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Wang P, Abdin E, Sambasivam R, Chong SA, Vaingankar JA, Subramaniam M. Smoking and Socio-demographic correlates of BMI. BMC Public Health 2016; 16:500. [PMID: 27287474 PMCID: PMC4902908 DOI: 10.1186/s12889-016-3182-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 06/06/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of the current study was to examine the associations between Body Mass Index (BMI) and socio-demographic factors and to examine the relationship between BMI, smoking status and ethnicity. METHODS The Singapore Mental Health Study (SMHS) surveyed Singapore Residents (Singapore Citizens and Permanent Residents) aged 18 years old and above. BMI was calculated using height and weight which were self-reported by respondents. Socio-demographic characteristics and smoking status were recorded in a standardized data collection form. RESULTS Six thousand and six hundred sixteen respondents completed the study (response rate of 75.9 %) which constituted a representative sample of the adult resident population in Singapore. Ethnicity, gender and education status were associated with obesity. There was an interaction effect between ethnicity smoking status, and BMI. Indian and Malay smokers were less likely to be obese compared to Chinese smokers. The relationship between ethnicity and BMI was thus reversed when smoking was taken into account. CONCLUSIONS The study identified certain subgroups and risk factors that are associated with obesity. There is a need for further research to explore and identify genetic, metabolic and ethnic differences that underlie the interaction between ethnicity and smoking status which affects BMI.
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Affiliation(s)
- Peizhi Wang
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Rajeswari Sambasivam
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Janhavi Ajit Vaingankar
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
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Blauw LL, Boon MR, Rosendaal FR, de Mutsert R, Gast KB, van Dijk KW, Rensen PCN, Dekkers OM. Smoking is associated with increased resting energy expenditure in the general population: The NEO study. Metabolism 2015; 64:1548-55. [PMID: 26363529 DOI: 10.1016/j.metabol.2015.08.008] [Citation(s) in RCA: 22] [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: 08/07/2015] [Accepted: 08/13/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Animal studies and human studies in small selected populations have shown a positive association between nicotine smoking and resting energy expenditure (REE), but data in large cohorts are lacking. We aimed to investigate the association between smoking behavior and REE in a large, population-based study. DESIGN Population-based cross-sectional study. METHODS In this cross-sectional analysis of baseline measurements from the Netherlands Epidemiology of Obesity (NEO) study (n=6673), we included participants with REE measurement by indirect calorimetry who were not using lipid or glucose lowering drugs (n=1189). We used linear regression analysis to examine the association of smoking status (never, former, occasional, current smoker) and smoking quantity (pack years) with REE per kilogram (kg) fat free mass (FFM) and with REE adjusted for FFM. Models were adjusted for age, sex, ethnicity, educational level, physical activity, energy intake and body mass index (BMI). RESULTS Mean (standard deviation, SD) age was 55.2 (5.9) years and BMI was 26.3 (4.4) kg/m(2). 60% of the participants were women. Mean (SD) REE/FFM (kcal/day/kg FFM) was for male never smokers 25.1 (2.0), male current smokers 26.4 (2.8), female never smokers 28.9 (2.5) and female current smokers 30.1 (3.7). After adjustment, only current smokers had a higher REE/FFM (mean difference 1.28, 95% CI 0.64, 1.92), and a higher REE adjusted for FFM (mean difference 60.3 kcal/day, 95% CI 29.1, 91.5), compared with never smokers. There was no association between pack years and REE/FFM (mean difference -0.01, 95% CI -0.06, 0.04) or REE adjusted for FFM (mean difference 0.2, 95% CI -2.4, 2.8) in current smokers. CONCLUSION Current smoking is associated with a higher resting energy expenditure compared with never smoking in a large population-based cohort.
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Affiliation(s)
- Lisanne L Blauw
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands; Department of Epidemiology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands.
| | - Mariëtte R Boon
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands; Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands
| | - Frits R Rosendaal
- Department of Epidemiology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands
| | - Renée de Mutsert
- Department of Epidemiology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands
| | - Karin B Gast
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands; Department of Epidemiology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands
| | - Ko Willems van Dijk
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands; Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands; Department of Human Genetics, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands
| | - Patrick C N Rensen
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands; Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands
| | - Olaf M Dekkers
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands; Department of Epidemiology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands; Department of Clinical Epidemiology, Aarhus University, DK-8000 Aarhus C, Denmark
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Mickens L, Ameringer K, Brightman M, Leventhal AM. Epidemiology, determinants, and consequences of cigarette smoking in African American women: an integrative review. Addict Behav 2010; 35:383-91. [PMID: 20061090 DOI: 10.1016/j.addbeh.2009.12.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2009] [Accepted: 12/11/2009] [Indexed: 10/20/2022]
Abstract
Tobacco smoking is a national public health problem that has been associated with numerous adverse health effects, including increased disease and cancer rates. Previous review articles on smoking in specific demographic populations have focused on smoking in women and on smoking in African Americans, but have not considered the dual roles of ethnicity and gender in smoking behavior. African American women (AAW) are an important subgroup to study because they are distinct from non-AAW and their male African American counterparts on biopsychosocial factors that are relevant to smoking behavior. The purpose of the present review paper is to integrate and summarize the current literature on the epidemiology, determinants, and consequences of cigarette smoking among AAW, by contrasting them to relevant comparison groups (non-AAW and African American men). Evidence suggests that AAW are generally more likely to be light smokers and initiate smoking later. The prevalence rates of AAW smokers have decreased over the past 25years, yet AAW are disproportionately affected by several smoking-related illnesses when compared to their ethnic and gender comparison groups. AAW smokers are distinct from relevant comparison groups in metabolic sensitivity to nicotine, aspects of smoking topography, and several psychosocial factors that influence smoking. Although a small literature on smoking in AAW is emerging, further empirical research of AAW smokers could inform the development of tailored interventions for AAW.
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Vanni H, Kazeros A, Wang R, Harvey BG, Ferris B, De BP, Carolan BJ, Hübner RH, O'Connor TP, Crystal RG. Cigarette smoking induces overexpression of a fat-depleting gene AZGP1 in the human. Chest 2009; 135:1197-1208. [PMID: 19188554 DOI: 10.1378/chest.08-1024] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Smokers weigh less and have less body fat than nonsmokers. Increased body fat and weight gain are observed following smoking cessation. To assess a possible molecular mechanism underlying the inverse association between smoking and body weight, we hypothesized that smoking may induce the expression of a fat-depleting gene in the airway epithelium, the cell population that takes the brunt of the stress of cigarette smoke. METHODS To assess whether smoking up-regulates expression in the airway epithelium of genes associated with weight loss, microarray analysis was used to evaluate genes associated with fat depletion in large airway epithelial samples obtained by fiberoptic bronchoscopy from healthy smokers and healthy nonsmokers. As a candidate gene we further evaluated the expression of alpha(2)-zinc-glycoprotein 1 (AZGP1), a soluble protein that stimulates lipolysis, induces a reduction in body fat in mice, is associated with the cachexia related to cancer, and is known to be expressed in secretory cells of lung epithelium. AZGP1 protein expression was assessed by Western analysis and localization in the large airway epithelium by immunohistochemistry. RESULTS Both microarray and TaqMan analysis demonstrated that AZGP1 messenger RNA levels were higher in the large airway epithelium of healthy smokers compared to healthy nonsmokers (p < 0.05, all comparisons). Western analysis of airway biopsy specimens from smokers compared with those from nonsmokers demonstrated up-regulation of AZGP1 at the protein level, and immunohistochemical analysis demonstrated up-regulation of AZGP1 in secretory as well as neuroendocrine cells of smokers. CONCLUSIONS In the context that AZGP1 is involved in lipolysis and fat loss, its overexpression in the airway epithelium of chronic smokers may represent one mechanism for the weight difference in smokers vs nonsmokers.
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Affiliation(s)
- Holly Vanni
- Department of Medicine, Weill Medical College of Cornell University, New York, NY
| | - Angeliki Kazeros
- Department of Medicine, Weill Medical College of Cornell University, New York, NY
| | - Rui Wang
- Division of Pulmonary and Critical Care Medicine, and Genetic Medicine, Weill Medical College of Cornell University, New York, NY
| | - Ben-Gary Harvey
- Department of Medicine, Weill Medical College of Cornell University, New York, NY
| | - Barbara Ferris
- Division of Pulmonary and Critical Care Medicine, and Genetic Medicine, Weill Medical College of Cornell University, New York, NY
| | - Bishnu P De
- Division of Pulmonary and Critical Care Medicine, and Genetic Medicine, Weill Medical College of Cornell University, New York, NY
| | - Brendan J Carolan
- Division of Pulmonary and Critical Care Medicine, and Genetic Medicine, Weill Medical College of Cornell University, New York, NY
| | - Ralf-Harto Hübner
- Division of Pulmonary and Critical Care Medicine, and Genetic Medicine, Weill Medical College of Cornell University, New York, NY
| | - Timothy P O'Connor
- Division of Pulmonary and Critical Care Medicine, and Genetic Medicine, Weill Medical College of Cornell University, New York, NY
| | - Ronald G Crystal
- Division of Pulmonary and Critical Care Medicine, and Genetic Medicine, Weill Medical College of Cornell University, New York, NY.
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Bowers K, Albanes D, Limburg P, Pietinen P, Taylor PR, Virtamo J, Stolzenberg-Solomon R. A prospective study of anthropometric and clinical measurements associated with insulin resistance syndrome and colorectal cancer in male smokers. Am J Epidemiol 2006; 164:652-64. [PMID: 16877536 DOI: 10.1093/aje/kwj253] [Citation(s) in RCA: 103] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Type 2 diabetes mellitus shares risk factors for and has shown a positive association with colorectal cancer. Anthropometric measures (height, weight, and body mass index (weight (kg)/height (m)(2)) and metabolic abnormalities associated with insulin resistance syndrome (IRS) (abnormalities in measured blood pressure, high density lipoprotein (HDL) cholesterol, and total cholesterol) were prospectively evaluated for associations with incident colon (n = 227), rectal (n = 183), and colorectal (n = 410) cancers diagnosed between 1985 and 2002 in 28,983 Finnish male smokers from the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. Cox proportional hazards models were used to calculate hazard ratios and 95% confidence intervals. In comparison with the lowest quintile, the highest quintile of body mass index was significantly associated with colorectal cancer (hazard ratio (HR) = 1.70, 95% confidence interval (CI): 1.01, 2.85; p-trend = 0.01), particularly colon cancer. Subjects with a cluster of three IRS-related conditions (hypertension, body mass index >/=25 kg/m(2), and HDL cholesterol level <40 mg/dl (<1.55 mmol/liter)), compared with those with fewer conditions, had a significantly increased risk of colorectal cancer (HR = 1.40, 95% CI: 1.12, 1.74), particularly colon cancer (HR = 1.58, 95% CI: 1.18, 2.10), but not rectal cancer. These results support the hypothesis that the significant association observed between IRS-defining metabolic abnormalities and colorectal cancer is determined primarily by adiposity.
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Affiliation(s)
- Katherine Bowers
- Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
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Agarwal R. Smoking, oxidative stress and inflammation: impact on resting energy expenditure in diabetic nephropathy. BMC Nephrol 2005; 6:13. [PMID: 16303055 PMCID: PMC1308817 DOI: 10.1186/1471-2369-6-13] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2005] [Accepted: 11/22/2005] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Inflammation is associated with increased resting energy expenditure (REE) in patients with chronic kidney disease. Oxidative stress, on the other hand, appears not to increase REE. Smoking is a common mechanism for generating oxidative stress and inflammation. Whether smokers have increased REE and if so, whether it is accounted for by the pro-oxidant and inflammatory state is not known. METHODS A case control study of 11 smokers and 24 non-smokers with overt diabetic nephropathy was performed to evaluate the chronic effect of smoking on REE. REE (indirect calorimetry), glomerular filtration rate (iothalamate clearance), markers of oxidative stress (urinary and plasma malondialdehyde (MDA), and protein carbonyls) and inflammation (C-reactive protein, tumor necrosis factor-alpha, interleukin-6) were measured on two occasions four months apart. RESULTS Biomarkers of inflammation (C-reactive protein) and oxidative stress (urinary and plasma MDA) were increased in smokers. REE was increased in smokers, 24.3 kcal/kg/day compared to 21 kcal/kg/day (p = 0.009) in non-smokers. After adjusting for age, GFR, MDA, C-reactive protein, and hemoglobin A1C the difference in REE between the two groups persisted (adjusted difference 3.51 kcal/kg/d, 95% confidence interval 0.59-6.45, p = 0.020). CONCLUSION Patients with overt diabetic nephropathy who smoke have a higher REE, oxidative and inflammatory state. Elevated REE is not attributable to heightened oxidative stress and inflammatory state. Smoking is an independent risk factor for elevated REE in patients with diabetic nephropathy and provides an additional mechanism by which it may lead to poor outcomes.
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Affiliation(s)
- Rajiv Agarwal
- Department of Medicine, Indiana University, RLR VA Medical Center, Indianapolis, Indiana, USA.
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Van Wymelbeke V, Brondel L, Marcel Brun J, Rigaud D. Factors associated with the increase in resting energy expenditure during refeeding in malnourished anorexia nervosa patients. Am J Clin Nutr 2004; 80:1469-77. [PMID: 15585757 DOI: 10.1093/ajcn/80.6.1469] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND In malnourished anorexia nervosa (AN) patients, body-weight gain during refeeding is slowed by an increase in resting energy expenditure (REE). OBJECTIVE The objective of the study was to identify factors associated with the increase in REE during refeeding. DESIGN Before and 8, 30, and 45 d after the beginning of refeeding, REE was studied by indirect calorimetry in 87 female AN patients [x +/- SD age: 23.4 +/- 7.9 y; body mass index (in kg/m2) 13.2 +/- 1.3]. Energy intake, body composition (by bioelectrical impedance analysis), physical activity, smoking behavior, abdominal pain, anxiety, depressive mood, serum thyrotropin and thyroid hormone, and urinary catecholamines were measured. REE was also evaluated in 18 patients after 1 y of recovery. RESULTS By day 8, REE increased from 3.84 +/- 0.6 to 4.36 +/- 0.59 MJ/d (P < 0.01). This increase (13.4%) was significantly (P <0.01) greater than that expected on the basis of the increase in fat-free mass (FFM; 1.6%). Thereafter, the ratio of REE to FFM remained high and, in multivariate analysis, was significantly related to 4 factors: energy intake (P <0.01), anxiety (P <0.01), abdominal pain (P <0.05), and depressive mood (P <0.05). The ratio also increased significantly with physical activity (P <0.01) and cigarette smoking (P <0.02). This rise in REE leveled off after recovery from AN. CONCLUSION In AN patients, the rise in REE observed during refeeding was independently linked to anxiety level, abdominal pain, physical activity, and cigarette smoking, and it contributed to resistance to weight gain.
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Affiliation(s)
- Virginie Van Wymelbeke
- Centre Européen des Sciences du Goût, Medical Research Unit-National Center of Scientific Research 5170, Dijon, France
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