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Kohls M, Freisling H, Charvat H, Soerjomataram I, Viallon V, Davila-Batista V, Kaaks R, Turzanski-Fortner R, Aleksandrova K, Schulze MB, Dahm CC, Tilma Vistisen H, Rostgaard-Hansen AL, Tjønneland A, Bonet C, Sánchez MJ, Colorado-Yohar S, Masala G, Palli D, Krogh V, Ricceri F, Rolandsson O, Lu SSM, Tsilidis KK, Weiderpass E, Gunter MJ, Ferrari P, Berger U, Arnold M. Impact of cumulative body mass index and cardiometabolic diseases on survival among patients with colorectal and breast cancer: a multi-centre cohort study. BMC Cancer 2022; 22:546. [PMID: 35568802 PMCID: PMC9107127 DOI: 10.1186/s12885-022-09589-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 04/11/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Body mass index (BMI) and cardiometabolic comorbidities such as cardiovascular disease and type 2 diabetes have been studied as negative prognostic factors in cancer survival, but possible dependencies in the mechanisms underlying these associations remain largely unexplored. We analysed these associations in colorectal and breast cancer patients. METHODS Based on repeated BMI assessments of cancer-free participants from four European countries in the European Prospective Investigation into Cancer and nutrition (EPIC) study, individual BMI-trajectories reflecting predicted mean BMI between ages 20 to 50 years were estimated using a growth curve model. Participants with incident colorectal or breast cancer after the age of 50 years were included in the survival analysis to study the prognostic effect of mean BMI and cardiometabolic diseases (CMD) prior to cancer. CMD were defined as one or more chronic conditions among stroke, myocardial infarction, and type 2 diabetes. Hazard ratios (HRs) and confidence intervals (CIs) of mean BMI and CMD were derived using multivariable-adjusted Cox proportional hazard regression for mean BMI and CMD separately and both exposures combined, in subgroups of localised and advanced disease. RESULTS In the total cohort of 159,045 participants, there were 1,045 and 1,620 eligible patients of colorectal and breast cancer. In colorectal cancer patients, a higher BMI (by 1 kg/m2) was associated with a 6% increase in risk of death (95% CI of HR: 1.02-1.10). The HR for CMD was 1.25 (95% CI: 0.97-1.61). The associations for both exposures were stronger in patients with localised colorectal cancer. In breast cancer patients, a higher BMI was associated with a 4% increase in risk of death (95% CI: 1.00-1.08). CMDs were associated with a 46% increase in risk of death (95% CI: 1.01-2.09). The estimates and CIs for BMI remained similar after adjustment for CMD and vice versa. CONCLUSIONS Our results suggest that cumulative exposure to higher BMI during early to mid-adulthood was associated with poorer survival in patients with breast and colorectal cancer, independent of CMD prior to cancer diagnosis. The association between a CMD diagnosis prior to cancer and survival in patients with breast and colorectal cancer was independent of BMI.
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Affiliation(s)
- Mirjam Kohls
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
- Cancer Surveillance Branch, International Agency for Research on Cancer - IARC/WHO, 150 cours Albert Thomas, 69372 CEDEX 08, Lyon, France
| | - Heinz Freisling
- Nutrition and Metabolism Branch, International Agency for Research on Cancer - IARC/WHO, 150 cours Albert Thomas, 69372 CEDEX 08, Lyon, France.
| | - Hadrien Charvat
- Cancer Surveillance Branch, International Agency for Research on Cancer - IARC/WHO, 150 cours Albert Thomas, 69372 CEDEX 08, Lyon, France
| | - Isabelle Soerjomataram
- Cancer Surveillance Branch, International Agency for Research on Cancer - IARC/WHO, 150 cours Albert Thomas, 69372 CEDEX 08, Lyon, France
| | - Vivian Viallon
- Nutrition and Metabolism Branch, International Agency for Research on Cancer - IARC/WHO, 150 cours Albert Thomas, 69372 CEDEX 08, Lyon, France
| | - Veronica Davila-Batista
- Nutrition and Metabolism Branch, International Agency for Research on Cancer - IARC/WHO, 150 cours Albert Thomas, 69372 CEDEX 08, Lyon, France
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Krasimira Aleksandrova
- Nutrition, Immunity and Metabolism Senior Scientist Group, Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany
- Institute of Nutritional Science, University of Potsdam, Potsdam, Germany
| | - Matthias B Schulze
- Institute of Nutritional Science, University of Potsdam, Potsdam, Germany
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | | | | | | | - Anne Tjønneland
- Danish Cancer Society Research Centre, Diet, Genes and Environment, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Catalina Bonet
- Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, Institut Català d'Oncologia, Barcelona, Spain
| | - Maria-Jose Sánchez
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
- CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Universidad de Granada, Granada, Spain
| | - Sandra Colorado-Yohar
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain
- CIBER Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain
- Research Group On Demography and Health, National Faculty of Public Health, University of Antioquia, Medellín, Colombia
| | - Giovanna Masala
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network - ISPRO, Florence, Italy
| | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network - ISPRO, Florence, Italy
| | - Vittorio Krogh
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori Di Milano, Milan, Italy
| | - Fulvio Ricceri
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Olov Rolandsson
- Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden
| | - Sai San Moon Lu
- Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden
| | - Konstantinos K Tsilidis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | | | - Marc J Gunter
- Nutrition and Metabolism Branch, International Agency for Research on Cancer - IARC/WHO, 150 cours Albert Thomas, 69372 CEDEX 08, Lyon, France
| | - Pietro Ferrari
- Nutrition and Metabolism Branch, International Agency for Research on Cancer - IARC/WHO, 150 cours Albert Thomas, 69372 CEDEX 08, Lyon, France
| | - Ursula Berger
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Melina Arnold
- Cancer Surveillance Branch, International Agency for Research on Cancer - IARC/WHO, 150 cours Albert Thomas, 69372 CEDEX 08, Lyon, France.
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Tamura N, Hanaoka T, Ito K, Araki A, Miyashita C, Ito S, Kobayashi S, Ito Y, Minakami H, Cho K, Endo T, Baba T, Sengoku K, Miyamoto T, Ogasawara K, Kishi R. Mediating Factors Between Parental Socioeconomic Status and Small for Gestational Age in Infants: Results from the Hokkaido Study on Environment and Children's Health. Matern Child Health J 2021; 25:645-655. [PMID: 33392928 DOI: 10.1007/s10995-020-03035-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Previous studies indicated a significant association between small for gestational age (SGA) in infants and their parents' socioeconomic status (SES). Thus, this study aimed to examine if parental factors, such as maternal smoking, and the pre-pregnancy body mass index (BMI) could mediate the associations between parental SES and SGA. METHODS The participants of this study were pregnant women who enrolled in an ongoing birth cohort study, the Hokkaido study, during the first trimester of their pregnancies. A total of 14,593 live singleton births were included in the statistical analysis, of which 1011 (6.9%) were SGA. Two structural equation models were employed to evaluate the associations between parental SES, parental characteristics, and SGA. RESULTS The effect of low SES on SGA was directly mediated by maternal pre-pregnancy BMI, smoking during the third trimester, and alcohol consumption during the first trimester in the first model, which was based the assumption of independent associations between mediating factors. In the second model, which additionally considered the mediating factors from the first model, smoking during pregnancy mediated decline in parental SES, consequently increased SGA. Moreover, an increase in pregnancy smoking status increased the prevalence of lower maternal pre-pregnancy BMI and its effect on SGA. CONCLUSIONS FOR PRACTICE In this study, we observed the independent mediating effect of maternal pre-pregnancy BMI, smoking, and alcohol consumption during pregnancy on low SES and, consequently, SGA, with the additional mediating pathway of SES to smoking to low BMI on SGA.
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Affiliation(s)
- Naomi Tamura
- Hokkaido University Center for Environmental and Health Sciences, Kita 12, Nishi 7, Kita-ku, Sapporo, Hokkaido, 060-0812, Japan.,Graduate School of Health Science, Hokkaido University, Sapporo, Japan.,Research Center for Medical and Health Data Science, The Institute of Statistical Mathematics, Tokyo, Japan
| | - Tomoyuki Hanaoka
- Hokkaido University Center for Environmental and Health Sciences, Kita 12, Nishi 7, Kita-ku, Sapporo, Hokkaido, 060-0812, Japan
| | - Kumiko Ito
- Hokkaido University Center for Environmental and Health Sciences, Kita 12, Nishi 7, Kita-ku, Sapporo, Hokkaido, 060-0812, Japan.,Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Atsuko Araki
- Hokkaido University Center for Environmental and Health Sciences, Kita 12, Nishi 7, Kita-ku, Sapporo, Hokkaido, 060-0812, Japan.,Graduate School of Health Science, Hokkaido University, Sapporo, Japan
| | - Chihiro Miyashita
- Hokkaido University Center for Environmental and Health Sciences, Kita 12, Nishi 7, Kita-ku, Sapporo, Hokkaido, 060-0812, Japan
| | - Sachiko Ito
- Hokkaido University Center for Environmental and Health Sciences, Kita 12, Nishi 7, Kita-ku, Sapporo, Hokkaido, 060-0812, Japan
| | - Sumitaka Kobayashi
- Hokkaido University Center for Environmental and Health Sciences, Kita 12, Nishi 7, Kita-ku, Sapporo, Hokkaido, 060-0812, Japan
| | - Yoichi Ito
- Research Center for Medical and Health Data Science, The Institute of Statistical Mathematics, Tokyo, Japan
| | - Hisanori Minakami
- Departments of Obstetrics and Gynecology, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Kazutoshi Cho
- Departments of Obstetrics and Gynecology, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Toshiaki Endo
- Departments of Obstetrics and Gynecology, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Tsuyoshi Baba
- Departments of Obstetrics and Gynecology, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Kazuo Sengoku
- Departments of Obstetrics and Gynecology, Asahikawa Medical University, Asahikawa, Japan
| | - Toshinobu Miyamoto
- Departments of Obstetrics and Gynecology, Asahikawa Medical University, Asahikawa, Japan
| | | | - Reiko Kishi
- Hokkaido University Center for Environmental and Health Sciences, Kita 12, Nishi 7, Kita-ku, Sapporo, Hokkaido, 060-0812, Japan.
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3
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Alcohol, smoking and rectal cancer risk in a Mediterranean cohort of adults: the European Prospective Investigation into Cancer and Nutrition (EPIC)-Italy cohort. Eur J Gastroenterol Hepatol 2020; 32:475-483. [PMID: 31834049 DOI: 10.1097/meg.0000000000001607] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Colorectal cancer (CRC) is one of the most diagnosed malignant cancers worldwide. Rectal cancers (Rcs) represent one-third of all CRCs. Cigarette smoking and alcohol drinking are two underestimated risk factors for RC. We aimed to evaluate the role of alcohol consumption and cigarette smoking in modulating RC risk and to estimate the attributable fraction in a Mediterranean population. METHODS In the Italian section of the European Prospective Investigation into Cancer and Nutrition, 45,553 healthy adults (31,252 women) were recruited and provided information about lifestyle and dietary habits. During 14.0 years of median follow-up, 154 incident RC cases were identified. RESULTS In multivariate models, a increase in RC risk emerged among subjects drinking more than 3 drinks/day, overall (hazard ratio [HR] = 1.74; 95% confidence interval [CI] 1.08-2.80), and in females (HR= 2.80; 95% CI 1.23-6.35), compared with drinkers of less than 1 drink/day. A increase in risk also emerged for current- compared with never-smokers, overall (HR = 1.57; 95% CI 1.06-2.35; P for trend 0.03) and among males (HR = 2.04; 95% CI 1.02-4.07; P for trend 0.045). Overall, 9% (95% CI 4-14%) of RC cases were attributable to drinking more than 3 drinks/day and 12% (95% CI 3-19%) were attributable to current smoke and 20% (95% CI 11-27%) of RC cases were attributable to the independent effects of these two exposures. CONCLUSION Our study supports a strategy to avoid a relevant proportion of rectal cancer cases through a combined reduction of alcohol consumption and cigarette smoking.
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Luijckx E, Lohse T, Faeh D, Rohrmann S. Joints effects of BMI and smoking on mortality of all-causes, CVD, and cancer. Cancer Causes Control 2019; 30:549-557. [DOI: 10.1007/s10552-019-01160-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 03/13/2019] [Indexed: 01/01/2023]
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Ishikawa S, Konta T, Susa S, Ishizawa K, Togashi H, Ueno Y, Kubota I, Yamashita H, Kayama T, Iino M. Fewer teeth are a risk factor for being underweight in community-dwelling Japanese aged 40 years and older: The Yamagata (Takahata) Study. Int J Dent Hyg 2018; 17:244-252. [PMID: 30431235 DOI: 10.1111/idh.12374] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 10/23/2018] [Accepted: 11/11/2018] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The aim of the present study was to investigate comprehensively, the risk factors for underweight in cross-sectional study in the general population of Japan. METHODS The survey population was the general population of individuals aged >40 years in Takahata town, Japan in 2005. A postal survey in the form of a self-administered questionnaire was distributed, and 6084 individuals were entered into the final statistical analysis. The self-administered questionnaire contained items regarding lifestyle, oral health status, socio-economic status and dietary intake. To examine the independent relationships between an underweight status and several parameters, a multivariate logistic regression analysis was used to estimate adjusted odds ratios (ORs). RESULTS The number of teeth, age, alcohol consumption, hypertension, spousal status, smoking habit, appetite, body weight at 20 years of age, habit of going out and physical activity were independently associated with an underweight status compared with the normal weight group. Individuals with fewer than 10 teeth were especially more likely to be underweight than individuals with more than 20 teeth (OR = 1.956, 95% CI = 1.261-3.035). CONCLUSION This study showed an independent association between the number of teeth and an underweight status, indicating that fewer teeth can increase the risk of being underweight.
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Affiliation(s)
- Shigeo Ishikawa
- Department of Dentistry, Oral and Maxillofacial Plastic and Reconstructive Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Tsuneo Konta
- Department of Public Health and Hygiene, Yamagata University Graduate School of Medicine, Yamagata, Japan
| | - Shinji Susa
- Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Kenichi Ishizawa
- Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology, Yamagata University Faculty of Medicine, Yamagata, Japan.,Global Center of Excellence, Yamagata University School of Medicine, Yamagata, Japan
| | - Hitoshi Togashi
- Yamagata University Health Administration Center, Yamagata, Japan
| | - Yoshiyuki Ueno
- Global Center of Excellence, Yamagata University School of Medicine, Yamagata, Japan
| | - Isao Kubota
- Global Center of Excellence, Yamagata University School of Medicine, Yamagata, Japan
| | - Hidetoshi Yamashita
- Global Center of Excellence, Yamagata University School of Medicine, Yamagata, Japan
| | - Takamasa Kayama
- Global Center of Excellence, Yamagata University School of Medicine, Yamagata, Japan
| | - Mitsuyoshi Iino
- Department of Dentistry, Oral and Maxillofacial Plastic and Reconstructive Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan
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Wakiya T, Ishido K, Kudo D, Kimura N, Sakuraba S, Tsutsumi S, Kagiya T, Uchida C, Hakamada K. Smoking cessation contributes to weight gain in patients with hepatobiliopancreatic malignancy. Clin Nutr ESPEN 2018; 23:54-60. [PMID: 29460814 DOI: 10.1016/j.clnesp.2017.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 10/14/2017] [Accepted: 12/13/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND & AIMS The relationship between smoking cessation and weight gain is well recognized. However, there is no data currently available on the effect of smoking cessation on weight gain in patients with malignancy. The aim of this study was to clarify the body weight (BW) change after smoking cessation in patients with malignancy. METHODS We retrospectively analyzed 159 subjects who underwent hepatobiliopancreatic surgery. The smoking status was determined using questionnaires administered at the initial presentation, and the candidates were divided into two groups: recent quitters and nonsmokers. The change in the BW was compared between these two groups. RESULTS There were 134 subjects with malignant disease (84.3%), with a median age of 68 (range: 26-84) years. In the nonsmoker group, 28 of 116 subjects (24.1%) gained weight between the initial presentation and admission. In the recent quitter group, 12 of 18 subjects (66.7%) gained weight in the same period (P < 0.01). Regarding the change in the BW from the initial presentation, recent quitters gained more weight than nonsmokers (+1.7 kg [+2.7%] vs. -1.0 kg [-2.0%], P < 0.01). Furthermore, the improvement from the initial presentation was seen in a higher percentage of recent quitters than nonsmokers with respect to Onodera's prognostic nutritional index (61.1% vs. 36.2%, P = 0.04) and the controlling nutritional status score (38.9% vs. 19.3%, P = 0.07). CONCLUSIONS Weight gain due to smoking cessation was observed even in patients with hepatobiliopancreatic malignancy.
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Affiliation(s)
- Taiichi Wakiya
- Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Japan.
| | - Keinosuke Ishido
- Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Japan
| | - Daisuke Kudo
- Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Japan
| | - Norihisa Kimura
- Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Japan
| | - Shingo Sakuraba
- Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Japan
| | - Shinji Tsutsumi
- Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Japan
| | - Takuji Kagiya
- Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Japan
| | - Chiaki Uchida
- Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Japan
| | - Kenichi Hakamada
- Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Japan
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Freitas ICMD, Moraes SAD. Social vulnerability effect over obesity anthropometric indexes: results from population-based epidemiological study. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2017; 19:433-50. [PMID: 27532764 DOI: 10.1590/1980-5497201600020018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 08/10/2015] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES The study aimed at evaluating the contextual effects of social vulnerability over anthropometric indexes related to global and central obesity in adults living in Ribeirão Preto (SP), Brazil, in 2006. METHODS In a population-based cross-sectional study using multistage sampling, multilevel linear models were applied considering two levels: ecological and individual. The 81 census tracts drafted for sample composition were considered the ecological level and classified according to Paulista Social Vulnerability Index (IPVS). RESULTS Individual correlates to body mass index (BMI) were age, familial and personal antecedents of overweight, and total fat consumption (direct relationship), exception to gender and schooling (inverse relationship). Individual correlates to waist circumference were age, familial antecedents of stroke, personal antecedent of overweight, BMI, number of medicines taken, time of smoking, and diet total energy (direct relationship), exception to gender (inverse relationship). Considering both outcomes (BMI and waist circumference), in the final models, the variance of IPVS showed statistical significance (p < 0.05), depicting the contextual effect (rho ≈ 8%) over global and central obesity, even after the adjustment for individual correlates. CONCLUSION Results showed that interventions to promote healthy behaviors and to prevent obesity might be focused not only on individual factors but also on socioenvironmental context in which people are inserted.
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Affiliation(s)
- Isabel Cristina Martins de Freitas
- Programa de Pós-Doutorado em Epidemiologia. Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo. Núcleo de Epidemiologia - Ribeirão Preto (SP), Brasil
| | - Suzana Alves de Moraes
- Departamento Materno-Infantil e Saúde Pública. Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo. Núcleo de Epidemiologia - Ribeirão Preto (SP), Brasil
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8
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Ben Taleb Z, Ward KD, Asfar T, Jaber R, Bahelah R, Maziak W. Smoking Cessation and Changes in Body Mass Index: Findings From the First Randomized Cessation Trial in a Low-Income Country Setting. Nicotine Tob Res 2017; 19:351-356. [PMID: 27613912 DOI: 10.1093/ntr/ntw223] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Accepted: 08/29/2016] [Indexed: 12/19/2022]
Abstract
Background In high-income countries, quitting cigarette smoking is associated with weight gain, which can reduce motivation to abstain. Whether smoking cessation is associated with weight gain in a low-income country context has never been investigated. We aimed to determine the post-cessation changes in body mass index (BMI) and its predictors among smokers who received a smoking cessation intervention in a low-income country setting. Methods We performed post hoc analyses of data from 269 smokers who participated in a two-group, parallel-arm, double-blind, placebo-controlled randomized trial of combined nicotine replacement therapy (NRT) and behavioral counseling in primary care clinics in Aleppo, Syria. We used generalized estimating equation modeling to identify predictors of changes in BMI at 6 weeks and 6- and 12-month follow-ups after quit date. Results The mean pre-cessation BMI of the sample was 27.9kg/m2 (SD = 5.2). Over 12 months of follow-up, BMI of smoking abstainers averaged 1.8 BMI units (approximately 4.8kg) greater than non-abstainers (p = .012). Throughout the study, greater BMI was associated with being female (p = .048), reporting smoking to control weight (p < .001) and having previously failed to quit due to weight gain (p = .036). Conclusion Similar to findings from high-income countries, smoking cessation in Syria is associated with weight gain, particularly among women and those who have weight concerns prior to quitting. This group of smokers may benefit from tailored cessation interventions with integrated body weight management elements that take into consideration the prevailing local and cultural influences on diet and levels of physical activity. Implications This study provides the first evidence regarding post-cessation changes in BMI among smokers who attempt to quit in a low-income country setting. Our findings advance knowledge regarding post-cessation weight gain and offers insight for researchers and clinicians to identify smokers at higher risk of post-cessation weight gain. This information will help in delivering interventions that take into account the prevailing cultural influence on diet and physical activity and will ultimately help in designing future tailored cessation programs in Syria and other low-income countries with similar cultural background and level of development.
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Affiliation(s)
- Ziyad Ben Taleb
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL
| | - Kenneth D Ward
- Division of Social and Behavioral Sciences, School of Public Health, University of Memphis, Memphis, TN.,Syrian Center for Tobacco Studies, Aleppo, Syria
| | - Taghrid Asfar
- Syrian Center for Tobacco Studies, Aleppo, Syria.,Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
| | - Rana Jaber
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL
| | - Raed Bahelah
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL
| | - Wasim Maziak
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL.,Syrian Center for Tobacco Studies, Aleppo, Syria
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Relationship between abdominal obesity and alcohol drinking pattern in normal-weight, middle-aged adults: the Korea National Health and Nutrition Examination Survey 2008-2013. Public Health Nutr 2017. [PMID: 28641594 DOI: 10.1017/s1368980017001045] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Abdominal obesity is associated with obesity-related health risks regardless of body weight. The present study aimed to determine whether alcohol drinking pattern is associated with abdominal obesity in normal-weight, middle-aged adults. DESIGN Cross-sectional study using complex sampling design analyses. SETTING The Korea National Health and Nutrition Examination Survey, which was conducted from 2008 to 2013. SUBJECTS Normal-weight participants aged 40-69 years with BMI of 18·5-25·0 kg/m2 (n 11 289, 4491 men and 6798 women) were included. Abdominal obesity was defined as waist circumference ≥90 cm for men or ≥85 cm for women. Alcohol drinking pattern was assessed by self-report on questionnaires. RESULTS Among 11 289 normal-weight participants, 7·9 % (n 379) of men and 7·6 % (n 609) of women had abdominal obesity. Both men and women who consumed a higher quantity of alcohol per drinking occasion had higher odds (OR; 95 % CI) for abdominal obesity compared with individuals who consumed fewer than 2 drinks (1·86; 1·04, 3·32 for ≥10 drinks/typical occasion in men; and 3·28; 1·13, 9·46 in women). Men who binge drink every day had higher odds for abdominal obesity (2·10; 1·21, 3·63). In both sexes, frequency of alcohol drinking was not associated with normal-weight abdominal obesity. CONCLUSIONS Our study showed that the amount of alcohol drinking per occasion influenced abdominal obesity in normal-weight, middle-aged individuals that may have impacted obesity-related health risks. Healthy alcohol drinking habits need to be controlled for prevention of abdominal obesity even among persons with normal weight.
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Kabat GC, Heo M, Allison M, Johnson KC, Ho GYF, Tindle HA, Asao K, LaMonte MJ, Giovino GA, Rohan TE. Smoking Habits and Body Weight Over the Adult Lifespan in Postmenopausal Women. Am J Prev Med 2017; 52:e77-e84. [PMID: 27939236 DOI: 10.1016/j.amepre.2016.10.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 09/28/2016] [Accepted: 10/17/2016] [Indexed: 12/14/2022]
Abstract
INTRODUCTION The inter-relationships between smoking habits and weight gain are complex. However, few studies have examined the association of smoking habits with weight gain over the life course. METHODS Major smoking parameters and weight gain over time were examined in a large cohort of postmenopausal women aged 50-79 years at enrollment between 1993 and 1998 (N=161,808) and followed through 2014 (analyses conducted in 2016). Cross-sectional analyses were used to assess the association of smoking and body weight at baseline. Retrospective data were used to correlate smoking status with body weight over a 45-year period prior to enrollment. In addition, the association of smoking with weight gain over 6 years of follow-up was examined. RESULTS At baseline, women who had quit smoking prior to enrollment weighed 4.7 kg more than current smokers and 2.6 kg more than never smokers. Former, never, and current smokers all gained weight over the 45-year period from age 18 years to time of enrollment (average age, 63 years): 16.8, 16.4, and 14.6 kg, respectively. In prospective analyses, women who were current smokers at baseline but who quit smoking during follow-up gained more than 5 kg by Year 6 compared with current smokers at baseline who continued to smoke. Among long-term quitters, greater intensity of smoking and more recent quitting were associated with greater weight gain. CONCLUSIONS These results suggest that excess weight gain associated with smoking cessation occurs soon after quitting and is modest relative to weight gain in never smokers over the adult lifespan.
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Affiliation(s)
- Geoffrey C Kabat
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York.
| | - Moonseong Heo
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Matthew Allison
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California
| | - Karen C Johnson
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Gloria Y F Ho
- Department of Occupational Medicine, Epidemiology and Prevention, Northwell Health, Great Neck, New York
| | - Hilary A Tindle
- Department of Medicine, Vanderbilt University, Nashville, Tennessee
| | - Keiko Asao
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Michael J LaMonte
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York
| | - Gary A Giovino
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York
| | - Thomas E Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
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Moon K, Krems C, Heuer T, Roth A, Hoffmann I. Predictors of BMI Vary along the BMI Range of German Adults - Results of the German National Nutrition Survey II. Obes Facts 2017; 10:38-49. [PMID: 28219069 PMCID: PMC5644963 DOI: 10.1159/000456665] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 01/11/2017] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE The objective of the study was to identify predictors of BMI in German adults by considering the BMI distribution and to determine whether the association between BMI and its predictors varies along the BMI distribution. METHODS The sample included 9,214 adults aged 18-80 years from the German National Nutrition Survey II (NVS II). Quantile regression analyses were conducted to examine the association between BMI and the following predictors: age, sports activities, socio-economic status (SES), healthy eating index-NVS II (HEI-NVS II), dietary knowledge, sleeping duration and energy intake as well as status of smoking, partner relationship and self-reported health. RESULTS Age, SES, self-reported health status, sports activities and energy intake were the strongest predictors of BMI. The important outcome of this study is that the association between BMI and its predictors varies along the BMI distribution. Especially, energy intake, health status and SES were marginally associated with BMI in normal-weight subjects; this relationships became stronger in the range of overweight, and were strongest in the range of obesity. CONCLUSIONS Predictors of BMI and the strength of these associations vary across the BMI distribution in German adults. Consequently, to identify predictors of BMI, the entire BMI distribution should be considered.
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Affiliation(s)
- Kilson Moon
- Department of Nutritional Behaviour, Max Rubner-Institut, Federal Research Institute of Nutrition and Food, Karlsruhe, Germany, Zurich, Switzerland
| | - Carolin Krems
- Department of Nutritional Behaviour, Max Rubner-Institut, Federal Research Institute of Nutrition and Food, Karlsruhe, Germany, Zurich, Switzerland
- *Dr. Carolin Krems, Max Rubner-Institut, Federal Research Institute of Nutrition and Food, Haid-und-Neu-Straße 9, 76131 Karlsruhe, Germany,
| | - Thorsten Heuer
- Department of Nutritional Behaviour, Max Rubner-Institut, Federal Research Institute of Nutrition and Food, Karlsruhe, Germany, Zurich, Switzerland
| | - Alexander Roth
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Zurich, Zurich, Switzerland
| | - Ingrid Hoffmann
- Department of Nutritional Behaviour, Max Rubner-Institut, Federal Research Institute of Nutrition and Food, Karlsruhe, Germany, Zurich, Switzerland
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Epidemiological risk factors associated with inflammatory breast cancer subtypes. Cancer Causes Control 2016; 27:359-66. [PMID: 26797453 DOI: 10.1007/s10552-015-0712-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 12/30/2015] [Indexed: 02/08/2023]
Abstract
BACKGROUND In this single-institution case-control study, we identified risk factors associated with inflammatory breast cancer (IBC) subtypes based on staining of estrogen receptor (ER), progesterone receptor (PR) and expression of human epidermal growth factor 2 (HER2neu) to determine distinct etiologic pathways. METHODS We identified 224 women with IBC and 396 cancer-free women seen at the MD Anderson Cancer Center. Multinomial logistic regression was used to estimate odds ratios (ORs) and 95 % confidence intervals (CIs) for associations between breast cancer risk factors and the IBC tumor subtypes: luminal (ER+ and/or PR+/HER2neu-), HER2neu+ (any ER and PR, HER2neu+), and triple-negative (ER-/PR-/HER2neu-). RESULTS In multivariable analysis, compared with women age ≥26 at first pregnancy, women age <26 had a higher risk of triple-negative IBC (OR 3.32, 95% CI 1.37-8.05). Women with a history of breast-feeding had a lower risk of triple-negative (OR 0.30; 95% CI 0.15-0.62) and luminal IBC (OR 0.35, 95% CI 0.18-0.68). A history of smoking was associated with an increased risk of luminal IBC (OR 2.37; 95% CI 1.24-4.52). Compared with normal-weight women, those who were overweight or obese (body mass index ≥25 kg/m(2)) had a higher risk of all three tumor subtypes (p < 0.01 for all subtypes). CONCLUSION Overweight or obese status is important modifiable risk factor for IBC of any subtype. Modifiable risk factors, age at first pregnancy (≥26), breast-feeding, and smoking may be associated with specific IBC subtypes. These results highlight the importance of evaluating epidemiologic risk factors for IBC for the identification of subtype-specific prevention strategies.
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Pre-diagnostic smoking behaviour and poorer prognosis in a German breast cancer patient cohort – Differential effects by tumour subtype, NAT2 status, BMI and alcohol intake. Cancer Epidemiol 2014; 38:419-26. [DOI: 10.1016/j.canep.2014.05.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Revised: 05/14/2014] [Accepted: 05/18/2014] [Indexed: 11/21/2022]
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Robertson L, McGee R, Hancox RJ. Smoking cessation and subsequent weight change. Nicotine Tob Res 2014; 16:867-71. [PMID: 24463712 DOI: 10.1093/ntr/ntt284] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
INTRODUCTION People who quit smoking tend to gain more weight over time than those who continue to smoke. Previous research using clinical samples of smokers suggests that quitters typically experience a weight gain of approximately 5 kg in the year following smoking cessation, but these studies may overestimate the extent of weight gain in the general population. The existing population-based research in this area has some methodological limitations. METHODS We assessed a cohort of individuals born in Dunedin, New Zealand, between 1972-1973 at regular intervals from age 15 to 38. We used multiple linear regression analysis to investigate the association between smoking cessation at ages 21 years to 38 years and subsequent change in body mass index (BMI) and weight, controlling for baseline BMI, socioeconomic status, physical activity, alcohol use, and parity (women). RESULTS Smoking status and outcome data were available at baseline and at follow-up for 914 study members. People who smoked at age 21 and who had quit by age 38 had a BMI on average 1.5 kg/m(2) greater than those who continued to smoke at age 38. This equated to a weight gain of approximately 5.7 kg in men and 5.1 kg in women above that of continuing smokers. However, the weight gain between age 21 and 38 among quitters was not significantly different to that of never-smokers. CONCLUSIONS The amount of long-term weight gained after quitting smoking is likely to be lower than previous estimates based on research with clinical samples. On average, quitters do not experience greater weight gain than never-smokers.
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Affiliation(s)
- Lindsay Robertson
- Cancer Society of New Zealand Social and Behavioural Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
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Klenk J, Rapp K, Ulmer H, Concin H, Nagel G. Changes of body mass index in relation to mortality: results of a cohort of 42,099 adults. PLoS One 2014; 9:e84817. [PMID: 24416291 PMCID: PMC3885599 DOI: 10.1371/journal.pone.0084817] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2013] [Accepted: 11/27/2013] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND High Body-Mass-Index (BMI) is associated with increased all-cause mortality, but little is known about the effect of short- and long-term BMI change on mortality. The aim of the study was to determine how long-term weight change affects mortality. METHODS AND FINDINGS Within a population-based prospective cohort of 42,099 Austrian men and women (mean age 43 years) with at least three BMI measurements we investigated the relationship of BMI at baseline and two subsequent BMI change intervals of five years each with all-cause mortality using Cox proportional Hazard models. During median follow-up of 12 years 4,119 deaths were identified. The lowest mortalities were found in persons with normal weight or overweight at baseline and stable BMI over 10 years. Weight gain (≥0.10 kg/m(2)/year) during the first five years was associated with increased mortality in overweight and obese people. For weight gain during both time intervals mortality risk remained significantly increased only in overweight (Hazard Ratio (HR): 1.39 (95% confidence interval: 1.01; 1.92)) and obese women (1.85 (95% confidence interval: 1.18; 2.89)). Weight loss (< -0.10 kg/m(2)/year) increased all-cause mortality in men and women consistently. BMI change over time assessed using accepted World Health Organisation BMI categories showed no increased mortality risk for people who remained in the normal or overweight category for all three measurements. In contrast, HRs for stable obese men and women were 1.57 (95% CI: 1.31; 1.87) and 1.46 (95% CI: 1.25; 1.71) respectively. CONCLUSION Our findings highlight the importance of weight stability and obesity avoidance in prevention strategy.
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Affiliation(s)
- Jochen Klenk
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
- Clinic for Geriatric Rehabilitation, Robert-Bosch Hospital, Stuttgart, Germany
| | - Kilian Rapp
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
- Clinic for Geriatric Rehabilitation, Robert-Bosch Hospital, Stuttgart, Germany
| | - Hanno Ulmer
- Department of Medical Statistics, Informatics and Health Economics, Medical University, Innsbruck, Austria
| | - Hans Concin
- Agency for Preventive and Social Medicine, Bregenz, Austria
| | - Gabriele Nagel
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
- Agency for Preventive and Social Medicine, Bregenz, Austria
- * E-mail:
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Bendsen NT, Christensen R, Bartels EM, Kok FJ, Sierksma A, Raben A, Astrup A. Is beer consumption related to measures of abdominal and general obesity? A systematic review and meta-analysis. Nutr Rev 2012; 71:67-87. [PMID: 23356635 DOI: 10.1111/j.1753-4887.2012.00548.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
A systematic review was conducted to assess the evidence linking beer consumption to abdominal and general obesity. Following a systematic search strategy, 35 eligible observational studies and 12 experimental studies were identified. Regarding abdominal obesity, most observational data pointed towards a positive association or no association between beer intake and waist circumference or waist-to-hip ratio in men, whereas results for women were inconsistent. Data from a subset of studies indicated that beer intake > 500 mL/day may be positively associated with abdominal obesity. Regarding general obesity, most observational studies pointed towards an inverse association or no association between beer intake and body weight in women and a positive association or no association in men. Data from six experimental studies in men, in which alcoholic beer was compared with low-alcoholic beer, suggested that consumption of alcoholic beer (for 21-126 days) results in weight gain (0.73 kg; P < 0.0001), but data from four studies comparing intake of alcoholic beer with intake of no alcohol did not support this finding. Generally, experimental studies had low-quality data. In conclusion, the available data provide inadequate scientific evidence to assess whether beer intake at moderate levels (<500 mL/day) is associated with general or abdominal obesity. Higher intake, however, may be positively associated with abdominal obesity.
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Affiliation(s)
- Nathalie T Bendsen
- Department of Human Nutrition, Centre for Advanced Food Studies, Faculty of Life Sciences, University of Copenhagen, Frederiksberg, Denmark
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May AM, Romaguera D, Travier N, Ekelund U, Bergmann MM, Kaaks R, Teucher B, Steffen A, Boeing H, Halkjaer J, Tjonneland A, Jakobsen MU, Overvad K, Dartois L, Fagherazzi G, Boutron-Ruault MC, Quirós JR, Agudo A, Gonzalez C, Sánchez MJ, Amiano P, Huerta JM, Ardanaz E, Wareham NJ, Crowe FL, Naska A, Orfanos P, Trichopoulou A, Palli D, Agnoli C, Tumino R, Vineis P, Panico S, Bueno-de-Mesquita HB, Verschuren M, Drake I, Sonestedt E, Braaten T, Rinaldi S, Romieu I, Slimani N, Norat T, Riboli E, Peeters PHM. Combined impact of lifestyle factors on prospective change in body weight and waist circumference in participants of the EPIC-PANACEA study. PLoS One 2012; 7:e50712. [PMID: 23226361 PMCID: PMC3511344 DOI: 10.1371/journal.pone.0050712] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2012] [Accepted: 10/26/2012] [Indexed: 01/12/2023] Open
Abstract
Background The evidence that individual dietary and lifestyle factors influence a person’s weight and waist circumference is well established; however their combined impact is less well documented. Therefore, we investigated the combined effect of physical activity, nutrition and smoking status on prospective gain in body weight and waist circumference. Methods We used data of the prospective EPIC-PANACEA study. Between 1992 and 2000, 325,537 participants (94,445 men and 231,092 women, aged between 25–70) were recruited from nine European countries. Participants were categorised into two groups (positive or negative health behaviours) for each of the following being physically active, adherent to a healthy (Mediterranean not including alcohol) diet, and never-smoking for a total score ranging from zero to three. Anthropometric measures were taken at baseline and were mainly self-reported after a medium follow-up time of 5 years. Results Mixed-effects linear regression models adjusted for age, educational level, alcohol consumption, baseline body mass index and follow-up time showed that men and women who reported to be physically active, never-smoking and adherent to the Mediterranean diet gained over a 5-year period 537 (95% CI −706, −368) and 200 (−478, −87) gram less weight and 0.95 (−1.27, −0.639) and 0.99 (−1.29, −0.69) cm less waist circumference, respectively, compared to participants with zero healthy behaviours. Conclusion The combination of positive health behaviours was associated with significantly lower weight and waist circumference gain.
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Affiliation(s)
- Anne M May
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
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18
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Liu T, Wang H, Wen X, Qiu Q, Ding P, He YH, Chen W, Yu XQ, Chen WQ. Smoking status and body fatness indicators: a cross-sectional survey among 1948 Chinese male adults. J Public Health (Oxf) 2012. [DOI: 10.1007/s10389-012-0543-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Turati F, Tramacere I, La Vecchia C, Negri E. A meta-analysis of body mass index and esophageal and gastric cardia adenocarcinoma. Ann Oncol 2012; 24:609-17. [PMID: 22898040 DOI: 10.1093/annonc/mds244] [Citation(s) in RCA: 126] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The incidence rates of esophageal and gastric cardia adenocarcinoma (EGCA) have increased over recent years in several countries, and overweight/obesity has been suggested to play a major role in these trends. In fact, higher body mass index (BMI) has been positively associated with EGCA in several studies. MATERIAL AND METHODS We conducted a meta-analysis of case-control and cohort studies on the BMI and EGCA updated to March 2011. We estimated overall relative risks (RRs) and 95% confidence intervals (CI) for BMI between 25 and 30 and BMI ≥ 30 kg/m(2), when compared with normo-weight subjects, using random-effects models. RESULTS We identified 22 studies, including almost 8000 EGCA cases. The overall RR was 1.71 (95% CI 1.50-1.96) for BMI between 25 and 30, and was 2.34 (95% CI 1.95-2.81) for BMI ≥ 30 kg/m(2). The continuous RR for an increment of 5 kg/m(2) of BMI was 1.11 (95% CI 1.09-1.14). The association was stronger for esophageal adenocarcinoma (RR for BMI ≥ 30 kg/m(2) = 2.73, 95% CI 2.16-3.46) than for gastric cardia adenocarcinoma (RR for BMI ≥ 30 kg/m(2) = 1.93, 95% CI 1.52-2.45). No substantial differences emerged across strata of sex and geographic areas. CONCLUSION Overweight and obesity are strongly related to EGCA, particularly to espophageal adenocarcinoma.
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Affiliation(s)
- F Turati
- Department of Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri, 20156 Milan, Italy
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Travier N, Agudo A, May AM, Gonzalez C, Luan J, Wareham NJ, Bueno-de-Mesquita HB, van den Berg SW, Slimani N, Rinaldi S, Clavel-Chapelon F, Boutron-Ruault MC, Palli D, Sieri S, Mattiello A, Tumino R, Vineis P, Norat T, Romaguera D, Rodriguez L, Sanchez MJ, Dorronsoro M, Barricarte A, Huerta JM, Key TJ, Orfanos P, Naska A, Trichopoulou A, Rohrmann S, Kaaks R, Bergmann MM, Boeing H, Hallmans G, Johansson I, Manjer J, Lindkvist B, Jakobsen MU, Overvad K, Tjonneland A, Halkjaer J, Lund E, Braaten T, Odysseos A, Riboli E, Peeters PH. Longitudinal changes in weight in relation to smoking cessation in participants of the EPIC-PANACEA study. Prev Med 2012; 54:183-92. [PMID: 21939684 DOI: 10.1016/j.ypmed.2011.09.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2011] [Revised: 08/30/2011] [Accepted: 09/04/2011] [Indexed: 01/28/2023]
Abstract
PURPOSE We assessed the association between smoking cessation and prospective weight change in the European population of the European Prospective Investigation into Cancer and Nutrition-Physical Activity, Nutrition, Alcohol, Cessation of smoking, Eating out of home And obesity (EPIC-PANACEA) project. METHODS The study involved more than 300,000 healthy volunteers, recruited between 1992 and 2000 in 9 European countries, who provided data on anthropometry and smoking habits at baseline and after a follow-up of 5 years on average. Adjusted mixed-effects linear regression models were used to obtain sex-specific summary estimates of the association between the change in smoking status and the annual change in weight. RESULTS Smoking cessation tends to be followed by weight gain; when compared to stable smokers, annual weight gain was higher in men (0.44 kg (95%CI: 0.36; 0.52)) and women (0.46 kg (95%CI: 0.41; 0.52)) who stopped smoking during follow-up. When smokers who stopped smoking at least 1 year before recruitment were compared to never smokers, no major differences in annual weight gain were observed. The excess weight gain following smoking cessation appears to mainly occur in the first years following the cessation. CONCLUSIONS When considering the benefits of smoking cessation, such findings strengthen the need for promoting cessation offering information on weight gain control and support to weight-concerned smokers in order to remove a barrier to quitting.
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Affiliation(s)
- Noémie Travier
- Unit of Nutrition, Environment and Cancer, Catalan Institute of Oncology, IDIBELL, Barcelona, Spain.
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Bulló M, Garcia-Aloy M, Martínez-González MA, Corella D, Fernández-Ballart JD, Fiol M, Gómez-Gracia E, Estruch R, Ortega-Calvo M, Francisco S, Flores-Mateo G, Serra-Majem L, Pintó X, Covas MI, Ros E, Lamuela-Raventós R, Salas-Salvadó J. Association between a healthy lifestyle and general obesity and abdominal obesity in an elderly population at high cardiovascular risk. Prev Med 2011; 53:155-61. [PMID: 21708186 DOI: 10.1016/j.ypmed.2011.06.008] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2011] [Accepted: 06/13/2011] [Indexed: 02/02/2023]
Abstract
BACKGROUND Diet, smoking and physical activity are important modifiable lifestyle factors that can influence body weight and fat accumulation. We assessed the relationship between lifestyle and obesity risk in a baseline analysis of the PREDIMED study, a randomized dietary primary prevention trial conducted in Spain. METHODS 7000 subjects at high cardiovascular risk were assessed cross-sectionally. A healthy lifestyle pattern (HLP) was determined using a score including: adherence to the Mediterranean diet, moderate alcohol consumption, expending ≥200 kcal/day in leisure-time physical activity, and non-smoking. RESULTS Inverse linear trends were observed between the HLP-score and body-mass-index (BMI) or waist circumference (p<0.001). The BMI and waist circumference of participants with a HLP-score=4 were, respectively, 1.3 kg/m(2) (95% CI: 0.9 to 1.7) and 4.3 cm (3.1 to 5.4) lower than those of subjects with an HLP≤1. The odds ratios of general obesity and abdominal obesity for an HLP score of 4 compared to an HPL score≤1 were 0.50 (0.42 to 0.60) and 0.51 (0.41 to 0.62), respectively. CONCLUSION A combination of four healthy lifestyle behaviors was associated with a lower prevalence of general obesity and abdominal obesity in Mediterranean elderly subjects at high cardiovascular risk.
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Affiliation(s)
- Mònica Bulló
- Human Nutrition Unit, Hospital Universitari de Sant Joan de Reus, IISPV, Universitat Rovira i Virgili, Reus, Spain
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Bergmann MM, Schütze M, Steffen A, Boeing H, Halkjaer J, Tjonneland A, Travier N, Agudo A, Slimani N, Rinaldi S, Norat T, Romaguera D, Rohrmann S, Kaaks R, Jakobsen MU, Overvad K, Ekelund U, Spencer EA, Rodríguez L, Sánchez MJ, Dorronsoro M, Barricarte A, Chirlaque MD, Orfanos P, Naska A, Trichopoulou A, Palli D, Grioni S, Vineis P, Panico S, Tumino R, Riboli E, Wareham NJ, Bueno-de-Mesquita B, May A, Peeters PHM. The association of lifetime alcohol use with measures of abdominal and general adiposity in a large-scale European cohort. Eur J Clin Nutr 2011; 65:1079-87. [PMID: 21559044 DOI: 10.1038/ejcn.2011.70] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND/OBJECTIVES The relation between lifetime use of alcohol and measures of abdominal and general adiposity is unknown. SUBJECTS/METHODS Among 99,381 men and 158,796 women of the European Prospective Investigation into Cancer and Nutrition (EPIC) study, means of waist circumference (WC), waist-to-hip-ratio (WHR) and body mass index (BMI), and odds ratios (OR) for a larger WC than predicted for a given BMI (WClp=positive residuals of gender specific linear regression of BMI on WC) across categories of average lifetime use of alcohol (total, from wine and from beer) were calculated, all adjusted for socio-demographic, lifestyle and health factors. RESULTS WC, WHR and BMI in men using lifetime ≤6 g/d alcohol were 95.1 cm, 0.942 and 27.3 kg/m(2), and 96.2 cm, 0.961 and 28.3 kg/m(2) when using >96 g/d. WC and WHR in women was 83.2 cm and 0.813 for ≤6 g/d, and 84.6 cm and 0.830 for >60 g/d, whereas BMI deviated only slightly with the lowest BMI (26.7 kg/m(2)) observed for >6-24 g/d. Compared with ≤6 g/d, OR for a WClp in both genders increased steadily across categories of alcohol use (up to 1.40 (95% confidence interval 1.32, 1.49) in men using >60 g/d and 1.63 (1.54, 1.73) in women using >24 g/d), though increase was higher for alcohol from beer than from wine (P for difference between beer and wine<0.001 (men) and=0.002 (women)). CONCLUSION Lifetime alcohol use is positively related to abdominal and general adiposity in men, possibly following the male weight gain pattern; in women, it is positively related only to abdominal adiposity. In this context, beer may contribute additionally to abdominal adiposity.
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Affiliation(s)
- M M Bergmann
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany.
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