Overweight and obesity in Italian adults 2004, and an overview of trends since 1983

Cancers attributable to overweight and obesity in Italy

BACKGROUND & AIMS

Overweight and obesity are associated with multiple cancers. We quantified the burden of cancer attributable to overweight and obesity in Italy.

METHODS

We estimated sex- and cancer site-specific population attributable fractions (PAFs) combining relative risks (from recent meta-analyses) with national obesity prevalence data (from a large sample survey conducted in 2005, to account for a 15-year lag period). Using nationwide mortality statistics and cancer registries data, we estimated the number of cancer cases and deaths attributable to overweight and obesity in Italy in 2020, based on the counterfactual scenario of a body mass index < 25 kg/m2.

RESULTS

3.6% of cancers in men and 4.0% in women in Italy were attributable to overweight and obesity, corresponding, respectively, to over 6900 and 7200 diagnoses in 2020. Attributable deaths were over 3600 in men and 2700 in women. PAFs (attributable cases) of overweight and obesity in men and women were, respectively, 38.1% (215 cases) and 21.8% (49 cases) for esophageal adenocarcinoma, 19.1% (1715 cases) and 14.5% (585 cases) for liver, 18.7% (1692 cases) and 16.7% (747 cases) for kidney, 13.7% (938 cases) and 10.1% (749 cases) for pancreatic, and 10.2% (2389 cases) and 3.4% (690 cases) for colorectal cancers. In women, PAFs were 22.3% (1859 cases) for endometrial and 5.7% (2556 cases) for post-menopausal breast cancer.

CONCLUSIONS

The cancer burden associated with overweight and obesity in Italy is considerable, but smaller compared to other high income countries, likely because of the lower prevalence of overweight and obesity in the Italian population.

Trends of overweight, obesity and anthropometric measurements among the adult population in Italy: The CUORE Project health examination surveys 1998, 2008, and 2018

Background/Objectives

Obesity is associated with an increased risk of noncommunicable diseases, such as diabetes, coronary heart disease, stroke, cancers, and conditions, including obstructive sleep apnea and osteoarthritis. Obesity is largely preventable, and halting its rise is one of the World Health Organization Global Action Plan for the Prevention of Noncommunicable Diseases targets. This study aimed to assess trends of anthropometric measurements in Italy using the data collected within the CUORE Project health examination surveys (HESs) 1998, 2008, and 2018.

Subjects/Methods

Within the HESs 1998–2002, 2008–2012, and 2018–2019, anthropometric measurements were collected in random samples of the resident population aged 35–74 years, stratified by age and sex, from 10 Italian Regions in Northern, Central, and Southern Italy (2984 men and 2944 women, 2224 men and 2188 women, 1035 men and 1065 women, respectively). Weight, height, and waist and hip circumferences were measured using standardized methodologies. A standardized questionnaire was used to collect data on education. Indicators were age standardized.

Results

For both men and women, mean body mass index in 2018 was comparable with those in 1998 and 2008 (in 1998, 2008, and 2018—men: 26.7, 27.5, and 27.0 kg/m²; women: 26.2, 26.6, and 26.3 kg/m²). In 1998, 2008, 2018 prevalence of overweight resulted 49%, 47%, 46% in men and 33%, 32%, 28% in women respectively; prevalence of obesity resulted 17%, 24% 20% in men and 19%, 23%, 23% in women respectively. All indicators of excess weight worsen with increasing age and are more severe in persons with a lower educational level.

Conclusions

Although the overall trend of excess weight over the past two decades appeared to be substantially stable in the Italian adult population, the continuous strengthening of undertaken initiatives should continue since there remains a high proportion of overweight or obesity and a gap between educational levels.

Prevalence and Sociodemographic Factors of Overweight and Obesity among Pakistani Adults

Background

Obesity is a serious public health problem that is growing alarmingly worldwide. The main objective of this study is to examine the current prevalence of overweight and obesity among Pakistani adults and to identify the sociodemographic factors that are associated with overweight and obesity.

Methods

Secondary data from a population-based household survey (the Pakistan Panel Household Survey) were used for this study. A total of 10,063 participants (3,916 men and 6,147 women) were included. Overweight and obese individuals were identified using the World Health Organization-recommended cutoffs for body mass index (kg/m²). Along with descriptive statistics, the Pearson chi-square test was used to investigate the association among categorical variables. Odds ratios (ORs) along with 95% confidence intervals (CIs) were estimated using univariate logistic regression analysis to evaluate the most significantly associated risk factors for overweight/obesity.

Results

The mean age and body mass index of the participants were 38.2 years and 22.9 kg/m², respectively. Overall, 22.8% of the participants (23.9% of the women and 21.1% of the men) were overweight, and 5.1% (6.3% of the women and 3.2% of the men) were obese. Sociodemographic factors, such as sex, marital status, and residential area, were significantly associated with body mass index categories. Women (OR, 1.34; 95% CI, 1.23-1.47; P<0.01), ever-married individuals (OR, 1.92; 95% CI, 1.70-2.16; P<0.01), and individuals living in urban areas (OR, 1.23; 95% CI, 1.12-1.35; P<0.01) were more likely to become overweight/obese than their counterparts.

Conclusion

We have found the excess weight problem to be quite high in the Pakistani adult population. The government and other health agencies should take initiatives in launching programs about nutritional awareness for adults to prevent obesity.

Is the Robson's classification system burdened by obstetric pathologies, maternal characteristics and assistential levels in comparing hospitals cesarean rates? A regional analysis of class 1 and 3

OBJECTIVE

To assess if maternal risk profile and Hospital assistential levels were able to influence the inter-Hospitals comparison in the class 1 and 3 of the "The Ten Group Classification System" (TGCS).

METHODS

A population-based analysis using data from Institutional data-base of an Italian Region was carried out. The 11 maternity wards were divided into two categories: second-level hospitals (SLH), and first-level hospitals (FLH). The recorded deliveries were classified according to the TGCS. To analyze if different maternal characteristics and the hospitals assistential level could influence the cesarean section (CS) risk, a multivariate analysis was done considering separately women in the TGCS class 1 and 3.

RESULTS

From January 2011 to December 2013 were recorded 19,987 deliveries. Of those 7,693 were in the TGCS class 1 and 4,919 in the class 3. The CS rates were 20.8% and 14.7% in class 1 (p < 0.0001) and 6.9% and 5.3% (p < 0.0230) in class 3, respectively in the FLH and SLH. The multivariate logistic regression showed that the FLH, older maternal age and gestational diabetes were independent risk factors for CS in groups 1 and 3. Obesity and gestational hypertension were also independent risk factors for group 1.

CONCLUSIONS

TGCS is a useful tool to analyze the incidence of CS in a single center but in comparing different Hospitals, maternal characteristics and different assistential levels should be considered as potential bias.

Obesity and urolithiasis: evidence of regional influences

There is evidence that obese patients have an increased risk of renal stone formation, although this relationship could be less evident in some populations. The aim of this study was to evaluate the impact of overweight and obesity on the risk of renal stone formation in a population consuming a Mediterranean diet and to better elucidate the mechanisms underlying the increased risk of urolithiasis observed in obese subjects. We performed a retrospective review of 1698 stone forming patients (mean age 45.9 ± 14.6 years; 984/714 M/F), attending outpatient stone clinics in Milan and Florence, seen between January 1986 and June 2014. Records were reviewed and data collected pertaining to age, gender, weight, height, stone composition, association with diabetes type 2 or gout and metabolic profile of 24-h urine to perform a descriptive study. We estimated prevalence ratios for body mass index (BMI) categories (underweight: BMI <18.5, normal: BMI 18.5-24.9, overweight: BMI 25-29.9 and obese ≥30). Overweight and obesity were present in 40.7 and 8 % of the men and in 19.9 and 8.7 % of the women in the study population. The mean BMI of patients with urolithiasis was found to be 24.5 ± 7.5 kg/m². BMI values were positively correlated with age (p = 0.000) and mean BMI was higher in males than in females (25.5 ± 8.9 vs 23.2 ± 4.4 kg/m²). In males, rates of overweight and obesity in renal stone formers were higher than the rates reported in the Italian general population in 2004 only for the age group 25-44 years, whereas males in all the other age groups and in females the rates of overweight and obesity in renal stone formers were similar to rates reported in the Italian general population. The rates of overweight and obesity were significantly different in patients with different chemical stone composition. In particular, patients with uric acid stones have rates of overweight and obesity higher than patients with calcium stones or other types of calculi. Also the rates of type 2 diabetes and gout were greater in patients with overweight and obesity. In overweight and obese patients, the urinary excretion of risk factors for stone formation, such as calcium, oxalate and urate, and also of inhibitory substances, such as citrate, were significantly higher than in patients with normal weight or underweight. The prevalence of overweight and obesity in patients with urinary calculi from a country consuming a Mediterranean diet is not higher than in the general population. It should be taken into account that not all the dietary patterns that are associated with obesity may involve a parallel increase in the risk of forming kidney stones and that epidemiological findings from one country could not be confirmed in other countries with different climatic, socioeconomic and cultural features.

Trends in overweight and obesity prevalence in Tuscan schoolchildren (2002-2012)

Objective

The aim of the present study was to examine the prevalence and time trends in childhood overweight including obesity and obesity among Tuscan children from 2002 to 2012.

Design

Cross-sectional study at five time points (Tuscan Nutritional Surveillance Surveys conducted in the years of 2002, 2006, 2008, 2010 and 2012). Trained personnel directly measured the height and weight of the subjects. BMI was assessed by means of the International Obesity Task Force (IOTF) and WHO cut-offs.

Setting

Representative sample of children in the Tuscany region (Italy).

Subjects

Children (n 7183) aged between 7·5 and 9·5 years (3711 boys and 3472 girls).

Results

With respect to the estimation of the absolute prevalence level of childhood overweight, a discrepancy was observed between the two criteria. In all surveys, more boys than girls were overweight (including obesity). Trend analysis showed a significant decrease in the prevalence of overweight including obesity and obesity in Tuscan children from 2002 to 2012 (32·0 % v. 25·8 %, P<0·001 on using IOTF criteria and 37·7 % v. 34·3 %, P<0·001 on using WHO criteria for overweight including obesity; and 10·0 % v. 6·7 %, P<0·001 on using IOTF criteria and 12·5 % v. 11·3 %, P=0·035 on using WHO criteria for obesity).

Conclusions

The present study is the first report from an Italian region showing a significant decrease in childhood obesity and overweight in the last 10 years. This reduction is probably a result of regional and local actions that have taken place in many sectors of society. However, efforts should be made to lower the prevalence of childhood obesity and overweight further.

Combined effect of established BMI loci on obesity-related traits in an Algerian population sample

Background

Genome-wide association studies have identified variants associated with BMI in populations of European descent. We sought to establish whether genetic variants that are robustly associated with BMI could modulate anthropometric traits and the obesity risk in an Algerian population sample, the ISOR study.

The ISOR study of 787 adult subjects (aged between 30 and 64) provided a representative sample of the population living in the city of Oran (north-west of Algeria). We investigated the combined effect of 29 BMI established genetic variants using a genetic predisposition score (GPS) on anthropometric traits and obesity risk in 740 subjects.

Results

We found that each additional risk allele in the GPS was associated with an increment in the mean [95% CI] for BMI of 0.15 [0.06 - 0.24] kg/m² (p = 0.001). Although the GPS was also associated with higher waist (p = 0.02) and hip (p = 0.02) circumferences, these associations were in fact driven by BMI. The GPS was also associated with an 11% higher risk of obesity (OR [95%CI] = 1.11 [1.05 - 1.18], p = 0.0004).

Conclusions

Our data showed that a GPS comprising 29 BMI established loci developed from Europeans seems to be a valid score in a North African population. Our findings contribute to a better understanding of the genetic susceptibility to obesity in Algeria.

Electronic supplementary material

The online version of this article (doi:10.1186/s12863-014-0128-1) contains supplementary material, which is available to authorized users.

Which dimensions of food-related lifestyle are likely to be associated with obesity in Italy?

OBJECTIVE

To compare obese v. non-obese consumers in terms of their general food-related lifestyles and to explore possible food-related factors affecting obesity in Italy.

DESIGN

The data were collected using a self-completion questionnaire. Data included sociodemographic information, measures of the Food-Related Lifestyle scale (FRL) and self-reported weight and height. A logistic regression model was fitted for the sample with obesity as the dependent variable and sociodemographic characteristics and FRL dimensions as the independent variables.

SETTING

The survey was carried out in Italy between October and November 2010.

SUBJECTS

One thousand respondents were recruited with equal quotas for men v. women. The sample was representative of the Italian population in term of age groups and geographic areas. The participants were over 18 years of age and were solely or jointly responsible for the family's food shopping.

RESULTS

Our analyses revealed that sociodemographic, economic and cultural variables affect the increasing rate of obesity in Italy. Obese respondents appeared to find more enjoyment from shopping and interest in cooking compared with non-obese ones. Moreover, they were more likely to find self-fulfilment in foods. However, obese respondents appeared to be less interested in the nutritional content of foods, suggesting their weak involvement in nutritional aspects when they eat. In fact, the obese respondents gave preference to snacks over meals.

CONCLUSIONS

The outcome of the study would suggest that in targeted interventions for public health purposes in order to address obesity, attention should be placed on the role that food plays in obese consumers' lives.

Early and long-term clinical outcomes of bilio-intestinal diversion in morbidly obese patients

PURPOSE

To evaluate the early and long-term postoperative results of malabsorptive surgery in morbidly obese patients.

METHODS

Between 2000 and 2007, 102 morbidly obese patients were referred to the Department of Surgery "Pietro Valdoni", "Sapienza" University of Rome, Policlinico "Umberto I°", Rome, Italy for malabsorptive surgery. All patients underwent derivative biliodigestive surgery after they had been reviewed by a team of surgeons, physicians, dieticians, and psychologists.

RESULTS

There were no intra-operative complications, but two patients suffered postoperative pulmonary embolisms, which resolved with medical treatment. The mean postoperative hospital stay was 7 days, with no early or late mortality. Maximum weight loss was reached 12-24 months after surgery, while the mean percentage excess weight loss at 3-5 years ranged from 45 to 64 %. Specific postoperative complications in the first 2 years after surgery were abdominal abscess (n = 2), gastroduodenal reflux (n = 4), and incisional hernia (n = 6). Diabetes resolved in 98 % of the diabetic patients within a few weeks after surgery and blood pressure normalised in 86.4 % of those who had had hypertension preoperatively. Obstructive sleep apnoea and obesity hypoventilation syndrome also improved significantly in 92 % of the patients.

CONCLUSIONS

Morbidly obese patients can undergo biliodigestive surgery safely with good long-term weight loss and quality of life expectancy.

Health and body mass index changes among Italian conscripts born in 1951 and 1980

This paper investigates changes in BMI in the second half of the twentieth century, focusing on two cohorts of Italian conscripts born in 1951 and 1980, and examines how the correlates of high and low BMI have changed over time. Data from conscript cohorts taken from the archives of Italian military districts show that younger conscripts exposed to the rising prevalence of immune-allergological and psychological diseases and metabolic dysfunctions underwent substantial increases in weight. These results are evidenced by quantile regression models, the largest BMI gains being found in diabetic conscripts at the 75th and 90th percentiles.

Prevalence of functional gastrointestinal disorders according to Rome III criteria in Italian morbidly obese patients

The relationship between GI symptoms and obesity has yet to be completely clarified.

AIM

To determine in a morbidly obese southern Italy adult population the prevalence of Functional Gastrointestinal Disorders (FGID) and its association with the presence of a Binge Eating (BE) behavior pattern.

METHODS

Consecutive obese patients eligible for bariatric surgery and 100 Healthy Controls (HC) were recruited. All participants were questioned and scored for the presence of FGID according to Rome III criteria and for the presence or the frequency-intensity of a number of upper and lower GI symptoms. BE behavior pattern was assessed.

RESULTS

One-hundred obese patients met the inclusion criteria. The prevalence of FGID was similar between obese patients and HC. There was a significant association between obese patients with BE behavior and postprandial distress syndrome (P = 0.04). Moreover, a significantly higher frequency-intensity score for epigastric fullness (1.23 ± 0.45 versus 0.35 ± 0.13, P = 0.01) was found in obese patients with BE behavior compared to obese patients without.

CONCLUSIONS

Obese patients with a BE behavior pattern showed a significantly higher prevalence of postprandial distress syndrome. A greater knowledge of the GI symptoms associated with obesity along with the pathophysiological mechanisms underlying will be important in the clinical management of these patients.

Exposure to priority organochlorine contaminants in the Italian general population. Part 2

Concentrations of 36 polychlorinated biphenyl (PCB) congeners were measured in serum of 372 Italian residents of general population living in Novafeltria, Pavia, and Milan. Total PCB level differed significantly between these sites ( p < 0.0001) with median concentrations of 836.50, 1354.57, and 2062.08 pmol/g lipid, respectively. However, there is no evidence for the difference in distribution of total PCB levels by genders. Total dioxin-like PCBs differed significantly ( p < 0.0001) between the sites (median 109.78, 50.88, and 166.99 pmol/g lipid, respectively) and genders of Novafeltria and Pavia ( p = 0.011 and 0.009, respectively). PCB 138, 153, 170, and 180 differed significantly between the places of residence ( p < 0.0001) with higher values in Milan population. In the overall population, total PCB and PCB 138, 153, 156, 170, and 180 correlated positively with age (correlations range between 0.320 and 0.569, p < 0.0001). In Novafeltria, the correlations ranged between 0.545 and 0.670, and in Pavia, the correlations ranged between 0.516 and 0.666. In Milan, correlations with age range between 0.327 and 0.417 for total PCB and congeners 138, 153, and 180. With an exception of PCB 170, there was no evidence of significant difference in the distribution of most abundant PCB congeners and total PCB across the body mass index categories.

Exposure to priority organochlorine contaminants in the Italian general population. Part 1. Eight priority organochlorinated pesticides in blood serum

Despite extensive use of organochlorinated pesticides (OCPs) such as dichlorodiphenyltrichloroethane (DDT) in Italy in the 1940s to 1970s, especially for public health control of malaria mosquitoes, information on their exposure levels among the general population is limited. These OCPs can be a source of health risk to human. A total of 137 blood samples were collected from residents of the general population of three Italian towns, Novafeltria, Pavia and Milan, to determine the levels of eight OCPs in blood serum. The concentrations of beta-hexachlorocyclohexane, hexachlorobenzene (HCB), 1,1-dichloro-2-( o-chlorophenyl)-2-( p-chlorophenyl)ethylene, 1,1-dichloro-2,2-bis( p-chlorophenyl)-ethylene ( p, p' -DDE), 1,1-dichloro-2-( o-chlorophenyl)-2-( p-chlorophenyl)ethane, 1,1-dichloro-2,2-bis (4-chlorophenyl)ethane, 1,1,1-trichloro-2-( o-chlorophenyl)-2-( p-chlorophenyl)-ethane and 1,1,1-trichloro-2,2-bis( p-chlorophenyl) ethane were measured by gas chromatography–mass spectrometry. Variations in serum concentrations of OCPs with respect to place of residence, gender, age and body mass index (BMI) were evaluated by non-parametric tests. p, p' -DDE and HCB were the most abundant and major contributors of total OCP concentration. Their levels differed significantly between the three towns with a trend Milan > Novafeltria > Pavia (  p < 0.0001). Females had significantly higher concentrations of HCB and p, p'-DDE than males in the overall population sample. HCB concentrations were significantly higher in females than in males of Milan ( p = 0.029). We observed positive correlations of p, p'-DDE and HCB with age in Novafeltria subjects ( r = 0.468, p = 0.004). Total OCP concentrations differed significantly across BMI categories ( p = 0.018) in overall population. We have demonstrated a clear pattern of the main OCPs in a fairly large population. Generally, our study provides information on OCPs exposure among the Italian general population and provides indications for further investigations.

Association between Leptin gene polymorphisms and plasma leptin level in three consanguineous families with obesity

INTRODUCTION

Leptin (LEP) gene is one of the most promising candidate genes for obesity. Previous studies have tested the association of polymorphisms in LEP gene with obesity and obesity-related metabolic biomarkers (anthropometric variables, glucose, insulin level, leptin level and lipid profile). However, the results of these studies were still controversial. To determine whether LEP gene is associated with obesity in Tunisian population, we performed a family-based association study between LEP polymorphisms and obesity and obesity-related metabolic biomarkers.

METHODS

Seven single nucleotide polymorphisms (SNPs) in 5' region of LEP gene were genotyped in three consanguineous families including 33 individuals. The previously reported LEP SNPs (H1328084, H1328082, rs10487506, H1328081, H1328080, G-2548A and A19G) were evaluated by PCR-RFLP and direct sequencing methods. Single SNP association and haplotype association analyses were performed using the family-based association test (FBAT). To determine allele frequencies of these SNPs in general population, 52 unrelated individuals from the general Tunisian population were also analyzed.

RESULTS

Two SNPs showed significant associations with plasma leptin level (H1328084: A>G, Z=2.058, p=0.039; A19G: G>A, Z=2.058, p=0.039). When haplotypes were constructed with these two-markers, the risk AA haplotype (frequency 57.1%) was positively associated with plasma leptin level (Z=2.058, p=0.039). Moreover, SNPs H1328084 and A19G are predicted to modify transcription-factor binding sites.

CONCLUSIONS

Our study provided that two functional variants in 5' regulatory region of LEP gene are associated with plasma leptin level as a quantitative trait. It suggested that H1328084 and A19G have an important role in regulating plasma leptin level.

Anthropometric, penile and testis measures in post-pubertal Italian males

BACKGROUND

Relationships between anthropometric measures, body proportions, weight and penile dimensions in young adult males have not been previously analyzed. Furthermore, although male fertility has declined in last decades, no data on testicular volume (the best surrogate measure for spermatogenic potential) are available for the general population of young men in Italy.

AIM

To analyze anthropometric measures and proportions, testicular volumes, and penile dimensions in a large cohort from the general population of young Italian men aged 18-19 yr. MATERIALS/SUBJECTS: We analyzed 2019 students aged 18-19 years for height, weight, body mass index (BMI), waist circumference, arm span, pubis-to-floor and crown-to-pubis length, and penile dimensions. Testicular volumes were measured by ultrasound in 776 subjects.

RESULTS

Thirty-six percent of the subjects had a pathological arm span-height difference (>3 cm) and 44.7% had a pathological pubis-to-floor/ crown-to-pubis ratio (≤ 0.92). The mean penis length was 8.9 ± 1.4 cm and the penis circumference was 9.5 ± 1.0 cm. BMI was positively associated with arm span-height difference and negatively with penis length; 23.2% of the subjects had low mean testicular volume (<12 ml).

CONCLUSIONS

The findings highlight a strong influence of BMI on skeletal proportions and penis length, identify a large proportion of subjects with testicular hypotrophy at risk for future fertility, and suggest to consider worldwide studies to redefine normal values for arm span-height difference and upper/ lower body segment ratio.

Acute diverticulitis in the young: the same disease in a different patient

Background. Natural history and risk factors for diverticulitis in young patients are still debatable. This study aimed to assess whether difference exists in patients aged 50 and younger when compared to older patients and to identify risk factors for acute diverticulitis in the young. Patients and Methods. From January 2006 to December 2011, 80 patients were admitted to our department for acute diverticulitis. We carried out a cross-sectional study in 23 patients (28.7%) aged 50 and younger and 57 older patients (71.3%). Results. Acute diverticulitis in the young was not more aggressive than in the older patient. Diverticulitis at patient's admission was similar with respect to Hinchey's stage and prior history of diverticulitis. No significant difference was found for both medical and surgical treatment. The rate of recurrent diverticulitis in nonoperated patients was similar. Male gender, body mass index ≥25, and assumption of alcohol were independent risk factors for the occurrence of an acute diverticulitis in the young. Conclusions. The same disease seems to be affecting young patients such as overweight or obese male individual. Current policies to prevent diverticular disease and its related complications must include obesity control together with high-fiber diet and regular exercise.

Dietary habits and ageing in a sample of Italian older people

OBJECTIVES

To analyse dietary habits and explore the role of socioeconomic status in a sample of elderly Italians.

STUDY DESIGN

Observational.

PARTICIPANTS AND SETTING

306 elderly subjects aged 65 and over living in the Marche Region (Italy).

MEASUREMENTS

Assessment of dietary habits and life-style characteristics using a "Life-style questionnaire". Nutritional data collected by means of a 53-item "Frequency food questionnaire".

RESULTS

The study revealed differences in dietary patterns and food consumption. Age was negatively related to all food categories. Some socio-economic characteristics (level of education and economic status) were correlated with consumption of many foods, such ad Fish, Red Meat and Diary products. Between-the-sexes differences were also documented.

CONCLUSION

Our findings showed that the nutritional and dietary habits varied greatly within the sample investigated. The mapping of these dietary and nutritional patterns may be of value for future research in elderly populations, particularly those with low educational status and poor economic means. Conclusively, greater promotion of healthy dietary habits should be targeted towards elderly populations.

Overweight and obesity prevalence and determinants in Italy: an update to 2010

PURPOSE

To provide updated information on trends and determinants of underweight, overweight, and obesity in Italian adults.

METHODS

We considered data from 5 surveys conducted annually between 2006 and 2010, on a total of 14,135 subjects aged 18 years or more (6,834 men and 7,301 women), representative of the Italian adult population, including self-reported information on height and weight.

RESULTS

Overall, 3.1 % of the Italian adult population was underweight (body mass index, BMI, <18.5 kg/m(2); 0.8 % men, 5.3 % women), 31.8 % overweight (25≤ BMI <30 kg/m(2); 39.8 % men, 24.4 % women), and 8.9 % obese (BMI ≥30 kg/m(2); 8.5 % men, 9.4 % women). We observed no specific pattern of overweight/obesity across calendar years in men (multivariate prevalence ratios, PR, for 2010 vs 2006: 0.95; p for trend: 0.980) and a non-significant decreased trend in women (PR: 0.92; p for trend: 0.051). Prevalence of overweight/obesity significantly increased with age (PRs for ≥65 vs 18-24 years: 2.01 in men, 2.65 in women), decreased with education (PRs for high vs low education: 0.79 in men, 0.54 in women), and was less frequent in single than in married adults (PRs: 0.85 in men, 0.78 in women). Overweight/obesity was significantly more frequent in adults from southern versus northern Italy (PRs: 1.13 in men, 1.32 in women) and in former versus never smokers (PRs: 1.23 in men, 1.19 in women).

CONCLUSIONS

In Italy, we did not find unfavorable trends in overweight and obesity prevalence across calendar years. However, there are specific subgroups of the population with elevated prevalence of overweight and obesity, mainly adults from southern Italy and less educated ones.

Age standardization in mapping adult overweight and obesity trends in the WHO European Region

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.

Differences in weight gain in hypertensive and diabetic elderly patients primary care study

BACKGROUND

Treatment and care of elderly patients with diabetes and hypertension means a hard task in primary care. Patients with these two components of metabolic syndrome are often overweight or obese. Although some parameters of metabolic syndrome are usually measured in a medical setting, checking body weight is usually done by the patients.

AIM

The aim of this study is to analyse the patients' self-recorded data on weight and compare them according to hypertension and diabetes.

PATIENTS AND METHODS

Five hundred and forty people (225 men and 315 women) between 60 and 75 years of age were eventually selected in primary care settings. Retrospective self-recorded data on recent weights and every decade since the age of 20, as well as the decade prior to diagnosis were collected. The data of patients with and without diabetes and/or hypertension were compared.

RESULTS

The current mean body weight was significantly higher in all groups than at the age of 20. Compared with the control group, hypertensive men and women were approximately of the same weight in their twenties and, also, recently, but they gained more weight in the 4th and 5th decades of their life. Diabetics started at higher weights. The greatest weight gain was observed as follows: between 20-30 years and 30-40 years in men and women, respectively, as well as between 50-60 years of age and in the last decade prior to diagnosis in both genders. Weight gain in the control group was steady at a lower rate.

CONCLUSIONS

Weight gain between 20-40 years of age could be an important factor in the aetiology of diabetes. Stable or at least limited weight gain may be a preventive factor. Considering the limitations of the study, further and decades long epidemiological evaluations are suggested in a larger study population.

Elevated body mass index correlates with higher seminal plasma interleukin 8 levels and ultrasonographic abnormalities of the prostate in men attending an andrology clinic for infertility

BACKGROUND

Obesity is associated with a systemic, low-grade inflammatory state. Although the relationship between obesity and semen parameters or prostate diseases has been previously investigated, the association between body mass index (BMI), prostate inflammatory diseases and color- Doppler ultrasound (CDU) of the male genital tract (MGT) has been poorly studied.

AIM

To evaluate the association between BMI and CDU features of the MGT, signs and symptoms of prostate inflammation, semen parameters.

MATERIALS/SUBJECTS AND METHODS

We studied 222 men seeking medical care for couple infertility. According to the World Health Organization classification, subjects were divided into 3 groups: normal weight (no.=131, BMI=18.5-24.9 kg/m2), overweight (no.=71, BMI=25.0-29.9 kg/m2), obese (no.=20, BMI≥30.0 kg/m2). All patients underwent simultaneous testosterone evaluation and seminal analysis, including interleukin 8 (sIL-8), along with scrotal and transrectal CDU, before and after ejaculation. Prostatitis symptoms were evaluated by National Institutes of Health- Chronic Prostatitis Symptom Index questionnaire.

RESULTS

After adjusting for age and testosterone levels, higher BMI was significantly related to higher prostate volume and several CDU features of the prostate, including macro-calcifications, inhomogeneity, higher arterial peak systolic velocity (the latter adjusted also for blood pressure), but not with abnormalities of testis, epididymis, seminal vesicles. Furthermore, higher BMI and BMI class were significantly related to higher sIL-8, a reliable surrogate marker of prostate inflammatory diseases, even after adjustment for age. Conversely, no associations among BMI, clinical symptoms of prostatitis or semen parameters were observed.

CONCLUSIONS

Subjects with higher BMI might develop CDU and biochemical signs suggestive of prostate inflammation, although not clinically overt.

Accounting for the multidimensional nature of the relationship between adult obesity and socio-economic status: the French second National Individual Survey on Food Consumption (INCA 2) dietary survey (2006-07)

The objective was to study the multidimensional nature of the relationship between adult obesity (OB) and socio-economic status (SES), using comprehensive indices of SES taken separately or synthesised in an overall index. A nationally representative sample of adults aged 18-79 years was taken from the French second National Individual Survey on Food Consumption (INCA 2) dietary survey (2006-07). Weight and height were measured and OB defined as BMI ≥ 30 kg/m2. SES variables were reported in questionnaires and included occupation, education and characteristics of household wealth. Composite indices of SES (household wealth and overall SES indices) were computed by correspondence analysis, and relationships with OB were investigated with logistic regression analysis. In total, 11·8 (95 % CI 10·1, 13·4) % of French adults were obese, without significant difference by sex. While no significant relationship was observed in men, all SES indicators were inversely correlated to OB in women. Both education and the household wealth index were retained in the stepwise multivariate model, confirming that different socio-economic variables are not necessarily proxies of each other regarding the OB issue. On the other hand, 'controlling for SES' while including several measures of SES in multivariate models may lead to collinearity, and thus over-adjustment. A more integrative approach may be to derive a synthetic index by including the SES factors available in a given study. Beyond this methodological perspective, understanding how OB is related to the different dimensions of SES should help to target the more vulnerable groups and increase the effectiveness of prevention.

Diabetes mellitus, other medical conditions and pancreatic cancer: a case-control study

BACKGROUND

Diabetes and other medical conditions have been related to pancreatic cancer, but time risk quantification is unsettled.

METHODS

We combined data from two case-control studies conducted in Italy, including 688 pancreatic cancer cases and 2204 controls. All subjects were interviewed by trained interviewers during their hospital stay. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were estimated using multiple logistic regression.

RESULTS

Overall, 103 cases (15%) and 125 controls (5.7%) reported a history of diabetes. The OR for pancreatic cancer was more pronounced among those diagnosed with diabetes in the previous 2 years (OR = 5.17; 95% CI = 2.71-9.87) than among those with diabetes diagnosed more than 2 years ago (OR = 2.35; 95% CI = 1.70-3.26). The ORs remained significantly elevated 2-4 years (OR = 3.81; 95% CI = 2.07-7.04) and 5-9 years (OR = 3.75; 95% CI = 2.13-6.59) since diagnosis of diabetes, after which a non-significant 20% increased risk for pancreatic cancer was observed. As compared to non-diabetic non-smokers, the OR was 1.85 among non-diabetic current smokers, 2.17 among diabetic never/former smokers, and rose to 4.67 among diabetic current smokers, indicating a multiplicative effect between these two risk factors. Pancreatic cancer was significantly associated with pancreatitis, primarily among those diagnosed within 2 years (OR = 7.16; 95% CI = 2.25-22.78). In addition, the ORs were elevated for cholelithiasis (3.53; 95% CI = 1.67-7.45) and gastroduodenal ulcer (3.16; 95% CI = 1.14-8.73) only among those diagnosed within the past 2 years.

CONCLUSIONS

Diabetes is associated with heightened risk of pancreatic cancer. The association is significant for diabetes diagnosed up to 10 years before pancreatic cancer.

Awareness and knowledge about weight status and management: results from the 1 d sensitization campaign 'Obesity Day' in northern Italy

OBJECTIVE

To evaluate the awareness and knowledge about weight status and its management.

DESIGN

A 1 d cross-sectional survey. Basic anthropometric assessments (weight, height, BMI and waist circumference) and a self-administered questionnaire were considered.

SETTING

Nineteen Clinical Nutrition or Endocrinology and Metabolic Disorders Units or Dietetics Services in the Italian region of Lombardy.

SUBJECTS

All adults attending the 'Obesity Day' initiative.

RESULTS

A total of 914 participants (605 female and 309 male) were recruited. Although most of the participants (83·5 %) considered obesity to be a disease, 38·5 % were likely to misperceive their weight status. In particular, 38·8 % of normal-weight adults believed themselves to be overweight, whereas 71·1 % and 37·5 % of classes I and II/III obese adults classified themselves as being overweight and mildly obese, respectively. However, most of the overweight (90·2 %), mildly (96·8 %) and moderately/severely obese adults (99·1 %) recognized the need to lose weight. In all, 37·8 % of the sample underestimated the role of physical activity in weight management. Interestingly, only 17·2 % of dieters (previous or current) declared being advised by their doctor to lose weight. Multivariate models revealed that higher age, low education and higher BMI were important determinants of poor weight control and management. In addition, previous dieting appeared not to provide better knowledge, whereas the role of physical activity was recognized mainly by those practising it.

CONCLUSIONS

The present study suggests that in Italy knowledge about weight management should be improved not only in the general population but also among health-care professionals. To confirm this finding, there is now the rationale for a nationally representative survey. New educational programmes can be designed on the basis of the information collected.

Incidence of thyroid cancer in Italy, 1991-2005: time trends and age-period-cohort effects

BACKGROUND

In Italy, some of the highest incidence rates (IRs) of thyroid cancer (TC) worldwide have been reported.

PATIENTS AND METHODS

TC cases <85 years of age reported to Italian cancer registries during 1991-2005 were included. Age-standardized IRs were computed for all TC and age-period-cohort effects were estimated for papillary TC.

RESULTS

IRs of TC were twofold higher in 2001-2005 than in 1991-1995 (18 and 8 per 100,000 women, 6 and 3 per 100,000 men, respectively). Increases were similar in the two sexes and nearly exclusively due to papillary TC. Increases of papillary TC by birth cohort were found in both sexes and among all age groups between 20 and 79 years. Age-period-cohort models showed a strong period effect in both sexes (rate ratio for 2001-2009 versus 1991-1995 = 2.5 in women and 2.3 in men), although IRs peaked at an earlier age in women (45-49 years) than men (65-69 years).

CONCLUSION

The strength of the period effect in both sexes and the earlier onset in women than men strongly implicated increased medical surveillance in the upward trends of papillary TC incidence in Italy. The consequences of the current intense search for TC on morbidity and possible overtreatment, especially among young women, should be carefully evaluated.

An interactive diary for diet management (DAI): a new telemedicine system able to promote body weight reduction, nutritional education, and consumption of fresh local produce

BACKGROUND

The aim of this multicenter, longitudinal, single-arm, pre-post comparison was to test a telemedicine system able to promote body weight reduction, nutritional education, and consumption of fresh local produce.

METHODS

DAI (MeTeDa srl, San Benedetto del Tronto, Italy) is a software for mobile phones to support patients following a specific dietetic program. It facilitates the communication between the patient and dietician via short text messages. Overall, three specialized dieticians enrolled 140 consecutive patients with body mass index (BMI) >or=25 kg/m(2) who voluntered to follow a specific diet program to be managed with DAI. At baseline and after 20 weeks, data on body weight, waist circumference, BMI, fasting blood glucose, lipid profile, food habits, and physical activity were collected and compared by the Wilcoxon test or the McNemar test.

RESULTS

Overall, 115 individuals (82.1%) completed the follow-up. The mean (95% confidence interval) reduction in body weight was -2.5 (-3.2; -1.8) kg, whereas the reduction in waist circumference was -3.7 (-4.6; -2.9) cm, and that in BMI was 1.0 (-0.7; -1.2) kg/m(2). The software was useful as an educational tool: participants achieving the Mediterranean diet targets increased from 14.4% to 69.8% after 20 weeks. On average, each patient recognized and chose fresh local vegetables eight times per week during the follow-up. Participants regularly communicated with dieticians through short text messages.

CONCLUSIONS

This study allowed the documentation of the efficacy of a new telemedicine system in supporting people who need to lose body weight. The tool was also suitable for a more articulated initiative of "nutritional education" aiming to promote the healthy properties of the Mediterranean diet and the consumption of local produce.

BMI, life-style and psychological conditions in a sample of elderly Italian men and women

OBJECTIVES

To identify the relationship among cognitive status, psychological conditions, anthropometric measurements and life-style in a sample of elderly Italian men and women.

METHODS

Three hundred and six volunteers for ZINCAGE Project recruited. The sample was made up of healthy older adults living in the Marche Region aged 65 and over. All elderly were given a complete medical, anthropometric assessment, and psycho-social evaluation.

RESULTS

Overall, the participants perceived themselves to be in very good or good (22%) or fair (69%) health; only 9% reported a poor health status. The 46% of the sample fell within the normal body mass index (BMI) range, though 38% were overweight, 12% were obese, and only 4% were underweight. In both sexes, BMI significantly decreased with age (p<0.001). BMI was positively associated with performing sedentary activities (r=0.188; p<0.001). Levels of both sedentary (r=0.221; p<0.001) and non-sedentary (r=0.258; p<0.001) leisure activities were positively associated with education level (p<0.05). It was found that lower scores of physical activity were associated to higher scores of Geriatric Depression Scale (r=-0.425; p<0.01), lower scores of Mini Mental State Examination (r=0.266; p<0.001) and higher score of Perceived Stress Scale (r=-0.131; p<0.05).

CONCLUSION

Men and women lead different lifestyles and have a different psychological status, with advancing age consequently stressing the need for healthy lifestyle programmes particularly in the case of overweight and obese elderly people.

Prevalence of overweight and obesity in Italy (2001-2008): is there a rising obesity epidemic?

PURPOSE

To provide national, population-based estimates of the prevalence of overweight and obesity in the Italian population.

METHODS

Prevalence estimates of overweight and obesity were calculated in seven waves (2001-2008) of the cross-sectional Multipurpose Household Survey organized by the Italian National Institute of Statistics, which are representative of the general adult Italian population. Sampling weights were used to estimate prevalence figures as well as their standard errors. Mean-difference plot was used to evaluate changes in the distribution of body mass index across sex and age categories.

RESULTS

Almost half of Italian men and about 1 of 3 Italian women are overweight or obese. Between 2001 and 2008 the age-standardized prevalence of overweight (obesity) increased 1.4% (1.9%) in men and 0.4% (0.5%) in women. Mean-difference plots showed an upward shift for body mass index distribution with an increasing skewness.

CONCLUSIONS

The obesity epidemic is one of the major issues in United States and other developed countries. However, if for "epidemic" we mean that in Italy obesity is steadily increasing, then our data give little support to this interpretation. In fact, trends observed between 1983 and 2008 suggest that the rates of changes in the prevalence of overweight and/or obesity are not increasing.

Testosterone deficiency in the aging male and its relationship with sexual dysfunction and cardiovascular diseases

: The relationship between age-associated dec-line of testosterone (T), cardiovascular (CV) risk and sexual dysfunction in males is not completely clear. The aim of the present study was to report our experience in a large series of patients seeking medical care for sexual dysfunction and comparing our results with current evidence.

: Here, we review published data from our laboratory and reported data from a cross-sectional analysis on a consecutive series of 3149 patients seeking medical care at our Unit for sexual dysfunction (between 2000 and 2010). Among them, 1687 (studied between 2000 and 2007) patients were also longitudinally evaluated (mean follow-up 4.3±2.6 years) for forthcoming major cardiovascular events (MACEs). All major findings were discussed in comparison with data reported in the literature.

: T levels were associated with a wide array of biological and psychological factors, which substantially differ as a function of age. Some of these associations were more evident in the youngest patients (psychological symptoms), whereas sexual symptoms, including erectile function, sexual desire and the frequency of sexual intercourse, were associated with T levels only in the oldest patients. We did not find any association between T and MACEs, whereas we reported a close link between CV mortality and low T. Both these observations are in line with data obtained in community-dwelling men.

: T plays a crucial role in regulating different aspects of male sexual function. The effect of T on CV risk needs to be confirmed in larger epidemiological and interventional studies.

A national survey of the prevalence of childhood overweight and obesity in Italy

To estimate the prevalence of childhood overweight and obesity among Italian schoolchildren and to examine geographic differences and present and future implications for health care, we used data from a nationwide representative survey performed in May 2008 among third-grade students in 18 of Italy's 21 regions. Cluster sampling was used to identify classes for participation. The study population included all children aged 8-9 years whose parents agreed to opt-out consent. Parents, children and teachers completed brief questionnaires, and children were weighed and measured by trained staff using standardized equipment. Consent was obtained for 97% of 50 197 third-graders, of whom 44 676 (89%) met study inclusion criteria. Obesity levels (defined using International Obesity Task Force cut-offs) ranged from 7.5% (95% confidence intervals 6.7-8.2) in the north to 16.6% (95% confidence intervals 15.8-17.4) in the south. Behaviours known to be associated with obesity also showed geographic differences. The estimated burden of obesity-related pathologies also increased from north to south. These findings suggest the need for community as well as individual interventions in all areas of the country but with particular attention to the south.

Changes in the prevalence of overweight and obesity: some evidence from the Swiss Health Surveys 1992/93 and 2002

BACKGROUND

This study examines changes in the prevalence of overweight and obesity in the Swiss general population from 1992/93 to 2002 and their relationship with changes in the distribution and effect of socioeconomic and health behavioural risk factors.

METHODS

Cross-sectional data from telephone interviews of the non-institutionalized Swiss population aged 19 years and more were obtained from the Swiss Health Study 1992/93 (n = 13798) and 2002 (n = 17677). Binary logistic regression was used to address changes in overweight and obesity, defined as body mass index 25.0 kg/m(2) or more. The expected prevalence of overweight and obesity under adjusted models was computed to demonstrate the influence of changes in risk factors.

RESULTS

The prevalence of overweight and obesity rose from 22.8% in 1992/93 to 30.9% in 2002 among women and from 41.1% to 48.1% among men. In international comparison, the increase in the overall prevalence of overweight and obesity in Switzerland was lower. Contrary to similar studies from other countries, the increase in prevalence was lower among men than that among women, possibly because of an increased protective effect of the observed health behavioural factors among men and unobserved behavioural factors among middle-aged men.

CONCLUSION

Public health action should consider the potential of changing health behavioural factors in subgroups with a higher prevalence of overweight and obesity. Measures that stimulate, for instance, light physical activity or healthy diet, to be supported by changes in the obesogenic environment, should be encouraged. More evidence is needed for gender-specific approaches.

Diet and cancer in Mediterranean countries: carbohydrates and fats

Objective

Several aspects of the diet characteristic of the Mediterranean countries are considered favourable not only on cardiovascular disease, but also on cancer risk. We considered some aspects of the Mediterranean diet (including, in particular, the consumption of olive oil and carbohydrates) on cancer risk.

Design, Setting and Subjects

Data were derived from a series of case-control studies, conducted in Italy since the early 1990s, on over 10 000 cases of thirteen cancer sites and over 17 000 controls.

Results

Olive oil, and other mono- and unsaturated fats, appear to be favourable indicators of breast, ovarian, colorectal, but mostly of upper aero-digestive tract cancers. Whole grain foods are also related to reduced risk of upper aero-digestive tract and various other cancers. In contrast, refined grain intake and, consequently, glycaemic index and glycaemic load were associated to increased risk for several cancer sites. Fish, and hence a diet rich in n-3 polyunsaturated fatty acids, tended to be another favourable diet indicator, while frequent red meat intake was directly related to some common neoplasms. An a priori defined Mediterranean diet score was inversely related to upper digestive and respiratory tract cancers.

Conclusions

These data provide additional evidence that major characteristics of the Mediterranean diet favourably affect cancer risk.

Association of socioeconomic status with overall overweight and central obesity in men and women: the French Nutrition and Health Survey 2006

Background

Identification of subpopulations at high risk of overweight and obesity is crucial for prevention and management of obesity in different socioeconomic status (SES) categories. The objective of the study was to describe disparities in the prevalence of overweight and obesity across socioeconomic status (SES) groups in 18–74 year-old French adults.

Methods

Analyses were based on a multistage stratified random sample of non-institutionalized adults aged 18–74-years-old from the French Nutrition and Health Survey (ENNS), a cross-sectional national survey carried out in 2006/2007. Collected data included measured anthropometry (weight, height and waist circumference (WC)), demographic and SES data (occupation, education and frequency of holiday trips as a marker of family income). SES factors associated with overweight (BMI ≥ 25) and central obesity (WC above gender-specific references) were identified using multiple logistic regression.

Results

Almost half (49.3%) of French adults were overweight or obese and 16.9% were obese. In men, the risk of overall overweight or obesity was associated with occupation (p < 0.05), whereas the risk of central obesity was independently associated with occupation (p < 0.05) and frequency of holiday trips (p < 0.01). In women, both overall and central overweight and obesity were independently associated with educational level (respectively p < 10^-3 and p < 10^-3) and frequency of holiday trips (respectively p < 0.05 and p < 10^-3).

Conclusion

The prevalence of overweight and obesity was found to be similar to that of several neighbouring western European countries, and lower than the UK and eastern Europe. Risk of being overweight or obese varied across SES groups both in men and women, but associations were different between men and women, indicating differing determinants.

CHOP 5'UTR-c.279T>C and +nt30C>T variants are not associated with overweight condition or with tumors/cancer in Italians - a case-control study

Background

Type 2 diabetes (T2D) is associated with obesity and has been shown recently to be associated with tumors/cancer. HNF1-beta and JAZF1 genes are associated with T2D and prostate cancer. We have previously shown that CHOP 5'UTR-c.279T>C and +nt30C>T haplotype variants contribute to T2D. CHOP deficiency causes obesity in mice, thus CHOP gene variants may contribute to human obesity. Furthermore, CHOP mediates apoptosis and is implicated in cancer pathogenesis. Hence, we aimed at identifying any potential association of CHOP 5'UTR-c.279T>C and +nt30C>T genotypes and corresponding haplotypes with overweight condition/pre-obesity and tumors/cancer in an Italian dataset.

Methods

We recruited from Italy 45 overweight subjects (body mass index (BMI) ≥ 25) and 44 control subjects (BMI < 25) as well as 54 cases with at least one cancer or at least one tumor and 43 control subjects without tumors/cancer from the general population. We excluded allelic departure from Hardy-Weinberg equilibrium in cases and control subjects, separately.

Results

We assessed the power to detect risk odds ratios by association tests in our datasets. We tested the hypothesis of association of CHOP 5'UTR-c.279T>C and +nt30C>T genotypes and haplotypes with tumors/cancer and, separately, with overweight condition. Both associations were not significant.

Conclusion

From our study, we may conclude that CHOP 5'UTR-c.279T>C and +nt30C>T genotypes and corresponding haplotypes are not associated with tumors/cancer and pre-obesity. However, more studies are warranted to establish the role of CHOP variants in tumor/cancer predisposition and in overweight condition.

Migration and health in Italy: a multiethnic adult sample

BACKGROUND

Immigration to Italy has increased drastically, but there is a paucity of data on the health of these immigrant populations and the need to improve their health care. Therefore, we analyzed a multiethnic immigrant population in Bologna (northern Italy) to identify the risk factors for health. This anthropometric study was part of a multiregional project "Health Assistance and Monitoring for Indigent Italian Citizens and Immigrants" funded by the Italian Ministry of Health.

METHODS

The sample consisted of 401 adult immigrants from southeastern Europe (Kosovars, Gypsies, or Roma) and four extra European countries (Senegalese, Moroccans, Tunisians, and Pakistanis). Ethnic ancestry was self-reported. Anthropometric (height, weight, and waist circumference) and blood pressure data were collected during the survey.

RESULTS

The prevalence of overweight (and obesity) exceeded 50% in Moroccans and Kosovars of both sexes and in male Roma. The ethnic heterogeneity was associated with different patterns of obesity: the highest prevalence of abdominal obesity was in Moroccan and Kosovar women and in male Kosovars and Gypsies. The highest prevalence of hypertension (more than 20%) was in Senegalese, Kosovar, and Gypsy males.

CONCLUSIONS

Some of the immigrant subsamples had a high prevalence of obesity, which is associated with morbidity. Our findings on the relationships between the anthropometric traits and the blood pressure suggest different cardiovascular disease risk profiles in the ethnic groups (higher for Kosovars and Roma) and an urgent need for preventive measures.

Prevalence of overweight and obesity among 2.6 million rural Chinese adults

OBJECTIVE

To investigate the prevalence of overweight and obesity among Chinese rural adults based on the World Health Organization and Chinese standards.

METHODS

A cross-sectional whole-population health survey of 1,250,062 men and 1,372,026 women aged 15 years and over was undertaken in Tianjin true rural areas in 2004 (response rate, 85.6%). Height and weight were measured using a standardized protocol.

RESULTS

Using the World Health Organization standard, the age-standardized prevalence of overweight (body mass index [BMI] 25-29.9 kg/m(2)) and obesity (BMI> or =30 kg/m(2)) was 21.8% and 3.1% in men, 23.1% and 4.7% in women, and 22.5% and 3.9% in men and women combined, respectively. Using the Chinese standard, the age-standardized prevalence of overweight (BMI 24-27.9 kg/m(2)) and obesity (BMI> or =28 kg/m(2)) was 31.3% and 7.0% in men, 28.7% and 9.7% in women, and 30.0% and 8.4% in men and women combined, respectively. The prevalence of overweight and obesity was higher among Tianjin rural adults than in the whole Chinese rural population based on the 2002 Fourth National Nutritional Survey.

CONCLUSIONS

The prevalence of overweight or overweight/obesity is relatively high in this Chinese rural population and might be an important lifestyle-related public health problem in China.

Why can patients with erectile dysfunction be considered lucky? The association with testosterone deficiency and metabolic syndrome

Metabolic syndrome (MetS) is a diagnostic category, based on a cluster of risk factors (hyperglycemia/diabetes, abdominal obesity, hypertriglyceridaemia, low HDL cholesterol and hypertension), which identifies subjects at high risk for forthcoming type 2 diabetes mellitus and cardiovascular (CV) diseases. Recently, a close association between MetS, erectile dysfunction (ED) and male hypogonadism has been reported. In patients with MetS, hypogonadism can exacerbate sexual dysfunction and arteriogenic ED because of its typical symptoms, such as decreased sexual desire and mood disturbances. On the other hand, hypogonadism per se has been associated with an increased risk of CV and overall mortality. Obesity and in particular central obesity is nowadays considered the most important determinant of MetS-induced hypogonadism whereas hypertension and diabetes play a major role in ED associated with MetS. This review analyses the current literature regarding the relationship between ED, MetS and hypogonadism emphasising the epidemiological and psychopathological aspects and stressing the concept that ED subjects are 'lucky', because ED offers a unique chance to undergo medical examination and therefore to improve not only their sexual but, most importantly, their overall health.

Obesity in Mediterranean region (1997-2007): a systematic review

The objective of this review is to determine the distribution of obesity by geographical location, income, age and sex in the Mediterranean region during the last decade. A meta-analysis was conducted for 102 articles cited during the period (1997-2007) in Medline database (for 17 Mediterranean countries) searched during the summer of 2007 using the word 'obesity' and its related keywords. The study showed that adults were more obese than children in all Mediterranean continents and in different levels of income. The prevalence of obesity among European children was higher than among Asians. Also, European adults were more obese than European children. The total female adults were found to be more obese (median: 25.3%) than male adults (median: 20.0%). The regression model analysis indicated that male adults were more likely to be obese in the Euro-Med region. Taking different factors into consideration, it was noticed that Mediterranean adults, especially those in the European region, are at higher risk of obesity. Awareness programmes addressing the importance of adopting healthy dietary habits combined with physical activity should target the whole community in general and adults in particular. The findings could guide health planners for better management of obesity.

Work, Weight, and Wellness: the 3W Program: a worksite obesity prevention and intervention trial

OBJECTIVE

In this paper, we describe the aims, intervention, and design of the Work, Weight, and Wellness program, a group-randomized worksite obesity prevention and intervention trial being conducted at 31 hotels with 11,559 employees on the island of Oahu in Hawaii. We report baseline prevalence of overweight and obesity, and the distribution of BMI (kilograms per meter squared) across sex, race, and job categories. We also describe factors that have influenced intervention adoption and employee participation.

RESEARCH METHODS AND PROCEDURES

The study's primary outcome is change in BMI among hotel employees over a 2-year intervention period. The intervention includes environmental and group components that target diet, physical activity, and weight management.

RESULTS

Men, Pacific Islanders, and individuals employed in managerial or facility maintenance roles had higher prevalence of obesity and higher mean BMI than women and individuals from other races or in other occupational categories.

DISCUSSION

These results may be helpful in guiding choices about the adoption or design of future worksite and community interventions addressing at-risk ethnically diverse populations and are especially relevant to the hotel industry and similar industries.