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Guarnido-Rueda A, Amate-Fortes I, Oliver-Márquez FJ, Martínez-Navarro D. Income or educational attainment: which is more effective in the fight against overweight? Evidence from Spain and Andalusia. J Biosoc Sci 2024; 56:270-291. [PMID: 38044837 DOI: 10.1017/s0021932023000263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Considered the epidemic of the 21st century by the WHO, obesity is a global problem that is on the rise and will continue to increase in the coming years. Spain and Andalusia, in particular, are no exception to this pathology, which has tripled since the 1970s, representing a public health challenge. The aim of this study is to analyse the socioeconomic determinants of this pathology, with special emphasis on answering the question of what has a greater influence on overweight, education level, or income. For this purpose, we have used the European Survey of Health in Spain (ESHS-2020), a microdata base, with a total of 22,072 valid individual observations (of which 2,820 belong to the Andalusian population). Results we obtain in our estimations of qualitative response models reveal that, although both income and educational attainment could be effective in the fight against overweight, the social gradient of this health problem is greater with respect to educational attainment. Additionally, there are many other variables and other factors related to the individual's overweight (mental health, subjective state of health, oral health, among others) which are much less explored and which must be considered in health policies to combat this disease.
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Affiliation(s)
- Almudena Guarnido-Rueda
- Department of Economics and Business, University of Almeria, Carretera de Sacramento, s/n, 04120, Almeria, Spain
| | - Ignacio Amate-Fortes
- Department of Economics and Business, University of Almeria, Carretera de Sacramento, s/n, 04120, Almeria, Spain
| | - Francisco J Oliver-Márquez
- Department of Economics and Business, University of Almeria, Carretera de Sacramento, s/n, 04120, Almeria, Spain
| | - Diego Martínez-Navarro
- Department of Economics and Business, University of Almeria, Carretera de Sacramento, s/n, 04120, Almeria, Spain
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Khodarahmi M, Farhangi MA, Khoshro S, Dehghan P. Factors associated with health-related quality of life in women using path analyses: mediation effect of the adiposity traits. BMC Womens Health 2021; 21:395. [PMID: 34819076 PMCID: PMC8611884 DOI: 10.1186/s12905-021-01535-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 11/08/2021] [Indexed: 11/12/2022] Open
Abstract
Background The current work aimed to investigate the mediating role of adiposity traits in the relationship between eating behaviors, sleep quality, socio-demographic factors, and the health-related quality of life in women of reproductive age in northwest of Iran. Methods In the current cross-sectional study, a total of 278 overweight and obese women of reproductive age (20–49 y) were enrolled. Anthropometric assessments were performed. Pittsburgh sleep quality index (PSQI) was used for assessment of sleep quality while Short Form 36 (SF-36) questionnaire was used to measure health-related quality of life (HRQoL). Three-Factor Eating Questionnaire-R18 (TFEQ-R18) was used to measure eating behaviors. Path analysis was used to test the relationships between parameters. Results Age was found to be indirectly and negatively associated with mental component score (MCS) (B = − 0.040; P = 0.049) and physical component score (PCS) (B = − 0.065; P = 0.036) through mediatory effects of obesity. Additionally, education was seen to be indirectly and positively related to MCS (B = 0.529; P = 0.045) and PCS (B = 0.870; P = 0.019), respectively. On the other hand, obesity (B = 0.608; P = 0.018) and PSQI score (B = − 0.240; P = 0.034) had direct associations with MCS. Age (B = − 0.065; P = 0.036) and education (B = 0.870; P = 0.019) were also directly associated with obesity. Conclusions Obesity seemed to mediate the effects of socio-demographic parameters on HRQoL. Poor sleep quality was also related to impairment of HRQoL. Further studies are needed to confirm these results.
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Biskup M, Macek P, Gozdz S, Terek-Derszniak M, Krol H, Kedzierawski P, Zak M. Two-year follow-up cohort study focused on gender-specific associations between socioeconomic status and body weight changes in overweight and obese middle-aged and older adults. BMJ Open 2021; 11:e050127. [PMID: 34330862 PMCID: PMC8327805 DOI: 10.1136/bmjopen-2021-050127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 07/05/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE As overall spread of obesity in populations is generally acknowledged to result from unhealthy lifestyles rather than individual genetic makeup, this study aimed to gain specific insights into its determinants through assessing the prevalent associations between individual socioeconomic status (SES) and weight loss in overweight and obese men and women. METHODS A prospective, 2-year follow-up study covered 3362 (38.0% men) respondents, aged 43-64 years, body mass index ≥25 kg/m2. Changes in body weight were estimated as a percentage of initial weight. Three categories of changes were defined: gained ≥3%, stable (gained <3% or lost <3%), lost ≥3%. Body weight loss was determined against three categories: lost ≥3 to <5%, lost ≥5 to <10%, lost ≥10%. Select SES variables (ie, gender, age, education, marital status, occupational activity and income) were determined in line with the Health Status Questionnaire. The associations between SES and body weight changes were analysed with the aid of logistic regression models. The results were presented as ORs with 95% CIs. RESULTS Only 18% of the respondents had complied with the medical recommendations on weight loss. Significant differences were encountered between the gender, age and occupational activity variables and the weight loss one. Multifactorial models were used to determine the following gender-specific associations between SES and weight loss. Men with moderate income had significantly higher odds for weight loss (≈75%), as compared with the higher earners, whereas women with low income, occupationally inactive, had significantly higher odds (≈30% and ≈50%, respectively), as compared with the high earners and occupationally active ones. CONCLUSIONS Lower education, male gender, lower income per household, older age and unemployment status were the established factors predisposing to obesity. While aiming to ensure effectiveness of the measures specifically aimed at preventing obesity, population groups deemed most at risk of potential weight gain must prior be identified.
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Affiliation(s)
- Malgorzata Biskup
- Institute of Health Sciences, Collegium Medicum, Jan Kochanowski University, Kielce, Poland
- Department of Rehabilitation, Holycross Cancer Centre, Kielce, Poland
| | - Pawel Macek
- Institute of Health Sciences, Collegium Medicum, Jan Kochanowski University, Kielce, Poland
- Department of Epidemiology and Cancer Control, Holycross Cancer Centre, Kielce, Poland
| | - Stanislaw Gozdz
- Institute of Health Sciences, Collegium Medicum, Jan Kochanowski University, Kielce, Poland
- Clinical Oncology Clinic, Holycross Cancer Centre, Kielce, Poland
| | | | - Halina Krol
- Institute of Health Sciences, Collegium Medicum, Jan Kochanowski University, Kielce, Poland
- Research and Education Department, Holycross Cancer Centre, Kielce, Poland
| | - Piotr Kedzierawski
- Institute of Health Sciences, Collegium Medicum, Jan Kochanowski University, Kielce, Poland
- Radiotherapy Clinic, Holycross Cancer Centre, Kielce, Poland
| | - Marek Zak
- Institute of Health Sciences, Collegium Medicum, Jan Kochanowski University, Kielce, Poland
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Golzarand M, Salari-Moghaddam A, Mirmiran P. Association between alcohol intake and overweight and obesity: a systematic review and dose-response meta-analysis of 127 observational studies. Crit Rev Food Sci Nutr 2021; 62:8078-8098. [PMID: 33998940 DOI: 10.1080/10408398.2021.1925221] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Several studies have assessed the relationship between alcohol intake and overweight/obesity; however, the reported results are inconsistent. Therefore, the present systematic review and dose-response meta-analysis of observational studies was designed to investigate the association between alcohol intake and general and abdominal obesity among the adults. Literature search was conducted in the PubMed/Medline and Web of Science databases up to August 2020. Odds ratio (OR), risk ratio (RR), or hazard ratio (HR) with 95% confidence interval (95% CI) were used to pool effect size. To conduct dose-response meta-analysis, amount of alcohol intake was classified into three categories including light (<14 g/d), moderate (14-28 g/d), and heavy (>28 g/d). In the present study, 127 eligible studies were included. In cohort studies, there was no significant association between alcohol drinking and risk of overweight (OR: 0.93, 95% CI: 0.46 to 1.89), obesity (OR: 0.84, 95% CI: 0.52 to 1.37), overweight/obesity (OR: 1.15, 95% CI: 0.84 to 1.58), and abdominal obesity (OR: 1.13, 95% CI: 0.90 to 1.41). In cross-sectional studies, alcohol intake was associated with the increased odds of overweight (OR: 1.11, 95% CI: 1.05 to 1.18), overweight/obesity (OR: 1.23, 95% CI: 1.11 to 1.37), and abdominal obesity (OR: 1.19, 95% CI: 1.09 to 1.29); but not obesity (OR: 1.03, 95% CI: 0.95 to 1.12). Results of dose-response analysis indicated that heavy alcohol drinking was positively associated with odds of overweight (OR: 1.12, 95% CI: 1.01 to 1.24), overweight/obesity (OR: 1.32, 95% CI: 1.16 to 1.51), and abdominal obesity (OR: 1.25, 95% CI: 1.12 to 1.38) compared to non- or light alcohol drinking. There was no publication bias among studied on outcomes of interest. In conclusion, our results revealed alcohol drinkers, especially heavy alcohol drinkers, had increased odds of overweight, overweight/obesity, and abdominal obesity than non-alcohol drinker or light alcohol drinkers among cross-sectional studies but not cohort studies.
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Affiliation(s)
- Mahdieh Golzarand
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Asma Salari-Moghaddam
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Sedaghat F, Naja F, Darand M, Beyzai B, Rashidkhani B. Adherence to a Mediterranean dietary pattern and overweight and obesity among female adolescents in Iran. Int J Adolesc Med Health 2017; 31:/j/ijamh.ahead-of-print/ijamh-2016-0160/ijamh-2016-0160.xml. [PMID: 29168955 DOI: 10.1515/ijamh-2016-0160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2016] [Accepted: 02/21/2017] [Indexed: 01/21/2023]
Abstract
Background Given the high prevalence of overweight and obesity in Iran, identification of a healthy diet is essential. Objective This study aimed to assess the association between adherence to a Mediterranean diet and overweight and obesity in female adolescents. Methods Two hundred and eighty female adolescents from high schools in Tehran were recruited. General information, physical activity and food frequency questionnaires were completed. Adherence to the Mediterranean diet was evaluated using the Mediterranean Style Dietary Pattern Score (MSDPS). Results Under and over reporters of energy intake were excluded from the analysis (n = 37). Results indicated that prevalence of overweight and obesity was 13.3% and 12.5%, respectively. The mean of MSDPS was low in this population (15.99 ± 5.64). The MSDPS was positively associated with mother's education level and energy intake (p < 0.05). No significant relation was observed between MSDPS and overweight and obesity among adolescents. However, there was a negative significant association between MSDPS and WHR just among students who had educated mothers [high: second median v. low: first median, odds ratio (OR) = 0.36, 95% confidence interval (CI) = 0.12-1.03]. Conclusion Adherence to a Mediterranean dietary pattern is low among adolescent females in Tehran, with no association with overweight and obesity.
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Affiliation(s)
- Fatemeh Sedaghat
- Department of Basic Science and Cellular Molecular Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute (WHO Collaborating Center), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farah Naja
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Mina Darand
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bita Beyzai
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bahram Rashidkhani
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Phone: (0098) 9127388016, Fax: (0098)(21) 22376467,
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Figueiredo RADO, Roos E, Eriksson JG, Simola-Ström S, Weiderpass E. Maternal alcohol and tobacco consumption and the association with their 9 to 14-year-old children’s Body Mass Index. Scand J Public Health 2017; 45:503-510. [DOI: 10.1177/1403494817702264] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims: Little is known about impact of maternal alcohol and tobacco consumption on adolescents’ body size. The purpose of this study was to evaluate whether maternal alcohol or tobacco consumption is associated with their children’s body size in adolescence, assessed by Body Mass Index (BMI). Methods: This study was conduct in subjects recruited into the Finnish Health in Teens cohort (Fin-HIT) between 2011 and 2014. A total of 4525 subjects aged between 9 and 14 years and their mothers or female adults responsible for the children were analysed. Relative risks (RR) and 95% confidence intervals (CI) were estimated using Multinomial Logistic Regression. Results: Most children were normal weight (74.5%), 10.6% were underweight and 14.9% were overweight or obese. Among mothers, 50.6% were never smokers, 35.7% were former smokers, and 13.7% were current smokers. Alcohol consumption was classified by Alcohol Use Disorders Identification Test (AUDIT), 12.7% were abstainers (score=0), 65.0% were low–moderate drinkers (scores 1–4) and 22.3% were harmful drinkers (scores ⩾5). There were statistically significant associations between currently smoking mothers and children’s overweight (RR=1.36; 95% CI: 1.05–1.76). There was an inverse association between maternal former smoking and children’s underweight (RR=0.70; CI: 0.56–0.87) compared with never smoker mothers. Among children in puberty, abstainer mothers were more likely to have underweight children compared with low–moderate mothers (RR=1.57; 95% CI: 1.03–2.41). Conclusions: Current smoker mothers were associated with children’s overweight and former-smoker mothers were inversely associated with the children’s underweight. Being an abstainer mother was associated with the children’s underweight in puberty stage. If other studies confirm these results, public health interventions aiming at healthy weight of adolescents should target the whole family, not only the adolescents themselves.
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Affiliation(s)
| | - Eva Roos
- Folkhälsan Research Center, Helsinki, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Johan G. Eriksson
- Folkhälsan Research Center, Helsinki, Finland
- Department of General Practice and Primary Healthcare, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | | | - Elisabete Weiderpass
- Folkhälsan Research Center, Helsinki, Finland
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Research, Cancer Registry of Norway, Oslo, Norway
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
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López-Sobaler AM, Rodríguez-Rodríguez E, Aranceta-Bartrina J, Gil Á, González-Gross M, Serra-Majem L, Varela-Moreiras G, Ortega RM. General and Abdominal Obesity Is Related to Physical Activity, Smoking and Sleeping Behaviours and Mediated by the Educational Level: Findings from the ANIBES Study in Spain. PLoS One 2016; 11:e0169027. [PMID: 28033380 PMCID: PMC5199068 DOI: 10.1371/journal.pone.0169027] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Accepted: 12/09/2016] [Indexed: 12/30/2022] Open
Abstract
The aim of the present study was to analyze the association of socioeconomic (SES) and lifestyle factors, with the conditions of overweight (OW), general (OB) and abdominal obesity (AO) in Spanish adults. A representative sample of 1655 Spanish adults (18 to 65 years) from the ANIBES Study was investigated. Collected data included measured anthropometry (weight, height and waist circumference), demographic and SES data (region and habitant population size, educational level, family income, unemployment rate), physical activity (PA) and other lifestyle factors (sleeping time and frequency of viewing television). OW, OB and AO were determined in each participant. Being male, older than 40 years, and watching television more frequently were associated with higher risk of OB and AO, whereas those with a higher level of education, smokers, and more time in sleeping and in vigorous PA, but not in moderate-vigorous PA, were associated with a lower risk. Living in the Atlantic region and stating no answer to the question regarding family income were also associated with lower risk of AO. Strategies for preventing and reducing OB and AO should consider improving sleeping habits and PA. They should also pay more attention to the most vulnerable groups such as those less educated.
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Affiliation(s)
- Ana M López-Sobaler
- VALORNUT Research Group, Department of Nutrition, Faculty of Pharmacy, Complutense University of Madrid, Madrid, Spain
| | - Elena Rodríguez-Rodríguez
- VALORNUT Research Group, Department Section of Analytical Chemistry, Faculty of Pharmacy, Complutense University of Madrid, Madrid, Spain
| | - Javier Aranceta-Bartrina
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain.,CIBEROBN, Biomedical Research Networking Center for Physiopathology of Obesity and Nutrition, Carlos III Health Institute, Madrid, Spain
| | - Ángel Gil
- CIBEROBN, Biomedical Research Networking Center for Physiopathology of Obesity and Nutrition, Carlos III Health Institute, Madrid, Spain.,Department of Biochemistry and Molecular Biology II, and Institute of Nutrition and Food Sciences, University of Granada, Campus de la Salud, Armilla, Granada, Spain
| | - Marcela González-Gross
- CIBEROBN, Biomedical Research Networking Center for Physiopathology of Obesity and Nutrition, Carlos III Health Institute, Madrid, Spain.,ImFINE Research Group, Department of Health and Human Performance, Technical University of Madrid, Madrid, Spain
| | - Lluis Serra-Majem
- CIBEROBN, Biomedical Research Networking Center for Physiopathology of Obesity and Nutrition, Carlos III Health Institute, Madrid, Spain.,Research Institute of Biomedical and Health Sciences & Medical School, University of Las Palmas de Gran Canaria, Edificio Departamental y de Investigación, Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Gregorio Varela-Moreiras
- Department of Pharmaceutical and Health Sciences, Faculty of Pharmacy, CEU San Pablo University, Urb. Montepríncipe, Boadilla del Monte, Madrid, Spain.,Spanish Nutrition Foundation (FEN), Madrid, Spain
| | - Rosa M Ortega
- VALORNUT Research Group, Department of Nutrition, Faculty of Pharmacy, Complutense University of Madrid, Madrid, Spain
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Yu Y. Four Decades of Obesity Trends among Non-Hispanic Whites and Blacks in the United States: Analyzing the Influences of Educational Inequalities in Obesity and Population Improvements in Education. PLoS One 2016; 11:e0167193. [PMID: 27893853 PMCID: PMC5125692 DOI: 10.1371/journal.pone.0167193] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2014] [Accepted: 11/11/2016] [Indexed: 11/28/2022] Open
Abstract
Both obesity (body mass index ≥ 30) and educational attainment have increased dramatically in the United States since the 1970s. This study analyzed the influences of educational inequalities in obesity and population improvements in education on national obesity trends between 1970 and 2010. For non-Hispanic white and black males and females aged 25-74 years, educational differences in the probability of being obese were estimated from the 1971-2012 National Health and Nutrition Examination Surveys, and population distributions of age and educational groups, from the 1970 Census and 2010 American Community Survey. In the total population, obesity increased from 15.7% to 38.8%, and there were increases in the greater obese probabilities of non-college graduates relative to four-year college graduates. The increase in obesity would have been lower by 10% (2.2 percentage points) if educational inequalities in obesity had stayed at their 1970 values and lower by one third (7.9 points) if obesity inequalities had been eliminated. Obesity inequalities were larger for females than males and for whites than blacks, and obesity did not differ by education among black males. As a result, the impact of obesity inequalities on the obesity trend was largest among white females (a 47% reduction in the obesity increase if obesity inequalities had been eliminated), and virtually zero among black males. On the other hand, without educational improvements, the obesity increase would have been 9% more in the total population, 23% more among white females and not different in the other three subpopulations. Results indicate that obesity inequalities made sizable contributions to the obesity trends, and the obesity reductions associated with educational improvements were more limited.
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Affiliation(s)
- Yan Yu
- Health Research Institute, University of Canberra, Bruce, ACT, Australia
- School of Demography, Australian National University, Acton, ACT, Australia
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9
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Soler-Vila H, García-Esquinas E, León-Muñoz LM, López-García E, Banegas JR, Rodríguez-Artalejo F. Contribution of health behaviours and clinical factors to socioeconomic differences in frailty among older adults. J Epidemiol Community Health 2015; 70:354-60. [PMID: 26567320 DOI: 10.1136/jech-2015-206406] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 10/24/2015] [Indexed: 11/04/2022]
Abstract
BACKGROUND To examine the association between socioeconomic status (SES) and risk of frailty, and to assess whether behavioural and clinical factors (BCF) mediate this association. METHODS Cohort of 1857 non-institutionalised individuals aged ≥ 60 years recruited in 2008-2010 and followed through 2012. Education, occupation, and BCF were ascertained at baseline, and incident frailty was assessed at follow-up with the Fried frailty criteria. RESULTS Men showed no differences in frailty risk by education or occupation. Compared with women with university education, the adjusted OR (aOR) adjusted for age and the number of frailty criteria at baseline for incident frailty in women with primary or lower education was 3.02 (95% CI 1.25 to 7.30); once fully adjusted for BCF, the OR was 2.00 (95% CI 0.76 to 5.23). No alcohol intake (vs light-moderate), longer time spent watching TV, less time spent reading, and a higher frequency of obesity, depression and musculoskeletal disease in those with primary or lower education accounted for most of the decline in OR. BCF explained 50.5% of the excess frailty risk associated with lower education. The aOR of frailty incidence for manual versus non-manual occupation was 2.24 (95% CI 1.41 to 3.56) versus a fully aOR of 2.05 (95% CI 1.24 to 3.37). BCF explained 15.3% of the association, with individual mediators being similar to those for education-related differences. CONCLUSIONS A lower education or a manual occupation was associated with higher frailty risk in older women. These associations were partly explained by lower alcohol consumption, higher sedentariness, and higher obesity and chronic disease rates in women with lower SES.
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Affiliation(s)
- Hosanna Soler-Vila
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid and IdiPaz and CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain Department of Public Health Sciences, Leonard Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Esther García-Esquinas
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid and IdiPaz and CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Luz Ma León-Muñoz
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid and IdiPaz and CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Esther López-García
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid and IdiPaz and CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - José R Banegas
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid and IdiPaz and CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid and IdiPaz and CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
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