1
|
Martins RBM, Torres JL, Moreira BDS, Lima-Costa MF, Ygnatios NTM. [Sociodemographic characteristics associated with underweight and overweight in adults aged 50 years and over (ELSI-Brasil): differences between sexes]. CAD SAUDE PUBLICA 2024; 40:e00037023. [PMID: 38324866 PMCID: PMC10841375 DOI: 10.1590/0102-311xpt037023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 09/01/2023] [Accepted: 09/18/2023] [Indexed: 02/09/2024] Open
Abstract
The objective were to describe the prevalence of underweight and overweight, assessed by body mass index (BMI), stratified by sex and age group, and to analyze the sociodemographic characteristics associated with BMI in older women and men. This is a cross-sectional analysis of 8,974 participants aged ≥ 50 years from the baseline of the Brazilian Longitudinal Study of Aging (ELSI-Brasil, 2015-2016). BMI was classified as underweight, eutrophy, and overweight according to the participant's age. A multinomial logistic regression model was used, considering the sociodemographic characteristics of women and men. The results showed a higher prevalence of overweight in women compared to men (64.1% vs. 57.3%). In both sexes, the prevalence of underweight was higher in the longest-lived individuals, while overweight was lower. In women, the chance of underweight was higher than the chance of eutrophy in those who were single/widowed/divorced (OR = 1.95; 95%CI: 1.42-2.66) and in those living in rural areas (OR = 1.58; 95%CI: 1.01-2.49), while the chance of being overweight was lower than the chance of being eutrophy in those living in rural areas (OR = 0.78; 95%CI: 0.62-0.97) and in all geographic macro-regions related to the South Region. For men, the chance of being overweight was lower than the chance of being eutrophy among single/widowed/divorced individuals (OR = 0.58; 95%CI: 0.48-0.69). The richest had a lower chance of being underweight (OR = 0.59; 95%CI: 0.38-0.90), as well as a higher chance of being overweight (OR = 1.52; 95%CI: 1.20-1.92). In conclusion, the sociodemographic characteristics associated with BMI differed between the sexes.
Collapse
Affiliation(s)
| | - Juliana Lustosa Torres
- Núcleo de Estudos em Saúde Pública e Envelhecimento, Fundação Oswaldo Cruz/Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
- Departamento de Medicina Preventiva e Social, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | - Bruno de Souza Moreira
- Núcleo de Estudos em Saúde Pública e Envelhecimento, Fundação Oswaldo Cruz/Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | - Maria Fernanda Lima-Costa
- Núcleo de Estudos em Saúde Pública e Envelhecimento, Fundação Oswaldo Cruz/Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
- Departamento de Medicina Preventiva e Social, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
- Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brasil
| | - Nair Tavares Milhem Ygnatios
- Centro Universitário Santa Rita, Conselheiro Lafaiete, Brasil
- Núcleo de Estudos em Saúde Pública e Envelhecimento, Fundação Oswaldo Cruz/Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| |
Collapse
|
2
|
Lowy AS, Rodgers RF, Franko DL, Pluhar E, Webb JB. Body image and internalization of appearance ideals in Black women: An update and call for culturally-sensitive research. Body Image 2021; 39:313-327. [PMID: 34749264 DOI: 10.1016/j.bodyim.2021.10.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 10/11/2021] [Accepted: 10/14/2021] [Indexed: 11/18/2022]
Abstract
Extant research on body image supports sociocultural theories emphasizing the internalization of societal pressures to attain the thin-ideal, as well as other White or Eurocentric ideals that are predominant in mainstream media. While earlier research suggests that Black women are less likely to report body dissatisfaction and thin-ideal internalization compared to women of other racial backgrounds, recent studies argue that most measures of body image and appearance ideals may not be accurate assessments of body dissatisfaction for this population. In this paper, we summarize the literature over the past two decades on body image and appearance ideals among cisgender Black girls and women and discuss the applications of well-established sociocultural theories of body dissatisfaction. We additionally highlight existing gaps in culturally-sensitive theory and assessment tools and consider the benefits of applying intersectionality-informed research. We lastly propose future directions in research, assessment, and intervention to develop more culturally-sensitive approaches to identifying, assessing, and addressing body dissatisfaction among Black girls and women. This paper encourages researchers to apply culturally-sensitive and intersectionality-informed theory to improve efforts in assessing early warning signs of body dissatisfaction and developing effective interventions for this population.
Collapse
Affiliation(s)
- Alice S Lowy
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
| | - Rachel F Rodgers
- Department of Applied Psychology, Northeastern University, Boston, MA, USA
| | - Debra L Franko
- Department of Applied Psychology, Northeastern University, Boston, MA, USA
| | - Emily Pluhar
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Jennifer B Webb
- Department of Psychological Science, University of North Carolina at Charlotte, Charlotte, NC, USA
| |
Collapse
|
3
|
Ford CN, Chang S, Wood AC, Manson JE, Garcia DO, Laroche H, Bird CE, Vitolins MZ. On the joint role of non-Hispanic Black race/ethnicity and weight status in predicting postmenopausal weight gain. PLoS One 2021; 16:e0247821. [PMID: 33647066 PMCID: PMC7920337 DOI: 10.1371/journal.pone.0247821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 02/15/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To determine how baseline weight status contributes to differences in postmenopausal weight gain among non-Hispanic Blacks (NHBs) and non-Hispanic Whites (NHWs). METHODS Data were included from 70,750 NHW and NHB postmenopausal women from the Women's Health Initiative Observational Study (WHI OS). Body Mass Index (BMI) at baseline was used to classify women as having normal weight, overweight, obese class I, obese class II or obese class III. Cox proportional hazards was used to estimate the hazard of a 10% or more increase in weight from baseline. RESULTS In both crude and adjusted models, NHBs were more likely to experience ≥10% weight gain than NHWs within the same category of baseline weight status. Moreover, NHBs who were normal weight at baseline were most likely to experience ≥10% weight gain in both crude and adjusted models. Age-stratified results were consistent with overall findings. In all age categories, NHBs who were normal weight at baseline were most likely to experience ≥10% weight gain. Based on the results of adjusted models, the joint influence of NHB race/ethnicity and weight status on risk of postmenopausal weight gain was both sub-additive and sub-multiplicative. CONCLUSION NHBs are more likely to experience postmenopausal weight gain than NHWs, and the disparity in risk is most pronounced among those who are normal weight at baseline. To address the disparity in postmenopausal obesity, future studies should focus on identifying and modifying factors that promote weight gain among normal weight NHBs.
Collapse
Affiliation(s)
- Christopher N. Ford
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL, United States of America
| | - Shine Chang
- Department of Epidemiology, University of Texas MD Anderson Cancer Center, Houston, TX, United States of America
| | - Alexis C. Wood
- USDA/ARS Children’s Nutrition Research Center, Baylor College of Medicine, Houston, TX, United States of America
| | - JoAnn E. Manson
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States of America
| | - David O. Garcia
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States of America
| | - Helena Laroche
- Center for Children’s Healthy Lifestyles and Nutrition, Children’s Mercy Hospital, Kansas City and University of Missouri, Kansas City, MO, United States of America
| | - Chloe E. Bird
- RAND Corporation, Santa Monica, CA, United States of America
| | - Mara Z. Vitolins
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Wake Forest, NC, United States of America
| |
Collapse
|
4
|
Kinnunen TI, Richardsen KR, Sletner L, Torgersen L, Sommer C, Waage CW, Mdala I, Jenum AK. Ethnic differences in body mass index trajectories from 18 years to postpartum in a population-based cohort of pregnant women in Norway. BMJ Open 2019; 9:e022640. [PMID: 30798304 PMCID: PMC6398684 DOI: 10.1136/bmjopen-2018-022640] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To explore ethnic differences in changes in body mass index (BMI) from the age of 18 years to 3 months postpartum. DESIGN A population-based cohort study. SETTING Child Health Clinics in Oslo, Norway. PARTICIPANTS Participants were 811 pregnant women (mean age 30 years). Ethnicity was categorised into six groups. PRIMARY OUTCOME MEASURES The outcome variable was BMI (kg/m2) measured at the age of 18 and 25 years, at prepregnancy and at 3 months postpartum. Body weight at 18 years, 25 years and prepregnancy were self-reported in early pregnancy, while body height and weight at 3 months postpartum were measured. The main statistical method was generalised estimating equations, adjusted for age. The analyses were stratified by parity due to ethnicity×time×parity interaction (p<0.001). RESULTS Primiparous South Asian women had a 1.45 (95% CI 0.39 to 2.52) kg/m² higher and Middle Eastern women had 1.43 (0.16 to 2.70) kg/m2 higher mean BMI increase from 18 years to postpartum than Western European women. Among multiparous women, the mean BMI increased 1.99 (1.02 to 2.95) kg/m2 more in South Asian women, 1.48 (0.31 to 2.64) kg/m2 more in Middle Eastern women and 2.49 (0.55 to 4.42) kg/m2 more in African women than in Western European women from 18 years to prepregnancy. From 18 years to postpartum, the mean increase was 4.40 (2.38 to 6.42) kg/m2 higher in African women and 1.94 to 2.78 kg/m2 higher in the other groups than in Western European women. CONCLUSIONS Multiparous women of ethnic minority origin seem substantially more prone to long-term weight gain than multiparous Western European women in Norway.
Collapse
Affiliation(s)
- Tarja I Kinnunen
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Kåre R Richardsen
- Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
| | - Line Sletner
- Department of Child and Adolescents Medicine, Akershus University Hospital, Lørenskog, Norway
| | - Leila Torgersen
- Department of Child Development, Norwegian Institute of Public Health, Oslo, Norway
| | - Christine Sommer
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - Christin W Waage
- Institute of Health and Society, Department of General Practice, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ibrahimu Mdala
- General Practice Research Unit (AFE), Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Anne Karen Jenum
- General Practice Research Unit (AFE), Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
| |
Collapse
|
5
|
Assari S. Depressive Symptoms Increase the Risk of Mortality for White but Not Black Older Adults. Healthcare (Basel) 2018; 6:E36. [PMID: 29690578 PMCID: PMC6026472 DOI: 10.3390/healthcare6020036] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 03/22/2018] [Accepted: 03/23/2018] [Indexed: 11/16/2022] Open
Abstract
Introduction. Long-term studies have shown that depressive symptoms predict the risk of mortality. However, it is unknown if this effect is present in shorter time intervals. In addition, recent research suggests that the salience of the negative affect on the risk of mortality is not similar across racial groups. The current study uses data from a national study of Black and White older adults to examine racial differences in the effect of baseline depressive symptoms on mortality risk over three years in the United States. Methods. This study used a longitudinal prospective design and followed 1493 older adults who were either White (n = 759) or Black (n = 734) for three years from 2001 to 2004. Depressive symptoms measured at baseline was the independent variable. Demographic factors, socio-economic characteristics (education, income, marital status), health behaviors (smoking and drinking), and health (self-rated health) measured at baseline in 2001 were covariates. The dependent variable was all-cause mortality between 2001 and 2004. Race was the moderator. Logistic regressions were used for data analysis. Results. In the pooled sample, high depressive symptoms at baseline were not associated with the three-year risk of mortality. In the pooled sample, we found a significant interaction between race and depressive symptoms on mortality, suggesting a stronger effect for Whites in comparison to Blacks. In race stratified models, depressive symptoms at baseline were predictive of mortality risk for Whites, but not Blacks. Conclusions. In the United States, Black-White differences exist in the effects of depressive symptoms on mortality risk in older adults. White older adults may be more vulnerable to the effects of depressive symptoms on mortality risk.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109, USA.
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA.
| |
Collapse
|
6
|
Assari S. Race and Ethnic Differences in Additive and Multiplicative Effects of Depression and Anxiety on Cardiovascular Risk. Int J Prev Med 2016; 7:22. [PMID: 26941923 PMCID: PMC4755257 DOI: 10.4103/2008-7802.173931] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 04/03/2015] [Indexed: 11/05/2022] Open
Affiliation(s)
- Shervin Assari
- Department of Psychiatry, School of Medicine, University of Michigan, Ann Arbor, MI, USA
- Center for Research on Ethnicity, Culture, and Health, University of Michigan School of Public Health, Ann Arbor, MI, USA
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
| |
Collapse
|
7
|
Bailey ZD, Williams DR, Kawachi I, Okechukwu CA. Incarceration and adult weight gain in the National Survey of American Life (NSAL). Prev Med 2015; 81:380-6. [PMID: 26456214 PMCID: PMC4958024 DOI: 10.1016/j.ypmed.2015.09.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Revised: 09/22/2015] [Accepted: 09/26/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND The United States has the unenviable distinction of having both the highest obesity rate among Organisation for Economic Co-operation and Development (OECD) member countries and the highest incarceration rate in the world. Further, both are socially patterned by race/ethnicity and socioeconomic position. Incarceration involves various health behaviors that could influence adult weight trajectory. METHODS We evaluated the associations between history and duration of adult incarceration and weight gain using the National Survey of American Life (N=6082 adults residing in the 48 contiguous states between February 2001 and March 2003). We propensity score-matched individuals to control for the probability of having a history of incarceration. To examine the relation between prior incarceration and adult weight gain, we fit gender-stratified generalized estimating equations controlling for propensity of incarceration history, age, education, income, race/ethnicity, and marital status. RESULTS For males (N=563), incarceration was associated with about a 1.77 kg/m(2) lower gain in body mass index (BMI) during adulthood, after adjusting for age, education, income, race/ethnicity, and marital status in addition to the propensity of having a history of incarceration (95% CI: -2.63, -0.92). For females (N=286), no significant overall relationship was found between a history of incarceration and adult weight gain. In subgroup analyses among those with an incarceration history, we found no overall association between duration of incarceration and adult weight gain in men or women. In sensitivity analyses, neither tobacco smoking nor parity changed the results. CONCLUSIONS The results of this study indicate that incarceration is associated with a lower transition of weight gain in males, but not in females..
Collapse
Affiliation(s)
- Zinzi D Bailey
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA; Montreal Health Equity Research Consortium, Institute of Health and Social Policy, McGill University, Montreal, QC, Canada.
| | - David R Williams
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA
| | - Cassandra A Okechukwu
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA
| |
Collapse
|