1
|
Jakob J, Schwerdtel F, Sidney S, Rodondi N, Pletcher MJ, Reis JP, Muniyappa R, Clair C, Tal K, Bancks MP, Rana JS, Collet TH, Auer R. Associations of cannabis use and body mass index-The Coronary Artery Risk Development in Young Adults (CARDIA) study. Eur J Intern Med 2024:S0953-6205(24)00289-9. [PMID: 38987097 DOI: 10.1016/j.ejim.2024.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 07/03/2024] [Accepted: 07/05/2024] [Indexed: 07/12/2024]
Abstract
BACKGROUND With increasing use of cannabis, we need to know if cannabis use and Body Mass Index (BMI) are associated. METHODS The Coronary Artery Risk Development in Young Adults Study followed Black and White adults over 30 years with assessments every 2 to 5 years in four centers in the USA. We assessed self-reported current and computed cumulative cannabis exposure at every visit, and studied associations with BMI, adjusted for relevant covariables in mixed longitudinal models. We also applied marginal structural models (MSM) accounting for the probability of having stopped cannabis over the last 5 years. RESULTS At the Year 30 visit, 1,912 (58 %) identified as women and 1,600 (48 %) as Black, mean age was 56 (SD 2) years. While 2,849 (85 %) had ever used cannabis, 479 (14 %) currently used cannabis. Overall, participants contributed to 35,882 individual visits over 30 years. In multivariable adjusted models, mean BMI was significantly lower in daily cannabis users (26.6 kg/m2, 95 %CI 26.3 to 27.0) than in participants without current use (27.7 kg/m2, 95 %CI 27.5 to 27.9, p < 0.001). Cumulative cannabis use was not associated with BMI. The MSM showed no change in BMI when stopping cannabis use over a 5-year period (β=0.2 kg/m2 total, 95 %CI -0.2 to 0.6). CONCLUSIONS Current cannabis use was associated with lower BMI, but cumulative cannabis use and cessation were not. This suggests that recreational cannabis use may not lead to clinically relevant changes in BMI and that the association between current cannabis use and lower BMI is likely due to residual confounding.
Collapse
Affiliation(s)
- Julian Jakob
- Institute of Primary Health Care (BIHAM), University of Bern, Mittelstrasse 43, Bern 3012, Switzerland; Department of Paediatrics, University Hospital Bern, Inselspital, Bern, Switzerland.
| | - Fiona Schwerdtel
- Institute of Primary Health Care (BIHAM), University of Bern, Mittelstrasse 43, Bern 3012, Switzerland
| | - Steve Sidney
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Nicolas Rodondi
- Institute of Primary Health Care (BIHAM), University of Bern, Mittelstrasse 43, Bern 3012, Switzerland; Department of General Internal Medicine, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Mark J Pletcher
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA; Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Jared P Reis
- National Heart, Lung, and Blood Institute, Bethesda, USA
| | - Ranganath Muniyappa
- Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, USA
| | - Carole Clair
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Kali Tal
- Institute of Primary Health Care (BIHAM), University of Bern, Mittelstrasse 43, Bern 3012, Switzerland
| | - Michael P Bancks
- Department of Epidemiology & Prevention, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Jamal S Rana
- Department of Cardiology, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Tinh-Hai Collet
- Service of Endocrinology, Diabetology, Nutrition and Therapeutic Education, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland; Diabetes Centre, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Reto Auer
- Institute of Primary Health Care (BIHAM), University of Bern, Mittelstrasse 43, Bern 3012, Switzerland; Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| |
Collapse
|
2
|
Saintila J, Ruiz Mamani PG, Ramos-Vera C, Serpa-Barrientos A, Oblitas-Guerrero SM, Lizarraga-De-Maguiña IG, Calizaya-Milla YE. Intake of foods high in saturated fats, vegetarian dietary pattern, and sociodemographic characteristics associated with body weight in Peruvian university students. Front Nutr 2024; 11:1361091. [PMID: 38571749 PMCID: PMC10987770 DOI: 10.3389/fnut.2024.1361091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Accepted: 03/11/2024] [Indexed: 04/05/2024] Open
Abstract
Background The prevalence of obesity continues to increase among university students and the general population. Consumption of a diet high in saturated fats could be one of the risk factors. Objective The consumption of foods high in saturated fats, the vegetarian diet pattern, and sociodemographic characteristics associated with excess body weight (overweight/obesity) were evaluated in Peruvian university students. Methods A cross-sectional study was carried out selecting 5,608 Peruvian university students through no probabilistic convenience sampling. The survey was carried out during the months of February and April 2022. The Chi-square test and binary logistic regression analysis were used to evaluate the association between diet (saturated fats intake and dietary pattern) and sociodemographic factors with excess body weight in a cross-sectional analysis. Results It was observed that students who reported high consumption of foods high in saturated fats (ORB = 1.14) and those who had a non-vegetarian dietary pattern (ORB = 2.76) were found to be more likely to have excess body weight. On the contrary, students who reported adherence to the vegetarian diet pattern for more than 5 years were less likely to be overweight or obese (ORB = 0.84). Being ≥26 years of age (ORB = 3.28), living in urban areas (ORB = 1.68) and coastal areas of the country (ORB = 1.17), and enrolled in the engineering faculty (ORB = 1.19), were significantly associated with excess body weight. Conclusion The findings of the current study evidenced several factors associated with excess body weight in university students. Therefore, it is necessary to promote and implement healthy lifestyle programs, considering sociodemographic and dietary aspects such as age and dietary intake to control and prevent obesity in university students.
Collapse
|
3
|
Witkam R, Gwinnutt JM, Humphreys J, Gandrup J, Cooper R, Verstappen SM. Do associations between education and obesity vary depending on the measure of obesity used? A systematic literature review and meta-analysis. SSM Popul Health 2021; 15:100884. [PMID: 34401462 PMCID: PMC8350379 DOI: 10.1016/j.ssmph.2021.100884] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 07/26/2021] [Accepted: 07/26/2021] [Indexed: 01/22/2023] Open
Abstract
Background Consistent evidence suggests a relationship between lower educational attainment and total obesity defined using body mass index (BMI); however, a comparison of the relationships between educational attainment and total obesity (BMI ≥30 kg/m2) and central obesity (waist circumference (WC) > 102 cm for men and WC > 88 cm for women) has yet to be carried out. This systematic literature review (SLR) and meta-analyses aimed to understand whether i) the associations between education and obesity are different depending on the measures of obesity used (BMI and WC), and ii) to explore whether these relationships differ by gender and region. Methods Medline, Embase and Web of Science were searched to identify studies investigating the associations between education and total and central obesity among adults in the general population of countries in the Organisation for Economic Co-operation and Development (OECD). Meta-analyses and meta-regression were performed in a subset of comparable studies (n=36 studies; 724,992 participants). Results 86 eligible studies (78 cross-sectional and eight longitudinal) were identified. Among women, most studies reported an association between a lower education and total and central obesity. Among men, there was a weaker association between lower education and central than total obesity (OR central vs total obesity in men 0.79 (95% CI 0.60, 1.03)). The association between lower education and obesity was stronger in women compared with men (OR women vs men 1.66 (95% CI 1.32, 2.08)). The relationship between lower education and obesity was less strong in women from Northern than Southern Europe (OR Northern vs Southern Europe in women 0.37 (95% CI 0.27, 0.51)), but not among men. Conclusions Associations between education and obesity differ depending on whether total or central obesity is used among men, but not in women. These associations are stronger among women than men, particularly in Southern European countries.
Collapse
Affiliation(s)
- Rozemarijn Witkam
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, The University of Manchester, UK
| | - James M. Gwinnutt
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, The University of Manchester, UK
| | - Jennifer Humphreys
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, The University of Manchester, UK
- NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, UK
| | - Julie Gandrup
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, The University of Manchester, UK
| | - Rachel Cooper
- Department of Sport and Exercise Sciences, Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, UK
| | - Suzanne M.M. Verstappen
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, The University of Manchester, UK
- NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, UK
- Corresponding author. Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
| |
Collapse
|
4
|
Simo LP, Agbor VN, Temgoua FZ, Fozeu LCF, Bonghaseh DT, Mbonda AGN, Yurika R, Dotse-Gborgbortsi W, Mbanya D. Prevalence and factors associated with overweight and obesity in selected health areas in a rural health district in Cameroon: a cross-sectional analysis. BMC Public Health 2021; 21:475. [PMID: 33691650 PMCID: PMC7944596 DOI: 10.1186/s12889-021-10403-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 02/07/2021] [Indexed: 12/28/2022] Open
Abstract
Background Overweight and obesity are major public health problems worldwide, with projections suggesting a proportional increase in the number of affected individuals in developing countries by the year 2030. Evidence-based preventive strategies are needed to reduce the burden of overweight and obesity in developing countries. We assessed the prevalence of, and factors associated with overweight and obesity in selected health areas in West Cameroon. Methods Data were collected from a community-based cross-sectional study, involving the consecutive recruitment of participants aged 18 years or older. Overweight and obesity were defined according to the WHO classification. The statistical software R (version 3.5.1, The R Foundation for statistical computing, Vienna, Austria) was used for statistical analysis. Multivariable logistic regression analysis was used to assess independent factors associated with overweight and obesity, and obesity. Results Records of 485 participants were included for analysis. The age and sex-standardized prevalence of overweight, obesity, and overweight and obesity were 31.1% (95% CI, 27.0–35.2), 18.9% (95% CI, 14.9–22.9), and 50.1% (95% CI, 45.7–54.6), respectively. In multivariable analysis, being female (adjusted OR [aOR] = 2.79, 95% CI = 1.69–4.63), married (aOR = 3.90, 95% CI = 2.23–6.95), and having secondary or tertiary education (aOR = 3.27, 95% CI = 1.77–6.17) were associated with higher odds of overweight and obesity, while current smokers had lower odds of overweight and obesity (aOR = 0.37, 95% CI = 0.16–0.82) when compared to their respective counterpart. Compared to their respective reference categories, being female being (aOR = 3.74, 95% CI = 2.01–7.30), married (aOR = 2.58, 95% CI = 1.37–5.05) and having secondary or tertiary education (aOR = 2.03, 95% CI = 1.00–4.23) were associated with higher odds of obesity after adjustments for confounding. Conclusion We observed a high prevalence of overweight and obesity in this study. The odds of overweight and obesity was higher in females, married participants, and those with higher levels of education. Community-based interventions to control overweight and obesity should consider targeting these groups. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10403-w.
Collapse
Affiliation(s)
- Larissa Pone Simo
- Clinical Research Education, Networking & Consultancy (CRENC), Douala, Cameroon
| | - Valirie Ndip Agbor
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK. .,Department of Clinical Research, Health Education and Research Organization (HERO), Douala, Cameroon.
| | | | | | | | | | - Raymond Yurika
- Technical Group for Tuberculosis Control, North West Regional Delegation of Public Health, Bamenda, Cameroon
| | - Winfred Dotse-Gborgbortsi
- School of Geography and Environmental Science, Highfield, University of Southampton, Southampton, SO17 1BJ, UK
| | - Dora Mbanya
- Faculty of Health Sciences, the University of Bamenda, Bamenda, Cameroon.,Yaoundé University Teaching Hospital (YUTH), Yaoundé, Cameroon
| |
Collapse
|
5
|
Anthamatten P, Thomas DSK, Williford D, Barrow JC, Bol KA, Davidson AJ, Deakyne Davies SJ, Kraus EM, Tabano DC, Daley MF. Geospatial Monitoring of Body Mass Index: Use of Electronic Health Record Data Across Health Care Systems. Public Health Rep 2020; 135:211-219. [PMID: 32053469 DOI: 10.1177/0033354920904078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES The Colorado BMI Monitoring System was developed to assess geographic (ie, census tract) patterns of obesity prevalence rates among children and adults in the Denver-metropolitan region. This project also sought to assess the feasibility of a surveillance system that integrates data across multiple health care and governmental organizations. MATERIALS AND METHODS We extracted data on height and weight measures, obtained through routine clinical care, from electronic health records (EHRs) at multiple health care sites. We selected sites from 5 Denver health care systems and collected data from visits that occurred between January 1, 2013, and December 31, 2015. We produced shaded maps showing observed obesity prevalence rates by census tract for various geographic regions across the Denver-metropolitan region. RESULTS We identified clearly distinguishable areas by higher rates of obesity among children than among adults, with several pockets of lower body mass index. Patterns for adults were similar to patterns for children: the highest obesity prevalence rates were concentrated around the central part of the metropolitan region. Obesity prevalence rates were moderately higher along the western and northern areas than in other parts of the study region. PRACTICE IMPLICATIONS The Colorado BMI Monitoring System demonstrates the feasibility of combining EHRs across multiple systems for public health and research. Challenges include ensuring de-duplication across organizations and ensuring that geocoding is performed in a consistent way that does not pose a risk for patient privacy.
Collapse
Affiliation(s)
- Peter Anthamatten
- Department of Geography and Environmental Sciences, University of Colorado Denver, Denver, CO, USA
| | - Deborah S K Thomas
- Department of Geography and Environmental Sciences, University of Colorado Denver, Denver, CO, USA
| | - Devon Williford
- Center for Health and Environment Data, Colorado Department of Public Health and Environment, Denver, CO, USA
| | - Jennifer C Barrow
- Institute for Health Research, Kaiser Permanente Colorado, Denver, CO, USA
| | - Kirk A Bol
- Center for Health and Environment Data, Colorado Department of Public Health and Environment, Denver, CO, USA
| | | | - Sara J Deakyne Davies
- Research Informatics, Analytics Resource Center, Children's Hospital Colorado, Aurora, CO, USA
| | | | - David C Tabano
- Institute for Health Research, Kaiser Permanente Colorado, Denver, CO, USA
| | - Matthew F Daley
- Institute for Health Research, Kaiser Permanente Colorado, Denver, CO, USA.,Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
| |
Collapse
|
6
|
Chung W, Lim SJ, Lee S, Kim R, Kim J. Gender-specific interactions between education and income in relation to obesity: a cross-sectional analysis of the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V). BMJ Open 2017; 7:e014276. [PMID: 29288171 PMCID: PMC5770831 DOI: 10.1136/bmjopen-2016-014276] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES To identify gender-specific associations between education and income in relation to obesity in developed countries by considering both the interaction-effect terms of the independent variables and their main-effect terms. DESIGN A cross-sectional study. Education and income levels were chosen as socioeconomic status indicators. Sociodemographics, lifestyles and medical conditions were used as covariates in multivariable logistic regression models. Adjusted ORs and predicted probabilities of being obese were computed and adjusted for a complex survey design. SETTING Data were obtained from the Fifth Korea National Health and Nutrition Examination Survey (2010-2012). PARTICIPANTS The sample included 7337 male and 9908 female participants aged ≥19 years. OUTCOME MEASURE Obesity was defined as body mass index of ≥25, according to a guideline for Asians. RESULTS In models with no interaction-effect terms of independent variables, education was significantly associated with obesity in both men and women, but income was significant only in women. However, in models with the interaction-effect terms, education was significant only in women, but income was significant only in men. The interaction effect between income and education was significant in men but not in women. Participants having the highest predicted probability of being obese over educational and income levels differed between the two types of models, and between men and women. A prediction using the models with the interaction-effect terms demonstrated that for all men, the highest level of formal education was associated with an increase in their probability of being obese by as much as 26%. CONCLUSIONS The well-known, negative association between socioeconomic status and obesity in developed countries may not be valid when interaction effects are included. Ignoring these effects and their gender differences may result in the targeting of wrong populations for reducing obesity prevalence and its resultant socioeconomic gradients.
Collapse
Affiliation(s)
- Woojin Chung
- Department of Health Policy, Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Seung-Ji Lim
- Health Insurance Policy Research Institute, National Health Insurance Service, Wonju, Republic of Korea
| | - Sunmi Lee
- Health Insurance Policy Research Institute, National Health Insurance Service, Wonju, Republic of Korea
| | - Roeul Kim
- Labor Welfare Research Institute, Korea Worker's Compensation and Welfare Service, Seoul, Republic of Korea
| | - Jaeyeun Kim
- Health Insurance Policy Research Institute, National Health Insurance Service, Wonju, Republic of Korea
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
| |
Collapse
|
7
|
Hartmann B, Lanzinger S, Bramlage P, Groß F, Danne T, Wagner S, Krakow D, Zimmermann A, Malcharzik C, Holl RW. Lean diabetes in middle-aged adults: A joint analysis of the German DIVE and DPV registries. PLoS One 2017; 12:e0183235. [PMID: 28827839 PMCID: PMC5565180 DOI: 10.1371/journal.pone.0183235] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Accepted: 08/01/2017] [Indexed: 12/29/2022] Open
Abstract
AIMS To assess differences in demographics, treatment and outcome of lean (LD) compared to overweight and obese people with diabetes clinically classified as type 2 diabetes mellitus (T2DM). MATERIALS AND METHODS We combined data from the German DIVE (Diabetes Versorgungs-Evaluation) and DPV (Diabetes-Patienten-Verlaufsdokumentation) databases to produce a large cohort of people with T2DM. The characteristics of people with Body Mass Index (BMI) <25 kg/m2, ≥25-30 kg/m2 and ≥30 kg/m2 aged 30 to 50 years were compared, including demographics, cardiovascular (CV) risk factors, comorbidities and outcomes. RESULTS A total of 37,870 people were included in the analysis, 3,191 of these (8.4%) had a BMI < 25 kg/m2. LD reported more nicotine (41.6% of 2,070 vs. 38.1% of 6,070 and 33.4% of 16,823; P<0.001)and alcohol consumption (12.0% of 1,282, 10.3% of 3,594 and 6.6% of 9,418; P<0.001)compared to overweight and obese people. More LD were treated with insulin in comparison to the other subgroups (short acting insulin 33.1% of 3,191 vs. 28.4% of 9,234 and 28.0% of 25,445; P <0.001; long acting insulin 31.3% of 3,191 vs. 28.9% of 9,234 and 29.3% of 25,445; P = 0.043). Regression models adjusted for age, gender and diabetes duration showed a 2.50 times higher odds ratio (OR) for hypoglycemia and a 2.52 higher OR for mortality in LD compared to the BMI subgroup ≥30 kg/m2. CONCLUSIONS LD is associated with an increased risk of hypoglycaemia and death. Patients are characterized by male gender, lifestyle habits as smoking and alcohol consumption while cardiovascular comorbidities are less important. In comparison to patients of the other weight groups they are treated with insulin more often and considerably less with metformin.
Collapse
Affiliation(s)
- Bettina Hartmann
- Department of Gastroenterology and Diabetology, Klinikum Ludwigshafen, Ludwigshafen, Germany
| | - Stefanie Lanzinger
- Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Peter Bramlage
- Institute for Pharmacology and Preventive Medicine, Mahlow, Germany
| | | | - Thomas Danne
- Diabeteszentrum für Kinder und Jugendliche, Kinderkrankenhaus auf der Bult, Hannover, Germany
| | - Siegfried Wagner
- Department of Internal Medicine II, DONAUISAR Klinikum, Deggendorf, Germany
| | | | - Artur Zimmermann
- Praxis Dr. Zimmermann- Diabeteszentrum Bad Aibling, Bad Aibling, Germany
| | | | - Reinhard W. Holl
- Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| |
Collapse
|
8
|
Liao C, Gao W, Cao W, Lv J, Yu C, Wang S, Zhou B, Pang Z, Cong L, Dong Z, Wu F, Wang H, Wu X, Jiang G, Wang X, Wang B, Li L. The association of cigarette smoking and alcohol drinking with body mass index: a cross-sectional, population-based study among Chinese adult male twins. BMC Public Health 2016; 16:311. [PMID: 27068329 PMCID: PMC4827244 DOI: 10.1186/s12889-016-2967-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 03/17/2016] [Indexed: 01/10/2023] Open
Abstract
Background Obesity is a multifactorial abnormality which has an underlying genetic control but requires environmental influences to trigger. Numerous epidemiological studies have examined the roles of physical inactivity and dietary factors in obesity development. Interactions between obesity-related genes and these lifestyles have also been confirmed. However, less attention has been paid to these complex relationship between cigarette smoking, alcohol drinking and obesity. The purpose of this study was to assess whether cigarette smoking and alcohol drinking were associated with body mass index (BMI), and whether these lifestyle factors modified the genetic variance of BMI. Methods Subjects were twins recruited through the Chinese National Twin Registry, aged 18 to 79 years, and the sample comprised 6121 complete male twin pairs. Information on height, weight, cigarette smoking and alcohol drinking status were assessed with self-report questionnaires. The associations of cigarette smoking and alcohol drinking with BMI were evaluated by linear regression models. Further, structure equation models were conducted to estimate whether cigarette smoking and alcohol drinking status modified the degree of genetic variance of BMI. Results After adjustment for a variety of socio-demographic and lifestyle factors, former smokers had higher BMI (β = 0.475; 95 % CI, 0.196 to 0.754) whereas moderate to heavy smokers had lower BMI (β = −0.115; 95 % CI, −0.223 to −0.007) when compared with nonsmokers. BMI decreased with increased cigarette pack-years (β = −0.008; 95 % CI, −0.013 to −0.003). These effects still existed substantially in within-MZ twin pair analyses. By contrast, current alcohol drinking had no significant influence on BMI when additionally controlled for shared factors in within-pair analyses. Genetic modification by alcohol drinking was statistically significant for BMI (β = −0.137; 95 % CI, −0.215 to −0.058), with the intake of alcohol decreasing the additive genetic component of BMI. Conclusions Cigarette smoking was negatively associated with BMI independent of genetic influences. The influence of genes on BMI was moderated by alcohol drinking, such that for individuals who were regular drinkers, genetic factors became less influential. Our findings highlight gene-alcohol interaction in finding candidate genes of BMI and elucidating the etiological factors of obesity.
Collapse
Affiliation(s)
- Chunxiao Liao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, China
| | - Wenjing Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, China.
| | - Weihua Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, China
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, China
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, China
| | - Shengfeng Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, China
| | - Bin Zhou
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, China
| | - Zengchang Pang
- Qingdao Center for Diseases Control and Prevention, Qingdao, 266033, China
| | - Liming Cong
- Zhejiang Center for Disease Control and Prevention, Hangzhou, 310051, China
| | - Zhong Dong
- Beijing Center for Disease Control and Prevention, Beijing, 100013, China
| | - Fan Wu
- Shanghai Center for Disease Control and Prevention, Shanghai, 200336, China
| | - Hua Wang
- Jiangsu Center for Disease Control and Prevention, Nanjing, 210009, China
| | - Xianping Wu
- Sichuan Center for Disease Control and Prevention, Chengdu, 610041, China
| | - Guohong Jiang
- Tianjin Center for Disease Control and Prevention, Tianjin, 300011, China
| | - Xiaojie Wang
- Qinghai Center for Disease Control and Prevention, Xining, 810007, China
| | - Binyou Wang
- Harbin Medical University, Harbin, 150081, China
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, China.
| |
Collapse
|
9
|
Wasfi RA, Dasgupta K, Orpana H, Ross NA. Neighborhood Walkability and Body Mass Index Trajectories: Longitudinal Study of Canadians. Am J Public Health 2016; 106:934-40. [PMID: 26985612 DOI: 10.2105/ajph.2016.303096] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To assess the impact of neighborhood walkability on body mass index (BMI) trajectories of urban Canadians. METHODS Data are from Canada's National Population Health Survey (n = 2935; biannual assessments 1994-2006). We measured walkability with the Walk Score. We modeled body mass index (BMI, defined as weight in kilograms divided by the square of height in meters [kg/m(2)]) trajectories as a function of Walk Score and sociodemographic and behavioral covariates with growth curve models and fixed-effects regression models. RESULTS In men, BMI increased annually by an average of 0.13 kg/m(2) (95% confidence interval [CI] = 0.11, 0.14) over the 12 years of follow-up. Moving to a high-walkable neighborhood (2 or more Walk Score quartiles higher) decreased BMI trajectories for men by approximately 1 kg/m(2) (95% CI = -1.16, -0.17). Moving to a low-walkable neighborhood increased BMI for men by approximately 0.45 kg/m(2) (95% CI = 0.01, 0.89). There was no detectable influence of neighborhood walkability on body weight for women. CONCLUSIONS Our study of a large sample of urban Canadians followed for 12 years confirms that neighborhood walkability influences BMI trajectories for men, and may be influential in curtailing male age-related weight gain.
Collapse
Affiliation(s)
- Rania A Wasfi
- Rania A. Wasfi is with the Department of Geography, McGill University, Montreal, Quebec. Kaberi Dasgupta is with the Department of Medicine, Division of Internal Medicine, Clinical Epidemiology, and Endocrinology and Metabolism, McGill University. Heather Orpana is with the School of Psychology, University of Ottawa, Ottawa, Ontario. Nancy A. Ross is with the Department of Geography and Department of Epidemiology and Biostatistics, McGill University
| | - Kaberi Dasgupta
- Rania A. Wasfi is with the Department of Geography, McGill University, Montreal, Quebec. Kaberi Dasgupta is with the Department of Medicine, Division of Internal Medicine, Clinical Epidemiology, and Endocrinology and Metabolism, McGill University. Heather Orpana is with the School of Psychology, University of Ottawa, Ottawa, Ontario. Nancy A. Ross is with the Department of Geography and Department of Epidemiology and Biostatistics, McGill University
| | - Heather Orpana
- Rania A. Wasfi is with the Department of Geography, McGill University, Montreal, Quebec. Kaberi Dasgupta is with the Department of Medicine, Division of Internal Medicine, Clinical Epidemiology, and Endocrinology and Metabolism, McGill University. Heather Orpana is with the School of Psychology, University of Ottawa, Ottawa, Ontario. Nancy A. Ross is with the Department of Geography and Department of Epidemiology and Biostatistics, McGill University
| | - Nancy A Ross
- Rania A. Wasfi is with the Department of Geography, McGill University, Montreal, Quebec. Kaberi Dasgupta is with the Department of Medicine, Division of Internal Medicine, Clinical Epidemiology, and Endocrinology and Metabolism, McGill University. Heather Orpana is with the School of Psychology, University of Ottawa, Ottawa, Ontario. Nancy A. Ross is with the Department of Geography and Department of Epidemiology and Biostatistics, McGill University
| |
Collapse
|
10
|
Won KB, Chang HJ, Niinuma H, Niwa K, Jeon K, Cho IJ, Shim CY, Hong GR, Chung N. Inverse association between central obesity and arterial stiffness in Korean subjects with metabolic syndrome: a cross-sectional cohort study. Diabetol Metab Syndr 2015; 7:3. [PMID: 25810782 PMCID: PMC4373323 DOI: 10.1186/1758-5996-7-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 01/09/2015] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) is associated with increased risks of diabetes and atherosclerotic cardiovascular disease. Whether central obesity (CeO) is a prerequisite for the diagnosis of MetS in the International Diabetes Federation (IDF) definition is a substantial issue because it may influence the clinical value of MetS for predicting subclinical atherosclerosis. METHODS We investigated the relation between MetS, as defined by the National Cholesterol Education Program-Adult Treatment Panel (NCEP-ATP) III criteria, and arterial stiffness according to CeO status in 2,560 healthy Korean subjects who participated in a community-based cohort study. Arterial stiffness was measured using brachial-ankle pulse wave velocity (baPWV). RESULTS The prevalence of MetS was 37%; 84% of MetS subjects had CeO. The prevalence of diabetes was significantly higher in MetS subjects than in non-MetS subjects (30 vs. 8%, p <0.001). The number of MetS components was significantly correlated with baPWV (r = 0.311, p <0.001). In a subgroup analysis of MetS subjects, the prevalence of diabetes was not significantly different in MetS subjects with and without CeO. MetS subjects without CeO had significantly higher baPWV than those with CeO (1654 ± 315 vs. 1578 ± 270 cm/s, p = 0.002). Multiple regression models revealed that waist circumference was independently associated with decreased baPWV in MetS subjects. CONCLUSIONS Despite the significant correlation between the number of MetS components and arterial stiffness, there appeared to be an inverse association between CeO and arterial stiffness in MetS subjects. In contrast to the IDF definition, our findings suggest that CeO is not crucial for the diagnosis of MetS in otherwise healthy Koreans having multiple metabolic risk factors with respect to subclinical atherosclerosis reflected in arterial stiffness.
Collapse
Affiliation(s)
- Ki-Bum Won
- />Division of Cardiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemungu, Seoul, 120-752 Republic of Korea
- />Division of Cardiology, St. Luke’s International Hospital, Tokyo, Japan
| | - Hyuk-Jae Chang
- />Division of Cardiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemungu, Seoul, 120-752 Republic of Korea
- />Severance Biomedical Science Institute, Seoul, Republic of Korea
| | - Hiroyuki Niinuma
- />Division of Cardiology, St. Luke’s International Hospital, Tokyo, Japan
| | - Koichiro Niwa
- />Division of Cardiology, St. Luke’s International Hospital, Tokyo, Japan
| | - Kyewon Jeon
- />Severance Biomedical Science Institute, Seoul, Republic of Korea
| | - In-Jeong Cho
- />Division of Cardiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemungu, Seoul, 120-752 Republic of Korea
| | - Chi-Young Shim
- />Division of Cardiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemungu, Seoul, 120-752 Republic of Korea
| | - Geu-Ru Hong
- />Division of Cardiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemungu, Seoul, 120-752 Republic of Korea
| | - Namsik Chung
- />Division of Cardiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemungu, Seoul, 120-752 Republic of Korea
| |
Collapse
|
11
|
Hajizadeh M, Campbell MK, Sarma S. Socioeconomic inequalities in adult obesity risk in Canada: trends and decomposition analyses. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2014; 15:203-221. [PMID: 23543117 DOI: 10.1007/s10198-013-0469-0] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2012] [Accepted: 02/20/2013] [Indexed: 06/02/2023]
Abstract
This study examines trends in socioeconomic-related inequalities in obesity risk among Canadian adults (aged 18-65 years) from 2000 to 2010 using five nationally representative Canadian Community Health Surveys (CCHSs). We employed the concentration index (C) to quantify the socioeconomic inequalities in obesity risk across different demographic groups and geographic regions in each survey period. A decomposition analysis of inequality is performed to determine factors that lie behind income-related inequality in obesity risk. Although declining over time, the results show that there exists income-related inequality in obesity risk in Canada. The estimated Cs for men indicate that obesity is concentrated among the rich and its trend is increasing over time. The findings, however, suggest that obesity is more prevalent among economically disadvantaged women. While we found that obesity is mainly concentrated among the poor in the Atlantic Provinces, the degree of socioeconomic related inequality in obesity risk is increasing in these provinces. The results for Alberta showed that obesity is concentrated among the better-off individuals. The decomposition analysis suggests that factors such as demographics, income, immigration, education, drinking habits, and physical activity are the key factors explaining income-related inequality in obesity risk in Canada. Our empirical findings suggest that, in order to combat the obesity epidemic, health policies should focus on poorer females and economically well-off males.
Collapse
Affiliation(s)
- Mohammad Hajizadeh
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, N6A 5C1, Canada,
| | | | | |
Collapse
|
12
|
Sundararajan K, Campbell MK, Choi YH, Sarma S. The Relationship Between Diet Quality and Adult Obesity: Evidence from Canada. J Am Coll Nutr 2014; 33:1-17. [DOI: 10.1080/07315724.2013.848157] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
13
|
Duncan P, Howe L, Manukusa Z, Purdy S. Determinants of obesity and perception of weight in hypertensive patients in rural South Africa. SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2014. [DOI: 10.1080/16070658.2014.11734488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
14
|
Cohen AK, Rai M, Rehkopf DH, Abrams B. Educational attainment and obesity: a systematic review. Obes Rev 2013; 14:989-1005. [PMID: 23889851 PMCID: PMC3902051 DOI: 10.1111/obr.12062] [Citation(s) in RCA: 258] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Revised: 05/14/2013] [Accepted: 05/28/2013] [Indexed: 01/17/2023]
Abstract
Although previous systematic reviews considered the relationship between socioeconomic status and obesity, almost 200 peer-reviewed articles have been published since the last review on that topic, and this paper focuses specifically on education, which has different implications. The authors systematically review the peer-reviewed literature from around the world considering the association between educational attainment and obesity. Databases from public health and medicine, education, psychology, economics, and other social sciences were searched, and articles published in English, French, Portuguese and Spanish were included. This paper includes 289 articles that report on 410 populations in 91 countries. The relationship between educational attainment and obesity was modified by both gender and the country's economic development level: an inverse association was more common in studies of higher-income countries and a positive association was more common in lower-income countries, with stronger social patterning among women. Relatively few studies reported on lower-income countries, controlled for a comprehensive set of potential confounding variables and/or attempted to assess causality through the use of quasi-experimental designs. Future research should address these gaps to understand if the relationship between educational attainment and obesity may be causal, thus supporting education policy as a tool for obesity prevention.
Collapse
Affiliation(s)
- A K Cohen
- Division of Epidemiology, University of California Berkeley School of Public Health, Berkeley, California, USA
| | | | | | | |
Collapse
|
15
|
Gagnon-Arpin I, Makvandi E, Imbeault P, Batal M, Bouchard L. [The surplus weight among the Francophones and Anglophones]. Canadian Journal of Public Health 2013. [PMID: 24300315 DOI: 10.17269/cjph.104.3465] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVES Recent studies show a higher prevalence of being obese or overweight in Francophones living in minority settings compared to Canada's Anglophone majority. The objective of our study was to determine whether belonging to the linguistic minority constituted a social determinant of having a weight problem. METHODS Descriptive variables (n=128,986) from five cycles of the Canadian Community Health Survey were stratified by respondents' language and sex. Two logistic regression models tested the association between being overweight/obese (as defined by the measure of body mass index) and language, for men and women, while adjusting for social and behavioural determinants. RESULTS Prevalence of excess weight was higher among Francophones compared to Anglophones of Ontario, although the difference was not significant after adjustment for socio-economic and behavioural determinants. However, Francophones were older, less educated and more likely to live in rural areas than their Anglophone counterparts, a situation which makes them more vulnerable. CONCLUSION The study confirms the role of social and behavioural determinants of being obese/overweight. Although language does not have a direct influence on having a weight problem, the socio-economic reality of the Francophone minority makes them more likely than the Anglophone majority to fall in vulnerable strata of the population with regards to being overweight/obese. This situation should be considered when planning health services.
Collapse
|
16
|
Cortes TR, Schlussel MM, Franco-Sena AB, Rebelo F, Kac G. Television viewing and abdominal obesity in women according to smoking status: results from a large cross-sectional population-based study in Brazil. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2013. [DOI: 10.1590/s1415-790x2013000100013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE: To investigate the associations between television viewing and abdominal obesity (AO) in Brazilian women, according to smoking status. METHODS: Data of 13,262 adult women (18-49 years) from the 2006's Demographic Health Survey, a cross-sectional household study with complex probabilistic sample and national representativeness, were analyzed. AO, defined as waist circumference ≥ 80.0 cm, was the outcome. Television viewing frequency (≥ 5 times/week, 1-4 times/week, < 1 time/week) was the main exposure variable, and smoking status (yes or no) the main co-variable. Prevalence ratios were estimated using Poisson regression models separately for smokers and non-smokers. RESULTS: A statistically significant interaction term was observed between smoking status and television viewing (p < 0.05). Prevalence of AO among smokers who reported television viewing ≥ 5 times/week amounted to 59.0%, higher than the 35.0% for those with < 1 time/week television viewing (p-value = 0.020). The values for non-smokers were 55.2% and 55.7%, respectively. Smokers with television viewing ≥ 5 times/week were 1.7 times (95% CI: 1.1 - 2.5) more likely to pre-sent AO, compared to those who reported a frequency < 1 time/week. There was no significant association among non-smokers. CONCLUSIONS: Television viewing ≥ 5 times/week may increase the prevalence of AO among women who smoke. More detailed information on media use, as hours per day, may offer better estimates.
Collapse
Affiliation(s)
| | | | | | | | - Gilberto Kac
- Federal University of Rio de Janeiro, Brazil; Federal University of Rio de Janeiro, Brazil
| |
Collapse
|
17
|
MacFarlane AJ, Greene-Finestone LS, Shi Y. Vitamin B-12 and homocysteine status in a folate-replete population: results from the Canadian Health Measures Survey. Am J Clin Nutr 2011; 94:1079-87. [PMID: 21900461 DOI: 10.3945/ajcn.111.020230] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Vitamin B-12 is an important cofactor required for nucleotide and amino acid metabolism. Vitamin B-12 deficiency causes anemia and neurologic abnormalities-a cause for concern for the elderly, who are at increased risk of vitamin B-12 malabsorption. Vitamin B-12 deficiency is also associated with an increased risk of neural tube defects and hyperhomocysteinemia. The metabolism of vitamin B-12 and folate is interdependent, which makes it of public health interest to monitor biomarkers of vitamin B-12, folate, and homocysteine in a folic acid-fortified population. OBJECTIVE The objective was to determine the vitamin B-12, folate, and homocysteine status of the Canadian population in the period after folic acid fortification was initiated. DESIGN Blood was collected from a nationally representative sample of ∼5600 participants aged 6-79 y in the Canadian Health Measures Survey during 2007-2009 and was analyzed for serum vitamin B-12, red blood cell folate, and plasma total homocysteine (tHcy). RESULTS A total of 4.6% of Canadians were vitamin B-12 deficient (<148 pmol/L). Folate deficiency (<320 nmol/L) was essentially nonexistent. Obese individuals were less likely to be vitamin B-12 adequate than were individuals with a normal BMI. A total of 94.9% of Canadians had a normal tHcy status (≤13 μmol/L), and individuals with normal tHcy were more likely to be vitamin B-12 adequate and to have high folate status (>1090 nmol/L). CONCLUSIONS Approximately 5% of Canadians are vitamin B-12 deficient. One percent of adult Canadians have metabolic vitamin B-12 deficiency, as evidenced by combined vitamin B-12 deficiency and high tHcy status. In a folate-replete population, vitamin B-12 is a major determinant of tHcy.
Collapse
|
18
|
De Pergola G, Ciampolillo A, Alò D, Sciaraffia M, Guida P. Free triiodothyronine is associated with smoking habit, independently of obesity, body fat distribution, insulin, and metabolic parameters. J Endocrinol Invest 2010; 33:815-8. [PMID: 20634638 DOI: 10.1007/bf03350348] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND The aim of this study was to examine the relationship between thyroid hormones and smoking and several other parameters like age, gender, insulin, and anthropometric and metabolic parameters in subjects with a wide range of body mass index (BMI). PATIENTS AND METHODS A total of 931 euthyroid normal weight (BMI<25.0 kg/m2), overweight and obese subjects (BMI ≥25.0 kg/m2), 663 women and 268 men, aged 18-68 yr, were investigated. Fasting TSH, free T3 (FT3), free T4 (FT4), insulin, glucose, and lipid serum levels were determined. Waist circumference was measured as an indirect parameter of central fat accumulation. RESULTS Smokers were younger (p<0.001) and showed higher FT3 (p<0.01), and triglyceride (p<0.01) levels and lower glucose (p<0.01) and HDL (p<0.001) concentrations than non smoking subjects. FT3 levels were directly associated with BMI (p<0.001), waist circumference (p<0.001), insulin (p<0.001), and triglyceride (p<0.01) levels and negatively correlated with age (p<0.001) and HDL-cholesterol levels (p<0.001). When a multiple regression analysis was performed with FT3 levels as the dependent variable, and smoking, age, gender, and TSH, insulin, triglyceride, and HDL-cholesterol serum concentrations as independent variables, FT3 levels maintained an independent positive association with smoking (p<0.05), age (p<0.001), male sex (p<0.001), waist circumference (p<0.05), and insulin levels (p<0.001). CONCLUSIONS Smoking increases FT3 levels independently of age, gender, obesity, body fat distribution and metabolic parameters.
Collapse
Affiliation(s)
- G De Pergola
- Internal Medicine, Endocrinology, Andrology, and Metabolic Disease, Department of Emergency and Organ Transplantation, University of Bari, School of Medicine, Policlinico, Via Putignani 236, Bari, Italy.
| | | | | | | | | |
Collapse
|
19
|
Duncan AE, Lessov-Schlaggar CN, Nelson EC, Pergadia ML, Madden PAF, Heath AC. Body mass index and regular smoking in young adult women. Addict Behav 2010; 35:983-8. [PMID: 20634004 PMCID: PMC3071024 DOI: 10.1016/j.addbeh.2010.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2009] [Revised: 05/14/2010] [Accepted: 06/14/2010] [Indexed: 11/17/2022]
Abstract
Little is known about the relationship between relative body weight and transition from experimentation to regular smoking in young adult women. In the current study, data from 2494 participants in wave 4 of the Missouri Adolescent Female Twin Study (aged 18-29years) who reported ever smoking a cigarette were analyzed using logistic regression. Body mass index (BMI) at time of interview was categorized according to CDC adult guidelines, and regular smoking was defined as having ever smoked 100 or more cigarettes and having smoked at least once a week for two months in a row. Since the OR's for the overweight and obese groups did not differ significantly from one another in any model tested, these groups were combined. Forty-five percent of women who had ever smoked had become regular smokers. Testing of interactions between potential covariates and levels of the categorical BMI variable revealed a significant interaction between overweight/obesity and childhood sexual abuse (CSA; p<0.001) associated with regular smoking. Among women reporting CSA, the association between overweight/obesity and having become a regular smoker was negative (n=374; OR=0.48, 95% CI: 0.28-0.81). Both underweight and overweight/obesity were positively associated with transition to regular smoking among women who did not report CSA (n=2076; OR=1.57, 95% CI: 1.05-2.35 and OR=1.73, 95% CI: 1.35-2.20, respectively). These results suggest that experiencing CSA alters the association between BMI and regular smoking in women who have experimented with cigarettes.
Collapse
Affiliation(s)
- Alexis E Duncan
- Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, United States.
| | | | | | | | | | | |
Collapse
|
20
|
Lebel A, Riva M, Pampalon R, Thériault M. The geography of overweight in Quebec: analyzing and visualizing spatial inequalities using second-level residuals. Canadian Journal of Public Health 2010. [PMID: 20524378 DOI: 10.1007/bf03404358] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To discuss critically the contribution of using second-level residuals from multilevel analyses to further the understanding of how place relates to health and to visualize areas, in the province of Quebec (Canada), with above- and below-average levels of overweight. METHODS Data on 20,449 individuals are from the Canadian Community Health Survey (CCHS Cycle 2.1) and were linked to 51 spatial units. Area-level residuals were computed from a multilevel analysis examining individual and area characteristics associated with the risk of overweight. Mapping the area-level residuals indicates geographic areas where the risk of overweight is higher or lower compared to the provincial adjusted prevalence. RESULTS Controlling for socio-economic conditions and lifestyle, distinct spatial patterns of overweight were observed, indicating that the processes linking place to health may differ between men and women and between regional contexts. In some regions, the probability of overweight differed by 23% for men and 38% for women living in privileged conditions in comparison to the province's adjusted prevalence of overweight. CONCLUSIONS Analyzing and visualizing area-level residuals provides multi-scaled information that could enhance the understanding of the geographic distribution of overweight and has the potential to support more integrated and locally relevant interventions.
Collapse
Affiliation(s)
- Alexandre Lebel
- Centre de recherche en aménagement et développement, Pavilion Félix-Antoine-Savard, 2325 rue des Bibliothêques, local 1612, Université Laval, Québec, QC G1V 0A6.
| | | | | | | |
Collapse
|
21
|
Tucci SA. Phytochemicals in the Control of Human Appetite and Body Weight. Pharmaceuticals (Basel) 2010; 3:748-763. [PMID: 27713277 PMCID: PMC4033978 DOI: 10.3390/ph3030748] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2009] [Revised: 03/10/2010] [Accepted: 03/19/2010] [Indexed: 12/20/2022] Open
Abstract
Since obesity has grown to epidemic proportions, its effective management is a very important clinical issue. Despite the great amount of scientific effort that has been put into understanding the mechanisms that lead to overconsumption and overweight, at the moment very few approaches to weight management are effective in the long term. On the other hand, modern society is also affected by the growing incidence of eating disorders on the other side of the spectrum such as anorexia and bulimia nervosa which are equally difficult to treat. This review will try to summarise the main findings available in the literature regarding the effect of plants or plant extracts (phytochemicals) on human appetite and body weight. The majority of plant extracts are not single compounds but rather a mixture of different molecules, therefore their mechanism of action usually targets several systems. In addition, since some cellular receptors tend to be widely distributed, sometimes a single molecule can have a widespread effect. This review will attempt to describe the main phytochemicals that have been suggested to affect the homeostatic mechanisms that influence intake and body weight. Clinical data will be summarised and scientific evidence will be reviewed.
Collapse
Affiliation(s)
- Sonia A Tucci
- Kissileff Laboratory for the Study of Human Ingestive Behaviour, School of Psychology, University of Liverpool, Eleanor Rathbone Building, Bedford Street South, Liverpool L69 7ZA, UK.
| |
Collapse
|
22
|
Suleiman AA, Alboqai OK, Yasein N, El-Qudah JM, Bataineh MF, Obeidat BA. Prevalence of and Factors Associated with Overweight and Obesity among Jordan University Students. ACTA ACUST UNITED AC 2009. [DOI: 10.3923/jbs.2009.738.745] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
23
|
LaRowe TL, Piper ME, Schlam TR, Fiore MC, Baker TB. Obesity and smoking: comparing cessation treatment seekers with the general smoking population. Obesity (Silver Spring) 2009; 17:1301-5. [PMID: 19247276 PMCID: PMC2918403 DOI: 10.1038/oby.2009.36] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Obesity and smoking represent the leading preventable causes of morbidity and mortality in the United States. This study compared the prevalence of obesity among smokers seeking cessation treatment (n=1,428) vs. a general population (n=4,081) of never smokers, former smoker, and current smokers. Data from treatment-seeking smokers in the Wisconsin Smokers' Health Study (WSHS) and individuals who completed the National Health and Nutrition Examination Survey (NHANES) 2005-2006 were pooled and obesity rates and other health characteristics were compared. The prevalence of obesity was significantly higher among WSHS treatment-seeking smokers (36.8%) vs. NHANES current smokers (29.6%), but the obesity rates of WSHS treatment-seeking smokers did not differ from NHANES former smokers (36.5%) or never smokers (36.5%). Treatment-seeking smokers were more likely to be female and to have higher educational attainment compared to NHANES participants. Analysis of health characteristics revealed that treatment-seeking smokers had higher levels of dietary fiber and vitamin C and lower blood levels of total cholesterol, triglycerides, and fasting glucose compared to NHANES current smokers. Results suggest that treatment-seeking smokers may have a different health profile than current smokers in the general population. Health care providers should be aware of underlying heath issues, particularly obesity, in patients seeking smoking cessation treatment.
Collapse
Affiliation(s)
- Tara L LaRowe
- School of Medicine and Public Health, Department of Family Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA.
| | | | | | | | | |
Collapse
|
24
|
Lebel A, Pampalon R, Hamel D, Thériault M. The geography of overweight in Quebec: a multilevel perspective. Canadian Journal of Public Health 2009. [PMID: 19263970 DOI: 10.1007/bf03405486] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Explore the contextual aspects of overweight in Quebec through multilevel modelling, using a purposely designed set of spatial units and a few area-based characteristics. METHODS Data came from the Canadian Community Health Survey (CCHS Cycle 2.1). Multilevel logistic regressions were performed to test for the presence of an independent contextual effect on overweight and obesity (BMI > or = 25 kg/m2), separately for men and women. Modelling considered individual attributes, including some lifestyle aspects, and contextual characteristics. A geographic grid integrating spatial elements related to overweight and obesity in the literature was developed. Also, an area-level residuals analysis was carried out to identify spatial units presenting higher or lower odds of being overweight. RESULTS After accounting for individual and area-level characteristics, there remain significant geographic variations in overweight in Quebec. Although this contextual effect is small for men and women, many spatial units differ significantly from the provincial average. There are differences between the geography of overweight in men and women which suggest that socio-economic mechanisms and land use patterns underlying overweight might be different between genders. Also, there is considerable variability within rural and urban areas. CONCLUSION A complex geography of overweight is revealed. Small-scale studies, as well as methodological and data developments, are needed to deepen our understanding of this geography.
Collapse
Affiliation(s)
- Alexandre Lebel
- Centre de recherche en aménagement et développement, Université Laval, Québec, QC.
| | | | | | | |
Collapse
|
25
|
Harrington DW, Elliott SJ. Weighing the importance of neighbourhood: A multilevel exploration of the determinants of overweight and obesity. Soc Sci Med 2009; 68:593-600. [DOI: 10.1016/j.socscimed.2008.11.021] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2008] [Indexed: 11/26/2022]
|
26
|
Abstract
The objective was to examine BMI of working-age Canadian adults in relation to occupational prestige, adjusting for other aspects of social class including household income and respondent's education. We analyzed data from 49,252 adults (age 25-64) from Cycle 2.1 of the Canadian Community Health Survey, a cross-sectional self-report survey conducted in 2003. Multiple linear regression was used to examine the relation between BMI and occupational prestige, adjusting for other sociodemographic variables. For women, higher ranking occupations showed lower average BMI relative to the lowest ranking occupations, but this effect was largely eliminated when adjusting for education. For men, occupation effects endured in adjusted models and we detected some evidence of a pattern whereby men in occupations characterized by management/supervisory responsibilities were heavier than those in the lowest ranking occupations (i.e., elemental sales and service). Results are interpreted in light of the symbolic value of body size in western culture, which differs for men and women. Men in positions of management/supervision may benefit from the physical dominance conveyed by a larger body size, and thus occupational prestige rankings may help us to understand the gender differences in the patterning of BMI by different indicators of social class.
Collapse
Affiliation(s)
- Lindsay McLaren
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
| | | |
Collapse
|
27
|
Validity of self-report screening for overweight and obesity. Evidence from the Canadian Community Health Survey. Canadian Journal of Public Health 2009. [PMID: 19009930 DOI: 10.1007/bf03405254] [Citation(s) in RCA: 133] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Community health surveys often collect self-report data on body height and weight for the purposes of calculating the Body Mass Index (BMI) and identifying cases of overweight and obesity. The aim of the study was to test the validity of this method and to describe age and gender trends in self-report bias in height, weight, and BMI. METHODS This population survey included 4,615 adolescents and adults from across Canada who were interviewed and then measured in their homes. Overweight and obesity were identified using self-reports and cut points in BMI. RESULTS Self-reports correlated highly with body measurements but on average, self-reported height was 0.88 cm greater than measured height, self-reported weight was 2.33 kg less than measured weight, and BMI derived from self-reports was 1.16 lower than BMI derived from measurements. Consequently, self-reports yielded lower rates of overweight (31.87%) and obesity (15.32%) than measurements (33.67% and 22.92%, respectively). The magnitude and variability of self-report bias in BMI were related to female gender, older age, and the presence of overweight or obesity. DISCUSSION Comparison of self-reported and measured height and weight indicated that most survey respondents under-reported weight and over-reported height. Intentional or not, these biases were compounded in the BMI formula and affected the accuracy of self-reports as a tool for identifying weight problems. Self-reports may be easier to collect than body measurements but should not be used exclusively as an obesity surveillance tool.
Collapse
|
28
|
Alcácera MA, Marques-Lopes I, Fajó-Pascual M, Puzo J, Blas Pérez J, Bes-Rastrollo M, Martínez-González MÁ. Lifestyle factors associated with BMI in a Spanish graduate population: the SUN Study. Obes Facts 2008; 1:80-7. [PMID: 20054166 PMCID: PMC6452167 DOI: 10.1159/000124237] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE To study the association between BMI and lifestyle factors such as alcohol consumption, smoking habits, education level and marital status in a Spanish graduate population. METHOD Cross-sectional analysis of 8,706 participants (3,643 men and 5,063 women) from the Seguimiento Universidad de Navarra (SUN) Study, an ongoing dynamic cohort study in Spain. Data on body weight, height and sociodemographic characteristics, and lifestyle habits were collected with self-administered validated questionnaires. RESULTS Among older participants (above sex-specific median age), educational level was a factor independently associated with BMI. University graduates with a lower educational level (3-year college degree or 5-year university degree) had a significantly higher BMI than those with doctorate which requires, at least, 8 years of university studies in Spain. Mean BMI was significantly higher among past smokers than among never smokers. Alcohol consumption, marital and smoking status were associated with BMI only among men. CONCLUSION In a study whose members were all university graduates, several factors were independently associated with a higher BMI, such as less years of higher education, past smoking, marital status and higher alcohol consumption.
Collapse
Affiliation(s)
| | - Iva Marques-Lopes
- Faculty of Health Sciences and Sports, University of Zaragoza, Huesca, Spain
| | - Marta Fajó-Pascual
- Faculty of Health Sciences and Sports, University of Zaragoza, Huesca, Spain
| | - José Puzo
- Faculty of Health Sciences and Sports, University of Zaragoza, Huesca, Spain
| | - Juan Blas Pérez
- Faculty of Health Sciences and Sports, University of Zaragoza, Huesca, Spain
| | - Maira Bes-Rastrollo
- Department of Preventive Medicine and Public Health, Clinica Universitaria-Medical School, University of Navarra, Pamplona, Spain
- Department of Nutrition, Harvard School of Public Health, Boston, MS, USA
| | - Miguel Ángel Martínez-González
- Department of Preventive Medicine and Public Health, Clinica Universitaria-Medical School, University of Navarra, Pamplona, Spain
| |
Collapse
|
29
|
Chiolero A, Faeh D, Paccaud F, Cornuz J. Consequences of smoking for body weight, body fat distribution, and insulin resistance. Am J Clin Nutr 2008; 87:801-9. [PMID: 18400700 DOI: 10.1093/ajcn/87.4.801] [Citation(s) in RCA: 695] [Impact Index Per Article: 43.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Our aim was to critically evaluate the relations among smoking, body weight, body fat distribution, and insulin resistance as reported in the literature. In the short term, nicotine increases energy expenditure and could reduce appetite, which may explain why smokers tend to have lower body weight than do nonsmokers and why smoking cessation is frequently followed by weight gain. In contrast, heavy smokers tend to have greater body weight than do light smokers or nonsmokers, which likely reflects a clustering of risky behaviors (eg, low degree of physical activity, poor diet, and smoking) that is conducive to weight gain. Other factors, such as weight cycling, could also be involved. In addition, smoking increases insulin resistance and is associated with central fat accumulation. As a result, smoking increases the risk of metabolic syndrome and diabetes, and these factors increase risk of cardiovascular disease. In the context of the worldwide obesity epidemic and a high prevalence of smoking, the greater risk of (central) obesity and insulin resistance among smokers is a matter of major concern.
Collapse
Affiliation(s)
- Arnaud Chiolero
- Institute of Social and Preventive Medicine (IUMSP), University of Lausanne, 17 Rue du Bugnon, 1005 Lausanne, Switzerland.
| | | | | | | |
Collapse
|
30
|
Ross NA, Tremblay S, Khan S, Crouse D, Tremblay M, Berthelot JM. Body mass index in urban Canada: neighborhood and metropolitan area effects. Am J Public Health 2007; 97:500-8. [PMID: 17267734 PMCID: PMC1805015 DOI: 10.2105/ajph.2004.060954] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2005] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We investigated the influence of neighborhood and metropolitan area characteristics on body mass index (BMI) in urban Canada in 2001. METHODS We conducted a multilevel analysis with data collected from a cross-sectional survey of men and women nested in neighborhoods and metropolitan areas in urban Canada during 2001. RESULTS After we controlled for individual sociodemographic characteristics and behaviors, the average BMIs of residents of neighborhoods in which a large proportion of individuals had less than a high school education were higher than those BMIs of residents in neighborhoods with small proportions of such individuals (P< .01). Living in a neighborhood with a high proportion of recent immigrants was associated with lower BMI for men (P<.01), but not for women. Neighborhood dwelling density was not associated with BMI for either gender. Metropolitan sprawl was associated with higher BMI for men (P=.02), but the effect was not significant for women (P= .09). CONCLUSIONS BMI is strongly patterned by an individual's social position in urban Canada. A neighborhood's social condition has an incremental influence on the average BMI of its residents. However, BMI is not influenced by dwelling density. Metropolitan sprawl is associated with higher BMI for Canadian men, which supports recent evidence of this same association among American men. Individuals and their environments collectively influence BMI in urban Canada.
Collapse
Affiliation(s)
- Nancy A Ross
- Department of Geography, McGill University, Montreal, Quebec, Canada.
| | | | | | | | | | | |
Collapse
|
31
|
Duvigneaud N, Wijndaele K, Matton L, Deriemaeker P, Philippaerts R, Lefevre J, Thomis M, Duquet W. Socio-economic and lifestyle factors associated with overweight in Flemish adult men and women. BMC Public Health 2007; 7:23. [PMID: 17324255 PMCID: PMC1819374 DOI: 10.1186/1471-2458-7-23] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2006] [Accepted: 02/26/2007] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Changes in lifestyles and in the environment over the last decades are probably the most important cause of the overweight epidemic, but the findings are inconsistent among studies. The purpose of this study was to investigate the association of several socio-economic and lifestyle factors with overweight in Flemish adults, using BMI > or = 25 kg/m2, waist circumference (WC) > or = 94 cm (men) or > or = 80 cm (women) and the combination of BMI and WC for identifying overweight. METHODS This cross-sectional epidemiological study was conducted by the Flemish Policy Research Centre Sport, Physical Activity and Health between October 2002 and February 2004 in 46 Flemish communities. A total of 4903 Flemish adults (2595 men and 2308 women), aged 18 to 75 years, from a population-based random sample were included in the analysis. Body weight, height and WC were measured, and socio-economic and lifestyle factors were reported by means of validated questionnaires. RESULTS The results of the logistic regressions revealed that age is positively associated with overweight in both genders. Alcohol consumption is associated with overweight only in men. Men smoking in the past and watching TV >11 h/week have significantly higher OR's for overweight, while men who participate in health related sports >4 h/week have significantly lower OR's for overweight. In women, watching TV >9 h/week was positively associated with overweight. Women who are current smokers or participate in health related sports >2.5 h/week or with a higher educational level have significantly lower odds for overweight. Different results are observed between the first (BMI) and the second model (WC) in both genders. In men, the models differ for education and health related sports, while in women they differ for smoking status and leisure time physical activity. CONCLUSION The present study confirms the contention that overweight is a multifactorial problem. Age and TV viewing are positively associated with overweight, while educational level and health related sports are negatively related to overweight in both genders. In men, alcohol consumption and smoking in the past are also among the lifestyle factors associated with overweight. This study also indicates that BMI and WC do not have the same discriminative function regarding different lifestyle factors.
Collapse
Affiliation(s)
- Nathalie Duvigneaud
- Department of Human Biometry and Biomechanics, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Pleinlaan 2, B-1050 Brussel, Belgium
| | - Katrien Wijndaele
- Department of Movement and Sports Sciences, Ghent University, Watersportlaan 2, B-9000 Gent, Belgium
| | - Lynn Matton
- Department of Biomedical Kinesiology, Faculty of Kinesiology and Rehabilitation Sciences, K.U.Leuven, Tervuursevest 101, B-3001 Leuven, Belgium
| | - Peter Deriemaeker
- Department of Human Biometry and Biomechanics, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Pleinlaan 2, B-1050 Brussel, Belgium
| | - Renaat Philippaerts
- Department of Movement and Sports Sciences, Ghent University, Watersportlaan 2, B-9000 Gent, Belgium
| | - Johan Lefevre
- Department of Biomedical Kinesiology, Faculty of Kinesiology and Rehabilitation Sciences, K.U.Leuven, Tervuursevest 101, B-3001 Leuven, Belgium
| | - Martine Thomis
- Department of Biomedical Kinesiology, Faculty of Kinesiology and Rehabilitation Sciences, K.U.Leuven, Tervuursevest 101, B-3001 Leuven, Belgium
| | - William Duquet
- Department of Human Biometry and Biomechanics, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Pleinlaan 2, B-1050 Brussel, Belgium
| |
Collapse
|
32
|
Dubois L, Girad M. Accuracy of maternal reports of pre-schoolers’ weights and heights as estimates of BMI values. Int J Epidemiol 2007; 36:132-8. [PMID: 17510077 DOI: 10.1093/ije/dyl281] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Data is lacking on the reliability of weight and height for young children as reported by parents participating in population-based studies. We analysed the accuracy of parental reports of children's weights and heights as estimates of body mass index, and evaluated the factors associated with the misclassification of overweight and obese children. METHODS Analyses were conducted on a population-based birth cohort of 1549 4-year-old children from the province of Québec (Canada) in 2002. Mothers reported weights and heights for the children as part of the regular annual data collection. Within the following 3 months, children's weights and heights were measured at home as part of a nutrition survey. RESULTS This study indicates that mothers overestimate their children's weight more than their height, resulting in an overestimation of overweight children of more than 3% in the studied population. Only 58% of the children were reported as overweight/obese with reported values. Maternal misreporting is more important for boys than girls, and for low socioeconomic status children compared with high socioeconomic status children. CONCLUSIONS Research on the prevalence of overweight and obesity has often used self-reported measures of height and weight to estimate BMI. However, the results emphasize the importance of collecting measured data in childhood studies of overweight and obesity at the population level.
Collapse
Affiliation(s)
- Lise Dubois
- Department of Epidemiology and Community Medicine, University of Ottawa, Institute at Population Health, 1 Stewart Street, Office 303, Ottawa, Ontario, Canada.
| | | |
Collapse
|
33
|
Abstract
CONTEXT Obesity rates are rising sharply among all industrialized countries; the situation seems to be worse in English speaking countries. Taking into account genetic predisposition, excess of caloric intake combined with low energy expenditure will usually result in obesity. OBJECTIVES To describe and compare regional obesity rates across Canada and assess the ecological relationship between regional rates of obesity, low level of leisure-time physical activity, and low fruit and vegetable consumption. DESIGN Cross-sectional population-based analysis from the 2003 Canadian Community Health Survey. MEASURES AND DATA ANALYSES: Canadian population distributions of body mass index (BMI), leisure-time physical activity and daily fruit and vegetable consumption were obtained from Statistics Canada. All these measures were based on the respondent's self-reported answers to a computer-assisted personal or telephone interview. Obesity rates (BMI> or =30), rates of low level of leisure-time physical activity (less than 1.5 kcal of energy expenditure per day), and rates of low fruit and vegetable consumption (less than five times a day) for the 106 Canadian Health regions were mapped to illustrate their geographical distribution. Cartograms were used in addition to traditional mapping to take into account the differences in population density between these small areas. RESULTS In 2003, 15.2% of Canadian individuals aged 20 years and older were considered obese. The rates of obesity varied substantially between the 106 Canadian health regions: from 6.2% in Vancouver to 47.5% in aboriginal population area. At the health region level, low leisure-time physical activity and low fruit and vegetable consumption are both good predictors of obesity (odds ratio of 9.2 and positive predictive value of 93% when considered simultaneously). CONCLUSION There is a strong gradient in obesity prevalence between Canadian health regions. At the regional level, high rates of low level of physical activity, and high rates of low fruit and vegetable consumption were both found good predictors of high rates of obesity.
Collapse
Affiliation(s)
- A Vanasse
- Family Medicine Department, Faculty of Medicine, Université de Sherbrooke , Sherbrooke, Quebec, Canada.
| | | | | | | |
Collapse
|
34
|
Padez C. Trends in overweight and obesity in Portuguese conscripts from 1986 to 2000 in relation to place of residence and educational level. Public Health 2006; 120:946-52. [PMID: 16895735 DOI: 10.1016/j.puhe.2006.05.023] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2005] [Revised: 04/07/2006] [Accepted: 05/18/2006] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The aim of this study was to analyse changes in the prevalence of overweight and obesity between 1986 and 2000 in Portuguese conscripts, and to examine the role of place of residence and educational level. STUDY DESIGN Cross-sectional study. METHODS Data sets from the cross-sectional annual surveys of all 18-year-old Portuguese males born between 1966 and 1981 and examined between 1986 and 2000 (850 081 subjects) were used in this study. Height and weight were measured and body mass index was calculated. Data on educational level (4, 6, 9, 11 and 12+ years) and residence (urban, semi-urban and rural) were collected. RESULTS The prevalence of overweight increased from 10.5% in 1986 to 21.3% in 2000, and the prevalence of obesity increased from 0.9% to 4.2% in the same period (P<0.001). After adjustment for year of examination, the odds ratio (OR) for being overweight increased with educational level (reference 4-6 years: 1.19; 9 years: 1.30; 11 years: 1.47; 12+ years: 2.41) and place of residence (reference urban-semi-urban: 1.04; rural: 1.06). The prevalence of obesity increased with educational level (reference 4-6 years: 1.27; 9 years: 1.79; 11 years: 1.83; 12+ years: 2.66) and decreased with place of residence, i.e. those who lived in rural areas had a lower risk of becoming obese (OR: 0.94). CONCLUSIONS Despite the low prevalence of obesity in young males in Portugal compared with other European countries, the sharp increase in recent years indicates that public health strategies are needed to prevent obesity.
Collapse
Affiliation(s)
- Cristina Padez
- Departamento de Antropologia, Departamento de Antropologia, Rua do Arco da Traição, Universidade de Coimbra, 3000-056 Coimbra, Portugal.
| |
Collapse
|
35
|
Davis JN, Hodges VA, Gillham MB. Normal-weight adults consume more fiber and fruit than their age- and height-matched overweight/obese counterparts. ACTA ACUST UNITED AC 2006; 106:833-40. [PMID: 16720124 DOI: 10.1016/j.jada.2006.03.013] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2004] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To assess differences in dietary intake of overweight/obese subjects and sex-, age-, and height-matched controls and to identify dietary components associated with increased deposition of body fat. DESIGN/SUBJECTS A convenience sample of 52 overweight/obese and 52 normal-weight adults matched for sex, age (+/-1 year), and height (+/-1 inch) were recruited from the local area. Dietary intake was assessed with the Block 60-item food frequency questionnaire, physical activity was measured by the Yale Physical Activity Survey, and percent body fat was measured via dual-energy x-ray absorptiometry. STATISTICAL ANALYSES PERFORMED Independent t tests compared between-group consumption of dietary components. The ability of dietary components to predict percent body fat before and after controlling for age-, sex-, and physical activity-related energy expenditure and other macronutrients was assessed with multiple regression analyses. Spearman correlation coefficients examined relationships among nutrients, Food Guide Pyramid servings, and percent body fat. RESULTS Overweight/obese subjects consumed more total fat, saturated fat, and cholesterol and less carbohydrate, complex carbohydrate, and dietary fiber than control subjects. Reported intake of dietary fiber was inversely related to percent body fat without (R(2)=0.052, P=0.02) and with (R(2)=0.045, P=0.013) control for potential confounding factors. Servings of fruit per day were negatively related to percent body fat (r=-0.40, P<0.01). CONCLUSIONS These findings suggest that the composition of a diet, especially low dietary fiber and fruit intake, plays a role in the etiology of obesity.
Collapse
Affiliation(s)
- Jaimie N Davis
- Department of Human Ecology, The University of Texas at Austin, 1 University Station A2700, Austin, TX 78712, USA
| | | | | |
Collapse
|
36
|
Mohan V, Gokulakrishnan K, Deepa R, Shanthirani CS, Datta M. Association of physical inactivity with components of metabolic syndrome and coronary artery disease--the Chennai Urban Population Study (CUPS no. 15). Diabet Med 2005; 22:1206-11. [PMID: 16108850 DOI: 10.1111/j.1464-5491.2005.01616.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
AIM The aim of the study was to assess the influence of physical activity on the components of metabolic syndrome (MS) in an urban south Indian population in Chennai. METHODS The Chennai Urban Population Study (CUPS) is an epidemiological study involving two residential areas in Chennai in South India. Of the total of 1399 eligible subjects (age > or = 20 years), 1262 individuals participated in the study. MS was diagnosed based on modified Adult Treatment Panel (ATP) III guidelines. Details about the physical activity were collected using questionnaire, which included job-related and leisure-time activities, and specific questions on exercise. Study individuals were then graded as light, moderate and heavy using a scoring system. We assessed the relationship between the grades of physical activity and the components of MS and coronary artery disease (CAD). Insulin resistance was calculated using the homeostasis assessment model (HOMA-IR). RESULTS Prevalence of most of the components of MS (diabetes P < 0.001, obesity P = 0.003, abdominal obesity P < 0.001 and hypertension P < 0.001) and MS per se (P < 0.001) increased significantly with decrease in physical activity. Among non-diabetic subjects, HOMA-IR was significantly higher in subjects who did light-grade activity compared with heavy-grade activity (P = 0.041). Logistic regression analysis revealed physical activity to be significantly associated with MS [heavy activity: reference, moderate activity, odds ratio (OR) 1.639, (P = 0.017); light activity: OR 2.289, (P < 0.001)]. Subjects in the light-grade activity group also had higher odds of CAD (OR 2.42, 95% confidence interval 1.40, 4.24, P = 0.011), compared with the heavy-grade activity group. CONCLUSION Physical inactivity is associated with the components of MS and CAD in this urban south-Indian population. Lifestyle changes focusing on increasing physical activity could help to prevent the exploding epidemic of MS and CAD in India.
Collapse
Affiliation(s)
- V Mohan
- Madras Diabetes Research Foundation, Gopalapuram, Chennai, India.
| | | | | | | | | |
Collapse
|