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Banas J, McDowell Cook A, Raygoza-Cortez K, Davila D, Irwin ML, Ferrucci LM, Humphries DL. United States Long-Term Trends in Adult BMI (1959-2018): Unraveling the Roots of the Obesity Epidemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:73. [PMID: 38248537 PMCID: PMC10815706 DOI: 10.3390/ijerph21010073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/03/2024] [Accepted: 01/05/2024] [Indexed: 01/23/2024]
Abstract
The escalating rates of obesity since the 1950s poses a critical public health challenge across all age groups in the United States. While numerous studies have examined cross-sectional disparities across racial, ethnic, and socioeconomic groups, there has been limited research on long-term trends. To address this gap, we analyzed average adult body mass index (BMI) trends from 1959 to 2018, using data from the National Health and Nutrition Examination Survey (NHANES) and the National Health Examination Survey (NHES). Employing time series analysis, we evaluated BMI trends across income, education, and race/ethnicity. The results revealed a consistent upward trajectory in average BMI across all groups over the six-decade period, with no significant differences by income or education levels among high school graduates. However, individuals with less than a high school education displayed a more gradual increase in BMI. Racial disparities were also evident, with Black adults showing higher BMI growth rates compared to White adults, while Hispanic and other racial groups experienced slower increases. These findings underscore the need for systemic interventions to address the ongoing obesity epidemic, emphasizing the importance of research to identify trends over time and a system-thinking approach to inform effective population-level interventions and policy decisions.
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Affiliation(s)
- Julia Banas
- Yale School of Public Health, Yale University, New Haven, CT 06510, USA
| | | | | | - Daniel Davila
- Yale School of Public Health, Yale University, New Haven, CT 06510, USA
| | - Melinda L Irwin
- Yale School of Public Health, Yale University, New Haven, CT 06510, USA
- Yale Cancer Center, New Haven, CT 06510, USA
| | - Leah M Ferrucci
- Yale School of Public Health, Yale University, New Haven, CT 06510, USA
- Yale Cancer Center, New Haven, CT 06510, USA
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2
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Glei DA, Weinstein M. Economic distress, obesity, and the rise in pain. Soc Sci Med 2023; 339:116399. [PMID: 37984183 PMCID: PMC10841727 DOI: 10.1016/j.socscimed.2023.116399] [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: 08/15/2023] [Revised: 10/30/2023] [Accepted: 11/04/2023] [Indexed: 11/22/2023]
Abstract
Growing obesity may have contributed to widening socioeconomic disparities in pain in the US, but some researchers have suggested that deteriorating social and economic conditions among less advantaged Americans could be the root cause. We evaluated whether widening socioeconomic disparities in pain are associated with growing economic distress, particularly among those with low socioeconomic status (SES). We also assessed whether the link between economic distress and pain is mediated by obesity. Using data from nationally-representative samples targeting Americans aged 25-74 in 1995-96 (N = 3034) and 2011-14 (N = 2598), we fit a structural equation model to estimate the contributions of economic distress and obesity to period changes in the SES disparity in different types of pain. Socioeconomic disparities in backaches and joint pain widened substantially over recent decades, although there was no significant widening for headaches. Economic distress accounted for 34% of SES widening for backaches and 41% for joint pain, but the effect was largely independent of obesity. There was little evidence that economic distress led to obesity, which in turn fueled a rise in pain. Obesity alone explained another 8% of the widening SES disparity in backaches and 17% for joint pain. Economic distress played a larger role than obesity because economic distress increased over time for those with low SES whereas it decreased slightly for those with high SES. In contrast, obesity grew at all levels of SES, albeit more for those with low SES. Unfortunately, we cannot establish the direction of causation. Our model assumes that economic distress and obesity affect pain, but it is also possible that pain exacerbates obesity and/or economic distress. If SES disparities in pain continue to widen, it bodes poorly for the overall well-being of the US population, labor productivity, and the prospects for these cohorts as they reach older ages.
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Affiliation(s)
- Dana A Glei
- Center for Population and Health, Georgetown University, Washington, DC, USA.
| | - Maxine Weinstein
- Center for Population and Health, Georgetown University, 37th & O Streets, NW, 312 Healy Hall, Washington, DC, 20057-1197, USA.
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3
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Masters RK. Sources and severity of bias in estimates of the BMI-mortality association. POPULATION STUDIES 2023; 77:35-53. [PMID: 36756765 PMCID: PMC9992219 DOI: 10.1080/00324728.2023.2168035] [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: 06/18/2021] [Accepted: 07/13/2022] [Indexed: 02/10/2023]
Abstract
Estimates of mortality differences by body mass index (BMI) are likely biased by: (1) confounding bias from heterogeneity in body shape; (2) positive survival bias in high-BMI samples due to recent weight gain; and (3) negative survival bias in low-BMI samples due to recent weight loss. I investigate these sources of bias in the National Health and Nutrition Examination Survey (NHANES) 1988-94 and 1999-2006 linked to mortality up to 2015 (17,784 cases; 4,468 deaths). I use Cox survival models to estimate BMI differences in all-cause mortality risks among adults aged [45-85) in the United States. I test for age-based differences in BMI-mortality associations and estimate functional forms of the association using nine BMI levels. Estimates of the BMI-mortality association in NHANES data are significantly affected by all three biases, and obesity-mortality associations adjusted for bias are substantively strong at all ages. The mortality consequences of overweight and obesity have likely been underestimated, especially at older ages.
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Affiliation(s)
- Ryan K. Masters
- Department of Sociology, University of Colorado Boulder
- University of Colorado Population Center
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4
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Sex differences in overweight and obesity among Mexican Americans in the National Health and Nutrition Examination Survey: A comparison of measures. SSM Popul Health 2022; 20:101297. [DOI: 10.1016/j.ssmph.2022.101297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 11/15/2022] [Accepted: 11/16/2022] [Indexed: 11/24/2022] Open
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5
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What factors drive gender differences in the body mass index? Evidence from Turkish adults. J Biosoc Sci 2022; 55:538-563. [PMID: 35509172 DOI: 10.1017/s0021932022000190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
In recent years, studies show that obesity has become an important health condition, especially among adults. The first aim of this study is to examine socio-demographic and behavioural factors on body mass index distribution of male and female adults over 20 years old in Turkey. The second aim is to determine the body mass index disparity by gender and the socio-demographic and behavioural factors that might wider or narrow it. This study adopts unconditional quantile regression and decomposition methods, and the data set covers the Turkish Health Surveys for 2014, 2016, and 2019. The findings document that high level of body mass index are associated with being married, aging, and physical inactivity. Interestingly, employment status has different contributions on the body mass index of males and females. The results also claim a body mass index gap among males and females as a result of differences in some potential socio-demographic and behavioural factors, and the gap gets higher at the upper and lower quantiles of BMI distribution. This study may provide a clear understanding for policymakers on how to design efficacious obesity policies considering the differences in the effect of socio-demographic and behavioural factors on the distribution of body mass index across females and males. The results suggest that the Ministry of Health should specifically target different groups for males and females and should reduce the differences in socio-demographic and behavioural determinants between females and males to prevent and reduce obesity prevalence in Turkey.
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Glei DA, Stokes AC, Weinstein M. Widening Socioeconomic Disparities in Pain and Physical Function Among Americans Are Linked with Growing Obesity. J Aging Health 2022; 34:78-87. [PMID: 34459255 PMCID: PMC8751296 DOI: 10.1177/08982643211028121] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Objectives: We investigate whether obesity accounts for widening socioeconomic disparities in pain. Methods: Based on nationally representative samples of Americans aged 25-74 in 1995-1996 and 2011-2014, we use logistic regression to model period change in headaches, backaches, and joint aches as well as physical limitations and to determine whether those changes vary by a multidimensional measure of socioeconomic status. Results: Prevalence of backaches, joint aches, physical limitations, and obesity increased between the mid-1990s and the early 2010s, particularly among more disadvantaged Americans. Socioeconomic disparities in frequent backaches, frequent joint pain, and physical limitations more than doubled over this period. We estimate that obesity and health conditions may account for nearly a quarter of the widening disparity in frequent backaches and about half of the widening disparity in frequent joint pain and physical limitations. Discussion: Widening disparities in backaches, joint pain, and physical limitations have coincided with growing obesity.
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Affiliation(s)
- Dana A. Glei
- Center for Population and Health, Georgetown University, Washington, DC
| | - Andrew C. Stokes
- Department of Global Health, Boston University School of Public Health, Boston, MA
| | - Maxine Weinstein
- Center for Population and Health, Georgetown University, Washington, DC
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7
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Glei DA, Weinstein M. Disadvantaged Americans are suffering the brunt of rising pain and physical limitations. PLoS One 2021; 16:e0261375. [PMID: 34882731 PMCID: PMC8659634 DOI: 10.1371/journal.pone.0261375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 11/29/2021] [Indexed: 11/25/2022] Open
Abstract
Using data from three national surveys of US adults (one cohort and two cross-sectional studies, covering the period from the mid-1990s to the mid-2010s), we quantify the degree to which disparities by socioeconomic status (SES) in self-reported pain and physical limitations widened and explore whether they widened more in midlife than in later life. Unlike most prior studies that use proxy measures of SES (e.g., education), we use a multidimensional measure of SES that enables us to evaluate changes over time in each outcome for fixed percentiles of the population, thereby avoiding the problem of lagged selection bias. Results across multiple datasets demonstrate that socioeconomic disparities in pain and physical limitations consistently widened since the late 1990s, and if anything, widened even more in midlife than in late life (above 75). For those aged 50-74, the SES disparities in most outcomes widened by more than 50% and in some cases, the SES gap more than doubled. In contrast, the magnitude of SES widening was much smaller above age 75 and, in the vast majority of cases, not significant. Pain prevalence increased at all levels of SES, but disadvantaged Americans suffered the largest increases. Physical function deteriorated for those with low SES, but there was little change and perhaps improvement among the most advantaged Americans. At the 10th percentile of SES, the predicted percentage with a physical limitation at age 50 increased by 6-10 points between the late-1990s and the 2010s, whereas at the 90th percentile of SES, there was no change in two surveys and in the third survey, the corresponding percentage declined from 31% in 1996-99 to 22% in 2016-18. The worst-off Americans are being left behind in a sea of pain and physical infirmity, which may have dire consequences for their quality of life and for society as a whole (e.g., lost productivity, public costs).
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Affiliation(s)
- Dana A. Glei
- Center for Population and Health, Georgetown University, Washington, DC, United States of America
| | - Maxine Weinstein
- Center for Population and Health, Georgetown University, Washington, DC, United States of America
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8
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Dougherty M, Lomiguen CM, Chin J, McElroy PK. Obesity Hypoventilation Syndrome-Related Challenges in Acute Respiratory Failure. Cureus 2021; 13:e18066. [PMID: 34692288 PMCID: PMC8523440 DOI: 10.7759/cureus.18066] [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: 08/31/2021] [Accepted: 09/17/2021] [Indexed: 11/05/2022] Open
Abstract
Obesity hypoventilation syndrome (OHS) is a condition commonly found in severely obese patients in which they fail to breathe deeply or rapidly enough to offset the body's need for oxygen consumption and carbon dioxide release. This report presents a case of a 49-year-old super-super-morbid obese female with a body mass index (BMI) of 90 kilogram per meter squared (kg/m²), chronic obstructive pulmonary disease (COPD), and end-stage cor pulmonale, who was brought to the emergency department for altered mental status and requiring emergent airway due to respiratory failure secondary to OHS. The continued increase in rates of obesity worldwide, especially in those with BMI ≥ 50 kg/m², may lead to an increase in the incidence of OHS. With comorbidities secondary to obesity and associated complexity, this medically challenging case emphasizes the need for refined management strategies in caring for OHS in super-super-morbidly obese patients.
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Affiliation(s)
- Michael Dougherty
- Department of Anesthesiology, Thomas Jefferson University Hospital, Philadelphia, USA
| | - Christine M Lomiguen
- Department of Medical Education, Lake Erie College of Osteopathic Medicine, Erie, USA.,Department of Family Medicine, Millcreek Community Hospital, Erie, USA
| | - Justin Chin
- Department of Medical Education, Lake Erie College of Osteopathic Medicine, Erie, USA.,Department of Family Medicine, LifeLong Medical Care, Richmond, USA
| | - Philip K McElroy
- Department of Anesthesiology, Thomas Jefferson University Hospital, Philadelphia, USA
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9
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Kraft AN, Nunez J, Tarlov E, Slater S, Zenk SN. Racial/ethnic and educational differences in perceptions and use of a new urban trail. ETHNICITY & HEALTH 2021; 26:614-629. [PMID: 30372629 DOI: 10.1080/13557858.2018.1539218] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 10/10/2018] [Indexed: 06/08/2023]
Abstract
ABSTRACTObjectives: Obesity and its associated health risks are on the rise throughout the US due, in part, to an overall decline in physical activity. Although public green spaces, and in particular trails, show promise as population-level interventions to promote physical activity among adults, these amenities may have disparate impacts across racial/ethnic and socioeconomic groups within a community.Design: This cross-sectional study employed an intercept survey of users of a newly opened $95 million rail-to-trail development in Chicago, IL, immediately after its opening and one year later to examine differences by race/ethnicity and educational attainment in trail use behaviors, motivations for trail use, safety concerns, and change in physical activity attributed to the trail.Results: Although the overall impact of the trail was positive, Latino users were more likely to report frequent use (4+ times/week), health motivations for using the trail, and increased physical activity attributed to the trail. However, Latino users were also more likely to indicate safety concerns and less likely to use areas of the trail in predominately white communities, even after controlling for community of residence. The least educated trail users frequented fewer trail areas and were less likely to indicate health motivations for trail use.Conclusions: Although urban trails represent an opportunity for cost-effective community-wide health promotion, they may not benefit all groups equally. Urban trails may have particularly promising benefits for Latino users, but safety concerns and the possibility of community racial segregation being replicated on trails should be addressed to maximize and sustain these benefits. Less educated residents in particular may not benefit from such projects as intended.
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Affiliation(s)
- Amber N Kraft
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA
| | - Jessica Nunez
- College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
| | - Elizabeth Tarlov
- College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Hines VA Hospital, Hines, IL, USA
| | - Sandy Slater
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Shannon N Zenk
- College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
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10
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Shaik AN, Kiavash K, Stark K, Boerner JL, Ruterbusch JJ, Deirawan H, Bandyopadhyay S, Ali-Fehmi R, Dyson G, Cote ML. Inflammation markers on benign breast biopsy are associated with risk of invasive breast cancer in African American women. Breast Cancer Res Treat 2020; 185:831-839. [PMID: 33113091 DOI: 10.1007/s10549-020-05983-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 10/15/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE Markers of inflammation, including crown-like structures of the breast (CLS-B) and infiltrating lymphocytes (IL), have been identified in breast tissue and associated with increased risk of breast cancer (BrCa), however most of this work has been performed in primarily non-Hispanic white women. Here, we examined whether CLS-B and IL are associated with invasive BrCa in African American (AA) women. METHODS We assessed breast biopsies from three 5-year age-matched groups: BrCa-free AA women (50 Volunteer) from the Komen Normal Tissue Bank (KTB) and AA women with a clinically-indicated biopsy diagnosed with benign breast disease (BBD) from our Detroit cohort who developed BrCa (55 BBD-cancer) or did not develop BrCa (47 BBD only, year of biopsy matched to BBD-cancer). Mean adipocyte diameter and total adipose area were estimated from digital images using the Adiposoft plugin from ImageJ. Associations between CLS-B, IL, and BrCa among KTB and Detroit biopsies were assessed using multivariable multinomial and conditional logistic regression models. RESULTS Among all biopsies, Volunteer and BBD only biopsies did not harbor CLS-B or IL at significantly different rates after adjusting for logarithm of adipocyte area, adipocyte diameter, and BMI. Among clinically-indicated BBD biopsies, BBD-cancer biopsies were more likely to exhibit CLS-B (odds ratio (OR) = 3.36, 95% Confidence Interval (CI): 1.33-8.48) or IL (OR = 4.95, 95% CI 1.76-13.9) than BBD only biopsies after adjusting for total adipocyte area, adipocyte diameter, proliferative disease, and BMI. CONCLUSIONS CLS-B and IL may serve as histological markers of BrCa risk in benign breast biopsies from AA women.
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Affiliation(s)
- Asra N Shaik
- Department of Oncology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Katrin Kiavash
- Department of Pathology, Anatomy and Laboratory Medicine, West Virginia University School of Medicine, Morgantown, WV, USA
| | - Karri Stark
- Barbara Ann Karmanos Cancer Institute, 4100 John R. St, Mailstop: MM04EP, Detroit, MI, 48201, USA
| | - Julie L Boerner
- Department of Oncology, Wayne State University School of Medicine, Detroit, MI, USA.,Barbara Ann Karmanos Cancer Institute, 4100 John R. St, Mailstop: MM04EP, Detroit, MI, 48201, USA
| | - Julie J Ruterbusch
- Department of Oncology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Hany Deirawan
- Department of Pathology, Wayne State University School of Medicine, Detroit, MI, USA.,Barbara Ann Karmanos Cancer Institute, 4100 John R. St, Mailstop: MM04EP, Detroit, MI, 48201, USA
| | - Sudeshna Bandyopadhyay
- Department of Pathology, Wayne State University School of Medicine, Detroit, MI, USA.,Barbara Ann Karmanos Cancer Institute, 4100 John R. St, Mailstop: MM04EP, Detroit, MI, 48201, USA
| | - Rouba Ali-Fehmi
- Department of Pathology, Wayne State University School of Medicine, Detroit, MI, USA.,Barbara Ann Karmanos Cancer Institute, 4100 John R. St, Mailstop: MM04EP, Detroit, MI, 48201, USA
| | - Gregory Dyson
- Department of Oncology, Wayne State University School of Medicine, Detroit, MI, USA.,Barbara Ann Karmanos Cancer Institute, 4100 John R. St, Mailstop: MM04EP, Detroit, MI, 48201, USA
| | - Michele L Cote
- Department of Oncology, Wayne State University School of Medicine, Detroit, MI, USA. .,Barbara Ann Karmanos Cancer Institute, 4100 John R. St, Mailstop: MM04EP, Detroit, MI, 48201, USA.
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11
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Lucan SC, Maroko AR, Jin A, Chen A, Pan C, Sosa G, Schechter CB. Change in an urban food environment within a single year: Considerations for food-environment research and community health. Prev Med Rep 2020; 19:101102. [PMID: 32642401 PMCID: PMC7334403 DOI: 10.1016/j.pmedr.2020.101102] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 03/17/2020] [Accepted: 04/20/2020] [Indexed: 12/11/2022] Open
Abstract
Past research on food-environment change has been limited in critical ways. This study demonstrates business-level changes: openings, closings, new offerings. The number and proportion of businesses offering any food/drink increased in a year. Businesses offering less-healthful items increased and remained more numerous. Changes have implications for both food-environment research and community health.
Past research on food-environment change has been limited in key ways: (1) considering only select storefront businesses; (2) presuming items sold based on businesses category; (3) describing change only in ecological terms; (4) considering multi-year intervals. The current study addressed past limitations by: (1) considering a full range of both storefront and non-storefront businesses; (2) focusing on items actually offered (both healthful and less-healthful varieties); (3) describing individual-business-level changes (openings, closings, changes in offerings); (4) evaluating changes within a single year. Using a longitudinal, matched-pair comparison of 119 street segments in the Bronx, NY (October 2016-August 2017), investigators assessed all businesses—food stores, restaurants, other storefront businesses (OSBs), street vendors—for healthful and less-healthful food/drink offerings. Changes were described for individual businesses, individual street segments, and for the area overall. Overall, the number (and percentage) of businesses offering any food/drink increased from 45 (41.7%) in 2016 to 49 (45.8%) in 2017; businesses newly opening or newly offering food/drink cumulatively exceeded those shutting down or ceasing food/drink sales. In 2016, OSBs (gyms, barber shops, laundromats, furniture stores, gas stations, etc.) together with street vendors represented 20.0% and 27.3% of businesses offering healthful and less-healthful items, respectively; in 2017, the percentages were 31.0% and 37.0%. While the number of businesses offering healthful items increased, the number offering less-healthful items likewise increased and remained greater. If change in a full range of food/drink availability is not appreciated: food-environment studies may generate erroneous conclusions; communities may misdirect resources to address food-access disparities; and community residents may have increasing, but unrecognized, opportunities for unhealthful consumption.
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Affiliation(s)
- Sean C Lucan
- Department of Family and Social Medicine, Albert Einstein College of Medicine
- Montefiore Health System, Bronx, NY, United States
| | - Andrew R Maroko
- Department of Environmental, Occupational, and Geospatial Health Sciences, CUNY Graduate School of Public Health and Health Policy, New York, NY, United States
| | - Aurora Jin
- Albert Einstein College of Medicine, Bronx, NY, United States
| | - Aixin Chen
- Albert Einstein College of Medicine, Bronx, NY, United States
| | - Charles Pan
- Albert Einstein College of Medicine, Bronx, NY, United States
| | | | - Clyde B Schechter
- Department of Family and Social Medicine, Albert Einstein College of Medicine
- Montefiore Health System, Bronx, NY, United States
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12
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Piecewise regression equations for estimating stature: an anthropometric study in Spanish females. Int J Legal Med 2020; 134:2289-2296. [DOI: 10.1007/s00414-020-02350-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 06/15/2020] [Indexed: 01/10/2023]
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13
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Siegel RL, Medhanie GA, Fedewa SA, Jemal A. State Variation in Early-Onset Colorectal Cancer in the United States, 1995-2015. J Natl Cancer Inst 2020; 111:1104-1106. [PMID: 31141602 DOI: 10.1093/jnci/djz098] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 03/18/2019] [Accepted: 05/15/2019] [Indexed: 11/14/2022] Open
Abstract
The extent to which the increase in early-onset colorectal cancer (CRC) in the United States varies geographically is unknown. We analyzed changes in CRC incidence and risk factors among people aged 20-49 years by state using high-quality population-based cancer registry data provided by the North American Association of Central Cancer Registries and national survey data, respectively. Early-onset CRC incidence was mostly stable among blacks and Hispanics but increased in 40 of 47 states among non-Hispanic whites, most prominently in western states. For example, rates increased in Washington from 6.7 (per 100 000) during 1995-1996 to 11.5 during 2014-2015 (rate ratio = 1.73, 95% confidence interval = 1.48 to 2.01) and in Colorado from 6.0 to 9.5 (rate ratio = 1.57, 95% confidence interval = 1.30 to 1.91). Nevertheless, current CRC incidence was highest in southern states. From 1995 to 2005, increases occurred in obesity prevalence in all states and heavy alcohol consumption in one-third of states, but neither were correlated with CRC incidence trends. Early-onset CRC is increasing most rapidly among whites in western states. Etiologic studies are needed to explore early life colorectal carcinogenesis.
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Taylor WC, Durand CP, Knell G. Disparity Indices and Overweight: Frame of Reference. Health Equity 2019; 3:612-618. [PMID: 31872166 PMCID: PMC6918515 DOI: 10.1089/heq.2019.0064] [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] [Indexed: 11/17/2022] Open
Abstract
Purpose: The purpose of this study was to compare state rankings of body mass index (BMI) among three different indices of income disparities (i.e., low-, middle-, and high-income thresholds) and BMI. One measure of disparities was based on national standards and the other measure was based on state-specific data. Methods: Data were from the 2016 Behavioral Risk Factor Surveillance System and analyzed in 2018. To assess differences between the two indices, Spearman Rank Order Correlation coefficient with a Bonferroni adjustment and kappa statistic were used. Results: Spearman rank-order correlation coefficient with a Bonferroni adjustment found that the two indices had a very weak monotonic relationship (ρ=0.11, p=0.46). The kappa value [κ (df=48)=0.02, p-value=0.43] revealed the indices were not concordant. The rankings of states based on national and state-specific disparity indices were distinctly different. Conclusion: Our study highlights the importance of choosing disparity indices. To analyze state similarities and differences, findings and interpretations are different when using a national standard applied to all states versus state-specific data as the frame of reference for the disparity index. Future research is needed to confirm the generalizability of our findings. In addition to income, our approach can be used with other sociodemographic variables such as age, race/ethnicity, sex, and education. The overall goal is to present a comprehensive and nuanced perspective of disparities contributing to the overweight/obesity epidemic.
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Affiliation(s)
- Wendell C. Taylor
- Department of Health Promotion and Behavioral Sciences, Center for Health Promotion and Prevention Research, School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas
| | - Casey P. Durand
- Department of Health Promotion and Behavioral Sciences, Center for Health Promotion and Prevention Research, School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas
| | - Gregory Knell
- Department of Health Promotion and Behavioral Sciences, Center for Health Promotion and Prevention Research, School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas
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15
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Affiliation(s)
| | - Kiran Khush
- Division of Cardiovascular Medicine, Department of Medicine, Stanford University, CA
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16
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Quick V, Eck KM, Delaney C, Lewis R, Byrd-Bredbenner C. Stability of Differences in Weight-Related Characteristics of Mothers across Economic, Cultural, Social, and Environmental-Health Indicators of Socioeconomic Status. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3866. [PMID: 31614823 PMCID: PMC6843972 DOI: 10.3390/ijerph16203866] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 10/03/2019] [Accepted: 10/05/2019] [Indexed: 11/16/2022]
Abstract
This study explored the differences in weight-related characteristics when socioeconomic status (SES) was assessed by economic, cultural, social, and environmental-health capital individually and as a composite with the goal of determining the stability of differences across types of capital and to ascertain whether single or a combination of capital indicators of SES should be used in nutrition and public health studies. Mothers (n = 557) of young children completed a survey assessing capital and weight-related characteristics. Mothers with higher economic, cultural, and social capital and composite SES had fewer sugar-sweetened beverage servings, fewer meals in front of the TV, more food security, and greater neighborhood space/supports for physical activity than comparators. Few differences occurred among environmental-health capital groups. Composite SES performed similarly to individual economic, cultural, and social capital measures. Findings suggest single SES indicators may be sufficiently stable to capture differences in weight-related characteristics. Each capital type captures a unique aspect of SES; thus, assessing an array of capital types could advance understanding of SES aspects on weight-related characteristics.
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Affiliation(s)
- Virginia Quick
- Department of Nutritional Sciences, Rutgers University, New Brunswick, NJ 08520, USA.
| | - Kaitlyn M Eck
- Department of Nutritional Sciences, Rutgers University, New Brunswick, NJ 08520, USA.
| | - Colleen Delaney
- Department of Nutritional Sciences, Rutgers University, New Brunswick, NJ 08520, USA.
| | - Ryan Lewis
- Department of Nutritional Sciences, Rutgers University, New Brunswick, NJ 08520, USA.
| | - Carol Byrd-Bredbenner
- Department of Nutritional Sciences, Rutgers University, New Brunswick, NJ 08520, USA.
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17
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Abstract
IMPORTANCE Health equity is an often-cited goal of public health, included among the 4 overarching goals of the Department of Health and Human Services' Healthy People 2020. Yet it is difficult to find summary assessments of national progress toward this goal. OBJECTIVES To identify variation in several measures of health equity from 1993 to 2017 in the United States and to test whether there are significant time trends. DESIGN, SETTING, AND PARTICIPANTS Survey study using 25 years of data, from January 1, 1993, to December 31, 2017, from the Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System to assess trends in health equity and health justice by race/ethnicity, sex, and income in 3 categories by year. MAIN OUTCOMES AND MEASURES Health equity was assessed separately for each of 2 health constructs: healthy days-the average of physical and mental healthy days over the previous 30 days-and general health in 5 categories, rescaled to approximate a continuous variable. For each health construct, average health was calculated along with 4 measures of health equity: disparities across 3 income groups; black-white disparities; health justice-a measure of the correlation of health outcomes with income, race/ethnicity and sex; and a summary health equity metric. RESULTS Among the 5 456 006 respondents, the mean (SD) age was 44.5 (12.7) years; 3 178 688 (58.3%) were female; 4 163 945 (76.3%) were non-Latinx white; 474 855 (8.7%) were non-Latinx black; 419 542 (7.7%) were Latinx; and 397 664 (7.3%) were of other race/ethnicity. The final sample included 5 456 006 respondents for self-reported health and 5 349 527 respondents for healthy days. During the 25-year period, the black-white gap showed significant improvement (year coefficient: healthy days, 0.021; 97.5% CI, 0.012 to 0.029; P < .001; self-reported health, 0.030; 97.5% CI, 0.025 to 0.035; P < .001). The health equity metric for self-reported health showed no significant trend. For healthy days, the Health Equity Metric declined over time (year coefficient: healthy days, -0.025; 97.5% CI, -0.033 to -0.017; P < .001). Health justice declined over time (year coefficient: healthy days, -0.045; 97.5% CI, -0.053 to -0.038; P < .001; self-reported health, -0.035; 97.5% CI, -0.046 to-0.023; P < .001), and income disparities worsened (year coefficient: healthy days, -0.060; 97.5% CI, -0.076 to -0.044; P < .001; self-reported health, -0.029; 97.5% CI, -0.046 to -0.012; P < .001). CONCLUSIONS AND RELEVANCE Results of this analysis suggest that there has been a clear lack of progress on health equity during the past 25 years in the United States. Achieving widely shared goals of improving health equity will require greater effort from public health policy makers, along with their partners in medicine and the sectors that contribute to the social determinants of health.
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Affiliation(s)
- Frederick J. Zimmerman
- Jonathan and Karin Fielding School of Public Health, Department of Health Policy & Management, University of California, Los Angeles
| | - Nathaniel W. Anderson
- Jonathan and Karin Fielding School of Public Health, Department of Health Policy & Management, University of California, Los Angeles
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18
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McCullough KP, Morgenstern H, Saran R, Herman WH, Robinson BM. Projecting ESRD Incidence and Prevalence in the United States through 2030. J Am Soc Nephrol 2018; 30:127-135. [PMID: 30559143 DOI: 10.1681/asn.2018050531] [Citation(s) in RCA: 202] [Impact Index Per Article: 33.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 11/07/2018] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Population rates of obesity, hypertension, diabetes, age, and race can be used in simulation models to develop projections of ESRD incidence and prevalence. Such projections can inform long-range planning for ESRD resources needs. METHODS We used an open compartmental simulation model to estimate the incidence and prevalence of ESRD in the United States through 2030 on the basis of wide-ranging projections of population obesity and ESRD death rates. Population trends in age, race, hypertension, and diabetes were on the basis of data from the Centers for Disease Control and Prevention's National Health and Nutrition Examination Survey and the US Census. RESULTS The increase in ESRD incidence rates within age and race groups has leveled off and/or declined in recent years, but our model indicates that population changes in age and race distribution, obesity and diabetes prevalence, and ESRD survival will result in a 11%-18% increase in the crude incidence rate from 2015 to 2030. This incidence trend along with reductions in ESRD mortality will increase the number of patients with ESRD by 29%-68% during the same period to between 971,000 and 1,259,000 in 2030. CONCLUSIONS The burden of ESRD will increase in the United States population through 2030 due to demographic, clinical, and lifestyle shifts in the population and improvements in RRT. Planning for ESRD resource allocation should allow for substantial continued growth in the population of patients with ESRD. Future interventions should be directed to preventing the progression of CKD to kidney failure.
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Affiliation(s)
- Keith P McCullough
- Arbor Research Collaborative for Health, Ann Arbor, Michigan; and Departments of .,Epidemiology and
| | - Hal Morgenstern
- Epidemiology and.,Environmental Health Sciences, School of Public Health.,Department of Urology, Medical School, Divisions of
| | - Rajiv Saran
- Epidemiology and.,Metabolism, Endocrinology, and Diabetes and.,Nephrology, Department of Internal Medicine, and
| | | | - Bruce M Robinson
- Arbor Research Collaborative for Health, Ann Arbor, Michigan; and Departments of.,Nephrology, Department of Internal Medicine, and
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19
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Abstract
PURPOSE OF REVIEW An increasing trend in obesity prevalence since the early 1980s has posed a significant population health burden across the globe. We conducted a systematic review for studies using measured anthropometry to examine trends in obesity in the USA published from 2012 to 2018 and for systematic reviews to document trends in obesity across the globe published from 2014 to 2018. RECENT FINDINGS For the USA, the only nationally representative data source capturing trends in obesity in this period was the National Health and Nutrition Examination Survey, which uses repeated cross-sectional data to document national trends in obesity in the USA. For global trends, the only systematic reviews of obesity across the globe were the Global Burden of Disease Obesity study and the Non-communicable Disease Risk Factor Collaboration study. In general, the population distribution of body mass index (BMI) in the USA has shifted towards the upper end of its distribution over the past three decades. The global distribution has similarly increased, albeit with large regional differences. US and global studies suggest an increasing trend in obesity since the 1980s, and there is a dearth of nationally representative longitudinal studies using measured anthropometry to capture trends in adult obesity in the USA for the same individuals over time. Greater efforts are needed to identify factors contributing to the continued increases in obesity.
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Affiliation(s)
- Yosuke Inoue
- Carolina Population Center, The University of North Carolina at Chapel Hill, 123 W Franklin St, Chapel Hill, NC, 27516, USA
| | - Bo Qin
- Department of Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, 08903, USA
| | - Jennifer Poti
- Department of Nutrition, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Rebeccah Sokol
- Department of Health Behavior, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Penny Gordon-Larsen
- Carolina Population Center, The University of North Carolina at Chapel Hill, 123 W Franklin St, Chapel Hill, NC, 27516, USA.
- Department of Nutrition, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
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20
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Gąsior-Perczak D, Pałyga I, Szymonek M, Kowalik A, Walczyk A, Kopczyński J, Lizis-Kolus K, Trybek T, Mikina E, Szyska-Skrobot D, Gadawska-Juszczyk K, Hurej S, Szczodry A, Słuszniak A, Słuszniak J, Mężyk R, Góźdź S, Kowalska A. The impact of BMI on clinical progress, response to treatment, and disease course in patients with differentiated thyroid cancer. PLoS One 2018; 13:e0204668. [PMID: 30273371 PMCID: PMC6166948 DOI: 10.1371/journal.pone.0204668] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Accepted: 09/12/2018] [Indexed: 12/21/2022] Open
Abstract
Introduction Obesity is a serious health problem worldwide, particularly in developed countries. It is a risk factor for many diseases, including thyroid cancer. The relationship between obesity and prognostic factors of thyroid cancer is unclear. Aims We sought to ascertain the relationship between body mass index (BMI) and clinicopathological features increasing the risk of poor clinical course, treatment response, and clinical outcome in patients with differentiated thyroid cancer (DTC). Subjects & methods The study included 1181 patients with DTC (88% women and 12% men) treated at a single center from 2000 to 2016. BMI before surgery and aggressive clinicopathological features, according to the American Thyroid Initial Risk stratification system, were analyzed. The relationship between BMI and initial risk, treatment response, and final status of the disease was evaluated, incorporating the revised 2015 American Thyroid Association guidelines and the 8th edition of the American Joint Committee on Cancer/Tumor-Node-Metastasis (AJCC/TNM) staging system. Patients were stratified according to the World Health Organization classification of BMI. Statistical analysis was performed using univariate and multivariate logistic regression analysis. Results Median follow-up was 7.7 years (1–16 years). There were no significant associations between BMI and extrathyroidal extension (microscopic and gross), cervical lymph node metastasis, or distant metastasis in univariate and multivariate analyses. BMI did not affect initial risk, treatment response or disease outcome. Obesity was more prevalent in men (p = 0.035) and in patients ≥55 years old (p = 0.001). There was no statistically significant relationship between BMI and more advanced TNM stage in patients ≤55 years old (stage I vs. stage II) (p = 0.266) or in patients >55 years old (stage I–II vs. III–IV) (p = 0.877). Conclusions Obesity is not associated with more aggressive clinicopathological features of thyroid cancer. Obesity is not a risk factor for progression to more advanced stages of disease, nor is it a prognostic factor for poorer treatment response and clinical outcome.
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Affiliation(s)
| | - Iwona Pałyga
- Endocrinology Clinic, Holycross Cancer Centre, Kielce, Poland
| | - Monika Szymonek
- Endocrinology Clinic, Holycross Cancer Centre, Kielce, Poland
| | - Artur Kowalik
- Department of Molecular Diagnostics, Holycross Cancer Centre, Kielce, Poland
| | | | - Janusz Kopczyński
- Department of Surgical Pathology, Holycross Cancer Centre, Kielce, Poland
| | | | - Tomasz Trybek
- Endocrinology Clinic, Holycross Cancer Centre, Kielce, Poland
| | - Estera Mikina
- Endocrinology Clinic, Holycross Cancer Centre, Kielce, Poland
| | | | | | - Stefan Hurej
- Endocrinology Clinic, Holycross Cancer Centre, Kielce, Poland
| | - Artur Szczodry
- Endocrinology Clinic, Holycross Cancer Centre, Kielce, Poland
| | - Anna Słuszniak
- Laboratory of Tumor Markers, Holycross Cancer Centre, Kielce, Poland
| | - Janusz Słuszniak
- Department of Surgical Oncology, Holycross Cancer Centre, Kielce, Poland
| | - Ryszard Mężyk
- Cancer Epidemiology, Holycross Cancer Centre, Kielce, Poland
| | - Stanisław Góźdź
- Oncology Clinic, Holycross Cancer Centre, Kielce, Poland
- Faculty of Health Sciences, Jan Kochanowski University, Kielce, Poland
| | - Aldona Kowalska
- Endocrinology Clinic, Holycross Cancer Centre, Kielce, Poland
- Faculty of Health Sciences, Jan Kochanowski University, Kielce, Poland
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21
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Staples JN, Rauh L, Peach MS, Baker WD, Modesitt SC. Endometrial cancer in an increasingly obese population: Exploring alternative options when surgery may not cut it. Gynecol Oncol Rep 2018; 25:30-34. [PMID: 29977988 PMCID: PMC6030024 DOI: 10.1016/j.gore.2018.04.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Revised: 04/19/2018] [Accepted: 04/21/2018] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES The study objectives were to describe outcomes of obese patients with early endometrial cancer following primary non-surgical treatment, assess predictors of response, and estimate the increased surgical risk for these women. METHODS Retrospective chart review identified women with early stage endometrial cancer at a single institution with BMI ≥ 30 kg/m2 who did not undergo surgery as primary treatment modality due to obesity and medical co-morbidities. Clinicopathologic factors were abstracted, characteristics of responders vs. non-responders compared and the National Surgical Quality Improvement Program (NSQIP) surgical risk calculator utilized to quantify surgical risks. RESULTS Fifty-one patients were identified, with a mean BMI of 49.0 kg/m2. The NSQIP calculator predicted a significantly higher complication rate for our cohort compared to the expected average risk for hysterectomy (18.8% vs 7.2%, p < .0001). The majority of patients were treated with radiation alone (49%), followed by hormone therapy (45.1%). Response rates were 38.1% for women treated with hormones and 63.6% in the radiation group (p = .063). No significant differences were identified between responders and non-responders with regard to NSQIP scores, BMI, co-morbidities or age. Among those with persistent or progressive disease, 87.5% responded to secondary treatment. Only one death was from cancer progression. Two individuals died following treatment complications (one surgical, one chemotherapy); the remaining twelve deaths were due to pre-existing co-morbidities. CONCLUSIONS Hormone and radiation therapy are both viable options for obese patients deemed to have too significant risk of surgical complications. Pursuing surgical intervention in this population may do more harm than good.
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Affiliation(s)
- Jeanine N. Staples
- Division of Gynecology Oncology, Department of Obstetrics and Gynecology, University of Virginia, Charlottesville, VA, United States
| | - Lisa Rauh
- Division of Gynecology Oncology, Department of Obstetrics and Gynecology, University of Virginia, Charlottesville, VA, United States
| | - M. Sean Peach
- Department of Radiation Oncology, University of Virginia, Charlottesville, VA, United States
| | - William D. Baker
- Novant Health Oncology Specialists, Winston-Salem, NC, United States
| | - Susan C. Modesitt
- Division of Gynecology Oncology, Department of Obstetrics and Gynecology, University of Virginia, Charlottesville, VA, United States
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22
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Zenk SN, Tarlov E, Powell LM, Wing C, Matthews SA, Slater S, Gordon HS, Berbaum M, Fitzgibbon ML. Weight and Veterans' Environments Study (WAVES) I and II: Rationale, Methods, and Cohort Characteristics. Am J Health Promot 2018; 32:779-794. [PMID: 29214851 PMCID: PMC5876028 DOI: 10.1177/0890117117694448] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
PURPOSE To present the rationale, methods, and cohort characteristics for 2 complementary "big data" studies of residential environment contributions to body weight, metabolic risk, and weight management program participation and effectiveness. DESIGN Retrospective cohort. SETTING Continental United States. PARTICIPANTS A total of 3 261 115 veterans who received Department of Veterans Affairs (VA) health care in 2009 to 2014, including 169 910 weight management program participants and a propensity score-derived comparison group. INTERVENTION The VA MOVE! weight management program, an evidence-based lifestyle intervention. MEASURES Body mass index, metabolic risk measures, and MOVE! participation; residential environmental attributes (eg, food outlet availability and walkability); and MOVE! program characteristics. ANALYSIS Descriptive statistics presented on cohort characteristics and environments where they live. RESULTS Forty-four percent of men and 42.8% of women were obese, whereas 4.9% of men and 9.9% of women engaged in MOVE!. About half of the cohort had at least 1 supermarket within 1 mile of their home, whereas they averaged close to 4 convenience stores (3.6 for men, 3.9 for women) and 8 fast-food restaurants (7.9 for men, 8.2 for women). Forty-one percent of men and 38.6% of women did not have a park, and 35.5% of men and 31.3% of women did not have a commercial fitness facility within 1 mile. CONCLUSION Drawing on a large nationwide cohort residing in diverse environments, these studies are poised to significantly inform policy and weight management program design.
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Affiliation(s)
- Shannon N Zenk
- 1 Department of Health Systems Science, University of Illinois at Chicago College of Nursing, Chicago, IL, USA
| | - Elizabeth Tarlov
- 1 Department of Health Systems Science, University of Illinois at Chicago College of Nursing, Chicago, IL, USA
- 2 Center of Innovation for Complex Chronic Healthcare (CINCCH), Hines VA Hospital, Hines, IL, USA
| | - Lisa M Powell
- 3 Health Policy and Administration Division, University of Illinois at Chicago School of Public Health, Chicago, IL, USA
- 4 Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Coady Wing
- 5 Indiana University-Bloomington School of Public and Environmental Affairs, Bloomington, IN, USA
| | - Stephen A Matthews
- 6 Department of Sociology, Anthropology, and Demography, Pennsylvania State University, University Park, PA, USA
| | - Sandy Slater
- 3 Health Policy and Administration Division, University of Illinois at Chicago School of Public Health, Chicago, IL, USA
- 4 Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Howard S Gordon
- 7 Jesse Brown VA Medical Center, Chicago, IL, USA
- 8 Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Michael Berbaum
- 4 Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Marian L Fitzgibbon
- 3 Health Policy and Administration Division, University of Illinois at Chicago School of Public Health, Chicago, IL, USA
- 4 Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
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23
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Kim S, Subramanian SV, Oh J, Razak F. Trends in the distribution of body mass index and waist circumference among South Korean adults, 1998-2014. Eur J Clin Nutr 2017; 72:198-206. [PMID: 29242528 DOI: 10.1038/s41430-017-0024-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 08/21/2017] [Accepted: 08/22/2017] [Indexed: 01/14/2023]
Abstract
BACKGROUND/OBJECTIVES An increase in mean body mass index (BMI) or prevalence of obesity may be accompanied by changes in the population BMI distribution. This study aimed to examine how the distributions of BMI and waist circumference (WC) have changed in South Korea over a 16-year interval (1998-2014). SUBJECTS/METHODS Using the Korea National Health and Nutrition Examination Survey, we analyzed changes in mean, standard deviation (SD), 5th, and 95th percentile values of BMI and WC distributions for 46,343 (BMI) and 46,327 (WC) adults aged 25-64 years. RESULTS For men, mean BMI increased at an annual rate of 0.060 units (95% CI: 0.047-0.073) with annual increases of 0.029 units in SD (95% CI: 0.019-0.039), 0.121 units in the 95th percentile (95% CI: 0.097-0.145) and 0.042 units in the 5th percentile (95% CI: 0.021-0.062). The 95th percentile and SD of the WC distribution increased, but not mean WC and the 5th percentile. For women, mean BMI decreased at an annual rate of 0.030 units (95% CI: 0.010-0.049) with a 0.030-unit increase in SD (95% CI: 0.012-0.048) and a 0.049-unit decrease in the 5th percentile (95% CI: 0.029-0.070). Mean WC also decreased with an increase in SD and a decrease in the 5th percentile. CONCLUSIONS These findings suggest increasing dispersion in the distribution of BMI and WC derived from significant shifts in the upper tails for Korean men, but not women. Future research needs to identify the factors that underlie the increasing dispersion of obesity measures.
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Affiliation(s)
- Sujin Kim
- Institute of Health and Environment, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, South Korea.,Takemi Program in International Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - S V Subramanian
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Juhwan Oh
- College of Medicine, Seoul National University, Seoul, 03087, South Korea
| | - Fahad Razak
- St Michael's Hospital and the Li Ka Shing Knowledge Institute, University of Toronto, Toronto, ON, Canada. .,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada. .,Harvard Centre for Population and Development Studies, Harvard University, Cambridge, MA, USA.
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24
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Zagorsky JL, Smith PK. The association between socioeconomic status and adult fast-food consumption in the U.S. ECONOMICS AND HUMAN BIOLOGY 2017; 27:12-25. [PMID: 28472714 DOI: 10.1016/j.ehb.2017.04.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 03/13/2017] [Indexed: 06/07/2023]
Abstract
Health follows a socioeconomic status (SES) gradient in developed countries, with disease prevalence falling as SES rises. This pattern is partially attributed to differences in nutritional intake, with the poor eating the least healthy diets. This paper examines whether there is an SES gradient in one specific aspect of nutrition: fast-food consumption. Fast food is generally high in calories and low in nutrients. We use data from the 2008, 2010, and 2012 waves of the National Longitudinal Survey of Youth (NLSY79) to test whether adult fast-food consumption in the United States falls as monetary resources rise (n=8136). This research uses more recent data than previous fast-food studies and includes a comprehensive measure of wealth in addition to income to measure SES. We find little evidence of a gradient in adult fast-food consumption with respect to wealth. While adults in the highest quintile are 54.5% less likely to report fast-food consumption than those in the lowest quintile, adults in the second and third quintiles are no less likely to report fast food-food intake than the poorest. Contrary to popular belief, fast-food consumption rises as income rises from the lowest to middle quintiles. The variation in adult fast-food consumption across income and wealth groups is, however, small. Those in the wealthiest quintile ate about one less fast-food meal on average than those in the lowest quintile. Other factors play a bigger role in explaining fast-food consumption: reading ingredient labels is negatively associated while soda consumption and hours of work are positively associated with fast-food consumption.
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Affiliation(s)
- Jay L Zagorsky
- Center for Human Resource Research, The Ohio State University, 921 Chatham Lane, Suite 100, Columbus, OH 43221, USA.
| | - Patricia K Smith
- Department of Social Sciences, University of Michigan-Dearborn, 4901 Evergreen Road, Dearborn, MI 48128, USA.
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25
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Marteleto LJ, Gama LCD, Dondero M, Brown LEC. The Weight of Inequality: Socioeconomic Status and Adolescent Body Mass in Brazil. SOCIAL FORCES; A SCIENTIFIC MEDIUM OF SOCIAL STUDY AND INTERPRETATION 2017; 95:1637-1666. [PMID: 37461401 PMCID: PMC10351486 DOI: 10.1093/sf/sox028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
The high rate of obesity among adolescents is a global public health problem that has recently expanded to affect middle- and low-income countries. Brazil, which is undergoing a relatively rapid nutrition transition and has inadequate health systems, is currently experiencing the consequences of increasing rates of overweight and obesity concomitantly with the consequences of generations of malnourishment. Given this scenario, Brazil is an ideal context for examining the relationship between family socioeconomic status (SES) and adolescent body mass, as well as how this relationship varies across very different regions within the same country and across the body mass index (BMI) continuum. Guided by a framework that integrates nutrition transition and fundamental cause theories, we use unique nationally representative data with measured height and weight for all household members to conduct quantile regression models. The results suggest that family socioeconomic conditions are important theoretical factors associated with adolescent BMI, but that the way in which family SES impinges on adolescent BMI varies across regions characterized by different locations in the nutrition transition and varying levels of economic development. We also find that family socioeconomic disadvantages operate very differently according to BMI status. The results show that the socioeconomic gradient of adolescent BMI varies by stages of the nutrition transition and economic development and across BMI percentiles.
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Affiliation(s)
- Letícia J Marteleto
- Associate Professor of Sociology and Faculty Research Associate of the Population Research Center at the University of Texas at Austin
| | - Luiz C D Gama
- PhD candidate in the Economics Department at the Federal University of Minas Gerais and a lecturer at the Federal Center for Technological Education of Minas Gerais/Brazil
| | - Molly Dondero
- Assistant Professor of Sociology at American University
| | - Letisha E C Brown
- PhD candidate in the Sociology Department at the University of Texas at Austin
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26
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Zenk SN, Mentz G, Schulz AJ, Johnson-Lawrence V, Gaines CR. Longitudinal Associations Between Observed and Perceived Neighborhood Food Availability and Body Mass Index in a Multiethnic Urban Sample. HEALTH EDUCATION & BEHAVIOR 2017; 44:41-51. [PMID: 27230271 PMCID: PMC5777147 DOI: 10.1177/1090198116644150] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Blacks, Hispanics, and women of lower socioeconomic status tend to have a higher risk of obesity. Numerous studies over the past decade examined the role of the neighborhood food environment in body weight. However, few were longitudinal. PURPOSE This longitudinal study examined whether multiple measures of neighborhood food availability were associated with body mass index (BMI) in a predominately Black and Hispanic adult sample living in low- to moderate-income urban neighborhoods. METHOD This longitudinal study used two waves of data (2002, 2008), including interviewer-measured height and weight, from a community survey of adults ( n = 219). In both 2002 and 2008, multiple measures characterized neighborhood food availability: GIS-derived availability of retail food outlets (large grocery store, small grocery store, convenience store, liquor stores), observed fruit and vegetable availability (count of stores selling 10 or more fresh fruit or vegetable varieties), and perceived fruit and vegetable access. Random intercept models estimated multivariable associations, controlling for individual-level demographics and neighborhood median household income. RESULTS Small grocery store availability was associated with 1.22-unit increase in BMI ( p = .047), while each unit increase in perceived fruit and vegetable access was associated with a 0.69-unit decrease in BMI ( p = .055). BMI was not associated with large grocery store, convenience store, or liquor store availability, or with observed fruit and vegetable availability. CONCLUSIONS Findings suggest that improving the neighborhood food environment, particularly at small grocery stores, may help urban residents living in low- to moderate-income neighborhoods achieve healthier body weights over time.
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27
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Grant WB. Re: Prospective study of ultraviolet radiation exposure and risk of breast cancer in the United States. ENVIRONMENTAL RESEARCH 2017; 152:517-518. [PMID: 27751444 DOI: 10.1016/j.envres.2016.09.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 09/15/2016] [Indexed: 06/06/2023]
Affiliation(s)
- William B Grant
- Sunlight, Nutrition, and Health Research Center, P.O. Box 641603, San Francisco, CA 94164-1603, USA.
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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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29
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Burns TA. Effects of Common Equine Endocrine Diseases on Reproduction. Vet Clin North Am Equine Pract 2016; 32:435-449. [PMID: 27726988 DOI: 10.1016/j.cveq.2016.07.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Endocrine diseases, such as equine metabolic syndrome and pituitary pars intermedia dysfunction, are common in domesticated horse populations, and the frequency with which these diseases are encountered and managed by equine veterinary practitioners is expected to increase as the population ages. As clinicians learn more about the effects of these diseases on equine reproductive physiology and efficiency (including effects on reproductive seasonality, ovulation efficiency, implantation, early pregnancy loss, duration of pregnancy, and lactation), strategies and guidelines for improving fertility in affected animals continue to evolve. It is hoped that further research will establish these recommendations more firmly.
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Affiliation(s)
- Teresa A Burns
- Equine Internal Medicine, Department of Veterinary Clinical Sciences, The Ohio State University, College of Veterinary Medicine, 601 Vernon L. Tharp St, Columbus, OH 43210, USA.
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30
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Morton NM, Beltram J, Carter RN, Michailidou Z, Gorjanc G, Fadden CM, Barrios-Llerena ME, Rodriguez-Cuenca S, Gibbins MTG, Aird RE, Moreno-Navarrete JM, Munger SC, Svenson KL, Gastaldello A, Ramage L, Naredo G, Zeyda M, Wang ZV, Howie AF, Saari A, Sipilä P, Stulnig TM, Gudnason V, Kenyon CJ, Seckl JR, Walker BR, Webster SP, Dunbar DR, Churchill GA, Vidal-Puig A, Fernandez-Real JM, Emilsson V, Horvat S. Genetic identification of thiosulfate sulfurtransferase as an adipocyte-expressed antidiabetic target in mice selected for leanness. Nat Med 2016; 22:771-9. [PMID: 27270587 PMCID: PMC5524189 DOI: 10.1038/nm.4115] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Accepted: 04/29/2016] [Indexed: 12/13/2022]
Abstract
The discovery of genetic mechanisms for resistance to obesity and diabetes may illuminate new therapeutic strategies for the treatment of this global health challenge. We used the polygenic 'lean' mouse model, which has been selected for low adiposity over 60 generations, to identify mitochondrial thiosulfate sulfurtransferase (Tst; also known as rhodanese) as a candidate obesity-resistance gene with selectively increased expression in adipocytes. Elevated adipose Tst expression correlated with indices of metabolic health across diverse mouse strains. Transgenic overexpression of Tst in adipocytes protected mice from diet-induced obesity and insulin-resistant diabetes. Tst-deficient mice showed markedly exacerbated diabetes, whereas pharmacological activation of TST ameliorated diabetes in mice. Mechanistically, TST selectively augmented mitochondrial function combined with degradation of reactive oxygen species and sulfide. In humans, TST mRNA expression in adipose tissue correlated positively with insulin sensitivity in adipose tissue and negatively with fat mass. Thus, the genetic identification of Tst as a beneficial regulator of adipocyte mitochondrial function may have therapeutic significance for individuals with type 2 diabetes.
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Affiliation(s)
- Nicholas M. Morton
- University/British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Queen’s Medical Research Institute, Edinburgh, UK
| | - Jasmina Beltram
- Biotechnical Faculty, Animal Science Department, University of Ljubljana, Ljubljana, Slovenia
| | - Roderick N. Carter
- University/British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Queen’s Medical Research Institute, Edinburgh, UK
| | - Zoi Michailidou
- University/British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Queen’s Medical Research Institute, Edinburgh, UK
| | - Gregor Gorjanc
- Biotechnical Faculty, Animal Science Department, University of Ljubljana, Ljubljana, Slovenia
| | - Clare Mc Fadden
- University/British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Queen’s Medical Research Institute, Edinburgh, UK
| | - Martin E. Barrios-Llerena
- University/British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Queen’s Medical Research Institute, Edinburgh, UK
| | - Sergio Rodriguez-Cuenca
- Metabolic Research Laboratories, Level 4, Wellcome Trust-MRC Institute of Metabolic Science, Addenbrookes Hospital, Cambridge, UK
| | - Matthew T. G. Gibbins
- University/British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Queen’s Medical Research Institute, Edinburgh, UK
| | - Rhona E. Aird
- University/British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Queen’s Medical Research Institute, Edinburgh, UK
| | - José Maria Moreno-Navarrete
- Department of Diabetes, Endocrinology and Nutrition, Institut d'Investigació Biomédica de Girona; Department of Medicine, University of Girona
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Girona, Spain
| | | | | | - Annalisa Gastaldello
- University/British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Queen’s Medical Research Institute, Edinburgh, UK
| | - Lynne Ramage
- University/British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Queen’s Medical Research Institute, Edinburgh, UK
| | - Gregorio Naredo
- University/British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Queen’s Medical Research Institute, Edinburgh, UK
| | - Maximilian Zeyda
- Clinical Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Zhao V. Wang
- Department of Internal Medicine, Touchstone Diabetes Center University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Alexander F. Howie
- The MRC Centre for Reproductive Health, University of Edinburgh, Queen’s Medical Research Institute, Edinburgh, UK
| | - Aila Saari
- Department of Physiology, Institute of Biomedicine, University of Turku, Turku, Finland
| | - Petra Sipilä
- Central Animal Laboratory, University of Turku, Turku, Finland
| | - Thomas M. Stulnig
- Clinical Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | | | - Christopher J. Kenyon
- University/British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Queen’s Medical Research Institute, Edinburgh, UK
| | - Jonathan R. Seckl
- University/British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Queen’s Medical Research Institute, Edinburgh, UK
| | - Brian R. Walker
- University/British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Queen’s Medical Research Institute, Edinburgh, UK
| | - Scott P. Webster
- University/British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Queen’s Medical Research Institute, Edinburgh, UK
| | - Donald R. Dunbar
- University/British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Queen’s Medical Research Institute, Edinburgh, UK
| | | | - Antonio Vidal-Puig
- Metabolic Research Laboratories, Level 4, Wellcome Trust-MRC Institute of Metabolic Science, Addenbrookes Hospital, Cambridge, UK
| | - José Manuel Fernandez-Real
- Department of Diabetes, Endocrinology and Nutrition, Institut d'Investigació Biomédica de Girona; Department of Medicine, University of Girona
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Girona, Spain
| | - Valur Emilsson
- Icelandic Heart Association, Kopavogur, Iceland
- Faculty of Pharmaceutical Sciences, University of Iceland, Reykjavik, Iceland
| | - Simon Horvat
- Biotechnical Faculty, Animal Science Department, University of Ljubljana, Ljubljana, Slovenia
- National Institute of Chemistry, Ljubljana, Slovenia
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Ferrer RL, Burge SK, Palmer RF, Cruz I. Practical Opportunities for Healthy Diet and Physical Activity: Relationship to Intentions, Behaviors, and Body Mass Index. Ann Fam Med 2016; 14:109-16. [PMID: 26951585 PMCID: PMC4781513 DOI: 10.1370/afm.1886] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Current strategies for improving diet and activity patterns focus on encouraging patients to make better choices, but they meet with limited success. Because the choices people make depend on the choices they have, we examined how practical opportunities for diet and physical activity shape behavioral intentions and achieved behaviors. METHODS Participants included 746 adults who visited 8 large primary care practices in the Residency Research Network of Texas in 2012. We used structural equation models to confirm factor structures for a previously validated measure of practical opportunities, and then modeled achieved diet (Starting the Conversation - Diet questionnaire), physical activity (International Physical Activity Questionnaire), and BMI as a function of opportunities (classified as either resources or conversion factors that influence use of resources), behavioral intentions, and demographic covariates. RESULTS In path models, resources (P <.001) and conversion factors (P = .005) predicted behavioral intentions for activity. Conversion factors (P <.001), but not resources, predicted diet intentions. Both activity resources (P = .01) and conversion factors (P <.001) were positively associated with weekly activity minutes. Diet conversion factors (P <.001), but not diet resources (P = .08), were positively associated with diet quality. The same patterns were observed for body mass index (BMI). Socioeconomic gradients in resources and conversion factors were evident. CONCLUSIONS Individuals' feasible opportunities for healthy diet and activity have clinically meaningful associations with intentions, achieved behaviors, and BMI. Assessing opportunities as part of health behavior management could lead to more effective, efficient, and compassionate interventions.
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Affiliation(s)
- Robert L Ferrer
- Department of Family and Community Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Sandra K Burge
- Department of Family and Community Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Raymond F Palmer
- Department of Family and Community Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Inez Cruz
- Department of Family and Community Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas
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Abstract
Albert J. Stunkard's influential career in obesity research spanned over 50 years and included several landmark studies on social factors related to obesity. This review discusses the important contributions Stunkard made to research on the relationship between socioeconomic status socioeconomic status and obesity, extensions of his work, and reflects on Stunkard's role in the mentoring of succeeding generations of scientists.
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Affiliation(s)
- Gregory Pavela
- 227K, Ryals Public Health Building, Room 227K, University of Alabama at Birmingham, 1665 University Boulevard, Birmingham, Alabama 35294, , Phone: (205)-934-9325
| | - Dwight W. Lewis
- The University of Alabama School of Medicine (Tuscaloosa Regional Campus), 850 5th Ave East; Tuscaloosa, AL 35401,
| | - Julie Locher
- Departments of Medicine (Division of Gerontology, Geriatrics, and Palliative Care; Section of Social and Behavioral Sciences) and Health Care Organization and Policy, 1530 3 Avenue South; CH19-Room 218F; Birmingham, Alabama 35294-2041, Phone: 205.934.7542, Fax: 205.975.5870,
| | - David B. Allison
- Nutrition Obesity Research Center, Ryals Public Health Building, Room 140J, University of Alabama at Birmingham, 1665 University Boulevard, Birmingham, Alabama 35294
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33
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The relationship between income, economic freedom, and BMI. Public Health 2016; 134:18-25. [PMID: 26927823 DOI: 10.1016/j.puhe.2016.01.020] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Revised: 12/31/2015] [Accepted: 01/21/2016] [Indexed: 12/20/2022]
Abstract
OBJECTIVES What explains increases in BMI (and obesity) over time and across countries? Although many microeconomic forces are likely explanations, increasingly scholars are arguing that macroeconomic forces such as market liberalism and globalization are root causes of the obesity epidemic. The purpose of this paper is to examine the impact of economic freedom on obesity conditional on the level of income and other factors. STUDY DESIGN We use an unbalanced pooled cross section of up to 135 countries for 1995 and 2000-2009. METHODS Our statistical model specifications include pooled OLS and fixed effects. RESULTS First, we find that controlling for fixed effects siphons off much of the relationship previously documented between economic freedom and BMI. Second, economic freedom is associated with slightly higher BMIs but only for men in developing nations. Lastly, we show that economic freedom increases life expectancy for both men and women in developing countries. CONCLUSION Therefore, policies aimed at reducing obesity that limit economic liberalism may come at the expense of life expectancy in the developing world.
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Athens JK, Duncan DT, Elbel B. Proximity to Fast-Food Outlets and Supermarkets as Predictors of Fast-Food Dining Frequency. J Acad Nutr Diet 2016; 116:1266-75. [PMID: 26923712 DOI: 10.1016/j.jand.2015.12.022] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 12/21/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND This study used cross-sectional data to test the independent relationship of proximity to chain fast-food outlets and proximity to full-service supermarkets on the frequency of mealtime dining at fast-food outlets in two major urban areas, using three approaches to define access. Interactions between presence of a supermarket and presence of fast-food outlets as predictors of fast-food dining were also tested. METHODS Residential intersections for respondents in point-of-purchase and random-digit-dial telephone surveys of adults in Philadelphia, PA, and Baltimore, MD, were geocoded. The count of fast-food outlets and supermarkets within quarter-mile, half-mile, and 1-mile street network buffers around each respondent's intersection was calculated, as well as distance to the nearest fast-food outlet and supermarket. These variables were regressed on weekly fast-food dining frequency to determine whether proximity to fast food and supermarkets had independent and joint effects on fast-food dining. RESULTS The effect of access to supermarkets and chain fast-food outlets varied by study population. Among telephone survey respondents, supermarket access was the only significant predictor of fast-food dining frequency. Point-of-purchase respondents were generally unaffected by proximity to either supermarkets or fast-food outlets. However, ≥1 fast-food outlet within a 1-mile buffer was an independent predictor of consuming more fast-food meals among point-of-purchase respondents. At the quarter-mile distance, ≥1 supermarket was predictive of fewer fast-food meals. CONCLUSIONS Supermarket access was associated with less fast-food dining among telephone respondents, whereas access to fast-food outlets were associated with more fast-food visits among survey respondents identified at point-of-purchase. This study adds to the existing literature on geographic determinants of fast-food dining behavior among urban adults in the general population and those who regularly consume fast food.
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Abstract
Each year, the American Cancer Society estimates the numbers of new cancer cases and deaths that will occur in the United States in the current year and compiles the most recent data on cancer incidence, mortality, and survival. Incidence data were collected by the National Cancer Institute (Surveillance, Epidemiology, and End Results [SEER] Program), the Centers for Disease Control and Prevention (National Program of Cancer Registries), and the North American Association of Central Cancer Registries. Mortality data were collected by the National Center for Health Statistics. In 2016, 1,685,210 new cancer cases and 595,690 cancer deaths are projected to occur in the United States. Overall cancer incidence trends (13 oldest SEER registries) are stable in women, but declining by 3.1% per year in men (from 2009-2012), much of which is because of recent rapid declines in prostate cancer diagnoses. The cancer death rate has dropped by 23% since 1991, translating to more than 1.7 million deaths averted through 2012. Despite this progress, death rates are increasing for cancers of the liver, pancreas, and uterine corpus, and cancer is now the leading cause of death in 21 states, primarily due to exceptionally large reductions in death from heart disease. Among children and adolescents (aged birth-19 years), brain cancer has surpassed leukemia as the leading cause of cancer death because of the dramatic therapeutic advances against leukemia. Accelerating progress against cancer requires both increased national investment in cancer research and the application of existing cancer control knowledge across all segments of the population.
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Affiliation(s)
- Rebecca L Siegel
- Director, Surveillance Information, Surveillance and Health Services Research, American Cancer Society, Atlanta, GA
| | - Kimberly D Miller
- Epidemiologist, Surveillance and Health Services Research, American Cancer Society, Atlanta, GA
| | - Ahmedin Jemal
- Vice President, Surveillance and Health Services Research, American Cancer Society, Atlanta, GA
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36
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Prevalence of class-I, class-II and class-III obesity in Australian adults between 1995 and 2011–12. Obes Res Clin Pract 2015; 9:553-62. [DOI: 10.1016/j.orcp.2015.02.004] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Revised: 11/21/2014] [Accepted: 02/08/2015] [Indexed: 11/19/2022]
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Miech RA, Shanahan MJ, Boardman J, Bauldry S. The Sequencing of a College Degree during the Transition to Adulthood: Implications for Obesity. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2015; 56:281-95. [PMID: 26022787 PMCID: PMC5007865 DOI: 10.1177/0022146515581618] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
In this study we consider the health implications of the sequencing of a college degree vis-à-vis familial roles during the transition to adulthood. We hypothesize that people who earned a college degree before assuming familial roles will have better health than people who earned a college degree afterwards. To test this hypothesis, we focus on obesity and use data from the National Longitudinal Study of Adolescent Health. Results show that marriage before completion of college was associated with a 50% higher probability of becoming obese when compared with marriage after completion of college. Parenthood before college completion was associated with a greater than twofold increase in the probability of becoming obese when compared to parenthood afterwards for black men. These findings suggest that the well-established association of education with health depends on its place in a sequence of roles.
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Affiliation(s)
| | | | | | - Shawn Bauldry
- University of Alabama at Birmingham, Birmingham, AL, USA
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38
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Gangnon RE, Sprague BL, Stout NK, Alagoz O, Weedon-Fekjær H, Holford TR, Trentham-Dietz A. The contribution of mammography screening to breast cancer incidence trends in the United States: an updated age-period-cohort model. Cancer Epidemiol Biomarkers Prev 2015; 24:905-12. [PMID: 25787716 DOI: 10.1158/1055-9965.epi-14-1286] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 02/18/2015] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The impact of screening mammography on breast cancer incidence is difficult to disentangle from cohort- and age-related effects on incidence. METHODS We developed an age-period-cohort model of ductal carcinoma in situ (DCIS) and invasive breast cancer incidence in U.S. females using cancer registry data. Five functions were included in the model to estimate stage-specific effects for age, premenopausal birth cohorts, postmenopausal birth cohorts, period (for all years of diagnosis), and a mammography period effect limited to women ages ≥ 40 years after 1982. Incidence with and without the mammography period effect was calculated. RESULTS More recent birth cohorts have elevated underlying risk compared with earlier cohorts for both pre- and postmenopausal women. Comparing models with and without the mammography period effect showed that overall breast cancer incidence would have been 23.1% lower in the absence of mammography in 2010 (95% confidence intervals, 18.8-27.4), including 14.7% (9.5-19.3) lower for invasive breast cancer and 54.5% (47.4-59.6) lower for DCIS. Incidence of distant-staged breast cancer in 2010 would have been 29.0% (13.1-48.1) greater in the absence of mammography screening. CONCLUSIONS Mammography contributes to markedly elevated rates of DCIS and early-stage invasive cancers, but also contributes to substantial reductions in the incidence of metastatic breast cancer. IMPACT Mammography is an important tool for reducing the burden of breast cancer, but future work is needed to identify risk factors accounting for increasing underlying incidence and to distinguish between indolent and potentially lethal early-stage breast cancers that are detected via mammography.
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Affiliation(s)
- Ronald E Gangnon
- Department of Biostatistics and Medical Informatics, University of Wisconsin, Madison, Wisconsin. Department of Population Health Sciences, University of Wisconsin, Madison, Wisconsin. Carbone Cancer Center, University of Wisconsin, Madison, Wisconsin
| | - Brian L Sprague
- Department of Surgery and Vermont Cancer Center, University of Vermont, Burlington, Vermont
| | - Natasha K Stout
- Department of Population Medicine, Harvard Medical School, Boston, Massachusetts
| | - Oguz Alagoz
- Carbone Cancer Center, University of Wisconsin, Madison, Wisconsin. Department of Industrial and System Engineering, University of Wisconsin, Madison, Wisconsin
| | - Harald Weedon-Fekjær
- Oslo Center for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway
| | | | - Amy Trentham-Dietz
- Department of Population Health Sciences, University of Wisconsin, Madison, Wisconsin. Carbone Cancer Center, University of Wisconsin, Madison, Wisconsin.
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Nkeh-Chungag BN, Sekokotla AM, Sewani-Rusike C, Namugowa A, Iputo JE. Prevalence of Hypertension and Pre-hypertension in 13-17 Year Old Adolescents Living in Mthatha - South Africa: a Cross-Sectional Study. Cent Eur J Public Health 2015; 23:59-64. [DOI: 10.21101/cejph.a3922] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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40
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Krishna A, Razak F, Lebel A, Smith GD, Subramanian SV. Trends in group inequalities and interindividual inequalities in BMI in the United States, 1993-2012. Am J Clin Nutr 2015; 101:598-605. [PMID: 25733645 DOI: 10.3945/ajcn.114.100073] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Marked increases in mean body mass index (BMI) and prevalence of obesity and overweight in the United States are well known. However, whether these average increases were accompanied by changing dispersion (or SD) remains understudied. OBJECTIVE We investigated population-level changes in the BMI distribution over time to understand how changes in dispersion reflect between-group compared with within-group inequalities in weight gain in the United States. DESIGN Using data from the Behavioral Risk Factor Surveillance System survey (1993-2012), we analyzed associations between mean, SD, and median BMI and BMI at the 5th and 95th percentiles for 3,050,992 non-Hispanic white, non-Hispanic black, and Hispanic men and women aged 25-64 y. RESULTS Overall, an increase of 1.0 in mean BMI (in kg/m²) was associated with an increase of 0.70 (95% CI: 0.67, 0.73) in the SD of BMI. A change of 1.0 in median BMI was associated with a change of 0.18 (95% CI: 0.14, 0.21) in the BMI value at the 5th percentile compared with a change of 2.94 (95% CI: 2.81, 3.07) at the 95th percentile. Quantile-quantile plots showed unequal changes in the BMI distribution, with pronounced changes at higher percentiles. Similar patterns were observed in subgroups stratified by sex, race-ethnicity, and education with non-Hispanic black women and women with less than a high school education having highest mean BMI, SD of BMI, and BMI values at the 5th and 95th percentiles. CONCLUSIONS Mean BMI and the percentage of overweight and obese individuals do not fully describe population changes in BMI. Increases in within-group inequality in BMI represent an underrecognized characteristic of population-level weight gain. Crucially, similar increases in dispersion within groups suggest that growing inequalities in BMI at the population level are not driven by these socioeconomic and demographic factors. Future research should focus on understanding factors driving inequalities in weight gain between individuals.
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Affiliation(s)
- Aditi Krishna
- From the Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA (AK and SVS); the Department of Medicine, University of Toronto, Toronto, Canada (FR); the Li Ka Shing Knowledge Institute and Division of General Internal Medicine, St. Michael's Hospital, Toronto, Canada (FR); the Harvard Center for Population and Development Studies. Boston, MA (FR); Laval University, Quebec, Canada (AL); the Quebec Heart and Lung Institute Research Center, Quebec, Canada (AL); and the School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom (GDS)
| | - Fahad Razak
- From the Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA (AK and SVS); the Department of Medicine, University of Toronto, Toronto, Canada (FR); the Li Ka Shing Knowledge Institute and Division of General Internal Medicine, St. Michael's Hospital, Toronto, Canada (FR); the Harvard Center for Population and Development Studies. Boston, MA (FR); Laval University, Quebec, Canada (AL); the Quebec Heart and Lung Institute Research Center, Quebec, Canada (AL); and the School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom (GDS)
| | - Alexandre Lebel
- From the Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA (AK and SVS); the Department of Medicine, University of Toronto, Toronto, Canada (FR); the Li Ka Shing Knowledge Institute and Division of General Internal Medicine, St. Michael's Hospital, Toronto, Canada (FR); the Harvard Center for Population and Development Studies. Boston, MA (FR); Laval University, Quebec, Canada (AL); the Quebec Heart and Lung Institute Research Center, Quebec, Canada (AL); and the School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom (GDS)
| | - George Davey Smith
- From the Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA (AK and SVS); the Department of Medicine, University of Toronto, Toronto, Canada (FR); the Li Ka Shing Knowledge Institute and Division of General Internal Medicine, St. Michael's Hospital, Toronto, Canada (FR); the Harvard Center for Population and Development Studies. Boston, MA (FR); Laval University, Quebec, Canada (AL); the Quebec Heart and Lung Institute Research Center, Quebec, Canada (AL); and the School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom (GDS)
| | - S V Subramanian
- From the Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA (AK and SVS); the Department of Medicine, University of Toronto, Toronto, Canada (FR); the Li Ka Shing Knowledge Institute and Division of General Internal Medicine, St. Michael's Hospital, Toronto, Canada (FR); the Harvard Center for Population and Development Studies. Boston, MA (FR); Laval University, Quebec, Canada (AL); the Quebec Heart and Lung Institute Research Center, Quebec, Canada (AL); and the School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom (GDS)
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Ma J, Huang M, Wang L, Ye W, Tong Y, Wang H. Obesity and risk of thyroid cancer: evidence from a meta-analysis of 21 observational studies. Med Sci Monit 2015; 21:283-91. [PMID: 25612155 PMCID: PMC4315628 DOI: 10.12659/msm.892035] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Several studies have evaluated the association between obesity and thyroid cancer risk. However, the results remain uncertain. In this study, we conducted a meta-analysis to assess the association between obesity and thyroid cancer risk. MATERIAL/METHODS Published literature from PubMed, EMBASE, Springer Link, Ovid, Chinese Wanfang Data Knowledge Service Platform, Chinese National Knowledge Infrastructure (CNKI), and Chinese Biology Medicine (CBM) were retrieved before 10 August 2014. We included all studies that reported adjusted risk ratios (RRs), hazard ratios (HRs) or odds ratios (ORs), and 95% confidence intervals (CIs) of thyroid cancer risk. RESULTS Thirty-two studies (n=12 620 676) were included in this meta-analysis. Obesity was associated with a significantly increased risk of thyroid cancer (adjusted RR=1.33; 95% CI, 1.24-1.42; I2=25%). In the subgroup analysis by study type, increased risk of thyroid cancer was found in cohort studies and case-control studies. In subgroup analysis by sex, both obese men and women were at significantly greater risk of thyroid cancer than non-obese subjects. When stratified by ethnicity, significantly elevated risk was observed in Caucasians and in Asians. In the age subgroup analysis, both young and old populations showed increased thyroid cancer risk. Subgroup analysis on smoking status showed that increased thyroid cancer risks were found in smokers and in non-smokers. In the histology subgroup analyses, increased risks of papillary thyroid cancer, follicular thyroid cancer, and anaplastic thyroid cancer were observed. However, obesity was associated with decreased risk of medullary thyroid cancer. CONCLUSIONS Our results indicate that obesity is associated with an increased thyroid cancer risk, except medullary thyroid cancer.
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Affiliation(s)
- Jie Ma
- Department of Laboratory Medicine, Hubei Xinhua Hospital, Wuhan, Hubei, China (mainland)
| | - Min Huang
- Department of Scientific Research and Education, Hubei Xinhua Hospital, Wuhan, Hubei, China (mainland)
| | - Li Wang
- Department of Laboratory Medicine, Hubei Xinhua Hospital, Wuhan, Hubei, China (mainland)
| | - Wei Ye
- Department of Laboratory Medicine, Hubei Xinhua Hospital, Wuhan, Hubei, China (mainland)
| | - Yan Tong
- Department of Laboratory Medicine, Hubei Xinhua Hospital, Wuhan, Hubei, China (mainland)
| | - Hanmin Wang
- Department of Stomatology, Hubei Xinhua Hospital, Wuhan, Hubei, China (mainland)
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Jonklaas J, Bianco AC, Bauer AJ, Burman KD, Cappola AR, Celi FS, Cooper DS, Kim BW, Peeters RP, Rosenthal MS, Sawka AM. Guidelines for the treatment of hypothyroidism: prepared by the american thyroid association task force on thyroid hormone replacement. Thyroid 2014; 24:1670-751. [PMID: 25266247 PMCID: PMC4267409 DOI: 10.1089/thy.2014.0028] [Citation(s) in RCA: 953] [Impact Index Per Article: 95.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND A number of recent advances in our understanding of thyroid physiology may shed light on why some patients feel unwell while taking levothyroxine monotherapy. The purpose of this task force was to review the goals of levothyroxine therapy, the optimal prescription of conventional levothyroxine therapy, the sources of dissatisfaction with levothyroxine therapy, the evidence on treatment alternatives, and the relevant knowledge gaps. We wished to determine whether there are sufficient new data generated by well-designed studies to provide reason to pursue such therapies and change the current standard of care. This document is intended to inform clinical decision-making on thyroid hormone replacement therapy; it is not a replacement for individualized clinical judgment. METHODS Task force members identified 24 questions relevant to the treatment of hypothyroidism. The clinical literature relating to each question was then reviewed. Clinical reviews were supplemented, when relevant, with related mechanistic and bench research literature reviews, performed by our team of translational scientists. Ethics reviews were provided, when relevant, by a bioethicist. The responses to questions were formatted, when possible, in the form of a formal clinical recommendation statement. When responses were not suitable for a formal clinical recommendation, a summary response statement without a formal clinical recommendation was developed. For clinical recommendations, the supporting evidence was appraised, and the strength of each clinical recommendation was assessed, using the American College of Physicians system. The final document was organized so that each topic is introduced with a question, followed by a formal clinical recommendation. Stakeholder input was received at a national meeting, with some subsequent refinement of the clinical questions addressed in the document. Consensus was achieved for all recommendations by the task force. RESULTS We reviewed the following therapeutic categories: (i) levothyroxine therapy, (ii) non-levothyroxine-based thyroid hormone therapies, and (iii) use of thyroid hormone analogs. The second category included thyroid extracts, synthetic combination therapy, triiodothyronine therapy, and compounded thyroid hormones. CONCLUSIONS We concluded that levothyroxine should remain the standard of care for treating hypothyroidism. We found no consistently strong evidence for the superiority of alternative preparations (e.g., levothyroxine-liothyronine combination therapy, or thyroid extract therapy, or others) over monotherapy with levothyroxine, in improving health outcomes. Some examples of future research needs include the development of superior biomarkers of euthyroidism to supplement thyrotropin measurements, mechanistic research on serum triiodothyronine levels (including effects of age and disease status, relationship with tissue concentrations, as well as potential therapeutic targeting), and long-term outcome clinical trials testing combination therapy or thyroid extracts (including subgroup effects). Additional research is also needed to develop thyroid hormone analogs with a favorable benefit to risk profile.
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Affiliation(s)
| | - Antonio C. Bianco
- Division of Endocrinology, Rush University Medical Center, Chicago, Illinois
| | - Andrew J. Bauer
- Division of Endocrinology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Kenneth D. Burman
- Endocrine Section, Medstar Washington Hospital Center, Washington, DC
| | - Anne R. Cappola
- Division of Endocrinology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
| | - Francesco S. Celi
- Division of Endocrinology, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - David S. Cooper
- Division of Endocrinology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Brian W. Kim
- Division of Endocrinology, Rush University Medical Center, Chicago, Illinois
| | - Robin P. Peeters
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - M. Sara Rosenthal
- Program for Bioethics, Department of Internal Medicine, University of Kentucky College of Medicine, Lexington, Kentucky
| | - Anna M. Sawka
- Division of Endocrinology, University Health Network and University of Toronto, Toronto, Ontario, Canada
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Insaf TZ, Shaw BA, Yucel RM, Chasan-Taber L, Strogatz DS. Lifecourse socioeconomic position and 16 year body mass index trajectories: differences by race and sex. Prev Med 2014; 67:17-23. [PMID: 24967954 PMCID: PMC4167219 DOI: 10.1016/j.ypmed.2014.06.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Revised: 05/02/2014] [Accepted: 06/16/2014] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of this study is to evaluate the association between lifecourse socioeconomic position (SEP) and changes in body mass index (BMI), and assess disparities in these associations across racial/ethnic groups. METHODS With longitudinal data from 4 waves of the Americans' Changing Lives Study (1986-2002), we employed mixed-effects modeling to estimate BMI trajectories for 1174 Blacks and 2323 White adults. We also estimated associations between these trajectories and lifecourse SEP variables, including father's education, perceived childhood SEP, own education, income, wealth, and financial security. RESULTS Blacks had higher baseline BMIs, and steeper increases in BMI, compared to Whites. Childhood SEP, as measured by high father's education, was associated with lower baseline BMI among Whites. High education was associated with a lower baseline BMI within both race and sex categories. Income had contrasting effects among men and women. Higher income was associated with higher BMI only among males. Associations between indicators of SEP and BMI trajectories were only found for Whites. CONCLUSIONS Our study demonstrates that lifecourse SEP may influence adult BMI differently within different racial and sex groups.
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Affiliation(s)
- Tabassum Z Insaf
- University at Albany, State University of New York, Albany, NY, United States.
| | - Benjamin A Shaw
- University at Albany, State University of New York, Albany, NY, United States
| | - Recai M Yucel
- University at Albany, State University of New York, Albany, NY, United States
| | | | - David S Strogatz
- University at Albany, State University of New York, Albany, NY, United States; Bassett Research Institute, Cooperstown, NY, United States
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Nevison CD. A comparison of temporal trends in United States autism prevalence to trends in suspected environmental factors. Environ Health 2014; 13:73. [PMID: 25189402 PMCID: PMC4177682 DOI: 10.1186/1476-069x-13-73] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Accepted: 08/29/2014] [Indexed: 05/21/2023]
Abstract
BACKGROUND The prevalence of diagnosed autism has increased rapidly over the last several decades among U.S. children. Environmental factors are thought to be driving this increase and a list of the top ten suspected environmental toxins was published recently. METHODS Temporal trends in autism for birth years 1970-2005 were derived from a combination of data from the California Department of Developmental Services (CDDS) and the United States Individuals with Disabilities Education Act (IDEA). Temporal trends in suspected toxins were derived from data compiled during an extensive literature survey. Toxin and autism trends were compared by visual inspection and computed correlation coefficients. Using IDEA data, autism prevalence vs. birth year trends were calculated independently from snapshots of data from the most recent annual report, and by tracking prevalence at a constant age over many years of reports. The ratio of the snapshot:tracking trend slopes was used to estimate the "real" fraction of the increase in autism. RESULTS The CDDS and IDEA data sets are qualitatively consistent in suggesting a strong increase in autism prevalence over recent decades. The quantitative comparison of IDEA snapshot and constant-age tracking trend slopes suggests that ~75-80% of the tracked increase in autism since 1988 is due to an actual increase in the disorder rather than to changing diagnostic criteria. Most of the suspected environmental toxins examined have flat or decreasing temporal trends that correlate poorly to the rise in autism. Some, including lead, organochlorine pesticides and vehicular emissions, have strongly decreasing trends. Among the suspected toxins surveyed, polybrominated diphenyl ethers, aluminum adjuvants, and the herbicide glyphosate have increasing trends that correlate positively to the rise in autism. CONCLUSIONS Diagnosed autism prevalence has risen dramatically in the U.S over the last several decades and continued to trend upward as of birth year 2005. The increase is mainly real and has occurred mostly since the late 1980s. In contrast, children's exposure to most of the top ten toxic compounds has remained flat or decreased over this same time frame. Environmental factors with increasing temporal trends can help suggest hypotheses for drivers of autism that merit further investigation.
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Affiliation(s)
- Cynthia D Nevison
- Institute for Arctic and Alpine Research, University of Colorado, Boulder, Boulder, CO 80309-0450, USA.
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Food costs, diet quality and energy balance in the United States. Physiol Behav 2014; 134:20-31. [DOI: 10.1016/j.physbeh.2014.03.001] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Revised: 02/26/2014] [Accepted: 03/02/2014] [Indexed: 11/20/2022]
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Lebel A, Kestens Y, Clary C, Bisset S, Subramanian SV. Geographic variability in the association between socioeconomic status and BMI in the USA and Canada. PLoS One 2014; 9:e99158. [PMID: 24932774 PMCID: PMC4059636 DOI: 10.1371/journal.pone.0099158] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Accepted: 05/12/2014] [Indexed: 11/01/2022] Open
Abstract
OBJECTIVE Reported associations between socioeconomic status (SES) and obesity are inconsistent depending on gender and geographic location. Globally, these inconsistent observations may hide a variation in the contextual effect on individuals' risk of obesity for subgroups of the population. This study explored the regional variability in the association between SES and BMI in the USA and in Canada, and describes the geographical variance patterns by SES category. METHODS The 2009-2010 samples of the Behavioral Risk Factor Surveillance System (BRFSS) and the Canadian Community Health Survey (CCHS) were used for this comparison study. Three-level random intercept and differential variance multilevel models were built separately for women and men to assess region-specific BMI by SES category and their variance bounds. RESULTS Associations between individual SES and BMI differed importantly by gender and countries. At the regional-level, the mean BMI variation was significantly different between SES categories in the USA, but not in Canada. In the USA, whereas the county-specific mean BMI of higher SES individuals remained close to the mean, its variation grown as SES decreased. At the county level, variation of mean BMI around the regional mean was 5 kg/m2 in the high SES group, and reached 8.8 kg/m2 in the low SES group. CONCLUSIONS This study underlines how BMI varies by country, region, gender and SES. Lower socioeconomic groups within some regions show a much higher variation in BMI than in other regions. Above the BMI regional mean, important variation patterns of BMI by SES and place of residence were found in the USA. No such pattern was found in Canada. This study suggests that a change in the mean does not necessarily reflect the change in the variance. Analyzing the variance by SES may be a good way to detect subtle influences of social forces underlying social inequalities.
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Affiliation(s)
- Alexandre Lebel
- Evaluation Platform on Obesity Prevention, Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts, United States of America
- Graduate School of Land Management and Regional Planning, Laval University, Quebec City, Quebec, Canada
| | - Yan Kestens
- CHUM Research Center, Montreal, Canada
- Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Christelle Clary
- CHUM Research Center, Montreal, Canada
- Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Sherri Bisset
- Evaluation Platform on Obesity Prevention, Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
- Faculty of Nursing Science, Laval University, Quebec City, Quebec, Canada
| | - S. V. Subramanian
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts, United States of America
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Gunderson CC, Java J, Moore KN, Walker JL. The impact of obesity on surgical staging, complications, and survival with uterine cancer: a Gynecologic Oncology Group LAP2 ancillary data study. Gynecol Oncol 2014; 133:23-7. [PMID: 24680587 DOI: 10.1016/j.ygyno.2014.01.041] [Citation(s) in RCA: 85] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Revised: 01/18/2014] [Accepted: 01/22/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To determine the association of body mass index (BMI) on complications, recurrence, and survival in GOG LAP2, a randomized comparison of laparoscopic versus open staging in clinically early stage uterine cancer (EC). METHODS An ancillary data analysis of GOG LAP2 was performed. Categorical variables were compared using Pearson chi-square test and continuous variables using the Wilcoxon-Mann-Whitney and Kruskal-Wallis tests by BMI group. Survival was estimated using the Kaplan-Meier method. Cox proportional hazards model was used to evaluate independent prognostic factors on survival. Statistical tests were two-tailed with α=0.05, except where noted. Statistical analyses utilized R programming language. RESULTS 2596 women were included. BMI (kg/m(2)) groups were <25 (29.5%), 25-30 (28.2%), 30-35 (21%), 35-40 (10.9%), and ≥40 (10.4%). Stage (p=0.021), grade (p<0.001), and histology (p=0.005) differed by BMI. Obese women were less likely to have high risk (HR) disease (+lymph nodes/ovaries/cytology) or tumor features that met GOG99 high intermediate risk (HIR) criteria (p<0.001). Adjuvant therapy (p=0.151) and recurrence (p=0.46) did not vary by BMI. Hospitalization >2days, antibiotic use, wound infection, and venous thrombophlebitis were higher with BMI ≥40. BMI (p=0.016), age (p<0.0001), race (p=0.033), and risk group (p<0.0001) predicted all-cause mortality. BMI was not predictive of disease-specific survival (p=0.79), but age (p=0.032) and risk group (p<0.0001) were significant factors. CONCLUSION Obese women have greater surgical risk and lower risk of metastatic disease. BMI is associated with all-cause but not disease-specific mortality, emphasizing the detrimental effect of obesity (independent of EC), which deserves particular attention.
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Affiliation(s)
- Camille C Gunderson
- University of Oklahoma, Department of Obstetrics & Gynecology, Section of Gynecologic Oncology, Oklahoma City, OK, USA.
| | - James Java
- Gynecologic Oncology Group Statistical & Data Center, Roswell Park Cancer Institute, Buffalo, NY, USA.
| | - Kathleen N Moore
- University of Oklahoma, Department of Obstetrics & Gynecology, Section of Gynecologic Oncology, Oklahoma City, OK, USA.
| | - Joan L Walker
- University of Oklahoma, Department of Obstetrics & Gynecology, Section of Gynecologic Oncology, Oklahoma City, OK, USA.
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Krieger N, Kosheleva A, Waterman PD, Chen JT, Beckfield J, Kiang MV. 50-year trends in US socioeconomic inequalities in health: US-born Black and White Americans, 1959-2008. Int J Epidemiol 2014; 43:1294-313. [PMID: 24639440 DOI: 10.1093/ije/dyu047] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Debates exist over whether health inequities are bound to rise as population health improves, due to health improving more quickly among the better off, with most analyses focused on mortality data. METHODS We analysed 50 years of socioeconomic inequities in measured health status among US-born Black and White Americans, using data from the National Health Examination Surveys (NHES) I-III (1959-70), National Health and Nutrition Examination Surveys (NHANES) I-III (1971-94) and NHANES 1999-2008. RESULTS Absolute US socioeconomic health inequities for income percentile and education variously decreased (serum cholesterol; childhood height), stagnated [systolic blood pressure (SBP)], widened [body mass index (BMI), waist circumference (WC)] and in some cases reversed (age at menarche), even as on-average values rose (BMI, WC), idled (childhood height) and fell (SBP, serum cholesterol, age at menarche), with patterns often varying by race/ethnicity and socioeconomic measure; similar results occurred for relative inequities. For example, for WC, the adverse 20th (low) vs 80th (high) income percentile gap increased only among Whites (NHES I: 0.71 cm [95% confidence interval (CI) -0.74, 2.16); NHANES 2005-08: 2.10 (95% CI 0.96, 3.62)]. By contrast, age at menarche for girls in the 20th vs 80th income percentile among Black girls remained consistently lower, by 0.34 years (95% CI 0.12, 0.55) whereas among White girls the initial null difference became inverse [NHANES 2005-08: -0.49 years (95% CI -0.86, -0.12; overall P = 0.0015)]. Adjusting for socioeconomic position only modestly altered Black/White health inequities. CONCLUSIONS Health inequities need not rise as population health improves.
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Affiliation(s)
- Nancy Krieger
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA and Department of Sociology, Harvard University, Boston, MA, USA
| | - Anna Kosheleva
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA and Department of Sociology, Harvard University, Boston, MA, USA
| | - Pamela D Waterman
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA and Department of Sociology, Harvard University, Boston, MA, USA
| | - Jarvis T Chen
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA and Department of Sociology, Harvard University, Boston, MA, USA
| | - Jason Beckfield
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA and Department of Sociology, Harvard University, Boston, MA, USA
| | - Mathew V Kiang
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA and Department of Sociology, Harvard University, Boston, MA, USA
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Zenk SN, Powell LM, Odoms-Young AM, Krauss R, Fitzgibbon ML, Block D, Campbell RT. Impact of the revised Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food package policy on fruit and vegetable prices. J Acad Nutr Diet 2014; 114:288-296. [PMID: 24183996 PMCID: PMC4084875 DOI: 10.1016/j.jand.2013.08.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2012] [Accepted: 08/02/2013] [Indexed: 02/02/2023]
Abstract
Obesity is generally inversely related to income among women in the United States. Less access to healthy foods is one way lower income can influence dietary behaviors and body weight. Federal food assistance programs, such as the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), are an important source of healthy food for low-income populations. In 2009, as part of a nationwide policy revision, WIC added a fruit and vegetable (F/V) voucher to WIC food packages. This quasi-experimental study determined whether F/V prices at stores authorized to accept WIC (ie, WIC vendors) decreased after the policy revision in seven Illinois counties. It also examined cross-sectional F/V price variations by store type and neighborhood characteristics. Two pre-policy observations were conducted in 2008 and 2009; one post-policy observation was conducted in 2010. Small pre- to post-policy reductions in some F/V prices were found, particularly for canned fruit and frozen vegetables at small stores. Compared with chain supermarkets, mass merchandise stores had lower prices for fresh F/V and frozen F/V and small stores and non-chain supermarkets had higher canned and frozen F/V prices, but lower fresh F/V prices. Limited price differences were found across neighborhoods, although canned vegetables were more expensive in neighborhoods with higher concentrations of either Hispanics or blacks and fresh F/V prices were lower in neighborhoods with more Hispanics. Results suggest the WIC policy revision contributed to modest reductions in F/V prices. WIC participants' purchasing power can differ depending on the type and neighborhood of the WIC vendor used.
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Cheng H, Furnham A. Personality traits, education, physical exercise, and childhood neurological function as independent predictors of adult obesity. PLoS One 2013; 8:e79586. [PMID: 24250828 PMCID: PMC3821861 DOI: 10.1371/journal.pone.0079586] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Accepted: 10/02/2013] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To investigate whether personality traits, education, physical exercise, parental socio-economic conditions, and childhood neurological function are independently associated with obesity in 50 year old adults in a longitudinal birth cohort study. METHOD The sample consisted of 5,921 participants born in Great Britain in 1958 and followed up at 7, 11, 33, 42, and 50 years with data on body mass index measured at 42 and 50 years. RESULTS There was an increase of adult obesity from 14.2% at age 42 to 23.6% at 50 years. Cohort members who were reported by teachers on overall clumsiness as "certainly applied" at age 7 were more likely to become obese at age 50. In addition, educational qualifications, traits Conscientiousness and Extraversion, psychological distress, and physical exercise were all significantly associated with adult obesity. The associations remained to be significant after controlling for birth weight and gestation, maternal and paternal BMI, childhood BMI, childhood intelligence and behavioural adjustment, as well as diet. CONCLUSION Neurological function in childhood, education, trait Conscientiousness, and exercise were all significantly and independently associated with adult obesity, each explained unique individual variability.
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Affiliation(s)
- Helen Cheng
- Department of Psychology, University College London, London, United Kingdom
| | - Adrian Furnham
- Department of Psychology, University College London, London, United Kingdom
- BI: Norwegian Business School, Oslo, Norway
- * E-mail:
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