have PTC (men, OR, 5.39, 95% CI, 3.88-7.49; women, OR, 3.36, 95% CI, 2.87-3.93) compared with subjects with a stable weight (loss or gain <5 kg). A marked increase in BMI since age 35 years (annual average change of BMI ≥0.3 kg/m/yr) was related to an elevated PTC risk, and the association was more pronounced for large-sized PTC risks (<1 cm, OR, 2.34, 95% CI, 1.92-2.85; ≥1 cm, OR, 4.00, 95% CI, 2.91-5.49, P heterogeneity = 0.005) compared with low PTC risks. Weight gain and annual increases in obesity indicators in middle-aged adults may increase the risk of developing PTC.
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Affiliation(s)
- Yunji Hwang
- From the Department of Preventive Medicine (YH, DK, SKP), Seoul National University College of Medicine; Department of Biomedical Science (YH, DK, SKP), Seoul National University Graduate School; Cancer Research Institute (YH, KEL, DK, SKP), Seoul National University College of Medicine; Department of Surgery (KEL, S-JK, HK), Seoul National University Hospital and College of Medicine; Division of Surgery (KEL), Thyroid Center, Seoul National University Cancer Hospital; Department of Internal Medicine (YJP, DJP), Seoul National University College of Medicine; Department of Family Medicine (BC, H-CC), Health Promotion Center for Cancer Survivor, Seoul National University Hospital, Seoul; and Advanced Institutes of Convergence Technology (BC, H-CC), Seoul National University, Suwon-si, Gyeonggi-do, Korea
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