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Teh CH, Rampal S, Kee CC, Azahadi O, Tahir A. Body mass index and waist circumference trajectories across the life course and birth cohorts, 1996-2015 Malaysia: sex and ethnicity matter. Int J Obes (Lond) 2023; 47:1302-1308. [PMID: 37833560 PMCID: PMC10663154 DOI: 10.1038/s41366-023-01391-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 09/19/2023] [Accepted: 09/22/2023] [Indexed: 10/15/2023]
Abstract
OBJECTIVE The global obesity epidemic remains a significant threat to public health and the economy. Age-period-cohort (APC) analysis is one method to model the trajectory of obesity. However, there is scarce published evidence of such analyses among the South East Asian population. This study aims to explore the sex and ethnic variations of BMI and waist circumference trajectories over time among non-institutionalized Malaysian adults aged 18 to 80 years. METHODS Data from four population-based National Health and Morbidity Surveys conducted in 1996, 2006, 2010, and 2015 were pooled. Hierarchical Age-Period-Cohort (HAPC) analysis explored the trajectories of BMI and waist circumference across the life course and birth cohorts by sex and ethnicity. These models assumed no period effect. RESULTS Generally, BMI and waist circumference trajectories increased across age and birth cohorts. These trajectories varied by sex and ethnicity. Females have more profound increasing BMI and waist circumference trajectories than their male counterparts as they age and as cohort recency increases. Chinese have less profound BMI and waist circumference increases across the life course and birth cohorts than other ethnic groups. CONCLUSIONS The profound increasing cohort trajectories of obesity, regardless of sex and ethnicity, are alarming. Future studies should focus on identifying factors associated with the less profound cohort effect among the Chinese to reduce the magnitude of trajectories in obesity, particularly among future generations.
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Affiliation(s)
- Chien Huey Teh
- Centre for Epidemiology and Evidence-based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
- Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, 40170, Setia Alam, Malaysia
| | - Sanjay Rampal
- Centre for Epidemiology and Evidence-based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Chee Cheong Kee
- Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health Malaysia, 40170, Setia Alam, Malaysia
| | - Omar Azahadi
- Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health Malaysia, 40170, Setia Alam, Malaysia
| | - Aris Tahir
- Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, 40170, Setia Alam, Malaysia
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Dogra P, Bedatsova L, Van Gompel JJ, Giannini C, Donegan DM, Erickson D. Long-term outcomes in patients with adult-onset craniopharyngioma. Endocrine 2022; 78:123-134. [PMID: 35869972 PMCID: PMC9308022 DOI: 10.1007/s12020-022-03134-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 07/01/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE Craniopharyngiomas are nonmalignant sellar and parasellar tumors exhibiting a bimodal age distribution. While the outcomes following treatment in patients with childhood-onset craniopharyngiomas are well characterized, similar information in adult-onset craniopharyngiomas is limited. We aimed to describe the long-term outcomes (weight and metabolic parameters, mortality) in patients with adult-onset craniopharyngioma following treatment. METHODS Patients with adult-onset craniopharyngioma with initial treatment (1993-2017) and >6 months of follow-up at our institution were retrospectively identified. Body mass index (BMI) categories included obese (BMI ≥ 30 kg/m2), overweight (BMI 25-29.9 kg/m2), and normal weight (BMI < 25 kg/m2). RESULTS For the 91 patients with adult-onset craniopharyngioma (44% women, mean diagnosis age 48.2 ± 18 years) over a mean follow-up of 100.3 ± 69.5 months, weight at last follow-up was significantly higher than before surgery (mean difference 9.5 ± 14.8 kg, P < 0.001) with a higher percentage increase in weight seen in those with lower preoperative BMI (normal weight (20.7 ± 18%) vs. overweight (13.3 ± 18.0%) vs. obese (6.4 ± 15%), P = 0.012). At last follow-up, the prevalence of obesity (62 vs. 40.5%, P = 0.0042) and impaired glucose metabolism (17.4% vs. 34%, P = 0.017) increased significantly. All-cause mortality was 12%, with the average age of death 71.9 ± 19.7 years (average U.S. life expectancy 77.7 years, CDC 2020). CONCLUSION Patients with adult-onset craniopharyngioma following treatment may experience weight gain, increased prevalence of obesity, impaired glucose metabolism, and early mortality. Lower preoperative BMI is associated with a greater percentage increase in postoperative weight.
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Affiliation(s)
- Prerna Dogra
- Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, MN, USA
| | - Lucia Bedatsova
- Department of Internal Medicine, Hôpital Neuchâtelois, Neuchâtel, Switzerland
| | - Jamie J Van Gompel
- Departments of Neurosurgery and Otolaryngology, Mayo Clinic, Rochester, MN, USA
| | - Caterina Giannini
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | - Diane M Donegan
- Division of Endocrinology, Diabetes, and Metabolism, Indiana University, Indianapolis, IN, USA
| | - Dana Erickson
- Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, MN, USA.
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He DC, Zhu ZJ, Zhang XY, Zhang Y, Hong J, Shi TT, Han JH. Evaluating the influence of 6MV and 10MV photon beams on cervical volumetric-modulated arc therapy plans. Technol Health Care 2022; 30:1515-1523. [PMID: 35661033 DOI: 10.3233/thc-213617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Cervical cancer is a common gynecological cancer among women worldwide. OBJECTIVE To determine the effects of 6 MV and 10 MV volumetric-modulated arc therapy (VMAT) photon beams on the target volume (TV) planning and critical organs in cases of cervical cancer. METHODS Fifty patients with carcinoma of the cervix who underwent radiotherapy were selected. The transverse diameter (T) of the cross section of the upper edge of the sacroiliac joint on computerized tomography images of the patients was measured, and the mean value was calculated as 34 cm. All patients were divided into two groups: Group A (T < 34 cm) and Group B (T > 34 cm). The VMAT plans were generated using 6 MV and 10 MV plans separately. The prescription dose was 47.5 Gy, and the daily dose was 1.9 Gy. RESULTS In Group A, the planned TV (PTV) dose assessment parameters of 6 MV and 10 MV plans and their homogeneity and conformity indices were not statistically significantly different. A significant difference was observed between the 6 MV and 10 MV plans for the PTV dose assessment parameters and the homogeneity index of the plans for Group B. The monitor units of the 10 MV plans were lower than in the 6 MV plans in both Groups A and B, and the difference was statistically significant. The assessment parameter V40 Gy of both the rectum and bladder in the 6 MV plans was smaller than the corresponding parameter in the 10 MV plans in Group A; in Group B, the assessment parameter V50 Gy of the rectum in the 10 MV plans was smaller than in the 6 MV plans. CONCLUSION When T < 34 cm, 6 MV energy is more suitable for the external irradiation of cervical cancer. When T > 34 cm, 10 MV energy is more suitable for cervical cancer radiotherapy. Therefore, 10 MV should be considered for patients with a large abdominal size.
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Barzin M, Aryannezhad S, Bagheri M, Mahdavi M, Valizadeh M, Azizi F, Hosseinpanah F. The association of the age, period, and birth cohort with 15-year changes in body mass index and waist circumference in adults: Tehran lipid and glucose study (TLGS). BMC Public Health 2022; 22:418. [PMID: 35232416 PMCID: PMC8889713 DOI: 10.1186/s12889-022-12810-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 02/21/2022] [Indexed: 11/12/2022] Open
Abstract
Objective To examine the association of age, period, and birth cohort with body mass index (BMI) and waist circumference (WC) changes among the participants of the Tehran Lipid and Glucose Study from 1999 to 2015. Methods This prospective cohort study included 4895 participants aged ≥20 years (41.3% men), who were divided into twelve gender stratified groups, having a ten-year age difference between them. Analyses were conducted to explicitly assess the association of age vs. period on BMI and WC changes. In addition, we evaluated BMI and WC changes among different birth cohorts. Results Upon 15 years of follow-up, the mean BMI of men and women increased from 26.0 ± 3.9 to 27.5 ± 4.3 kg/m2 and from 27.5 ± 4.8 to 29.9 ± 5.4 kg/m2 (P trend < 0.001), and this trend was accompanied by an increase in WC from 88.8 ± 10.9 to 97.8 ± 10.4 cm and from 87.3 ± 12.4 to 95.8 ± 12.1 cm, respectively (P trend < 0.001). Men and women in all age cohorts tended to have a rise in their BMI and WC with aging throughout the follow-up period. For men, this trend was more prominent in younger birth cohorts at phase III for BMI and at phases III and V for WC (indicating a significant negative association with birth cohort). For women, this trend was more prominent in older birth cohorts at both phases III and V for BMI and WC (indicating a significant positive association with the birth cohort). Conclusion The rise in BMI and WC was strongly associated with age in both sexes. The men born in the recent birth cohorts and the women born in earlier birth cohorts had the most alarming BMI and WC trends. More efforts must be spent on obesity prevention policies, especially for younger men. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12810-z.
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Affiliation(s)
- Maryam Barzin
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shayan Aryannezhad
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Bagheri
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Mahdavi
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Majid Valizadeh
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farhad Hosseinpanah
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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A reversal in the obesity epidemic? A quasi-cohort and gender-oriented analysis in Spain. DEMOGRAPHIC RESEARCH 2022. [DOI: 10.4054/demres.2022.46.10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Socio-Psychological Factors Associated with Young Australian Adults' Consumption of Energy Dense and Nutrient Poor (EDNP) Foods. Nutrients 2022; 14:nu14040812. [PMID: 35215462 PMCID: PMC8879312 DOI: 10.3390/nu14040812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 02/09/2022] [Accepted: 02/11/2022] [Indexed: 11/16/2022] Open
Abstract
Young Australian adults' exhibit high consumption of Energy Dense and Nutrient Poor (EDNP) foods; however, there is limited research concerning the factors influencing their consumption. This study aimed to explore socio-psychological factors associated with young Australian adults' (18-30 years) consumption of EDNP foods with consideration of the Food Related Lifestyle Model (FRLM) as a potential framework. Through qualitative descriptive research methodology, 38 young adults were interviewed. Data were thematically analyzed. Participants were classified into three groups based on their living arrangements namely, parental, shared and independent households. Five themes emerged, (1) psychological factors (2) intrinsic qualities of EDNP foods, (3) social factors, (4) accessibility and affordability and (5) health related beliefs. The FRLM takes into consideration some of the factors reported in this study as influencers of EDNP food intakes. However, the FRLM omits important psychological factors (motivation, restraint, cravings, coping strategies and habits) identified by participants as influencers over their EDNP food intakes. The FRLM may need to be extended in its application to EDNP food intakes of young Australian adults. Social marketing campaigns highlighting health risks, addressing social and environmental factors are suggested. The social desirability of healthier alternatives in social gatherings of young adults could be increased.
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Tano S, Kotani T, Ushida T, Yoshihara M, Imai K, Nakano-Kobayashi T, Moriyama Y, Iitani Y, Kinoshita F, Yoshida S, Yamashita M, Kishigami Y, Oguchi H, Kajiyama H. Annual Body Mass Index Gain and Risk of Gestational Diabetes Mellitus in a Subsequent Pregnancy. Front Endocrinol (Lausanne) 2022; 13:815390. [PMID: 35399932 PMCID: PMC8990746 DOI: 10.3389/fendo.2022.815390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 02/16/2022] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Weight change during the interpregnancy is related to gestational diabetes mellitus (GDM) in the subsequent pregnancy. In interpregnancy care/counseling, the timeframe for goal setting is important, while the timing of the next conception is unpredictable and preventing age-related body weight gain is difficult. This study aimed to investigate the association between annual weight gain during the interpregnancy, which provide clearer timeframe, and GDM in subsequent pregnancies. METHODS This multicenter retrospective study was conducted by collecting data on two pregnancies of the same women in 2009-2019. The association between annual BMI gain and GDM during the subsequent pregnancy was examined. RESULTS This study included 1,640 pregnant women. A history of GDM [adjusted odds ratio (aOR), 26.22; 95% confidence interval (CI), 14.93-46.07] and annual BMI gain (aOR, 1.48; 95% CI, 1.22-1.81) were related to GDM during the subsequent pregnancy. In the women with a pre-pregnant BMI of <25.0 kg/m2 and without GDM during the index pregnancy, an annual BMI gain of ≥0.6 kg/m2/year during the interpregnancy were associated with GDM in subsequent pregnancies; however, in the other subgroups, it was not associated with GDM in subsequent pregnancies. CONCLUSIONS For women with a pre-pregnant BMI of <25.0 kg/m2 and without GDM during the index pregnancy, maintaining an annual BMI gain of <0.6 kg/m2/year may prevent GDM during the subsequent pregnancy.
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Affiliation(s)
- Sho Tano
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, Toyota, Japan
| | - Tomomi Kotani
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Division of Perinatology, Center for Maternal-Neonatal Care, Nagoya University Hospital, Nagoya, Japan
- *Correspondence: Tomomi Kotani,
| | - Takafumi Ushida
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masato Yoshihara
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kenji Imai
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tomoko Nakano-Kobayashi
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshinori Moriyama
- Department of Obstetrics and Gynecology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Yukako Iitani
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Fumie Kinoshita
- Data Science Division, Data Coordinating Center, Department of Advanced Medicine, Nagoya University Hospital, Nagoya, Japan
| | | | | | - Yasuyuki Kishigami
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, Toyota, Japan
| | - Hidenori Oguchi
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, Toyota, Japan
| | - Hiroaki Kajiyama
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Løvsletten O, Jacobsen BK, Grimsgaard S, Njølstad I, Wilsgaard T, Løchen ML, Eggen AE, Hopstock LA. Prevalence of general and abdominal obesity in 2015-2016 and 8-year longitudinal weight and waist circumference changes in adults and elderly: the Tromsø Study. BMJ Open 2020; 10:e038465. [PMID: 33154051 PMCID: PMC7646335 DOI: 10.1136/bmjopen-2020-038465] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES To describe the prevalence of general (body mass index (BMI) ≥30 kg/m2) and abdominal (waist circumference women >88 cm, men >102 cm) obesity in Tromsø 7 (2015-2016), and the secular change from Tromsø 6 (2007-2008). Furthermore, to study longitudinal changes in body weight and waist circumference from Tromsø 6 to Tromsø 7. SETTING A population study in Tromsø, Norway. PARTICIPANTS The cross-sectional analyses included 20 855 participants in Tromsø 7 (aged ≥40 years) and 12 868 in Tromsø 6 (aged ≥30 years). The longitudinal analyses included 8592 participants with repeated measurements, aged 35-79 in Tromsø 6. OUTCOME MEASURES Mean age-specific and sex-specific BMI, waist circumference, prevalence of general and abdominal overweight and obesity, as well as longitudinal changes in body weight and waist circumference according to sex and birth cohort. RESULTS Over 8 years, the age-adjusted prevalence of general obesity increased (p<0.0001) from 20.1% to 23.0% in women and from 20.7% to 25.2% in men. The age-adjusted prevalence of abdominal obesity did not increase in women (from 54.7% to 53.4%), and the increase in men was modest (from 36.8% to 38.6%, p=0.003). Longitudinal analyses showed an increase in body weight, by 1.1 kg (95% CI 0.9 to 1.2) in women and 0.7 kg (95% CI 0.6 to 0.9) in men, and also waist circumference, by 1.3 cm (95% CI 1.0 to 1.5) in women and 1.4 cm (95% CI 1.2 to 1.6) in men. There were inverse relationships (p<0.001) between age at baseline and change in weight and waist circumference. CONCLUSIONS Repeated cross-sectional analyses showed that the prevalence of general obesity increased, whereas the increase in abdominal obesity was less marked. Longitudinal analyses showed increases in both body weight and waist circumference. The youngest age groups have the largest increase.
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Affiliation(s)
- Ola Løvsletten
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Bjarne K Jacobsen
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- Centre for Sami Health Research, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Sameline Grimsgaard
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Inger Njølstad
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Tom Wilsgaard
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Maja-Lisa Løchen
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Anne Elise Eggen
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
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El Kishawi RR, Soo KL, Abed YA, Muda WAMW. Prevalence and predictors of overweight and obesity among women in the Gaza strip-Palestine: a cross-sectional study. BMC Public Health 2020; 20:864. [PMID: 32503538 PMCID: PMC7275345 DOI: 10.1186/s12889-020-08966-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 05/20/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The prevalence of overweight and obesity among women of childbearing age is considered a public health concern. Few studies have been conducted in the Gaza Strip to determine the magnitude of overweight and obesity. This study aimed to determine the prevalence of overweight and obesity along with their associated factors among women in the Gaza Strip. METHODS A cross-sectional study was conducted to recruit a total of 357 mothers aged 18-50 years. Interviews were carried out among mothers to collect sociodemographic information, nutritional information, and physical activity. Anthropometric measurements [height, weight and waist circumference (WC)] were conducted with the mothers. Body Mass Index (BMI) was computed to determine the prevalence of overweight and obesity. Multinomial logistic regression was used to examine the associated factors of overweight and obesity. RESULTS The combined prevalence of overweight and obesity among mothers was (64.1%). The results of multinomial logistic regression showed the risk of overweight and obesity increased with age, the highest risk being in mothers aged > 33.0 years (OR = 2.7, 95% CI: (1.06,6.86)), and (OR = 5.72, 95% CI: (2.07,15.78)), respectively, compared to mothers aged < 33.0 years. Moreover, mothers with medium and high educational levels had a slightly higher risk of obesity (OR = 0.31, 95% CI: (0.15,0.64)), and (OR = 0.32, 95% CI: (0.12,0.82)) respectively than mothers with low educational level. Household income was positively associated with overweight and obesity. Mothers exposed to higher monthly income were more likely to be overweight or obese (OR = 2.64, 95% CI: (1.20, 5.83)), and (OR = 3.06, 95% CI: (1.28,7.29)), respectively. Nutrition knowledge was significantly associated with a high prevalence of obesity (OR = 1.20, 95% CI: (1.03,1.38)). CONCLUSIONS This study showed a higher prevalence of overweight and obesity among Palestinian women than previous studies. Age, educational level, monthly income, and nutrition knowledge were associated with the prevalence of overweight and obesity, compared to other variables that were not associated with overweight and obesity such as location, work status, physical activity, and sitting hours. Urgent action is needed to tackle overweight and obesity among women. Effective intervention is required to increase nutrition knowledge among women to improve their eating behaviors.
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Affiliation(s)
| | - Kah Leng Soo
- Program of Nutrition, School of Health Sciences, Health Campus, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia
| | - Yehia Awad Abed
- School of Public Health, Al Quds University, Gaza City, Gaza Strip, Palestine
| | - Wan Abdul Manan Wan Muda
- Program of Nutrition, School of Health Sciences, Health Campus, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia
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Nutrition knowledge, attitudes, and self-regulation as predictors of overweight and obesity. J Am Assoc Nurse Pract 2020; 31:502-510. [PMID: 30829975 DOI: 10.1097/jxx.0000000000000169] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND PURPOSE Nutrition knowledge, attitudes, and eating self-regulation are important determinants of overweight and obesity. Eating self-regulation is the link between eating intention and behavior. However, the extent to which these factors influence overweight and obesity has not been thoroughly studied. The study examined nutrition knowledge, attitudes, and eating self-regulation as predictors of overweight and obesity among adults in a community setting. METHODS A total of 313 adults participated in an online survey, which included the General Nutrition Knowledge Questionnaire-Revised, the Nutrition Attitudes Questionnaire, and the Self-Regulation of Eating Behavior Questionnaire. Descriptive statistics, Kendall's tau tests, and multivariate logistic regression procedures were performed. CONCLUSIONS More than half of the participants were either overweight or obese (56.5%). The mean nutrition knowledge score was 74.1%, and only 28.1% correctly identified the body mass index for obesity. Positive predictors of overweight and obesity included poor eating self-regulation of giving up too easily on eating intentions (odds ratio [OR] = 3.81), male gender (OR = 2.0), and age (OR = 1.03), whereas nutrition attitudes were a negative predictor (OR = 0.74). IMPLICATIONS FOR PRACTICE The odds of overweight or obesity were nearly four times greater for those who gave up too easily on their eating intentions. Nurse practitioners can play a critical role in establishing healthy dietary habits to maintain weight control by promoting good eating self-regulation, despite the current obesogenic environment. After assessing patient readiness and motivation, it is important to help patients make eating self-regulation as manageable as possible to promote long-term weight management.
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Jacobsen BK, Melhus M, Kvaløy K, Siri SRA, Michalsen VL, Broderstad AR. A descriptive study of ten-year longitudinal changes in weight and waist circumference in the multi-ethnic rural Northern Norway. The SAMINOR Study, 2003-2014. PLoS One 2020; 15:e0229234. [PMID: 32074126 PMCID: PMC7029861 DOI: 10.1371/journal.pone.0229234] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 02/01/2020] [Indexed: 01/22/2023] Open
Abstract
The obesity epidemic is dynamic with varying secular trends and differences between countries and ethnic groups. The objective of this study was to describe the age- and sex-specific longitudinal changes in weight and waist circumference in a rural Norwegian population with a high proportion of the indigenous Sami population. Based on two population-based surveys, SAMINOR 1 (2003-2004) and SAMINOR 2 (2012-2014), we present longitudinal changes in weight and waist circumference according to age at baseline in the SAMINOR 1 Survey and sex during the 10-year period. The analyses included 1538 men and 1958 women aged 36 to 69 at baseline (birth year 1934 to 1967). Forty-one percent of the population were Sami. Both weight and waist circumference were measured. The mean weight increased 0.8 kg (95% confidence interval: 0.5, 1.1) in men and 0.3 kg (95% confidence interval: 0, 0.5) in women. In both men and women, younger individuals gained significantly more weight during the 10-year follow-up than older participants (p < 0.001). The mean weight showed a statistically significant increase in men aged 36-54 and women aged 36-49 at baseline and was statistically significantly reduced in men and women aged 60-69. The mean waist circumference increased by 6.3 cm (95% confidence interval: 6.0, 6.6) in men and 8.4 cm (95% confidence interval 8.1, 8.8) in women. The mean waist circumference increased statistically significantly from SAMINOR 1 to SAMINOR 2 in all age groups, and there was an inverse relationship between age at baseline and change in waist circumference (p < 0.001). Waist circumference increased more than can be explained by changes in weight and age during the 10-year period. The inverse relationships between age at baseline in SAMINOR 1 and the 10-year change in weight and waist circumference were found in both Sami and non-Sami participants. The findings underline the need for prevention of obesity, particularly in younger people, as it is difficult to achieve permanent weight loss.
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Affiliation(s)
- Bjarne K. Jacobsen
- Centre for Sami Health Research, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- * E-mail:
| | - Marita Melhus
- Centre for Sami Health Research, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Kirsti Kvaløy
- Centre for Sami Health Research, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- HUNT Research Centre, Department of Public Health and Nursing, NTNU–Norwegian University of Science and Technology, Trondheim, Norway
| | - Susanna R. A. Siri
- Centre for Sami Health Research, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Vilde Lehne Michalsen
- Centre for Sami Health Research, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Ann Ragnhild Broderstad
- Centre for Sami Health Research, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- Division of Internal Medicine, Department of Medicine, The University Hospital of North Norway, Harstad, Norway
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Hasegawa M, Akter S, Hu H, Kashino I, Kuwahara K, Okazaki H, Sasaki N, Ogasawara T, Eguchi M, Kochi T, Miyamoto T, Nakagawa T, Honda T, Yamamoto S, Murakami T, Shimizu M, Uehara A, Yamamoto M, Imai T, Nishihara A, Tomita K, Nagahama S, Hori A, Konishi M, Kabe I, Mizoue T, Kunugita N, Dohi S. Five-year cumulative incidence of overweight and obesity, and longitudinal change in body mass index in Japanese workers: The Japan Epidemiology Collaboration on Occupational Health Study. J Occup Health 2020; 62:e12095. [PMID: 31677232 PMCID: PMC6970396 DOI: 10.1002/1348-9585.12095] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 08/30/2019] [Accepted: 10/03/2019] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE The present study aimed to estimate cumulative incidence of overweight and obesity and describe 5-year longitudinal changes in body mass index (BMI) in a large occupational cohort in Japan. METHODS Participants were 55 229 Japanese employees, who were aged 20-59 years and attended at all subsequent annual health check-ups between 2009 and 2014. Mixed model analysis was performed to examine the effects of age and cohort by gender on BMI change, with age as a random variable. Cumulative incidence of overweight (23.0≤ BMI <27.5 kg/m2 ) and obesity (BMI ≥27.5 kg/m2 ) was calculated. Logistic regression analysis was used to estimate odds ratios for the incidence of overweight and obesity according to age group. RESULTS The incidence of overweight and obesity was approximately double in men (28.3% and 6.7%, respectively) compared to women (14.3% and 3.9%, respectively).The incidence of obesity decreased with age in men, but did not differ according to age in women (P for trend: .02 and .89, respectively). Among overweight participants, the incidence of obesity was higher in women (18.9%) than men (14.5%) and decreased with advancing age (P for trend: <.001 in men and .003 in women). Mean BMI was higher in men than women in all age groups throughout the period. Younger cohorts tended to have a higher BMI change compared with older cohorts. CONCLUSIONS In this Japanese occupational cohort, transition from overweight to obesity is higher in women than men, and the more recent cohorts had a higher change in mean BMI than the older cohorts.
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Affiliation(s)
- Miyuki Hasegawa
- Department of Epidemiology and PreventionCenter for Clinical SciencesNational Center for Global Health and MedicineTokyoJapan
| | - Shamima Akter
- Department of Epidemiology and PreventionCenter for Clinical SciencesNational Center for Global Health and MedicineTokyoJapan
| | - Huanhuan Hu
- Department of Epidemiology and PreventionCenter for Clinical SciencesNational Center for Global Health and MedicineTokyoJapan
| | - Ikuko Kashino
- Department of Epidemiology and PreventionCenter for Clinical SciencesNational Center for Global Health and MedicineTokyoJapan
| | - Keisuke Kuwahara
- Department of Epidemiology and PreventionCenter for Clinical SciencesNational Center for Global Health and MedicineTokyoJapan
- Teikyo University Graduate School of Public HealthTokyoJapan
| | | | - Naoko Sasaki
- Mitsubishi Fuso Truck and Bus CorporationKanagawaJapan
| | | | | | | | | | | | | | | | - Taizo Murakami
- Mizue Medical ClinicKeihin Occupational Health CenterKanagawaJapan
| | - Makiko Shimizu
- Mizue Medical ClinicKeihin Occupational Health CenterKanagawaJapan
| | | | | | | | | | | | | | - Ai Hori
- Department of Global Public HealthUniversity of TsukubaIbarakiJapan
| | - Maki Konishi
- Department of Epidemiology and PreventionCenter for Clinical SciencesNational Center for Global Health and MedicineTokyoJapan
| | | | - Tetsuya Mizoue
- Department of Epidemiology and PreventionCenter for Clinical SciencesNational Center for Global Health and MedicineTokyoJapan
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13
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Jansen MAC, Dalmeijer GW, Saldi SRF, Grobbee DE, Baharuddin M, Uiterwaal CSPM, Idris NS. Pre-pregnancy parental BMI and offspring blood pressure in infancy. Eur J Prev Cardiol 2019; 26:1581-1590. [PMID: 31238715 PMCID: PMC6753651 DOI: 10.1177/2047487319858157] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 05/29/2019] [Indexed: 12/11/2022]
Abstract
AIMS A growing body of evidence suggests that a higher maternal pre-pregnancy body mass index results in higher offspring's blood pressure, but there is inconsistency about the impact of father's body mass index. Furthermore, evidence is limited with regard to low and middle income countries. We aimed to determine the association between parental pre-pregnancy body mass index and offspring's blood pressure during the first year of life. METHODS In 587 infants of the BReastfeeding Attitude and Volume Optimization (BRAVO) trial systolic and diastolic blood pressure were measured twice at the right leg in a supine position, using an automatic oscillometric device at day 7, month 1, 2, 4, 6, 9 and 12. Parental pre-pregnancy body mass index was based on self-reported weight and height. Linear mixed models were performed to investigate the associations between parental pre-pregnancy body mass index and offspring blood pressure patterns. RESULTS Each unit increase in maternal body mass index was associated with 0.24 mmHg (95% confidence interval 0.05; 0.44) and 0.13 mmHg (0.01; 0.25) higher offspring's mean systolic and diastolic blood pressure, respectively, during the first year of life. A higher offspring blood pressure with increased maternal pre-pregnancy body mass index was seen at birth and remained higher during the first year of life. The association with systolic blood pressure remained similar after including birth size and offspring's weight and height over time. The association with diastolic blood pressure attenuated slightly to a non-significant result after including these variables. Paternal body mass index was not associated with offspring's blood pressure. CONCLUSION Higher maternal pre-pregnancy body mass index, but not paternal pre-pregnancy body mass index, is associated with higher offspring blood pressure already from birth onwards.
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Affiliation(s)
| | - Geertje W Dalmeijer
- Julius Center for Health Sciences and
Primary Care, University Medical Center Utrecht, The Netherlands
| | - Siti RF Saldi
- Department of Child Health/Center for
Clinical Epidemiology and Evidence Based Medicine (CEEBM), Cipto Mangunkusumo
National General Hospital, Indonesia
| | - Diederick E Grobbee
- Julius Center for Health Sciences and
Primary Care, University Medical Center Utrecht, The Netherlands
| | | | - Cuno SPM Uiterwaal
- Julius Center for Health Sciences and
Primary Care, University Medical Center Utrecht, The Netherlands
| | - Nikmah S Idris
- Julius Center for Health Sciences and
Primary Care, University Medical Center Utrecht, The Netherlands
- Department of Child Health/Center for
Clinical Epidemiology and Evidence Based Medicine (CEEBM), Cipto Mangunkusumo
National General Hospital, Indonesia
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14
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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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15
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The Relationship Between Delay and Social Discounting, and Body Mass Index in University Students. PSYCHOLOGICAL RECORD 2018. [DOI: 10.1007/s40732-018-0287-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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16
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Beeken RJ, Mahdi S, Johnson F, Meisel SF. Intentions to Prevent Weight Gain in Older and Younger Adults; The Importance of Perceived Health and Appearance Consequences. Obes Facts 2018; 11:83-92. [PMID: 29558747 PMCID: PMC5981668 DOI: 10.1159/000486961] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 01/15/2018] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES This study investigates whether health and appearance consequences predict intentions to prevent weight gain and whether these relationships differ in younger versus older adults and in men versus women. METHODS UK adults aged 18-26 years (younger adults; n = 584) or >45 years (older adults; n = 107) participated in an online survey. Logistic regression assessed associations between intentions to avoid gaining weight and age, gender as well as perceived negative consequences of weight gain for health and appearance. Co-variates were ethnicity, education, weight perception and perceived weight gain vulnerability. Interactions between age, gender and perceived health and appearance consequences of weight gain were also tested. RESULTS Perceived negative appearance consequences of weight gain predicted weight gain prevention intentions (OR = 9.3, p < 0.001). Health concerns were not a significant predictor of intentions overall but were a strong predictor for older adults (age × health concern interaction: OR = 13.6, p > 0.01). CONCLUSION Concerns about feeling unattractive predict intentions to prevent weight gain. However, health consequences of weight gain are only important motivators for older adults. Future research should identify ways to shift the focus of young people from appearance concerns towards the health benefits of maintaining a healthy weight.
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Affiliation(s)
- Rebecca J. Beeken
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
- Research Department of Behavioural Science and Health, University College London, London, UK
- *Rebecca J Beeken, PhD, Leeds Institute of Health Sciences, University of Leeds, Level 10, Worsley Building, Clarendon Way, Leeds, LS2 9NL, UK,
| | - Sundus Mahdi
- Research Department of Behavioural Science and Health, University College London, London, UK
| | - Fiona Johnson
- Research Department of Behavioural Science and Health, University College London, London, UK
| | - Susanne F. Meisel
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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17
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Picavet HSJ, Blokstra A, Spijkerman AMW, Verschuren WMM. Cohort Profile Update: The Doetinchem Cohort Study 1987-2017: lifestyle, health and chronic diseases in a life course and ageing perspective. Int J Epidemiol 2017; 46:1751-1751g. [PMID: 29040549 PMCID: PMC5837330 DOI: 10.1093/ije/dyx103] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 05/16/2017] [Accepted: 05/22/2017] [Indexed: 12/26/2022] Open
Affiliation(s)
- H S J Picavet
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands and
| | - Anneke Blokstra
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands and
| | - Annemieke MW Spijkerman
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands and
| | - WM Monique Verschuren
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands and
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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18
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Szulc P, Duboeuf F, Chapurlat R. Age-Related Changes in Fat Mass and Distribution in Men-the Cross-Sectional STRAMBO Study. J Clin Densitom 2017; 20:472-479. [PMID: 27601161 DOI: 10.1016/j.jocd.2016.08.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 08/05/2016] [Accepted: 08/11/2016] [Indexed: 12/26/2022]
Abstract
Data on age-related differences in fat mass and distribution in men are scarce. We performed a cross-sectional analysis of age-related differences in fat distribution in men. In a cohort of 1133 men aged 20-87 yr, body composition was assessed using a Hologic Discovery A device. We assessed fat mass (FM) and FM indices adjusted for height. Interindividual variability was calculated as standard deviation, interquartile range, and difference between the 95th and 5th percentiles in 5-yr age groups. After adjustment for lifestyle factors, the FM and FM index of appendicular, gynoid, central, android, and subcutaneous abdominal compartments increased with age. Their variability did not vary with age. Visceral FM was 181% higher in men aged >80 yr compared to men aged 20-30 yr, and the variability increased with age. FM in the central, android, subcutaneous abdominal, and visceral compartments correlated with age significantly more strongly before the age of 70 than after this age. The relative differences between the elderly and younger men were greater for visceral FM than for subcutaneous (abdominal and appendicular) fat. The interindividual variability in visceral FM is higher in elderly men. The association between visceral FM and age is stronger before the age of 70.
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Affiliation(s)
- Pawel Szulc
- INSERM UMR 1033, University of Lyon, Hospices Civils de Lyon, Lyon, France.
| | - François Duboeuf
- INSERM UMR 1033, University of Lyon, Hospices Civils de Lyon, Lyon, France
| | - Roland Chapurlat
- INSERM UMR 1033, University of Lyon, Hospices Civils de Lyon, Lyon, France
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19
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Badley EM, Canizares M, Perruccio AV. Population-Based Study of Changes in Arthritis Prevalence and Arthritis Risk Factors Over Time: Generational Differences and the Role of Obesity. Arthritis Care Res (Hoboken) 2017; 69:1818-1825. [PMID: 28271622 DOI: 10.1002/acr.23213] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 01/31/2017] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To investigate cohort effects in arthritis prevalence across 4 birth cohorts: World War II (born 1935-1944), older and younger baby boomers (born 1945-1954 and 1955-1964, respectively), and Generation X (born 1965-1974), and to determine whether birth cohort effects in arthritis prevalence were associated with differences in risk factors over time or period effects. METHODS Analysis of biannually collected data from the longitudinal Canadian National Population Health Survey, 1994-2011 (n = 8,817 at baseline). Data included self-reported arthritis diagnosed by a health professional, risk factors (years of education, household income, smoking, physical activity, sedentary behavior, body mass index [BMI]), and survey year as an indicator of period. We used hierarchical age-period-cohort analyses to compare the age trajectory of arthritis by birth cohort and to examine the contribution of changes in risk factors and period to cohort differences. RESULTS More recent cohorts had successively a greater prevalence of arthritis. Risk factors were significantly associated with arthritis prevalence independently of cohort differences. The effects of increasing education and income over time on potentially reducing the arthritis prevalence were almost counter-balanced by effects of increasing BMI. Significant cohort-BMI and age-BMI interactions indicated an earlier age of arthritis onset for obese individuals than those of normal weight. CONCLUSION Projections that only take into account the changing age structure of the population may underestimate future trends. Our understanding of the impact of BMI on arthritis is likely an underestimate. Cohort differences focus attention on the need to target arthritis management education to young and middle-aged adults.
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Affiliation(s)
- Elizabeth M Badley
- University of Toronto and Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Mayilee Canizares
- University of Toronto and Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Anthony V Perruccio
- The Arthritis Program, Toronto Western Hospital, University of Toronto, and Krembil Research Institute, Toronto, Ontario, Canada
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20
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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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21
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Is a Nutrition Education Intervention Associated with a Higher Intake of Fruit and Vegetables and Improved Nutritional Knowledge among Housewives in Mauritius? Nutrients 2016; 8:nu8120723. [PMID: 27916818 PMCID: PMC5188404 DOI: 10.3390/nu8120723] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Revised: 10/15/2016] [Accepted: 11/10/2016] [Indexed: 12/11/2022] Open
Abstract
The purpose of the study was to assess the determinants of nutrition behaviors and body mass index and determine the impact of a nutrition education intervention (NEI) among Mauritian housewives. A pretest-posttest design was used assessing Nutrition Knowledge (NK), Nutrition Attitudes, Fruit and Vegetable Intake (FVI), body mass index (BMI). Two hundred Mauritian housewives were recruited. The NEI was in the form of a lecture and lasted for twenty minutes. Statistical tests performed revealed that the mean NK score at baseline was 65.8 ± 6.92 and a significant increase of +17.1 at post-test and +16.1 at follow-up was observed. Determinants of NK were age, presence of elderly people, and BMI. Mean nutrition attitude score at baseline was 2.37 ± 0.22 with significant increase of +0.2 (post-test) and +0.17 at follow-up. Age, level of education, presence of elders, and NK were linked to a positive attitude. FVI was predicted by age, income, presence of elders, NK, and nutrition attitudes. Baseline FVI was 4.77 ± 1.11 which increased significantly (p < 0.001) to 4.98 ± 1.13 at post-test and 5.03 ± 1.20 at follow up. NEI had a positive impact suggesting the benefits of such intervention in the promotion of healthy nutrition behaviors.
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22
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Klaver M, Dekker MJHJ, de Mutsert R, Twisk JWR, den Heijer M. Cross-sex hormone therapy in transgender persons affects total body weight, body fat and lean body mass: a meta-analysis. Andrologia 2016; 49. [PMID: 27572683 DOI: 10.1111/and.12660] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2016] [Indexed: 01/12/2023] Open
Abstract
Weight gain and body fat increase the risk of cardiometabolic disease. Cross-sex hormone therapy in transgender persons leads to changes in body weight and body composition, but it is unclear to what extent. We performed a meta-analysis to investigate the changes in body weight, body fat and lean body mass during cross-sex hormone therapy in transgender persons. We searched the PubMed database for eligible studies until November 2015. Ten studies reporting changes in body weight, body fat or lean mass in hormone naive transgender persons were included, examining 171 male-to-female and 354 female-to-male transgender people. Pooled effect estimates in the male-to-female group were +1.8 kg (95% CI: 0.2;3.4) for body weight, +3.0 kg (2.0;3.9) for body fat and -2.4 kg (-2.8; -2.1) for lean body mass. In the female-to-male group, body weight changed with +1.7 kg (0.7;2.7), body fat with -2.6 kg (-3.9; -1.4) and lean body mass with +3.9 kg (3.2;4.5). Cross-sex hormone therapy increases body weight in both sexes. In the male-to-female group, a gain in body fat and a decline in lean body mass are observed, while the opposite effects are seen in the female-to-male group. Possibly, these changes increase the risk of cardiometabolic disease in the male-to-female group.
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Affiliation(s)
- M Klaver
- Department of Endocrinology, VU University Medical Center, Amsterdam, The Netherlands.,Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, The Netherlands
| | - M J H J Dekker
- Department of Endocrinology, VU University Medical Center, Amsterdam, The Netherlands.,Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, The Netherlands
| | - R de Mutsert
- Department of Clinical Epidemiology, Leiden University and Medical Center, Leiden, The Netherlands
| | - J W R Twisk
- Department of Epidemiology, VU University, Amsterdam, The Netherlands
| | - M den Heijer
- Department of Endocrinology, VU University Medical Center, Amsterdam, The Netherlands.,Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, The Netherlands
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23
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Gołąb S, Woronkowicz A, Kryst Ł. Biological aging and physical fitness in men aged 20-70 years from Kraków, Poland. Am J Hum Biol 2016; 28:503-9. [PMID: 27416874 DOI: 10.1002/ajhb.22820] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 09/03/2015] [Accepted: 11/23/2015] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES The increasing problem of population aging requires appropriate economic and health-related measures to mitigate its negative effects. The aim was to categorize the biological age of men between 20 and 70 years of age and assess its relationship to their physical activity and fitness. METHODS Data included morphological variables, total body water, the results of five Eurofit motor tests and the percentage of maximum heart rate (HR%), during a cardiovascular test of more than 1,400 20-70 year-old men living in Kraków. Biological age was estimated with regression equations. RESULTS There were significant and consistent differences in physical fitness profiles between the three established groups of relations between biological and chronological age (biologically younger, equal, and older). These three categories of biological age were generally consistent with the regression analysis of physical fitness results, although declared physical activity seemed to be an independent factor. CONCLUSIONS The selected morphological variables represent a set of characteristics useful for the determination of the biological age. The existing relationship between physical activity and biological age indicates that physical activity may contribute to the inhibition of involutional changes, even if it had only been performed regularly in the past. Am. J. Hum. Biol. 28:503-509, 2016. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- Stanisław Gołąb
- Krosno State College, Institute of Physical Education, Krosno, Poland
| | - Agnieszka Woronkowicz
- Faculty of Physical Education, Department of Anthropology, University of Physical Education, Kraków, Poland
| | - Łukasz Kryst
- Faculty of Physical Education, Department of Anthropology, University of Physical Education, Kraków, Poland
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Peverill RE, Chou B, Donelan L, Mottram PM, Gelman JS. Possible Mechanisms Underlying Aging-Related Changes in Early Diastolic Filling and Long Axis Motion-Left Ventricular Length and Blood Pressure. PLoS One 2016; 11:e0158302. [PMID: 27351745 PMCID: PMC4924872 DOI: 10.1371/journal.pone.0158302] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 06/13/2016] [Indexed: 01/19/2023] Open
Abstract
Background The transmitral E wave and the peak velocity of early diastolic mitral annular motion (e`) both decrease with age, but the mechanisms underlying these age-related changes are incompletely understood. This study investigated the possible contributions of blood pressure (BP) and left ventricular end-diastolic length (LVEDL) to age-related reductions in E and e`. Methods The study group were 82 healthy adult subjects <55 years of age who were not obese or hypertensive. Transmitral flow and mitral annular motion were recorded using pulsed-wave Doppler. LVEDL was measured from the mitral annular plane to the apical endocardium. Results Age was positively correlated with diastolic BP and septal wall thickness (SWT), inversely correlated with LVEDL (β = -0.25) after adjustment for sex and body surface area, but was not related to left ventricular end-diastolic diameter (LVEDD). Age was also inversely correlated with E (r = -0.36), septal e`(r = -0.53) and lateral e`(r = -0.53). On multivariable analysis, E was inversely correlated with diastolic BP and LVEDD, septal e`was inversely correlated with diastolic BP and positively correlated with SWT and LVEDL, after adjusting for body mass index, whilst lateral e`was inversely correlated with diastolic BP and positively correlated with LVEDL. Conclusion The above findings are consistent with higher BP being a contributor to age-related reductions in both E and e`and shortening of LVEDL with age being a contributor to the age-related reduction in e`. An implication of these findings is that slowing of myocyte relaxation is unlikely to be the sole, and may not be the main, mechanism underlying age-related decreases in E and e`.
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Affiliation(s)
- Roger E. Peverill
- Monash Cardiovascular Research Centre, Monash Heart and Department of Medicine (School of Clinical Sciences at Monash Medical Centre), Monash University and Monash Health, Clayton, Victoria, Australia
- * E-mail:
| | - Bon Chou
- Monash Cardiovascular Research Centre, Monash Heart and Department of Medicine (School of Clinical Sciences at Monash Medical Centre), Monash University and Monash Health, Clayton, Victoria, Australia
| | - Lesley Donelan
- Monash Cardiovascular Research Centre, Monash Heart and Department of Medicine (School of Clinical Sciences at Monash Medical Centre), Monash University and Monash Health, Clayton, Victoria, Australia
| | - Philip M. Mottram
- Monash Cardiovascular Research Centre, Monash Heart and Department of Medicine (School of Clinical Sciences at Monash Medical Centre), Monash University and Monash Health, Clayton, Victoria, Australia
| | - John S. Gelman
- Monash Cardiovascular Research Centre, Monash Heart and Department of Medicine (School of Clinical Sciences at Monash Medical Centre), Monash University and Monash Health, Clayton, Victoria, Australia
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Weight Gain Prevention among Midlife Women: A Randomized Controlled Trial to Address Needs Related to the Physical and Social Environment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13060530. [PMID: 27231927 PMCID: PMC4923987 DOI: 10.3390/ijerph13060530] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 05/19/2016] [Accepted: 05/20/2016] [Indexed: 11/17/2022]
Abstract
Women tend to gain weight at midlife (40–60 years) increasing risk of obesity-related chronic diseases. Within specific eating occasions, needs related to the physical and social environment may result in less healthy eating behavior, which can lead to weight gain over time. The purpose of this study was to determine if a dietitian-delivered nutrition counseling intervention tailored to eating occasion needs could improve diet and prevent weight gain among midlife women over two years. A randomized controlled trial was conducted with healthy midlife women (n = 354) in one U.S. metropolitan area. The intervention group (n = 185) received ten hours of individual nutrition counseling from dietitians over six months, while women in a control group (n = 169) received no counseling. Measured height, weight and waist circumference, and dietary intakes were collected at baseline and every six months over two years. Mixed linear models were used to test for intervention effect on change in outcome variables over time. Dietary intakes of fruit, reduced/low-fat dairy foods and refined grains were significantly improved over time in the intervention compared to control group. However, the intervention had no effect on weight over time (p = 0.48). Nutrition counseling tailored to address eating occasion needs improved self-reported diet but did not significantly affect weight change.
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Jacobsen BK, Aars NA. Changes in body mass index and the prevalence of obesity during 1994-2008: repeated cross-sectional surveys and longitudinal analyses. The Tromsø Study. BMJ Open 2015; 5:e007859. [PMID: 26070799 PMCID: PMC4466626 DOI: 10.1136/bmjopen-2015-007859] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES To determine the mean body mass index (BMI, kg/m(2)) and prevalence of low weight (BMI<20) and obesity (BMI ≥ 30) in 3 population-based surveys, and to describe the longitudinal changes during 1994-2008 in mean BMI, and the prevalence of low weight and obesity. SETTING A population study in Tromsø, Norway. PARTICIPANTS A total of 29,688 different participants in 1 or more of 3 surveys (1994-1995, 2001-2002 and 2007-2008). Longitudinal analyses comprised 9845 participants aged 25-69 in 1994 who participated in the 1994-1995 and 2007-2008 surveys and 4202 men and women who participated in all 3 surveys. OUTCOME MEASURES Mean age-specific and sex-specific BMI, prevalence of low weight and obesity, and changes in BMI and prevalence of low weight and obesity during 1994-2008, according to sex and birth cohort. RESULTS The age-adjusted (ages 30-84) prevalence of obesity increased from 9.8% and 11.8% in men and women, respectively, in 1994-1995 to 20.9% and 18.5%, respectively, in 2007-2008. The increase in mean age-adjusted BMI was stronger from 1994-1995 to 2001-2002 than from 2001-2002 to 2007-2008. Longitudinal results confirmed that the change in BMI from 1994-1995 to 2001-2002 was larger (0.9 kg/m(2) (95% CI 0.8 to 1.0) in men and 1.3 kg/m(2) (95% CI 1.2 to 1.4) in women) than from 2001-2002 to 2007-2008 (0.2 kg/m(2) (95% CI 0.1 to 0.3) in men and women). The most recently born had the largest increase (p<0.001). CONCLUSIONS The mean BMI and the prevalence of obesity are still increasing in Tromsø, and the increase is strongest in the youngest age groups. However, the increase in BMI was less marked in the last period (from 2001-2002 to 2007-2008) than in the first period (1994-1995 to 2001-2002).
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Affiliation(s)
- Bjarne K Jacobsen
- Department of Community Medicine, UiT-The Arctic University of Norway, Tromsø, Norway
| | - Nils Abel Aars
- Department of Community Medicine, UiT-The Arctic University of Norway, Tromsø, Norway
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Gardner RM, Lee BK, Magnusson C, Rai D, Frisell T, Karlsson H, Idring S, Dalman C. Maternal body mass index during early pregnancy, gestational weight gain, and risk of autism spectrum disorders: Results from a Swedish total population and discordant sibling study. Int J Epidemiol 2015; 44:870-83. [PMID: 26045508 PMCID: PMC4521130 DOI: 10.1093/ije/dyv081] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Prenatal environmental factors such as maternal adiposity may influence the risk of offspring autism spectrum disorders (ASD), though current evidence is inconsistent. The objective of this study was to assess the relationship of parental BMI and gestational weight gain (GWG) with risk of offspring ASD in a population-based cohort study using family-based study designs. METHODS The cohort was based in Stockholm County, Sweden, including 333,057 individuals born 1984-2007, of whom 6420 were diagnosed with an ASD. We evaluated maternal body mass index (BMI) at first antenatal visit, GWG and paternal BMI at the time of conscription into the Swedish military as exposures using general estimating equation (GEE) models with logit link. RESULTS At the population level, maternal overweight/obesity was associated with increased risk of offspring ASD [odds ratio (OR)25 ≤ BMI < 30 1.31, 95% confidence interval = 1.21-1.41; ORBMI ≥ 30 1.94, 1.72-2.17], as was paternal underweight (ORBMI < 18.5, 1.19, 1.06-1.33) and obesity (ORBMI ≥ 30 1.47, 1.12-1.92) in mutually adjusted models. However, in matched sibling analyses, the relationship between elevated maternal BMI and ASD risk was not apparent. GWG had a U-shaped association with offspring ASD at the population level (ORinsufficient 1.22, 1.07-1.40; ORexcessive 1.23, 1.08-1.40). Matched sibling analyses were suggestive of elevated risk with excessive GWG (ORinsufficient 1.12, 0.68-1.84; ORexcessive 1.48, 0.93-2.38). CONCLUSIONS Whereas population-level results suggested that maternal BMI was associated with ASD, sibling analyses and paternal BMI analyses indicate that maternal BMI may also be a proxy marker for other familial risk factors. Evidence is stronger for a direct link between GWG and ASD risk.
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Affiliation(s)
- Renee M Gardner
- Department of Public Health Sciences, and Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden,
| | - Brian K Lee
- Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, PA, USA, A.J. Drexel Autism Institute, Philadelphia, PA, USA
| | - Cecilia Magnusson
- Department of Public Health Sciences, and Centre for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden
| | - Dheeraj Rai
- School of Social and Community Medicine, University of Bristol, Bristol, UK, Avon and Wiltshire Partnership NHS Mental Health Trust, Bristol, UK
| | - Thomas Frisell
- Department of Medicine, Karolinska Institutet, Stockholm, Sweden and
| | - Håkan Karlsson
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Selma Idring
- Department of Public Health Sciences, and Neurodevelopmental Psychiatry Unit, Child and Youth Psychiatry, Stockholm County Council, Stockholm, Sweden
| | - Christina Dalman
- Department of Public Health Sciences, and Centre for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden
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Hebden L, Chan HN, Louie JC, Rangan A, Allman-Farinelli M. You are what you choose to eat: factors influencing young adults' food selection behaviour. J Hum Nutr Diet 2015; 28:401-8. [DOI: 10.1111/jhn.12312] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- L. Hebden
- School of Molecular Bioscience; Faculty of Science; The University of Sydney; Sydney NSW Australia
| | - H. N. Chan
- School of Molecular Bioscience; Faculty of Science; The University of Sydney; Sydney NSW Australia
| | - J. C. Louie
- School of Molecular Bioscience; Faculty of Science; The University of Sydney; Sydney NSW Australia
| | - A. Rangan
- School of Molecular Bioscience; Faculty of Science; The University of Sydney; Sydney NSW Australia
| | - M. Allman-Farinelli
- School of Molecular Bioscience; Faculty of Science; The University of Sydney; Sydney NSW Australia
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Viitasalo K, Hemiö K, Puttonen S, Hyvärinen HK, Leiviskä J, Härmä M, Peltonen M, Lindström J. Prevention of diabetes and cardiovascular diseases in occupational health care: feasibility and effectiveness. Prim Care Diabetes 2015; 9:96-104. [PMID: 25128324 DOI: 10.1016/j.pcd.2014.07.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 07/04/2014] [Accepted: 07/22/2014] [Indexed: 10/24/2022]
Abstract
AIMS To evaluate feasibility and effectiveness of lifestyle counseling in occupational setting on decreasing risk for diabetes and cardiovascular disease. METHODS A health check-up including physical examination, blood tests, questionnaires and health advice was completed on 2312 employees of an airline company. Participants with elevated risk for type 2 diabetes based on FINDRISC score and/or blood glucose measurement (n=657) were offered 1-3 additional lifestyle counseling sessions and 53% of them agreed to participate. After 2.5 years, 1347 employees of 2199 invited participated in a follow-up study. RESULTS Among women and men with low baseline diabetes risk, cardiovascular risk factors increased slightly during follow-up. Larger proportion of the men who attended interventions lost weight at least 5% compared with the non-attendees (18.4% vs. 8.4%, p=0.031) and their FINDRISC score increased less (0.6 vs. 1.5, p=0.037). Older age associated with participation in follow-up and higher baseline FINDRISC score and presence of clinical and lifestyle risk factors and problems in sleep and mood increased attendance in interventions. CONCLUSIONS Identification of employees with cardiovascular and diabetes risk, and the low intensity lifestyle intervention were feasible in occupational health-care setting. However, the health benefits were modest and observed only for men with increased risk.
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Affiliation(s)
| | - Katri Hemiö
- National Institute for Health and Welfare, P.O. Box 30, FI-00271 Helsinki, Finland.
| | - Sampsa Puttonen
- Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, FI-00250 Helsinki, Finland.
| | - Hanna-Kaisa Hyvärinen
- Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, FI-00250 Helsinki, Finland.
| | - Jaana Leiviskä
- National Institute for Health and Welfare, P.O. Box 30, FI-00271 Helsinki, Finland.
| | - Mikko Härmä
- Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, FI-00250 Helsinki, Finland.
| | - Markku Peltonen
- National Institute for Health and Welfare, P.O. Box 30, FI-00271 Helsinki, Finland.
| | - Jaana Lindström
- National Institute for Health and Welfare, P.O. Box 30, FI-00271 Helsinki, Finland.
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Badley EM, Canizares M, Perruccio AV, Hogg-Johnson S, Gignac MAM. Benefits gained, benefits lost: comparing baby boomers to other generations in a longitudinal cohort study of self-rated health. Milbank Q 2015; 93:40-72. [PMID: 25752350 PMCID: PMC4364431 DOI: 10.1111/1468-0009.12105] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
UNLABELLED POLICY POINTS: Despite beliefs that baby boomers are healthier than previous generations, we found no evidence that the health of baby boomers is substantially different from that of the previous or succeeding cohorts. The effects of increased education, higher income, and lower smoking rates on improving self-rated health were nearly counterbalanced by the adverse effect of increasing body mass index (BMI). Assumptions that baby boomers will require less health care as they age because of better education, more prosperity, and less propensity to smoke may not be realized because of increases in obesity. CONTEXT Baby boomers are commonly believed to be healthier than the previous generation. Using self-rated health (SRH) as an indicator of health status, this study examines the effects of age, period, and birth cohort on the trajectory of health across 4 generations: World War II (born between 1935 and 1944), older baby boomers (born between 1945 and 1954), younger baby boomers (born between 1955 and 1964), and Generation X (born between 1965 and 1974). METHODS We analyzed Canada's longitudinal National Population Health Survey 1994-2010 (n = 8,570 at baseline), using multilevel growth models to estimate the age trajectory of SRH by cohort, accounting for period and incorporating the influence of changes in education, household income, smoking status, and body mass index (BMI) on SRH over time. FINDINGS SRH worsened with increasing age in all cohorts. Cohort differences in SRH were modest (p = 0.034), but there was a significant period effect (p = 0.002). We found marked cohort effects for increasing education, income, and BMI, and decreasing smoking from the youngest to the oldest cohorts, which were much reduced (education and smoking) or removed (income and BMI) once period was taken into account. At the population level, multivariable analysis showed the benefits of increasing education and income and declines in smoking on the trajectory of improving SRH were almost counterbalanced by the effects of increasing BMI (obesity). CONCLUSIONS We found no evidence to support the expectation that baby boomers will age more or less healthily than previous cohorts did. We also found that increasing BMI has likely undermined improvements in health that might have otherwise occurred, with possible implications for the need for health care. Period effects had a more profound effect than birth cohort effects. This suggests that interventions to improve health, such as reducing obesity, can be targeted to the entire, or a major portion of the, population and need not single out particular birth cohorts.
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Affiliation(s)
- Elizabeth M Badley
- Toronto Western Research Institute, University Health Network; Dalla Lana School of Public Health, University of Toronto
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Mullie P, Clarys P. Relation between dietary pattern analysis (principal component analysis) and body mass index: a 5-year follow-up study in a Belgian military population. J ROY ARMY MED CORPS 2015; 162:23-9. [DOI: 10.1136/jramc-2014-000356] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 01/13/2015] [Indexed: 11/03/2022]
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Kaikkonen JE, Mikkilä V, Juonala M, Keltikangas-Järvinen L, Hintsanen M, Pulkki-Råback L, Viikari JSA, Kähönen M, Lehtimäki T, Telama R, Raitakari OT. Factors associated with six-year weight change in young and middle-aged adults in the Young Finns Study. Scandinavian Journal of Clinical and Laboratory Investigation 2015; 75:133-44. [PMID: 25600675 DOI: 10.3109/00365513.2014.992945] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To examine factors associated with weight change and obesity risk in young and middle-aged adults. SUBJECTS/METHODS The Young Finns Study with its 923 women and 792 men aged 24-39 years at baseline were followed for six years. Variables associated with the weight change were investigated with regression models. RESULTS The average weight change was 0.45 kg/year in women and 0.58 kg/year in men. In women, weight change was steady across all ages. In men, weight changes were more pronounced in younger age groups. In women (weight gain > 2 kg, n = 490), medication for anxiety, low occupational status, high baseline BMI (body mass index), high intake of sweet beverages, high childhood BMI, high salt (NaCl and/or KCl) use, low number of children, low childhood family income, high stature and low level of dependence (a temperament subscale) were associated with increased weight gain (in the order of importance). In men (weight gain > 2 kg, n = 455), high stature, high intake of french fries, low intake of sweet cookies, young age, recent divorce, low intake of cereals, high intake of milk, depressive symptoms, rural childhood origin, high baseline BMI and unemployment were associated with more pronounced weight gain. Sedentarity (screen-time) was associated with weight gain only in young men. Physical activity and genetic risk for high BMI (score of 31 known variants) were not consistently associated with weight change. CONCLUSIONS Socio-economic factors, temperamental and physical characteristics, and some dietary factors are related with weight change in young/middle-aged adults. The weight change occurring in adulthood is also determined by childhood factors, such as high BMI and low family income.
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Affiliation(s)
- Jari E Kaikkonen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku , Turku , Finland
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Engebretsen KB, Grotle M, Natvig B. Patterns of shoulder pain during a 14-year follow-up: results from a longitudinal population study in Norway. Shoulder Elbow 2015; 7:49-59. [PMID: 27582957 PMCID: PMC4935093 DOI: 10.1177/1758573214552007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Accepted: 08/20/2014] [Indexed: 12/21/2022]
Abstract
BACKGROUND Population studies have reported that shoulder pain is the third most frequently reported musculoskeletal pain. Long duration, pain intensity and high level of disability predict persistent complaints. The present study aimed to describe the prevalence of shoulder pain in a general population and follow this over a long period (1990 to 2004). The objective was also to describe the stability of shoulder pain and patterns of co-occurrence with neck and upper back pain. METHODS Data were obtained from a self-reported questionnaire in a population in Ullensaker muncipality, north-east of Oslo. The Standard Nordic Questionnaire was sent in 1990, 1994 and 2004 to inhabitants belonging to six birth cohorts from 1918-20 to 1968-70. RESULTS The 1-year prevalence of shoulder pain was 46.7% (95% CI, 44.9% to 48.6%) in 1990, 48.7% (95% CI, 46.8% to 50.5%) in 1994, and 55.2% (95% CI, 53.5% to 56.9%) in 2004. Approximately three-quarters of the persons with shoulder pain at one given time also reported shoulder pain at the next follow-up. CONCLUSIONS Prevalence of shoulder pain during a 14-year period was high and slightly increasing. Shoulder pain was reported most frequently in co-occurrence with neck pain. Classification models should include neck pain as well as other co-occurring pain sites.
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Affiliation(s)
- Kaia B Engebretsen
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Ullevaal, Norway,Kaia B Engebretsen, Department of Physical Medicine and Rehabilitation, Postboks 4950, 0424 Oslo, Oslo University Hospital, Ullevaal, Norway. Tel: +47 48239524.
| | - Margreth Grotle
- FORMI, Division for Neuroscience and Musculoskeletal Medicine, Oslo University Hospital, Ullevaal, Norway,Oslo and Akershus University College of Applied Sciences, Faculty of Health Sciences, Department of Physiotherapy, Oslo, Norway
| | - Bård Natvig
- Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
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van Bunderen CC, van den Dries CJ, Heymans MW, Franken AAM, Koppeschaar HPF, van der Lely AJ, Drent ML. Effect of long-term GH replacement therapy on cardiovascular outcomes in isolated GH deficiency compared with multiple pituitary hormone deficiencies: a sub-analysis from the Dutch National Registry of Growth Hormone Treatment in Adults. Eur J Endocrinol 2014; 171:151-60. [PMID: 24801587 DOI: 10.1530/eje-14-0069] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Isolated GH deficiency (IGHD) could provide a model to investigate the influence of GH deficiency per se and the effect of GH replacement therapy without the influence from other pituitary hormone deficiencies or their treatment. The aim of this study is to address the questions about differences between IGHD and multiple pituitary hormone deficiencies (MPHDs) in clinical presentation and in responsiveness to GH treatment. DESIGN A nationwide surveillance study was carried out to describe the difference in the clinical presentation and responsiveness to GH treatment of patients with IGHD and MPHDs. METHODS The Dutch National Registry of GH Treatment in Adults was founded in 1998 to gain more insight into long-term efficacy and safety of GH therapy. Out of 2891 enrolled patients, 266 patients with IGHD at the start of GH treatment were identified and compared with 310 patients with MPHDs. Cardiovascular indices will be investigated at baseline and during long-term follow-up, including body composition, lipid profile, glucose metabolism, blood pressure, and morbidity. RESULTS Patients with IGHD and MPHDs were demonstrated to be different entities at clinical presentation. Metabolically, patients with MPHDs had a larger waist circumference, lower HDL cholesterol level, and higher triglyceride level. The effect of GH treatment was comparable between patient groups. GH seems to protect against rising lipid levels and blood pressure, even after excluding patients using corresponding concomitant medication. The risk for cardiovascular disease or diabetes mellitus during follow-up was not different between patients with IGHD and MPHDs. CONCLUSIONS Patients with IGHD had a less impaired metabolic profile than patients with MPHDs at baseline. Influence of other pituitary hormone replacement therapies on the effect of GH treatment is not demonstrated.
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Affiliation(s)
- Christa C van Bunderen
- Section of EndocrinologyDepartment of Internal Medicine, Neuroscience Campus AmsterdamDepartment of Epidemiology and BiostatisticsVU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The NetherlandsDepartment of Internal MedicineIsala Clinics, Zwolle, The NetherlandsEmotional Brain and Alan Turing Institute for Multidisciplinary Health ResearchAlmere, The NetherlandsDivision of Endocrinology and MetabolismDepartment of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Carline J van den Dries
- Section of EndocrinologyDepartment of Internal Medicine, Neuroscience Campus AmsterdamDepartment of Epidemiology and BiostatisticsVU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The NetherlandsDepartment of Internal MedicineIsala Clinics, Zwolle, The NetherlandsEmotional Brain and Alan Turing Institute for Multidisciplinary Health ResearchAlmere, The NetherlandsDivision of Endocrinology and MetabolismDepartment of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Martijn W Heymans
- Section of EndocrinologyDepartment of Internal Medicine, Neuroscience Campus AmsterdamDepartment of Epidemiology and BiostatisticsVU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The NetherlandsDepartment of Internal MedicineIsala Clinics, Zwolle, The NetherlandsEmotional Brain and Alan Turing Institute for Multidisciplinary Health ResearchAlmere, The NetherlandsDivision of Endocrinology and MetabolismDepartment of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Anton A M Franken
- Section of EndocrinologyDepartment of Internal Medicine, Neuroscience Campus AmsterdamDepartment of Epidemiology and BiostatisticsVU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The NetherlandsDepartment of Internal MedicineIsala Clinics, Zwolle, The NetherlandsEmotional Brain and Alan Turing Institute for Multidisciplinary Health ResearchAlmere, The NetherlandsDivision of Endocrinology and MetabolismDepartment of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Hans P F Koppeschaar
- Section of EndocrinologyDepartment of Internal Medicine, Neuroscience Campus AmsterdamDepartment of Epidemiology and BiostatisticsVU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The NetherlandsDepartment of Internal MedicineIsala Clinics, Zwolle, The NetherlandsEmotional Brain and Alan Turing Institute for Multidisciplinary Health ResearchAlmere, The NetherlandsDivision of Endocrinology and MetabolismDepartment of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Aart J van der Lely
- Section of EndocrinologyDepartment of Internal Medicine, Neuroscience Campus AmsterdamDepartment of Epidemiology and BiostatisticsVU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The NetherlandsDepartment of Internal MedicineIsala Clinics, Zwolle, The NetherlandsEmotional Brain and Alan Turing Institute for Multidisciplinary Health ResearchAlmere, The NetherlandsDivision of Endocrinology and MetabolismDepartment of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Madeleine L Drent
- Section of EndocrinologyDepartment of Internal Medicine, Neuroscience Campus AmsterdamDepartment of Epidemiology and BiostatisticsVU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The NetherlandsDepartment of Internal MedicineIsala Clinics, Zwolle, The NetherlandsEmotional Brain and Alan Turing Institute for Multidisciplinary Health ResearchAlmere, The NetherlandsDivision of Endocrinology and MetabolismDepartment of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
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Peter RS, Fromm E, Klenk J, Concin H, Nagel G. Change in Height, Weight, and body mass index: Longitudinal data from
A
ustria. Am J Hum Biol 2014; 26:690-6. [DOI: 10.1002/ajhb.22582] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Revised: 05/27/2014] [Accepted: 06/11/2014] [Indexed: 11/08/2022] Open
Affiliation(s)
- Raphael Simon Peter
- Agency for Preventive and Social MedicineBregenz Austria
- Institute of Epidemiology and Medical BiometryUlm UniversityUlm Germany
| | - Ella Fromm
- Institute of Epidemiology and Medical BiometryUlm UniversityUlm Germany
| | - Jochen Klenk
- Institute of Epidemiology and Medical BiometryUlm UniversityUlm Germany
- Department of Clinical GerontologyRobert‐Bosch HospitalStuttgart Germany
| | - Hans Concin
- Agency for Preventive and Social MedicineBregenz Austria
| | - Gabriele Nagel
- Agency for Preventive and Social MedicineBregenz Austria
- Institute of Epidemiology and Medical BiometryUlm UniversityUlm Germany
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Visscher TLS, Heitmann BL, Rissanen A, Lahti-Koski M, Lissner L. A break in the obesity epidemic? Explained by biases or misinterpretation of the data? Int J Obes (Lond) 2014; 39:189-98. [PMID: 24909829 DOI: 10.1038/ijo.2014.98] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Revised: 03/14/2014] [Accepted: 04/01/2014] [Indexed: 12/24/2022]
Abstract
Recent epidemiologic papers are presenting prevalence data suggesting breaks and decreases in obesity rates. However, before concluding that the obesity epidemic is not increasing anymore, the validity of the presented data should be discussed more thoroughly. We had a closer look into the literature presented in recent reviews to address the major potential biases and distortions, and to develop insights about how to interpret the presented suggestions for a potential break in the obesity epidemic. Decreasing participation rates, the use of reported rather than measured data and small sample sizes, or lack of representativeness, did not seem to explain presented breaks in the obesity epidemic. Further, available evidence does not suggest that stabilization of obesity rates is seen in higher socioeconomic groups only, or that urbanization could explain a potential break in the obesity epidemic. However, follow-ups of short duration may, in part, explain the apparent break or decrease in the obesity epidemic. On the other hand, a single focus on body mass index (BMI) ⩾25 or ⩾30 kg m(-)(2) is likely to mask a real increase in the obesity epidemic. And, in both children and adults, trends in waist circumferences were generally suggesting an increase, and were stronger than those reported for trends in BMI. Studies concluding that there is a recent break in the obesity epidemic need to be interpreted with caution. Reported studies presenting a break were mostly of short duration. Further, focusing on trends in waist circumference rather than BMI leads to a less optimistic conclusion: the public health problem of obesity is still increasing.
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Affiliation(s)
- T L S Visscher
- 1] Research Centre for the Prevention of Overweight (Zwolle), Windesheim University of Applied Sciences and VU University, Zwolle, The Netherlands [2] Institute of Health Sciences, VU University, Amsterdam, The Netherlands [3] Prevention and Public Health Taskforce, European Association for the Study of Obesity, London, UK
| | - B L Heitmann
- 1] Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospitals, The Capital Region, Copenhagen, Denmark [2] National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark [3] The Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, University of Sydney, Sydney, New South Wales, Australia
| | - A Rissanen
- 1] Prevention and Public Health Taskforce, European Association for the Study of Obesity, London, UK [2] Helsinki University Central Hospital, Helsinki, Finland
| | - M Lahti-Koski
- 1] Prevention and Public Health Taskforce, European Association for the Study of Obesity, London, UK [2] Finnish Heart Association, Helsinki, Finland
| | - L Lissner
- 1] Prevention and Public Health Taskforce, European Association for the Study of Obesity, London, UK [2] Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
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Etile F. Education policies and health inequalities: evidence from changes in the distribution of Body Mass Index in France, 1981-2003. ECONOMICS AND HUMAN BIOLOGY 2014; 13:46-65. [PMID: 23433879 DOI: 10.1016/j.ehb.2013.01.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2011] [Revised: 01/23/2013] [Accepted: 01/25/2013] [Indexed: 06/01/2023]
Abstract
This paper contributes to the debate over the effectiveness of education policies in reducing overall health inequalities as compared to public health actions directed at the less-educated. Recentered Influence Function (RIF) regressions are used to decompose the contribution of education to the changing distribution of Body Mass Index (BMI) in France, between 1981 and 2003, into a composition effect (the shift in population education due to a massive educational expansion), and a structure effect (a changing educational gradient in BMI). Educational expansion has reduced overall BMI inequality by 3.4% for women and 2.3% for men. However, the structure effect on its own has produced a 10.9% increase in overall inequality for women, due to a steeper education gradient starting from the second quartile of the distribution. This structure effect on overall inequality is also large (7.6%) for men, albeit insignificant as it remains concentrated in the last decile. Educational expansion policies can thus reduce overall BMI inequalities; but attention must still be paid to the BMI gradient in education even for policies addressing overall rather than socioeconomic health inequalities.
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Affiliation(s)
- Fabrice Etile
- INRA, UR1303 ALISS, 65 Boulevard de Brandebourg, 94205 Ivry-sur-Seine, France; Paris School of Economics, 48 Boulevard Jourdan, 75014 Paris, France.
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Shaw RJ, Green MJ, Popham F, Benzeval M. Differences in adiposity trajectories by birth cohort and childhood social class: evidence from cohorts born in the 1930s, 1950s and 1970s in the west of Scotland. J Epidemiol Community Health 2014; 68:550-6. [PMID: 24502886 PMCID: PMC4033148 DOI: 10.1136/jech-2013-203551] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Background Since the 1930s, the environment has become increasingly obesogenic, leading to rising rates of adiposity and socioeconomic inequalities in adiposity. Building on studies comparing body mass index (BMI) for cohorts born over a period of 20 years, we examine the social patterning of BMI and central adiposity for three cohorts born over a 40-year period. Methods Using data from the West of Scotland Twenty-07 study (n=4510), we investigate 20-year trajectories of adiposity for three cohorts born in the 1930s, 1950s and 1970s, allowing us to study 60 years of the lifecourse. Stratified by gender, we employed multilevel models to generate trajectories for BMI and waist-to-height ratio (WHtR) and explored how these trajectories varied by childhood social class. Results Adiposity increased most quickly with age in the youngest cohort, and cohort differences were greater than socioeconomic differences. For example, the smallest cohort difference for BMI, a comparison of men in the 1930s and 1950s cohorts at age 55, was 2.66 (95% CI 2.11 to 3.20) kg/m2, while the largest socioeconomic difference, a comparison of manual and non-manual women at age 64, was 1.18 (95% CI 0.37 to 1.98) kg/m2. Socioeconomic inequalities in adiposity increased with age and were greater for women than for men. The results for WHtR differed in that increases in WHtR accelerated with age while increases in BMI slowed. Conclusions Socioeconomic differences in adiposity accumulate slowly across the lifecourse and are approximately only a third of the adiposity differences between cohorts.
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Affiliation(s)
- Richard J Shaw
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, , Glasgow, UK
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Hulmán A, Tabák AG, Nyári TA, Vistisen D, Kivimäki M, Brunner EJ, Witte DR. Effect of secular trends on age-related trajectories of cardiovascular risk factors: the Whitehall II longitudinal study 1985-2009. Int J Epidemiol 2014; 43:866-77. [PMID: 24464190 PMCID: PMC4052135 DOI: 10.1093/ije/dyt279] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Secular trends in cardiovascular risk factors have been described, but few studies have examined simultaneously the effects of both ageing and secular trends within the same cohort. METHODS Development of cardiovascular risk factors over the past three decades was analysed using serial measurements from 10 308 participants aged from 35 to 80 years over 25 years of follow-up from five clinical examination phases of the Whitehall II study. Changes of body mass index, waist circumference, blood pressure and total and high-density lipoprotein cholesterol distribution characteristics were analysed with quantile regression models in the 57-61 age group. Age-related trajectories of risk factors were assessed by fitting mixed-effects models with adjustment for year of birth to reveal secular trends. RESULTS Average body mass index and waist circumference increased faster with age in women than in men, but the unfavourable secular trend was more marked in men. Distributions showed a fattening of the right tail in each consecutive phase, meaning a stronger increase in higher percentiles. Despite the higher obesity levels in younger birth cohorts, total cholesterol decreased markedly in the 57-61 age group along the entire distribution rather than in higher extremes only. CONCLUSION The past three decades brought strong and heterogeneous changes in cardiovascular risk factor distributions. Secular trends appear to modify age-related trajectories of cardiovascular risk factors, which may be a source of bias in longitudinal analyses.
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Affiliation(s)
- Adam Hulmán
- Department of Medical Physics and Medical Informatics, University of Szeged, Szeged, Hungary, Department of Epidemiology and Public Health, University College London, London, UK, First Department of Medicine, Semmelweis University Faculty of Medicine, Budapest, Hungary, Steno Diabetes Center, Gentofte, Denmark and Centre de Recherche Public de la Santé, Strassen, Luxembourg
| | - Adam G Tabák
- Department of Medical Physics and Medical Informatics, University of Szeged, Szeged, Hungary, Department of Epidemiology and Public Health, University College London, London, UK, First Department of Medicine, Semmelweis University Faculty of Medicine, Budapest, Hungary, Steno Diabetes Center, Gentofte, Denmark and Centre de Recherche Public de la Santé, Strassen, LuxembourgDepartment of Medical Physics and Medical Informatics, University of Szeged, Szeged, Hungary, Department of Epidemiology and Public Health, University College London, London, UK, First Department of Medicine, Semmelweis University Faculty of Medicine, Budapest, Hungary, Steno Diabetes Center, Gentofte, Denmark and Centre de Recherche Public de la Santé, Strassen, Luxembourg
| | - Tibor A Nyári
- Department of Medical Physics and Medical Informatics, University of Szeged, Szeged, Hungary, Department of Epidemiology and Public Health, University College London, London, UK, First Department of Medicine, Semmelweis University Faculty of Medicine, Budapest, Hungary, Steno Diabetes Center, Gentofte, Denmark and Centre de Recherche Public de la Santé, Strassen, Luxembourg
| | - Dorte Vistisen
- Department of Medical Physics and Medical Informatics, University of Szeged, Szeged, Hungary, Department of Epidemiology and Public Health, University College London, London, UK, First Department of Medicine, Semmelweis University Faculty of Medicine, Budapest, Hungary, Steno Diabetes Center, Gentofte, Denmark and Centre de Recherche Public de la Santé, Strassen, Luxembourg
| | - Mika Kivimäki
- Department of Medical Physics and Medical Informatics, University of Szeged, Szeged, Hungary, Department of Epidemiology and Public Health, University College London, London, UK, First Department of Medicine, Semmelweis University Faculty of Medicine, Budapest, Hungary, Steno Diabetes Center, Gentofte, Denmark and Centre de Recherche Public de la Santé, Strassen, Luxembourg
| | - Eric J Brunner
- Department of Medical Physics and Medical Informatics, University of Szeged, Szeged, Hungary, Department of Epidemiology and Public Health, University College London, London, UK, First Department of Medicine, Semmelweis University Faculty of Medicine, Budapest, Hungary, Steno Diabetes Center, Gentofte, Denmark and Centre de Recherche Public de la Santé, Strassen, Luxembourg
| | - Daniel R Witte
- Department of Medical Physics and Medical Informatics, University of Szeged, Szeged, Hungary, Department of Epidemiology and Public Health, University College London, London, UK, First Department of Medicine, Semmelweis University Faculty of Medicine, Budapest, Hungary, Steno Diabetes Center, Gentofte, Denmark and Centre de Recherche Public de la Santé, Strassen, Luxembourg
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Caman OK, Calling S, Midlöv P, Sundquist J, Sundquist K, Johansson SE. Longitudinal age-and cohort trends in body mass index in Sweden--a 24-year follow-up study. BMC Public Health 2013; 13:893. [PMID: 24074433 PMCID: PMC3849274 DOI: 10.1186/1471-2458-13-893] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Accepted: 09/25/2013] [Indexed: 11/19/2022] Open
Abstract
Background The aim of this longitudinal study was to analyze whether mean Body Mass Index (BMI), assessed at four occasions, changed within different age groups and birth cohorts over time, i.e., between 1980/81 and 2004/05, after adjustment for possible confounders. Methods A sample of 2728 men and 2770 women aged 16–71 years at study start were randomly drawn from the Swedish Total Population Register and followed from 1980/81 to 2004/05. The same sample was assessed on four occasions during the 24-year study period (i.e., every eighth year). The outcome variable, BMI, was based on self-reported height and weight. A mixed model, with random intercept and random slope, was used to estimate annual changes in BMI within the different age groups and birth cohorts. Results Mean BMI increased from 24.1 to 25.5 for men and from 23.1 to 24.3 for women during the 24-year study period. The annual change by age group was highest in the ages of 32–39, 40–47 and 48–55 years among men, and in the ages of 24–31, 32–39, and 40–47 years among women. The highest annual changes were found in the youngest birth cohorts for both men and women, i.e., those born 1958–65, 1966–73, and 1974–81. For each birth cohort, the annual change in BMI increased compared to the previous, i.e., older, birth cohort. In addition, age-by-cohort interaction tests revealed that the increase in BMI by increasing age was higher in the younger birth cohorts (1966–1989) than in the older ones. Conclusions Public health policies should target those age groups and birth cohorts with the highest increases in BMI. For example, younger birth cohorts had higher annual increases in BMI than older birth cohorts, which means that younger cohorts increased their BMI more than older ones during the study period.
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Affiliation(s)
- Ozge Karadag Caman
- Department of Clinical Sciences, Center for Primary Health Care Research, Lund University, Malmö, Sweden.
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Groth SW, Holland ML, Kitzman H, Meng Y. Gestational weight gain of pregnant African American adolescents affects body mass index 18 years later. J Obstet Gynecol Neonatal Nurs 2013; 42:541-50. [PMID: 24003870 DOI: 10.1111/1552-6909.12230] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To determine if gestational weight gain (GWG) in adolescents is associated with long-term weight increases 12 years and 18 years after delivery of a first child and the differential effects of weight gain during pregnancy that is inadequate, the appropriate amount, and excessive based on the 2009 Institute of Medicine (IOM) recommendations. DESIGN Secondary data analysis of data from a randomized controlled trial. SETTING Memphis, Tennessee. PARTICIPANTS Two hundred ninety-eight (298) primiparous low-income Black women who were adolescents at the time of their first pregnancies. METHOD Linear regression was used to examine the relationship between body mass index (BMI) at 12 and 18 years postdelivery and GWG, parity, prepregnancy BMI, and smoking. RESULTS The total sample experienced a significant BMI increase from prepregnancy to 12 years and 18 years postdelivery. More than 50% of the women had a BMI increase greater than 10 kg/m(2) . By 18 years postdelivery, 85% were overweight or obese. Prepregnancy BMI and GWG had a positive significant effect on BMI 12 and 18 years later, whereas smoking had a negative effect. Those who gained excessive weight based on the IOM recommendations had a significantly higher BMI compared with those who gained appropriately. CONCLUSION Gestational weight gain had long-term effects on BMI in a minority adolescent population. Excessive pregnancy weight gain is likely to contribute to long-term weight retention, especially if adolescents are overweight or obese when they become pregnant with their first children. Intervention during pregnancy to limit GWG has the potential of limiting long-term negative health consequences that result from overweight and obesity in minority women.
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Rtveladze K, Marsh T, Webber L, Kilpi F, Levy D, Conde W, McPherson K, Brown M. Health and economic burden of obesity in Brazil. PLoS One 2013; 8:e68785. [PMID: 23874763 PMCID: PMC3708916 DOI: 10.1371/journal.pone.0068785] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Accepted: 06/01/2013] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Higher and lower-middle income countries are increasingly affected by obesity. Obesity-related diseases are placing a substantial health and economic burden on Brazil. Our aim is to measure the future consequences of these trends on the associated disease burden and health care costs. METHOD A previously developed micro-simulation model is used to project the extent of obesity, obesity-related diseases and associated healthcare costs to 2050. In total, thirteen diseases were considered: coronary heart disease, stroke, hypertension, diabetes, osteoarthritis, and eight cancers. We simulated three hypothetical intervention scenarios: no intervention, 1% and 5% reduction in body mass index (BMI). RESULTS In 2010, nearly 57% of the Brazilian male population was overweight or obese (BMI ≥25 kg/m(2)), but the model projects rates as high as 95% by 2050. A slightly less pessimistic picture is predicted for females, increasing from 43% in 2010 to 52% in 2050. Coronary heart disease, stroke, hypertension, cancers, osteoarthritis and diabetes prevalence cases are projected to at least double by 2050, reaching nearly 34,000 cases of hypertension by 2050 (per 100,000). 1% and 5% reduction in mean BMI will save over 800 prevalence cases and nearly 3,000 cases of hypertension by 2050 respectively (per 100,000). The health care costs will double from 2010 ($5.8 billion) in 2050 alone ($10.1 billion). Over 40 years costs will reach $330 billion. However, with effective interventions the costs can be reduced to $302 billion by 1% and to $273 billion by 5% reduction in mean BMI across the population. CONCLUSION Obesity rates are rapidly increasing creating a high burden of disease and associated costs. However, an effective intervention to decrease obesity by just 1% will substantially reduce obesity burden and will have a significant effect on health care expenditure.
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Appelman-Dijkstra NM, Claessen KMJA, Roelfsema F, Pereira AM, Biermasz NR. Long-term effects of recombinant human GH replacement in adults with GH deficiency: a systematic review. Eur J Endocrinol 2013; 169:R1-14. [PMID: 23572082 DOI: 10.1530/eje-12-1088] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The beneficial effects of recombinant human GH (rhGH) therapy in GH deficient (GHD) adults are well-established in the short term. However, data documenting the effects during prolonged follow-up are relatively scarce. OBJECTIVE To evaluate the reported effects of rhGH replacement (≥5 years) in GHD adults on biochemical and anthropometric parameters, quality of life (QoL), bone metabolism, muscle strength, serious adverse events and mortality. METHODS We conducted a systematic literature search. Quality assessment of retrieved papers was performed using a quality assessment based on the modified STROBE statement. RESULTS We included 23 prospective studies with a rhGH treatment duration ranging from 5 to 15 years. Overall, beneficial effects were reported on QoL, body composition, lipid profile, carotid intima media thickness and bone mineral density. In contrast, the prevalence of the metabolic syndrome, glucose levels, BMI and muscle strength were not, or negatively, influenced. Most of the studies were uncontrolled, lacked the presence of a control group (of non-treated GHD patients), and reported no data on lipid-lowering and anti-diabetic medication. Overall mortality was not increased. CONCLUSION rhGH treatment in adult GHD patients is well-tolerated and positively affects QoL in the long term. However, the metabolic and cardiovascular effects during long-term treatment are variable. The low numbers of long-term studies and studied patients and lack of control data hamper definite statements on the efficacy of prolonged treatment. Therefore continuous monitoring of the effects of rhGH replacement to enable an adequate risk-benefit analysis that may justify prolonged, potentially life-long, treatment is advisable.
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Affiliation(s)
- Natasha M Appelman-Dijkstra
- Department of Endocrinology and Metabolic Diseases C4-R and Center for Endocrine Tumors, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands.
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La Merrill M, Cirillo PM, Terry MB, Krigbaum NY, Flom JD, Cohn BA. Prenatal exposure to the pesticide DDT and hypertension diagnosed in women before age 50: a longitudinal birth cohort study. ENVIRONMENTAL HEALTH PERSPECTIVES 2013; 121:594-9. [PMID: 23591545 PMCID: PMC3673196 DOI: 10.1289/ehp.1205921] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2012] [Accepted: 03/07/2013] [Indexed: 05/02/2023]
Abstract
BACKGROUND Elevated levels of the pesticide DDT (dichlorodiphenyltrichloroethane) have been positively associated with blood pressure and hypertension in studies among adults. Accumulating epidemiologic and toxicologic evidence suggests that hypertension during adulthood may also be affected by earlier life and possibly the prenatal environment. OBJECTIVES We assessed whether prenatal exposure to the pesticide DDT increases risk of adult hypertension. METHODS We examined concentrations of DDT (p,p´- and o,p´-) and its metabolite p,p´-DDE (dichlorodiphenyldichloroethylene) in prenatal serum samples from a subset of women (n = 527) who had participated in the prospective Child Health and Development Studies birth cohort in the San Francisco Bay area while they were pregnant between 1959 and 1967. We surveyed daughters 39-47 years of age by telephone interview from 2005 to 2008 to obtain information on self-reported physician-diagnosed hypertension and use of hypertensive medication. We used multivariable regression analysis of time to hypertension based on the Cox proportional hazards model to estimate relative rates for the association between prenatal DDT exposures and hypertension treated with medication in adulthood, with adjustment for potential confounding by maternal, early-life, and adult exposures. RESULTS Prenatal p,p´-DDT exposure was associated with hypertension [adjusted hazard ratio (aHR) = 3.6; 95% CI: 1.8, 7.2 and aHR = 2.5; 95% CI: 1.2, 5.3 for middle and high tertiles of p,p´-DDT relative to the lowest tertile, respectively]. These associations between p,p´-DDT and hypertension were robust to adjustment for independent hypertension risk factors as well as sensitivity analyses. CONCLUSIONS These findings suggest that the association between DDT exposure and hypertension may have its origins early in development.
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Affiliation(s)
- Michele La Merrill
- Department of Environmental Toxicology, University of California, Davis, Davis, California 95616-5270, USA.
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Loman T, Lallukka T, Laaksonen M, Rahkonen O, Lahelma E. Multiple socioeconomic determinants of weight gain: the Helsinki Health Study. BMC Public Health 2013; 13:259. [PMID: 23517457 PMCID: PMC3608219 DOI: 10.1186/1471-2458-13-259] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Accepted: 03/14/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Socioeconomic differences in weight gain have been found, but several socioeconomic determinants have not been simultaneously studied using a longitudinal design. The aim of this study was to examine multiple socioeconomic determinants of weight gain. METHODS Mail surveys were conducted in 2000-2002 among 40 to 60-year old employees of the City of Helsinki, Finland (n = 8,960, response rate 67%). A follow-up survey was conducted among the baseline respondents in 2007 with a mean follow-up of 5 to 7 years (n = 7,332, response rate 83%). The outcome measure was weight gain of 5 kg or more over the follow-up. Socioeconomic position was measured by parental education, childhood economic difficulties, own education, occupational class, household income, home ownership and current economic difficulties. Multivariable logistic regression models were fitted adjusting simultaneously for all covariates in the final model. RESULTS Of women 27% and of men 24% gained 5 kg or more in weight over the follow-up. Among women, after adjusting for age, baseline weight and all socioeconomic determinants, those with basic (OR 1.40 95% CI 1.11-1.76) or intermediate education (OR 1.43 95% CI 1.08-1.90), renters (OR 1.18 95% CI 1.03-1.36) and those with occasional (OR 1.19 95% CI 1.03-1.38) or frequent (OR 1.50 95% CI 1.26-1.79) economic difficulties had increased risk of weight gain. Among men, after full adjustment, having current frequent economic difficulties (OR 1.70 95% CI 1.15-2.49) remained associated with weight gain. CONCLUSIONS Current economic difficulties among both women and men, and among women low education and renting, were associated with weight gain. Prevention of weight gain among ageing people would benefit from focusing in particular on those with economic difficulties.
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Affiliation(s)
- Tina Loman
- Hjelt Institute, Department of Public Health, University of Helsinki, Helsinki, FIN-00014, Finland
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Genetic and Environmental Influences on Longitudinal Changes in Leisure-Time Physical Activity From Adolescence to Young Adulthood. Twin Res Hum Genet 2013; 16:535-43. [DOI: 10.1017/thg.2013.9] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The aim of this study was to estimate genetic and environmental influences on the longitudinal evolution of leisure-time physical activity habits from adolescence to young adulthood. Data were gathered at four time points, at mean ages 16.2, 17.1, 18.6, and 24.5 years. At baseline, the sample comprised 5,216 monozygotic and dizygotic twins, born 1975–1979, and, at the last follow-up point, of 4,531 monozygotic and dizygotic twins. Physical activity volume was assessed as frequency of leisure-time physical activity and participants were categorized into three groups: inactive, moderately active, and active. Genetic and environmental influences were estimated using a multivariate, longitudinal Cholesky decomposition with a ‘multifactorial liability threshold’ approach. The results suggest that, in both sexes the heritability of leisure-time physical activity remained moderate (~43–52%) during adolescence, declining to ~30% in young adulthood. Shared environmental influences increased from adolescence (~18–26%) to young adulthood (43% in men and 49% in women). Specific environmental influences remained relatively stable during the total follow-up (~20–30%). New genetic, shared, and specific environmental influences at every follow-up point were suggested by the low correlations across occasions. In conclusion, the study demonstrated gender differences in genetic influences in the evolution of leisure-time physical activity habits from adolescence to young adulthood. However, shared environmental influences, especially in women, were crucial in explaining longitudinal changes in leisure-time physical activity. These outcomes emphasize the need of gender-specific measures to promote physical activity habits during young adulthood.
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Livshits G, Malkin I, Williams FMK, Hart DJ, Hakim A, Spector TD. Longitudinal study of variation in body mass index in middle-aged UK females. AGE (DORDRECHT, NETHERLANDS) 2012; 34:1285-94. [PMID: 21853263 PMCID: PMC3448995 DOI: 10.1007/s11357-011-9299-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2011] [Accepted: 07/25/2011] [Indexed: 05/21/2023]
Abstract
The importance of changing patterns of obesity in society and its implications for public health are well recognized. However, the adult life course of body mass index (BMI) changes in individuals over time is largely unknown and has mostly been extrapolated from cross-sectional studies. The present study examines individual specific variation of BMI during a 15-year follow-up period in a community-based sample of UK females. We attempted to establish whether there is a common, generalized pattern which captures variation in BMI over time. The participants of this study belong to a prospective population cohort of British women studied intensively since 1989: the Chingford Study. The sample originally consisted of 1,003 women aged 45-68 years, who were assessed annually for BMI during follow-up period. Polynomial regression models were used to assess longitudinal BMI variation. We observed a great stability in individual BMI variation during the follow-up period, reflected by high correlations between the baseline BMI and follow-up BMI 10 and 15 years later (r = 0.876, N = 810, and r = 0.824, N = 638, respectively). We also found that three different major age-related patterns in BMI could be clearly identified: no change in 30.6% in 58% it increased and in 11.4% it decreased with age. Thus, our data suggest that individual age-related changes in BMI are very different. Therefore, simply combining all individuals into groups by any other criteria (age, sex, etc.) and overlooking the distinctive patterns of BMI change may lead to biased inferences in epidemiologic and etiologic research of the future.
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Affiliation(s)
- Gregory Livshits
- Department of Twin Research and Genetic Epidemiology, Kings College London, St Thomas’ Hospital, London, SE1 7EH UK
- Human Population Biology Research Unit, Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ida Malkin
- Human Population Biology Research Unit, Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Frances M. K. Williams
- Department of Twin Research and Genetic Epidemiology, Kings College London, St Thomas’ Hospital, London, SE1 7EH UK
| | - Deborah J. Hart
- Department of Twin Research and Genetic Epidemiology, Kings College London, St Thomas’ Hospital, London, SE1 7EH UK
| | - Alan Hakim
- Department of Rheumatology, Whipps Cross University Hospital, Leytonstone, London, UK
| | - Timothy D. Spector
- Department of Twin Research and Genetic Epidemiology, Kings College London, St Thomas’ Hospital, London, SE1 7EH UK
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Korostishevsky M, Williams F, Hart D, Blumenfeld O, Spector T, Livshits G. Implementation of the simplified stochastic model of ageing for longitudinal osteoarthritis data assessment. Ann Hum Biol 2012; 39:214-22. [DOI: 10.3109/03014460.2012.681801] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Michael Korostishevsky
- Human Population Biology Research Unit, Department of Anatomy and Anthropology, Tel Aviv University,
Tel Aviv, Israel
| | - Frances Williams
- Department of Twin Research and Genetic Epidemiology, Kings College London,
London, UK
| | - Deborah Hart
- Department of Twin Research and Genetic Epidemiology, Kings College London,
London, UK
| | - Orit Blumenfeld
- Human Population Biology Research Unit, Department of Anatomy and Anthropology, Tel Aviv University,
Tel Aviv, Israel
| | - Timothy Spector
- Department of Twin Research and Genetic Epidemiology, Kings College London,
London, UK
| | - Gregory Livshits
- Human Population Biology Research Unit, Department of Anatomy and Anthropology, Tel Aviv University,
Tel Aviv, Israel
- Department of Twin Research and Genetic Epidemiology, Kings College London,
London, UK
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49
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Derksen RE, Brink-Melis WJ, Westerman MJ, Dam JJMT, Seidell JC, Visscher TLS. A local consensus process making use of focus groups to enhance the implementation of a national integrated health care standard on obesity care. Fam Pract 2012; 29 Suppl 1:i177-i184. [PMID: 22399550 DOI: 10.1093/fampra/cmr072] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Recent guidelines on obesity management promote integrated care. There is little knowledge about local opportunities and barriers, faced by health care professionals and patients, that affect implementation of an integrated national health care standard in a local setting. Our aim is to understand experiences and expectations of health care professionals and patients as part of the local implementation process. METHODS Eight focus groups and two interviews have been conducted among 24 patients (60+) and 29 professionals from seven different care disciplines. RESULTS Both patients and professionals have identified serious barriers to implement the national standard: older adults do not feel taken seriously and experience lacking support from professionals. Professionals give contradictory advice and recommendations do not match needs of older adults. Professionals actually feel reluctant to discuss weight-related topics due to several reasons: they do not consider obesity being a chronic disease, lack of qualifications to support self-management and perceived lack of awareness and motivation among patients. CONCLUSION Focus groups have proven their value to ascertain the opportunities and barriers older adults and professionals foresee while improving obesity care in order to meet the standards as required in a national guideline. Our research provides an emerging picture of health care professionals and patients having contradictory views and expectations about 'the others' role and their notions on the capability to intervene on patient's weight problems. Without this emerging picture, we would have missed important information on barriers to overcome. The likelihood of successful implementation would then have been small.
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Affiliation(s)
- R E Derksen
- Research Centre for the Prevention of Overweight, VU University Amsterdam/Windesheim University of Applied Sciences Zwolle, Zwolle, The Netherlands.
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50
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Doak CM, Wijnhoven TMA, Schokker DF, Visscher TLS, Seidell JC. Age standardization in mapping adult overweight and obesity trends in the WHO European Region. Obes Rev 2012; 13:174-91. [PMID: 22060052 DOI: 10.1111/j.1467-789x.2011.00943.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
This study aims to improve comparability of available data within the World Health Organization (WHO) European Region taking into account differences related to the aging of the population. Surveys were included if they were conducted on adults aged 25-64 years between 1985 and 2010 in the WHO European Region. Overweight/obesity prevalences were adjusted to the European standard population aged 25-64. Data were entered for each of the 5-year categories between 1981 and 2010. Measured height and weight data were available for males in 16 and females in 24 of the 53 countries. The 50-64-year-olds had higher prevalence of overweight and obesity as compared to the 25-49-year-olds. This pattern occurs in every country, by male and female, in almost all surveys. Age-standardized overweight prevalence was higher among males than females in all countries. Trend data showed increases in most countries. Age-standardized maps were based on self-reported data because of insufficient availability of measured data. Results showed more countries with available data as well as the higher category of obesity in the later surveys. Measured values are needed and age adjustment is important in documenting emerging overweight and obesity trends, independent of demographic changes, in the WHO European Region.
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Affiliation(s)
- C M Doak
- Institute of Health Sciences, VU University and VU Medical Centre, Amsterdam, the Netherlands.
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