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Cao X, Wang M, Zhou M, Mi Y, Fazekas-Pongor V, Major D, Lehoczki A, Guo Y. Trends in prevalence, mortality, and risk factors of dementia among the oldest-old adults in the United States: the role of the obesity epidemic. GeroScience 2024; 46:4761-4778. [PMID: 38696055 PMCID: PMC11336039 DOI: 10.1007/s11357-024-01180-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 04/25/2024] [Indexed: 08/22/2024] Open
Abstract
The oldest-old population, those aged ≥ 80 years, is the fastest-growing group in the United States (US), grappling with an increasingly heavy burden of dementia. We aimed to dissect the trends in dementia prevalence, mortality, and risk factors, and predict future levels among this demographic. Leveraging data from the Global Burden of Disease Study 2019, we examined the trends in dementia prevalence, mortality, and risk factors (with a particular focus on body mass index, BMI) for US oldest-old adults. Through decomposition analysis, we identified key population-level contributors to these trends. Predictive modeling was employed to estimate future prevalence and mortality levels over the next decade. Between 1990 and 2019, the number of dementia cases and deaths among the oldest-old in the US increased by approximately 1.37 million and 60,000 respectively. The population growth and aging were highlighted as the primary drivers of this increase. High BMI emerged as a growing risk factor. Females showed a disproportionately higher dementia burden, characterized by a unique risk factor profile, including BMI. Predictions for 2030 anticipate nearly 4 million dementia cases and 160,000 related deaths, with a marked increase in prevalence and mortality anticipated among those aged 80-89. The past 30 years have witnessed a notable rise in both the prevalence and mortality of dementia among the oldest-old in the US, accompanied by a significant shift in risk factors, with obesity taking a forefront position. Targeted age and sex-specific public health strategies that address obesity control are needed to mitigate the dementia burden effectively.
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Affiliation(s)
- Xueshan Cao
- Department of Occupational Health and Environmental Health, School of Public Health, Hebei Key Laboratory of Environment and Human Health , Hebei Medical University, Shijiazhuang, Hebei, China
| | - Minmin Wang
- Department of Global Health, School of Public Health, Peking University, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Mengge Zhou
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Yuanqi Mi
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | | | - David Major
- Department of Public Health, Semmelweis University, Budapest, Hungary
| | - Andrea Lehoczki
- Department of Public Health, Semmelweis University, Budapest, Hungary
- Doctoral College, Health Sciences Program, Semmelweis University, Budapest, Hungary
- Department of Haematology and Stem Cell Transplantation, National Institute for Haematology and Infectious Diseases, South Pest Central Hospital, Budapest, Hungary
| | - Yang Guo
- Department of Epidemiology and Statistics, School of Public Health, Hebei Key Laboratory of Environment and Human Health, Hebei Medical University, Shijiazhuang, Hebei, China.
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Owens S, Seto E, Hajat A, Fishman P, Koné A, Jones-Smith JC. Assessing the Influence of Redlining on Intergenerational Wealth and Body Mass Index Through a Quasi-experimental Framework. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-02044-7. [PMID: 38849692 DOI: 10.1007/s40615-024-02044-7] [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] [Received: 01/04/2024] [Revised: 05/24/2024] [Accepted: 05/27/2024] [Indexed: 06/09/2024]
Abstract
BACKGROUND Higher levels of body mass index (BMI), particularly for those who have obesity defined as class II and III, are correlated with excess risk of all-cause mortality in the USA, and these risks disproportionately affects marginalized communities impacted by systemic racism. Redlining, a form of structural racism, is a practice by which federal agencies and banks disincentivized mortgage investments in predominantly racialized minority neighborhoods, contributing to residential segregation. The extent to which redlining contributes to current-day wealth and health inequities, including obesity, through wealth pathways or limited access to health-promoting resources, remains unclear. Our quasi-experimental study aimed to investigate the generational impacts of redlining on wealth and body mass index (BMI) outcomes. METHODS We leveraged the Panel Study of Income Dynamics (PSID) and Home Owners' Loan Corporation (HOLC) maps to implement a geographical regression discontinuity design, where treatment assignment is randomly based on the boundary location of PSID grandparents in yellowlined vs. redlined areas and used outcome measures of wealth and mean BMI of grandchildren. To estimate our effects, we used a continuity-based approach and applied data-driven procedures to identify the most appropriate bandwidths for a valid estimation and inference. RESULTS In our fully adjusted model, grandchildren with grandparents living in redlined areas had lower average household wealth (β = - $35,419; 95% CIrbc - $37,423, - $7615) and a notably elevated mean BMI (β = 7.47; 95% CIrbc - 4.00, 16.60), when compared to grandchildren whose grandparents resided in yellowlined regions. CONCLUSION Our research supports the idea that redlining, a historical policy rooted in structural racism, is a key factor contributing to disparities in wealth accumulation and, conceivably, body mass index across racial groups.
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Affiliation(s)
- Shanise Owens
- Department of Health Systems and Population Health, School of Public Health, University of Washington, 3980 15Th Ave NE, Fourth Floor, Seattle, WA, 98195, USA.
| | - Edmund Seto
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Anjum Hajat
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Paul Fishman
- Department of Health Systems and Population Health, School of Public Health, University of Washington, 3980 15Th Ave NE, Fourth Floor, Seattle, WA, 98195, USA
| | - Ahoua Koné
- Department of Global Health, School of Public Health, University of Washington, Seattle, WA, USA
| | - Jessica C Jones-Smith
- Department of Health Systems and Population Health, School of Public Health, University of Washington, 3980 15Th Ave NE, Fourth Floor, Seattle, WA, 98195, USA
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
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Mao X, Yang Y, Yang J, Chen M, Hao Z. Association between body roundness index and prevalence of kidney stone in the U.S: a study based on the NHANES database. BMC Urol 2024; 24:93. [PMID: 38643130 PMCID: PMC11031997 DOI: 10.1186/s12894-024-01433-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 02/19/2024] [Indexed: 04/22/2024] Open
Abstract
OBJECTIVE This study aimed to evaluate the potential association between the body roundness index (BRI) and kidney stone prevalence in adults in the United States. METHODS A cohort of participants from the National Health and Nutrition Examination Survey (NHANES) database spanning 2007-2018 were gathered for analysis. Logistic regression analyses, subgroup assessments, and calculations were employed to examine the potential link between BRI and kidney stone prevalence. RESULTS The study included 30,990 participants aged > 20 years, of which 2,891 declared a kidney stone history. After modulating all relevant confounding factors, each unit increase in the BRI was linked to a 65% increase in kidney stone prevalence (OR = 1.65, 95% CI: 1.47, 1.85). Sensitivity analyses conducted by categorizing the BRI into three groups revealed a 59% increase in kidney stone prevalence in the highest tertile BRI group compared to the lowest one (OR = 1.59, 95% CI: 1.42, 1.79). Furthermore, dose-response curves depicted a positive near-linear correlation between the BRI and the risk of kidney stone prevalence. CONCLUSION These findings suggest a clinically noteworthy positive correlation between higher BRI values and kidney stone prevalence among the studied US adult population. However, it is essential to acknowledge that the observed relationship does not establish a causal link.
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Affiliation(s)
- Xike Mao
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China
- Institute of Urology, Anhui Medical University, Hefei, 230022, Anhui, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, 230022, Anhui, China
| | - Yuehan Yang
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China
- Institute of Urology, Anhui Medical University, Hefei, 230022, Anhui, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, 230022, Anhui, China
| | - Junping Yang
- Department of General Practice, Wuhu City SecondPeoplès Hospital, Wuhu, Anhui, China
| | - Mingwei Chen
- Department of Endocrinology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
| | - Zongyao Hao
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China.
- Institute of Urology, Anhui Medical University, Hefei, 230022, Anhui, China.
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, 230022, Anhui, China.
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Wilcox H, Bishop S, Francis B, Lombard K, Beresford SAA, Ornelas IJ. Process evaluation of the Yéego! Program to increase healthy eating and gardening among American Indian elementary school children. BMC Public Health 2024; 24:232. [PMID: 38243203 PMCID: PMC10797868 DOI: 10.1186/s12889-024-17689-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 01/06/2024] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND American Indian children are at increased risk for obesity and diabetes. School-based health promotion interventions are one approach to promoting healthy behaviors to reduce this risk, yet few studies have described their implementation and fidelity. We conducted a qualitative process evaluation of the Yéego! Healthy Eating and Gardening Program, a school-based intervention to promote healthy eating among Navajo elementary school children. The intervention included a yearlong integrated curriculum, as well as the construction and maintenance of a school-based garden. METHODS Our process evaluation included fidelity checklists completed by program staff and qualitative interviews with program staff and classroom teachers after the intervention was implemented. We used content analysis to identify themes. RESULTS We identified several themes related to evidence of delivery adherence, program satisfaction, and lessons learned about delivery. Intervention staff followed similar procedures to prepare for and deliver lessons, but timing, teaching styles, and school-level factors also impacted overall implementation fidelity. Teachers and students had positive perceptions of the program, especially lessons that were highly visual, experiential, and connected to Navajo culture and the surrounding community. Teachers and program staff identified ways to enhance the usability of the curriculum by narrowing the scope, relating content to student experiences, and aligning content with school curriculum standards. CONCLUSIONS The program was implemented with moderately high fidelity across contexts. We identified areas where modifications could improve engagement, acceptability, efficacy, and sustainability of the program. Our results have implications for the evaluation and dissemination of school-based health interventions to promote healthy eating among children, especially in American Indian communities.
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Affiliation(s)
- Heather Wilcox
- University of Washington, Box 351621, Seattle, WA, 98195, USA
| | - Sonia Bishop
- Fred Hutchinson Cancer Research Center, Seattle, USA
| | | | | | | | - India J Ornelas
- University of Washington, Box 351621, Seattle, WA, 98195, USA.
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Berberoğlu Z, Hocaoğlu Ç. The Relationship Between Childhood Trauma and Body Image, Self-Esteem and Eating Attitudes in Patients undergoing Bariatric Surgery. TURK PSIKIYATRI DERGISI = TURKISH JOURNAL OF PSYCHIATRY 2024; 35:116-126. [PMID: 38842153 PMCID: PMC11164075 DOI: 10.5080/u26831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 05/16/2022] [Indexed: 06/07/2024]
Abstract
OBJECTIVE Psychiatric evaluation of candidate patients before bariatric surgery (BS) has an important place in the success of the treatment. In this study, it was aimed to examine the relationship between childhood trauma (CT) and body image, self-esteem and eating attitudes of individuals who applied for BS. METHOD A total of 87 BS candidate patients with morbid obesity, 57 women and 30 men, were included in the study. Sociodemographic Information Form, Childhood Trauma Questionnaire (CTQ), Body Perception Scale (BPS), Rosenberg Self-Esteem Scale (RSES), and Eating Attitude Test (EAT-40) were used as data collection tools in the study. RESULTS CT was detected in 47.1% of the cases. RSES (t=3.296; p<0.01) and BPS (t=3.267; p<0.01) scores were found to be significantly higher in those with a history of CT. A positive and significant relationship was found between EAT-40 and CTQ -sexual abuse (SA) sub-dimension (r=0.570; p<0.01). A significant relationship was found between all subdimensions of CTQ and RSES. A significant relationship was found between CTQ physical neglect (PN), emotional neglect (EN), and emotional abuse (EA) sub-dimensions and BPS. In addition, CTQ total score was found to significantly and negatively predict self-esteem (β=- 4.432; p<0.001) and body image (β=-3.700; p<0.001). CONCLUSION In our study, it was found that those with CT were dissatisfied with their bodies and had lower self-esteem. Questioning CT in the psychological evaluation of pre-BS cases may contribute to the understanding of the etiology of obesity and may play an important role in planning the follow-up after BS.
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Affiliation(s)
- Ziya Berberoğlu
- Ph.D, OkanUniversity, Institute of Social Sciences, Department of Pyschology, İstanbul
| | - Çiçek Hocaoğlu
- Prof., Recep Tayyip Erdoğan University, Faculty of Medicine, Department of Psychiatry, Rize, Turkey
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Xu S, Ren R, Li W, Liang Y, Ma J, Zheng Y, Zhao W, Ma Y, Zhou T, Zhang Y. The association between obesity indicators and metabolic risk factors in type-2 diabetic patients. Heliyon 2023; 9:e20013. [PMID: 37809456 PMCID: PMC10559737 DOI: 10.1016/j.heliyon.2023.e20013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 09/06/2023] [Accepted: 09/08/2023] [Indexed: 10/10/2023] Open
Abstract
Rationale and objectives Obesity, accumulation of adipose tissue, is a global disease that can lead to cardiovascular and metabolic complications. The aim of this study was to investigate the relationship between obesity indicators and metabolic risk factors in type 2 diabetes mellitus (T2DM) patients. Materials and methods A total of 337 T2DM subjects were included in our study. The metabolic risk factors including diabetes duration, fast plasma glucose (FPG), height, weight, systolic blood pressure (SBP), diastolic blood pressure (DBP), estimated average glucose (eAG), glycated hemoglobin (HbA1c), total cholesterol (TC), high-density lipoprotein-cholesterol (HDL-c), low-density lipoprotein-cholesterol (LDL-c), triglyceride (TG), blood urea nitrogen (BUN), serum creatinine (Scr), free fatty acid (FFA), uric acid (UA), cystatin c (cysc), albumin (Alb), urinary albumin creatinine ratio (UACR) were recorded. The obesity indicators included body surface area (BSA), body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), para-perirenal fat thickness (PRFT), total abdominal fat (TAF), subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT). The association between obesity indicators and metabolic risk factors was investigated by univariate and multivariate analysis. Results HDL-c was independently associated with WHR and PRFT (β = -0.126 vs. -0.214, both p < 0.05). TG and Scr were both independently associated with PRFT (β = 0.173 vs. 0.218, both p < 0.01, respectively). UA was independently associated with BSA (β = 0.172, p < 0.01) and PRFT (β = 0.151, p < 0.01). cysc, Alb and UACR were independently associated with WC (β = 0.274 vs. 0.204 vs. 0.182, all p < 0.01). Conclusion In T2DM patients, obesity indicators were significantly associated with metabolic risk factors.
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Affiliation(s)
- Sunan Xu
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, China
| | - Ruichen Ren
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, China
| | - Wenting Li
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, China
| | - Yongfeng Liang
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, China
| | - Junqing Ma
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, China
| | - Yongze Zheng
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, China
| | - Wei Zhao
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, China
| | - Yu Ma
- Department of Radiology, Shandong Rongjun General Hospital, Jinan, China
| | - Tao Zhou
- Department of Radiology, Tai'an First People's Hospital, Tai'an, Shandong, China
| | - Yang Zhang
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, China
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Linn W, Persson M, Rathsman B, Ludvigsson J, Lind M, Andersson Franko M, Nyström T. Estimated glucose disposal rate is associated with retinopathy and kidney disease in young people with type 1 diabetes: a nationwide observational study. Cardiovasc Diabetol 2023; 22:61. [PMID: 36935526 PMCID: PMC10024828 DOI: 10.1186/s12933-023-01791-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 03/05/2023] [Indexed: 03/21/2023] Open
Abstract
AIMS The aim of this study was to investigate the association between estimated glucose disposal rate (eGDR), a proxy for insulin resistance, and retinopathy or kidney disease, i.e. micro-, or macroalbuminuria, in young individuals with type 1 diabetes (T1D). MATERIAL AND METHODS Using data from the Swedish pediatric registry for diabetes (SweDiabKids) and the registry for adults (NDR), all individuals with T1D with a duration of diabetes of less than 10 years between 1998 and 2017 were included. We calculated the crude incidence rates with 95% confidence intervals (CIs) and used multivariable Cox regression to estimate crude and adjusted hazard ratios (HRs) for two cohorts: retinopathy cohort or kidney disease cohort, stratified by eGDR categories: < 4, 4 to 5.99, 6 to 7.99, and ≥ 8 mg/kg/min (reference). RESULTS A total of 22 146 (10 289 retinopathy cohort, and 11 857 kidney disease cohort with an overlapping of 9575) children and adults with T1D (median age 21 years, female 42% and diabetes duration of 6 and 7 years, respectively for the cohorts) were studied. During a median follow-up of 4.8 years (IQR 2.6-7.7) there were 5040 (24.7%), 1909 (48.1%), 504 (52.3%) and 179 (57.6%) events for retinopathy in individuals with an eGDR ≥ 8, 7.99 to 6, 5.99 to 4, and < 4 mg/kg/min, respectively. Corresponding numbers for kidney disease was 1321 (6.5%), 526 (13.3%), 255 (26.8%) and 145 (46.6%). After multiple adjustments for different covariates, individuals with an eGDR 7.99 to 6, 5.99 to 4 and < 4 mg/kg/min, had an increased risk of retinopathy compared to those with an eGDR ≥ 8 mg/kg/min (adjusted HRs, 95% CIs) 1.29 (1.20 to 1.40); 1.50 (1.31 to 1.71) and 1.74 (1.41 to 2.14). Corresponding numbers for kidney disease was (adjusted HRs, 95% CIs) 1.30 (1.11 to 1.52); 1.58 (1.25 to 1.99) and 1.33 (0.95 to 1.86), respectively. CONCLUSIONS eGDR, a proxy for insulin resistance, is associated with retinopathy and kidney disease in young adults with T1D. The risk of retinopathy increased with lower eGDR. The risk of kidney disease also increased with lower eGDR; however results show no association between the lowest eGDR and kidney disease. eGDR can be helpful to identify young T1D individuals at risk.
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Affiliation(s)
- Wedén Linn
- Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Sjukhusbacken 10, 118 83, Stockholm, Sweden
| | - Martina Persson
- Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | - Björn Rathsman
- Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | - Johnny Ludvigsson
- Division of Paediatrics, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Crown Princess Victoria Children's Hospital, Region Östergötland, Linköping, Sweden
| | - Marcus Lind
- Department of Medicine, NU Hospital Group, Uddevalla, Sweden
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Mikael Andersson Franko
- Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Sjukhusbacken 10, 118 83, Stockholm, Sweden
| | - Thomas Nyström
- Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Sjukhusbacken 10, 118 83, Stockholm, Sweden.
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Al-Shihabi F, Moore A, Chowdhury TA. Diabetes and climate change. Diabet Med 2023; 40:e14971. [PMID: 36209378 DOI: 10.1111/dme.14971] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 10/03/2022] [Indexed: 11/26/2022]
Abstract
It is widely accepted that climate change is the biggest threat to human health. The pandemic of diabetes is also a major threat to human health, especially in rapidly developing nations. Climate change and diabetes appear to have common global vectors, including increased urbanisation, increased use of transportation, and production and ingestion of ultra-processed foods. People with diabetes appear to be at higher risk of threats to health from climate change, including effects from extreme heat or extreme cold, and natural disasters. Solutions to climate change offer some benefits for the prevention of diabetes and diabetes-related complications. Moving towards lower carbon economies is likely to help reduce reliance on intensive agriculture, reduce physical inactivity, reduce air pollution and enhance quality of life. It may enable a reduction in the prevalence of diabetes and reduced morbidity from the condition.
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Affiliation(s)
- Fatima Al-Shihabi
- Department of Diabetes and Metabolism, Royal London Hospital, London, UK
| | - Anna Moore
- Department of Diabetes and Metabolism, Royal London Hospital, London, UK
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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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Hayward MD, Farina MP, Zhang YS, Kim JK, Crimmins EM. The Importance of Improving Educational Attainment for Dementia Prevalence Trends From 2000 to 2014, Among Older Non-Hispanic Black and White Americans. J Gerontol B Psychol Sci Soc Sci 2021; 76:1870-1879. [PMID: 33481025 PMCID: PMC8557827 DOI: 10.1093/geronb/gbab015] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES While a number of studies have documented a notable decline in age-standardized prevalence in dementia in the U.S. population, relatively little is known about how dementia has declined for specific age and race groups, and the importance of changing educational attainment on the downward trend. We assess (a) how the trends in dementia prevalence may have differed across age and race groups and (b) the role of changing educational attainment in understanding these trends. METHODS This article estimates a series of logistic regression models using data from the Health and Retirement Study (2000-2014) to assess the relative annual decline in dementia prevalence and the importance of improving educational attainment for non-Hispanic Whites and non-Hispanic Blacks. RESULTS Consistent with other studies, we found significant declines in dementia for non-Hispanic Blacks and non-Hispanic Whites across this period. Nonetheless, these declines were not uniform across age and race groups. Non-Hispanic Blacks aged 65-74 years had the steepest decline in this period. We also found that improved educational attainment in the population was fundamentally important in understanding declining dementia prevalence in the United States. DISCUSSION This study shows the importance of improvement in educational attainment in the early part of the twentieth century to understand the downward trend in dementia prevalence in the United States from 2000 to 2014.
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Affiliation(s)
| | | | - Yuan S Zhang
- University of North Carolina at Chapel Hill, USA
| | - Jung Ki Kim
- University of Southern California, Los Angeles, USA
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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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12
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Danilovic A, Marchini GS, Pucci ND, Coimbra B, Torricelli FCM, Batagello C, Vicentini FC, Srougi M, Nahas WC, Mazzucchi E. Effect of a low-calorie diet on 24-hour urinary parameters of obese adults with idiopathic calcium oxalate kidney stones. Int Braz J Urol 2021; 47:1136-1147. [PMID: 34469666 PMCID: PMC8486438 DOI: 10.1590/s1677-5538.ibju.2021.0140] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 05/15/2021] [Indexed: 12/13/2022] Open
Abstract
Purpose: to evaluate the effect of low-calorie diet on 24-hour urinary metabolic parameters of obese adults with idiopathic calcium oxalate kidney stones. Materials and Methods: Adult idiopathic calcium oxalate stone formers, with body mass index (BMI) ≥30kg/m2 and a known lithogenic metabolic abnormality, were submitted to low-calorie diet for twelve weeks. After enrolment, anthropometric measures, serum exams, 24-hour urinary metabolic parameters and body impedance were collected one month prior to dietary intervention and at the end of twelve weeks. Correlations between weight loss, waist circumference loss, fat loss and variation in 24-hour urinary lithogenic parameters and calcium oxalate urinary supersaturation (CaOx SS) as per Tiselius equation were analysed. Results: From January 2017 to January 2018, 39 patients were enrolled to participate in this study. Median (range) prescribed diet was 1300 (1100-2100) Kcal/day. Mean age was 51.7±11.0 (29-68) years old and 69.2% were female. 30.8% of the participants shifted from obesity to BMI <30kg/m2 and none to BMI <25kg/m2. A significant correlation was found between baseline 24-hour urinary oxalate and weight (p=0.018) and BMI (p=0.026). No correlation was found between variation of weight, waist circumference, fat mass and 24-h urinary stone risk factors or CaOx SS. Conclusions: Short-term modest weight loss induced by twelve weeks of low-calorie diet is not associated with a decrease of 24-hour urinary lithogenic parameters in idiopathic calcium oxalate stone formers. Calcium oxalate urinary stone formation is probably multifactorial and driven by other factors than weight.
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Affiliation(s)
- Alexandre Danilovic
- Departamento de Urologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil
| | - Giovanni Scala Marchini
- Departamento de Nutrição, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil
| | - Nidia Denise Pucci
- Departamento de Nutrição, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil
| | - Brian Coimbra
- Departamento de Urologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil
| | - Fabio Cesar Miranda Torricelli
- Departamento de Urologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil
| | - Carlos Batagello
- Departamento de Urologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil
| | - Fabio Carvalho Vicentini
- Departamento de Urologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil
| | - Miguel Srougi
- Departamento de Urologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil
| | - William C Nahas
- Departamento de Urologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil
| | - Eduardo Mazzucchi
- Departamento de Urologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil
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13
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Elangovan A, Skeans J, Landsman M, Ali SMJ, Elangovan AG, Kaelber DC, Sandhu DS, Cooper GS. Colorectal Cancer, Age, and Obesity-Related Comorbidities: A Large Database Study. Dig Dis Sci 2021; 66:3156-3163. [PMID: 32954457 DOI: 10.1007/s10620-020-06602-x] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 09/03/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS The association between obesity and colorectal cancer (CRC) is well established in older individuals, but evidence is limited in the younger population. The study aims to analyze the relationship of obesity and its related comorbidities in early-onset CRC (E-CRC) and compare it to late-onset CRC (L-CRC). METHODS A retrospective, cross-sectional study was performed on average-risk individuals ≥ 20 years who were active patients in the commercial database, IBM Watson Health Explorys in the last 5 years. Individuals with CRC were compared to those without CRC across different age groups (20-39, 40-49, and 50-74 years). Individuals with CRC diagnosed < 50 years (E-CRC) were compared to those with CRC between 50 and 74 years (L-CRC). Variables included sex, smoking, obese BMI, diabetes mellitus type 2 (DM2), hypertension (HTN), and hyperlipidemia (HLD). Since Explorys aggregates population-level, de-identified data, approval from institutional review board was not required. RESULTS Among 37,483,140 individuals, 162,150 cases of sporadic CRC were identified. Compared to the general population, obesity and HLD were independent risk factors for CRC across all age groups; DM2, HTN, and smoking were independent risk factors for CRC in men of all age groups and women with L-CRC. Compared to L-CRC, individuals with E-CRC had lower percentages of obesity-related comorbidities. CONCLUSION In E-CRC, obesity, DM2, HTN, HLD, and smoking are independent risk factors for CRC among men; obesity and HLD are independent risk factors for CRC in women. These subgroups may benefit from a personalized screening approach to detect early-onset CRC.
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Affiliation(s)
- Abbinaya Elangovan
- Department of Internal Medicine-Pediatrics, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Jacob Skeans
- Division of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Marc Landsman
- Department of Gastroenterology and Hepatology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Sajjadh M J Ali
- Department of Internal Medicine, Saint Vincent Hospital, Worchester, MA, USA
| | | | - David C Kaelber
- Department of Internal Medicine-Pediatrics, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Dalbir S Sandhu
- Department of Gastroenterology, Hepatology and Nutrition, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Gregory S Cooper
- Division of Gastroenterology, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Wearn 244, Cleveland, OH, 44106-5066, USA.
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14
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Ong LQ, Bellettiere J, Alvarado C, Chavez P, Berardi V. Cannabis use, sedentary behavior, and physical activity in a nationally representative sample of US adults. Harm Reduct J 2021; 18:48. [PMID: 33926458 PMCID: PMC8086340 DOI: 10.1186/s12954-021-00496-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 04/20/2021] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Prior research examining the relationship between cannabis use, sedentary behavior, and physical activity has generated conflicting findings, potentially due to biases in the self-reported measures used to assess physical activity. This study aimed to more precisely explore the relationship between cannabis use and sedentary behavior/physical activity using objective measures. METHODS Data were obtained from the 2005-2006 National Health and Nutrition Examination Survey. A total of 2,092 participants (ages 20-59; 48.8% female) had accelerometer-measured sedentary behavior, light physical activity, and moderate-to-vigorous physical activity. Participants were classified as light, moderate, frequent, or non-current cannabis users depending on how often they used cannabis in the previous 30 days. Multivariable linear regression estimated minutes in sedentary behavior/physical activity by cannabis use status. Logistic regression modeled self-reported moderate-to-vigorous physical activity in relation to current cannabis use. RESULTS Fully adjusted regression models indicated that current cannabis users' accelerometer-measured sedentary behavior did not significantly differ from non-current users. Frequent cannabis users engaged in more physical activity than non-current users. Light cannabis users had greater odds of self-reporting physical activity compared to non-current users. CONCLUSIONS This study is the first to evaluate the relationship between cannabis use and accelerometer-measured sedentary behavior and physical activity. Such objective measures should be used in other cohorts to replicate our findings that cannabis use is associated with greater physical activity and not associated with sedentary behavior in order to fully assess the potential public health impact of increases in cannabis use.
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Affiliation(s)
- Lydia Q Ong
- Department of Psychology, University of British Columbia, 2136 West Mall, Vancouver, BC, V6T 1Z4, USA
| | - John Bellettiere
- Herbert Wertheim School of Public Health and Longevity Science, University of California San Diego, 9500 Gillman Drive, San Diego, CA, 92093, USA.
| | - Citlali Alvarado
- Graduate School of Public Health, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182, USA
| | - Paul Chavez
- Herbert Wertheim School of Public Health and Longevity Science, University of California San Diego, 9500 Gillman Drive, San Diego, CA, 92093, USA
| | - Vincent Berardi
- Department of Psychology, Chapman University, 1 University Drive, Orange, CA, 92866, USA.
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15
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US Obesity Mortality Trends and Associated Noncommunicable Diseases Contributing Conditions Among White, Black, and Hispanic Individuals by Age from 1999 to 2017. ACTA ACUST UNITED AC 2021; 3:1334-1343. [PMID: 33842841 PMCID: PMC8020827 DOI: 10.1007/s42399-021-00850-2] [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] [Subscribe] [Scholar Register] [Accepted: 03/04/2021] [Indexed: 12/11/2022]
Abstract
This study aims to assess the effect of obesity as an underlying cause of death in association with four main noncommunicable diseases (NCDs) as contributing causes of mortality on the age of death in White, Black, and Hispanic individuals in the USA. To estimate mortality hazard ratios, we ran a Cox regression on the US National Center for Health Statistics mortality integrated datasets from 1999 to 2017, which included almost 48 million cases. The variable in the model was the age of death in years as a proxy for time to death. The cause-of-death variable allowed for the derivation of predictor variables of obesity and the four main NCDs. The overall highest obesity mortality HR when associated with NCD contributing conditions for the year 1999-2017 was diabetes (2.15; 95% CI: 2.11-2.18), while Whites had the highest HR (2.46; 95% CI: 2.41-2.51) when compared with Black (1.32; 95% CI: 1.27-1.38) and Hispanics (1.25; 95% CI: 1.18-1.33). Hispanics had lower mortality HR for CVD (1.21; 95% CI: 1.15-1.27) and diabetes (1.25; 95% CI: 1.18-1.33) of the three studied groups. The obesity death mean was 57.3 years for all groups. People who die from obesity are, on average, 15.4 years younger than those without obesity. Although Hispanics in the USA have a higher prevalence of diabetes and cardiovascular disease (CVD), they also have the lowest mortality HR for obesity as an underlying cause of death when associated with CVD and cancer. While there is no obvious solution for obesity and its complications, continued efforts to address obesity are needed.
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16
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Hu EA, Pasupuleti M, Nguyen V, Langheier J, Shurney D. Sustaining weight loss among adults with obesity using a digital meal planning and food purchasing platform for 12, 24, and 36 months: a longitudinal study. Nutr J 2021; 20:8. [PMID: 33478516 PMCID: PMC7818217 DOI: 10.1186/s12937-021-00666-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 01/17/2021] [Indexed: 12/22/2022] Open
Abstract
Background Previous studies have shown that lifestyle changes, such as diet and exercise, can lead to weight loss, resulting in dramatic improvements in overall health and chronic disease risk. However, while many traditional dieting, food tracking and weight loss coaching programs result in short-term weight loss, there is less evidence of their effectiveness on sustaining weight loss over time. Methods We conducted a retrospective analysis of 1,740 adults with obesity who used Foodsmart, a digital personalized dietary assessment, meal planning and food purchasing platform. Participants reported age, gender, at least three measures of weight, and their diet using a food frequency questionnaire. We defined sustained weight loss as participants who lost 5 % of initial weight between their first and second reported weights and lost weight or maintained weight between second and third reported weights. A healthy eating score, Nutriscore, was calculated to assess overall diet quality. We used multivariate logistic regression models to examine the association between user characteristics and odds of sustained weight loss. Results Over a median of 25 months, the mean (standard deviation) change in weight among participants was − 6.2 (19.8) pounds. In total, 39.3 % (684/1,740) of participants lost at least 5 % of their initial weight, and 22.4 % percent (389/1,740) of participants sustained weight loss. In the fully-adjusted logistic regression model, we found that obesity class 2 (odds ratio, OR: 1.69, 95 % confidence interval, CI: 1.27–2.24, P < 0.001), obesity class 3 (OR: 2.23, 95 % CI: 1.68–2.97, P < 0.001), baseline diet quality (OR: 1.06, 95 % CI: 1.02–1.09, P < 0.001), and greater change in diet quality (OR: 1.10, 95 % CI: 1.07–1.14, P < 0.001) were significantly associated with sustained weight loss. Conclusions This study characterized and demonstrated the utility of Foodsmart, a digital platform that gives personalized nutrition recommendations and meal planning tools, in sustained weight reduction among users with obesity.
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Affiliation(s)
- Emily A Hu
- Zipongo, Inc, DBA Foodsmart, 595 Pacific Ave, 4th Floor, San Francisco, CA, 94133, USA.
| | - Mahesh Pasupuleti
- Zipongo, Inc, DBA Foodsmart, 595 Pacific Ave, 4th Floor, San Francisco, CA, 94133, USA
| | - Viet Nguyen
- Zipongo, Inc, DBA Foodsmart, 595 Pacific Ave, 4th Floor, San Francisco, CA, 94133, USA
| | - Jason Langheier
- Zipongo, Inc, DBA Foodsmart, 595 Pacific Ave, 4th Floor, San Francisco, CA, 94133, USA
| | - Dexter Shurney
- Adventist Health, 1 Adventist Health Way, Roseville, CA, 95661, USA
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17
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Codipilly DC, Sawas T, Dhaliwal L, Johnson ML, Lansing R, Wang KK, Leggett CL, Katzka DA, Iyer PG. Epidemiology and Outcomes of Young-Onset Esophageal Adenocarcinoma: An Analysis from a Population-Based Database. Cancer Epidemiol Biomarkers Prev 2021; 30:142-149. [PMID: 33328255 PMCID: PMC7855414 DOI: 10.1158/1055-9965.epi-20-0944] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 08/20/2020] [Accepted: 10/05/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Esophageal adenocarcinoma is a lethal cancer with rising incidence. There are limited data in younger (<50 years) patients with esophageal adenocarcinoma. We aimed to assess time trends in the incidence and outcomes of "young-onset" esophageal adenocarcinoma using a population-based database. METHODS We queried the Surveillance, Epidemiology, and End Results 9 database to identify patients with esophageal adenocarcinoma between 1975 and 2015. Patients were stratified into three age strata: <50, 50 to 69, and ≥70 years. Staging was stratified as localized, regional, and distant. Trends in incidence, disease stage, and survival were assessed in three periods (1975-89, 1990-99, and 2000-2015). Univariate and multivariate models were created to identify predictors of mortality. RESULTS Esophageal adenocarcinoma incidence has increased in patients <50 years of age, with an annual percentage change of 2.9% (95% confidence interval, 1.4%-4.4%) from 1975 to 2015. Young-onset esophageal adenocarcinoma presented at more advanced stages (regional + distant) compared with older patients (84.9% vs. 67.3%; P < 0.01), with increasing proportion of advanced stages over the study period. These patients also experienced poorer 5-year esophageal adenocarcinoma-free survival compared with older patients (22.9%% vs. 29.6%; P < 0.01), although this finding was attenuated on stage-stratified analysis. CONCLUSIONS Young-onset esophageal adenocarcinoma, while uncommon, is rising in incidence. Concerningly, the proportion of advanced disease continues to increase. Young-onset esophageal adenocarcinoma also presents at more advanced stages, resulting in poorer esophageal adenocarcinoma-free survival. IMPACT Patients with esophageal adenocarcinoma younger than 50 years present at more advanced stages with higher esophageal adenocarcinoma-specific mortality compared with older peers. Current diagnostic and management strategies for young-onset esophageal adenocarcinoma may need to be reevaluated.
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Affiliation(s)
- Don C Codipilly
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Tarek Sawas
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Lovekirat Dhaliwal
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Michele L Johnson
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Ramona Lansing
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Kenneth K Wang
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Cadman L Leggett
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - David A Katzka
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Prasad G Iyer
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota.
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18
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Hofseth LJ, Hebert JR, Chanda A, Chen H, Love BL, Pena MM, Murphy EA, Sajish M, Sheth A, Buckhaults PJ, Berger FG. Early-onset colorectal cancer: initial clues and current views. Nat Rev Gastroenterol Hepatol 2020; 17:352-364. [PMID: 32086499 PMCID: PMC10711686 DOI: 10.1038/s41575-019-0253-4] [Citation(s) in RCA: 210] [Impact Index Per Article: 52.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/05/2019] [Indexed: 02/07/2023]
Abstract
Over the past several decades, the incidence of early-onset colorectal cancer (EOCRC; in patients <50 years old) has increased at an alarming rate. Although robust and scientifically rigorous epidemiological studies have sifted out environmental elements linked to EOCRC, our knowledge of the causes and mechanisms of this disease is far from complete. Here, we highlight potential risk factors and putative mechanisms that drive EOCRC and suggest likely areas for fruitful research. In addition, we identify inconsistencies in the evidence implicating a strong effect of increased adiposity and suggest that certain behaviours (such as diet and stress) might place nonobese and otherwise healthy people at risk of this disease. Key risk factors are reviewed, including the global westernization of diets (usually involving a high intake of red and processed meats, high-fructose corn syrup and unhealthy cooking methods), stress, antibiotics, synthetic food dyes, monosodium glutamate, titanium dioxide, and physical inactivity and/or sedentary behaviour. The gut microbiota is probably at the crossroads of these risk factors and EOCRC. The time course of the disease and the fact that relevant exposures probably occur in childhood raise important methodological issues that are also discussed.
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Affiliation(s)
- Lorne J Hofseth
- Center for Colon Cancer Research, University of South Carolina, Columbia, SC, USA.
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA.
- Department of Drug Discovery and Biomedical Sciences, College of Pharmacy, University of South Carolina, Columbia, SC, USA.
| | - James R Hebert
- Center for Colon Cancer Research, University of South Carolina, Columbia, SC, USA
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA
- Department of Epidemiology & Biostatistics, University of South Carolina, Columbia, SC, USA
| | - Anindya Chanda
- Center for Colon Cancer Research, University of South Carolina, Columbia, SC, USA
- Department of Environmental Health Sciences, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Hexin Chen
- Center for Colon Cancer Research, University of South Carolina, Columbia, SC, USA
- Department of Biology, College of Arts and Sciences, University of South Carolina, Columbia, SC, USA
| | - Bryan L Love
- Center for Colon Cancer Research, University of South Carolina, Columbia, SC, USA
- Department of Clinical Pharmacy and Outcomes Sciences, College of Pharmacy, University of South Carolina, Columbia, SC, USA
| | - Maria M Pena
- Center for Colon Cancer Research, University of South Carolina, Columbia, SC, USA
- Department of Biology, College of Arts and Sciences, University of South Carolina, Columbia, SC, USA
| | - E Angela Murphy
- Center for Colon Cancer Research, University of South Carolina, Columbia, SC, USA
- Department of Pathology, Microbiology & Immunology, School of Medicine, University of South Carolina, Columbia, SC, USA
| | - Mathew Sajish
- Center for Colon Cancer Research, University of South Carolina, Columbia, SC, USA
- Department of Drug Discovery and Biomedical Sciences, College of Pharmacy, University of South Carolina, Columbia, SC, USA
| | - Amit Sheth
- Center for Colon Cancer Research, University of South Carolina, Columbia, SC, USA
- Department of Computer Science and Engineering, College of Engineering, University of South Carolina, Columbia, SC, USA
| | - Phillip J Buckhaults
- Center for Colon Cancer Research, University of South Carolina, Columbia, SC, USA
- Department of Drug Discovery and Biomedical Sciences, College of Pharmacy, University of South Carolina, Columbia, SC, USA
| | - Franklin G Berger
- Center for Colon Cancer Research, University of South Carolina, Columbia, SC, USA
- Department of Biology, College of Arts and Sciences, University of South Carolina, Columbia, SC, USA
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19
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Cueva K, Speakman K, Neault N, Richards J, Lovato V, Parker S, Carroll D, Sundbo A, Barlow A. Cultural Connectedness as Obesity Prevention: Indigenous Youth Perspectives on Feast for the Future. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2020; 52:632-639. [PMID: 31924560 DOI: 10.1016/j.jneb.2019.11.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 11/12/2019] [Accepted: 11/18/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To describe a community-based obesity-prevention initiative that promoted cultural connectedness and traditional food revitalization and gained insight into youth participants' perspectives on the program through a photovoice methodology. METHODS Photovoice methods were used with fourth- and fifth-grade youths (aged 9-11 years) in the US Southwest who had participated in the Feast for the Future program. A total of 44 youths from 3 communities met for 8-9 sessions; they took photos of current food environments and traditional food systems, and discussed them as well as Feast for the Future and hopes for the future, and then prepared a final presentation. Photovoice sessions were recorded, transcribed verbatim, then open coded using Atlas.ti. RESULTS Five common themes emerged: traditional food is farmed or gardened, traditional foods are healthy, Feast for the Future supported positive connections to culture, hope for more farming or gardening for future generations, and store or less nutrient-dense food is unhealthy. CONCLUSIONS AND IMPLICATIONS Photovoice can be an effective way to engage Indigenous youths in conversations about their culture and food environments. The findings suggest that attention to revitalizing traditional food systems and supporting cultural connectedness may be an effective approach to obesity prevention in tribal communities, although future research would be needed to assess the impact of the intervention on obesity rates.
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Affiliation(s)
- Katie Cueva
- Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Anchorage, AK.
| | - Kristen Speakman
- Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Anchorage, AK
| | - Nicole Neault
- Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Anchorage, AK
| | - Jennifer Richards
- Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Anchorage, AK
| | - Ventura Lovato
- Native American Community Academy Inspired Schools Network
| | - Sean Parker
- Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Anchorage, AK
| | | | - Anna Sundbo
- Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Anchorage, AK
| | - Allison Barlow
- Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Anchorage, AK
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Abstract
PURPOSE OF REVIEW This review is an assessment of the state of the science on nutrition disparities and their contribution to disparities in cardiovascular health. RECENT FINDINGS Nutrition disparities remain pervasive by race/ethnicity, sex/gender, socioeconomic status, and geography. They are rooted in differences in social, cultural, and environmental determinants of health, behavioral and lifestyle factors, and the impact of policy interventions. Systematic differences in diet quality, dietary patterns, and nutrient intakes contribute to cardiovascular disparities and are mediated by microbiota, and CVD risk factors including high levels of blood pressure, low density lipoprotein cholesterol (LDL), and glucose; oxidative stress, pro-inflammatory cytokines, and endothelial dysfunction. Despite the progress made in nutrition research, important gaps persist that signal the need for more effective interventions at multiple levels to reduce cardiovascular disparities. Research opportunities include (1) exploring the gene-nutrient-environment interactions in the context of ancestral diversity; (2) investigating the causal link between diet and gut microbiota and impact of social determinants of health; (3) understanding resilience; (4) testing the effectiveness of multi-level interventions that address social and environmental determinants; and (4) supporting intervention research informed by validated implementation science frameworks.
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Affiliation(s)
- George A Mensah
- Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), 6705 Rockledge Drive, Suite 6070, Bethesda, MD, 20892, USA.
| | - Alison G M Brown
- Division of Cardiovascular Sciences, NHLBI, NIH, 6710 Rockledge Drive, Suite 10115, Bethesda, MD, 20892, USA
| | - Charlotte A Pratt
- Division of Cardiovascular Sciences, NHLBI, NIH, 6710 Rockledge Drive, Suite 10115, Bethesda, MD, 20892, USA
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21
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Zhao J, Sun J, Su C. Gender differences in the relationship between dietary energy and macronutrients intake and body weight outcomes in Chinese adults. Nutr J 2020; 19:45. [PMID: 32423458 PMCID: PMC7236212 DOI: 10.1186/s12937-020-00564-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 05/08/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND To explore the gender differences in the relationship between dietary energy and macronutrients intake and body weight outcomes in Chinese adults. METHODS Data from the China Health and Nutrition Survey (CHNS, 2015) for10,898 participants aged 18-64 years. Three consecutive 24-h dietary recalls was used to assess the dietary intake. Quantile regression models for body mass index (BMI) and waist circumference (WC) were performed separately for each sex. RESULTS Adult males showed greater absolute intakes of energy and macronutrients as compared to females as per the body weight outcomes. A 10% increase in BMI resulted in an additional intake of 0.002-0.004 kcal/d of dietary energy, 0.032-0.057 g/d of fats, 0.039-0.084 g/d of proteins, and 0.018-0.028 g/d of carbohydrates across all quantiles in males (p < 0.05). A 10% increase in WC lead to an additional intake of 0.004-0.008 kcal/d of dietary energy, 0.051-0.052 g/d of carbohydrates across the entire quantile in males (p < 0.05), and an increased intake of 0.060-0.150 kcal/d of fat in females (p < 0.05). CONCLUSIONS Dietary fat intake could be the risk factor of abdominal obesity in women. The importance of gender-specific evidence should be considered before promoting macronutrient allocation for the prevention and treatment of obesity.
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Affiliation(s)
- Jian Zhao
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences / School of Basic Medicine, Peking Union Medical College, Beijing, 100005 China
| | - Jian Sun
- School of Public Health & Management, Ningxia Medical University, Yinchuan, 750004 Ningxia China
| | - Chang Su
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Number 29, Nanwei Road, Xicheng District, Beijing, 100050 China
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Zhou J, Zhou F, Wang W, Zhang XJ, Ji YX, Zhang P, She ZG, Zhu L, Cai J, Li H. Epidemiological Features of NAFLD From 1999 to 2018 in China. Hepatology 2020; 71:1851-1864. [PMID: 32012320 DOI: 10.1002/hep.31150] [Citation(s) in RCA: 357] [Impact Index Per Article: 89.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 01/06/2020] [Indexed: 12/12/2022]
Abstract
With dramatic changes in lifestyles over the last 20 years, nonalcoholic fatty liver disease (NAFLD) has become the most prevalent liver disorder in China but has not received sufficient attention. NAFLD-related advanced liver disease and its mortality along with its overall disease burden are expected to increase substantially. There is thus an imperative need to clarify the epidemiological features of NAFLD to guide a holistic approach to management. We summarize eight epidemiological features of NAFLD in China over the past two decades using systematic review and meta-analysis methodology. Our data reveal a rapid growth in the NAFLD population, especially among younger individuals. Importantly, there is a strong ethnic difference in body mass index (BMI) and genetic risk of NAFLD compared with the US population. The etiology of advanced liver disease and its complications (e.g., hepatocellular carcinoma) has been altered because of a Westernized lifestyle and the implementation of effective vaccination strategies against viral hepatitis. Regional epidemiological patterns of NAFLD indicate that economics, environment, and lifestyle are critical factors in disease progression. The analysis also indicates that a large number of patients remain undiagnosed and untreated because of the inadequacy of diagnostic tools and the absence of effective pharmacologic therapies. Given the burden of NAFLD, future policy and research efforts need to address knowledge gaps to mitigate the risk burden.
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Affiliation(s)
- Jianghua Zhou
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China.,Institute of Model Animal of Wuhan University, Wuhan, China.,Basic Medical School, Wuhan University, Wuhan, China
| | - Feng Zhou
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China.,Institute of Model Animal of Wuhan University, Wuhan, China.,Basic Medical School, Wuhan University, Wuhan, China.,Medical Science Research Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Wenxin Wang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China.,Institute of Model Animal of Wuhan University, Wuhan, China.,Basic Medical School, Wuhan University, Wuhan, China
| | - Xiao-Jing Zhang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China.,Institute of Model Animal of Wuhan University, Wuhan, China.,Basic Medical School, Wuhan University, Wuhan, China
| | - Yan-Xiao Ji
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China.,Institute of Model Animal of Wuhan University, Wuhan, China.,Basic Medical School, Wuhan University, Wuhan, China
| | - Peng Zhang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China.,Institute of Model Animal of Wuhan University, Wuhan, China.,Basic Medical School, Wuhan University, Wuhan, China
| | - Zhi-Gang She
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China.,Institute of Model Animal of Wuhan University, Wuhan, China.,Basic Medical School, Wuhan University, Wuhan, China
| | - Lihua Zhu
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China.,Institute of Model Animal of Wuhan University, Wuhan, China.,Basic Medical School, Wuhan University, Wuhan, China
| | - Jingjing Cai
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China.,Institute of Model Animal of Wuhan University, Wuhan, China.,Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Hongliang Li
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China.,Institute of Model Animal of Wuhan University, Wuhan, China.,Basic Medical School, Wuhan University, Wuhan, China
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23
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A Qualitative Evaluation of a Community Based, Culturally Relevant Intervention to Promote Healthy Food Access in American Indian Communities. J Community Health 2020; 45:458-464. [PMID: 32060672 DOI: 10.1007/s10900-019-00760-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
In response to a need for healthy, affordable food, Johns Hopkins Center for American Indian Health and three rural indigenous communities launched the "Feast for the Future," (FFF) to promote access to healthy foods and the transfer of traditional food-based knowledge from farmers/elders to youth. To assess program impact, 43 in-depth interviews were conducted with participating farmers, elders, and Community Advisory Board members. Interviews were recorded, transcribed, and analyzed in Atlas.ti. Common themes from qualitative analyses included: FFF programs support farming/gardening revitalization and cultural connectedness/identity; FFF has supported positive behavior change among interviewees and their families; There is a need to revitalize traditional food systems; Farming/gardening is central to cultural identity; and Responsibility for food choices. The interviews revealed that the community-based program is perceived by key stakeholders as reaffirming cultural identity and promoting healthy eating. As a CAB member shared.
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24
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Preferences for Sweet and Fatty Taste in Children and Their Mothers in Association with Weight Status. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17020538. [PMID: 31952132 PMCID: PMC7013461 DOI: 10.3390/ijerph17020538] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 01/02/2020] [Accepted: 01/10/2020] [Indexed: 12/14/2022]
Abstract
Strong preferences for sweet and fat tastes (characters) are associated with the consumption of foods high in calories. The taste preferences, especially the sweet and fat tastes (characters), might be one of the factors predisposing children to become overweight and/or develop obesity. The aim of the study is to assess taste preferences in children and their mothers in association with their weight status. In the study, 150 children aged 8–15 were included; among them, 75 had overweight and/or obesity, and 150 mothers of whom 69 were overweight and/or obese. Body composition estimates were obtained using a bioelectrical impedance analysis-body height was measured using a stadiometerSeca 213. Sensory tests were carried out using apple juice of various sugar content and crackers of various fat content. Results show that children prefer a sweet taste more often than their mothers (50.0% vs. 35.3%, p = 0.009). In the group of children who preferred the high-sweet taste, there were twice as many obese children when compared to the group who preferred the low-sweet taste. Similar relationships applied to mothers. Preferences for fat taste (character) among mothers increased the risk of obesity among their children (39% vs. 20%; p = 0.039). Taste preferences, especially a sweet taste preference, seem to be one of the important factors determining overweight and obesity in children and adults. The fat taste(character) preferences in mothers correlate with the overweight and/or obesity of their children, while such preferences among children were not significantly different irrespective of body weight status.
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25
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Kuder MM, Nyenhuis SM. Optimizing lifestyle interventions in adult patients with comorbid asthma and obesity. Ther Adv Respir Dis 2020; 14:1753466620906323. [PMID: 32103702 PMCID: PMC7047422 DOI: 10.1177/1753466620906323] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 01/21/2020] [Indexed: 12/25/2022] Open
Abstract
The prevalence of obesity and asthma are both increasing at alarming rates. The link between obesity and asthma suggests that obesity contributes to both risk of new onset asthma and increased asthma severity. The emerging evidence demonstrating the role of obesity and other lifestyle factors, such as diet and physical activity, on asthma outcomes warrants lifestyle interventions that can address these components of asthma care. This review examines the current literature on the pathophysiology of obesity's role in asthma, as well as the role of diet and physical activity in weight loss and in asthma outcomes. We discuss recent studies that employ lifestyle interventions to target improved asthma outcomes. Finally, we discuss the future direction of research in this area. The reviews of this paper are available via the supplemental material section.
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Affiliation(s)
- Margaret M. Kuder
- Department of Allergy and Immunology, Cleveland Clinic, Cleveland, OH, USA
| | - Sharmilee M. Nyenhuis
- Division of Pulmonary, Critical Care, Sleep and Allergy, Affiliate Faculty, Center for Dissemination and Implementation Science, University of Illinois at Chicago, 840 S. Wood St. MC 719, Chicago, IL 60612, USA
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26
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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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27
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Esdaile E, Hernandez E, Moores CJ, Vidgen HA. Enrolment of families with overweight children into a program aimed at reducing childhood obesity with and without a weight criterion: a natural experiment. BMC Public Health 2019; 19:756. [PMID: 31200674 PMCID: PMC6570944 DOI: 10.1186/s12889-019-6894-y] [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: 12/20/2018] [Accepted: 04/25/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Difficulties engaging families with overweight children to enrol into programs aimed at reducing childhood obesity have been well documented. During the implementation of the Parenting, Eating and Activity for Child Health Program (PEACH™) over a large geographical area (Queensland (QLD), Australia), a natural experiment developed. This experiment provided an opportunity to observe if there was a difference in enrolment for families with overweight children with a weight criterion (referred to as the period with a Targeted Eligibility Criterion (TEC)) compared to when a weight criterion was removed (the period referred to as Universal Eligibility Criterion (UEC)). We also examined the eligibility criterion's relationship with attendance, parental concern about their child's weight, estimation of overweight and obesity from parent-reported data. METHODS A secondary analysis of baseline data from 926 overweight/obese children from 817 families enrolled in PEACH™ QLD was performed. Analyses were adjusted to control for the presence of clustered data. Bivariate statistics were performed using Pearson chi-square test with the second-order Rao-Scott correction, and Mann-Whitney U-test for non-parametric continuous variables. Generalized Estimating Equations (GEE) explored the association between weight status-based eligibility criteria and enrolment of overweight children. GEE were adjusted for sex, age and socioeconomic index and stratified for weight category. RESULTS Compared to obese children, overweight children were almost twice as likely to be enrolled when the program did not have weight status-based eligibility criteria (during UEC period) (OR = 1.90 (CI 95% 1.35-2.68, p < 0.001)). Parents of overweight children enrolled during the UEC period were more likely to regard their child's weight as less of a concern than during the TEC period (UEC 67% vs. TEC 45%, p = 0.036). Children whose parent-reported data underestimated their weight category were more likely to be enrolled while the program did not have weight-related eligibility criteria OR = 2.27 (CI 1.38-3.70, p < 0.01). Program session attendance did not appear to be impacted by the changes in eligibility criteria. CONCLUSIONS The omission of weight criteria for healthy lifestyle programs is a consideration for health professionals and decision-makers alike when encouraging the enrolment of children who are overweight into healthy lifestyle programs. TRIAL REGISTRATION ACTRN12617000315314 . Retrospectively registered 28 February 2017.
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Affiliation(s)
- Emma Esdaile
- School of Exercise & Nutrition Sciences, Faculty of Health, Queensland University of Technology, Level 4, A Wing, O Block, Kelvin Grove, Brisbane, Queensland Qld 4059 Australia
| | - Emely Hernandez
- School of Exercise & Nutrition Sciences, Faculty of Health, Queensland University of Technology, Level 4, A Wing, O Block, Kelvin Grove, Brisbane, Queensland Qld 4059 Australia
| | - Carly Jane Moores
- Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, South Australia 5001 Australia
| | - Helen Anna Vidgen
- School of Exercise & Nutrition Sciences, Faculty of Health, Queensland University of Technology, Level 4, A Wing, O Block, Kelvin Grove, Brisbane, Queensland Qld 4059 Australia
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28
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O'Rourke RW. Adipose tissue and the physiologic underpinnings of metabolic disease. Surg Obes Relat Dis 2018; 14:1755-1763. [PMID: 30193906 PMCID: PMC6289667 DOI: 10.1016/j.soard.2018.07.032] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Revised: 07/20/2018] [Accepted: 07/28/2018] [Indexed: 12/22/2022]
Abstract
Adipose tissue dysfunction underlies the pathogenesis of metabolic disease. The metrics used to quantify adiposity and its association with metabolic disease, including body mass index, have limitations with important clinical implications. An understanding of the molecular and cellular mechanisms by which adipose tissue regulates systemic metabolism and contributes to metabolic disease will lead to next-generation adipose tissue-based therapy.
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Affiliation(s)
- Robert W O'Rourke
- Department of Surgery, University of Michigan Medical School, Michigan Medicine, and Ann Arbor Veterans Administration Hospital, Ann Arbor, Michigan.
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29
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Household chaos and screen media use among preschool-aged children: a cross-sectional study. BMC Public Health 2018; 18:1210. [PMID: 30373557 PMCID: PMC6206857 DOI: 10.1186/s12889-018-6113-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 10/11/2018] [Indexed: 01/08/2023] Open
Abstract
Background Excess screen media use is a robust predictor of childhood obesity. Understanding how household factors may affect children’s screen use is needed to tailor effective intervention efforts. The preschool years are a critical time for obesity prevention, and while it is likely that greater household disorder influences preschool-aged children’s screen use, data on that relationship are absent. In this study, our goal was to quantify the relationships between household chaos and screen use in preschool-aged children. Methods A cross-sectional, online survey was administered to 385 parents of 2–5 year-olds recruited in 2017. Household chaos was measured with the Confusion, Hubbub and Order Scale (i.e., the chaos scale), a validated, parent-reported scale. The scale consists of 15 items, each scored on a 4-point Likert scale. Final scores were the sum across the 15 items and modeled as quartiles for analyses. Parents reported their children’s screen use for nine electronic media activities. Adjusted linear and Poisson regression were used to model associations between household chaos and children’s total weekly screen use, screen use within one hour of bedtime and screen use in the bedroom. Results Children averaged 31.0 (SD = 23.8) hours per week with screens, 49.6% used screens within one hour of bedtime and 41.0% used screens in their bedrooms. In adjusted regression models, greater household chaos was positively associated with weekly screen use (P = 0.03) and use of screens within one hour of bedtime (P < 0.01) in a dose-dependent manner. Children in the fourth versus the first quartile of household chaos were more likely to use screens in their bedroom (P = 0.03). Conclusions Greater household chaos was associated with increased total screen use as well as screen use behaviors that are related to disrupted nighttime sleep. Findings suggest that household chaos may be an obesity risk factor during the preschool years because of such effects on screen use, and highlight the need to consider household chaos when implementing home-based obesity prevention programs for young children. Electronic supplementary material The online version of this article (10.1186/s12889-018-6113-2) contains supplementary material, which is available to authorized users.
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Halbert CH, Jefferson M, Nemeth L, Melvin CL, Nietert P, Rice L, Chukwuka KM. Weight loss attempts in a racially diverse sample of primary care patients. Prev Med Rep 2018; 10:167-171. [PMID: 29868362 PMCID: PMC5984215 DOI: 10.1016/j.pmedr.2017.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 11/20/2017] [Accepted: 11/24/2017] [Indexed: 11/29/2022] Open
Abstract
Despite efforts to promote healthy weight, obesity is at epidemic levels among adults in the US. We examined the prevalence of weight loss attempts among a racially diverse sample of overweight and obese primary care patients (n = 274) based on sociodemographic, clinical and psychological factors, and shared decision-making (SDM) about weight loss/management. This observational study was conducted from December 2015 through January 2017. Data were obtained by self-report via survey. Overall, 64% of participants were attempting to lose weight at the time of survey. No significant differences in current weight loss attempts were found based on racial background, sociodemographic characteristics, or clinical factors. Participants who believed they were obese/overweight (OR = 6.70, 95% CI = 2.86, 15.72, p < 0.0001) or who were ready to lose/manage their weight (OR = 4.50, 95% CI = 1.82, 11.09, p = 0.001) had an increased likelihood of attempting to lose weight. The likelihood of attempting to lose weight increased with greater SDM with providers (OR = 1.54, 95% CI = 1.06, 2.22, p = 0.02). Patient perceptions about their weight, their readiness for weight loss/management, and SDM were associated significantly with weight loss attempts. Obesity is a significant clinical and public health issue. 64% of obese/overweight primary care patients was trying to lose weight. Weight loss attempts did not differ based on race, SES, or clinical factors. Weight loss efforts were associated with perceived obesity status and readiness. Greater shared decision-making was associated with making weight loss efforts.
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31
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Torre‐Villalvazo I, Bunt AE, Alemán G, Marquez‐Mota CC, Diaz‐Villaseñor A, Noriega LG, Estrada I, Figueroa‐Juárez E, Tovar‐Palacio C, Rodriguez‐López LA, López‐Romero P, Torres N, Tovar AR. Adiponectin synthesis and secretion by subcutaneous adipose tissue is impaired during obesity by endoplasmic reticulum stress. J Cell Biochem 2018; 119:5970-5984. [DOI: 10.1002/jcb.26794] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 02/16/2018] [Indexed: 12/18/2022]
Affiliation(s)
- Ivan Torre‐Villalvazo
- Departamento de Fisiología de la NutriciónInstituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMéxico CityMéxico
| | - Ana E. Bunt
- Departamento de Fisiología de la NutriciónInstituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMéxico CityMéxico
| | - Gabriela Alemán
- Departamento de Fisiología de la NutriciónInstituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMéxico CityMéxico
| | - Claudia C. Marquez‐Mota
- Departamento de Fisiología de la NutriciónInstituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMéxico CityMéxico
- Departamento de Nutrición Animal y BioquímicaFMVZ‐UNAMMéxico CityMéxico
| | - Andrea Diaz‐Villaseñor
- Departamento de Fisiología de la NutriciónInstituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMéxico CityMéxico
- Instituto de Investigaciones BiomédicasIIB‐UNAMMéxico CityMéxico
| | - Lilia G. Noriega
- Departamento de Fisiología de la NutriciónInstituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMéxico CityMéxico
| | - Isabela Estrada
- Departamento de Fisiología de la NutriciónInstituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMéxico CityMéxico
| | - Elizabeth Figueroa‐Juárez
- Departamento de Nefrología y Metabolismo MineralInstituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMéxico CityMéxico
| | - Claudia Tovar‐Palacio
- Departamento de Nefrología y Metabolismo MineralInstituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMéxico CityMéxico
| | - Leonardo A. Rodriguez‐López
- Departamento de Fisiología de la NutriciónInstituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMéxico CityMéxico
| | - Patricia López‐Romero
- Departamento de Fisiología de la NutriciónInstituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMéxico CityMéxico
| | - Nimbe Torres
- Departamento de Fisiología de la NutriciónInstituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMéxico CityMéxico
| | - Armando R. Tovar
- Departamento de Fisiología de la NutriciónInstituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMéxico CityMéxico
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