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Yao R, Yao L, Rao A, Ou J, Wang W, Hou Q, Xu C, Gao BL. Prevalence and risk factors of stroke-related sarcopenia at the subacute stage: A case control study. Front Neurol 2022; 13:899658. [PMID: 36003303 PMCID: PMC9393529 DOI: 10.3389/fneur.2022.899658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 07/15/2022] [Indexed: 12/02/2022] Open
Abstract
Purpose To investigate the prevalence and risk factors of stroke-related sarcopenia (SRS) in hospitalized patients receiving rehabilitation treatment. Methods Approximately, 259 patients with stroke that satisfied the inclusion and exclusion criteria were consecutively recruited between June 2020 and July 2022. The epidemiologic data, history, clinical data, and measured data of the skeletal muscle index were collected. The patients were divided into the sarcopenia and non-sarcopenia group for comparison and analysis with the univariate and multivariate analysis. Results SRS was presented in 121 (46.7%) patients with a mean age of 59.6 ± 9.7 years, including 42 women and 79 men. Multivariate logistic regression analysis revealed the following parameters to be significant (p < 0.05) risk factors for SRS: college degree or above (OR, 2.1, 95% CI, 1.1–4.1), ICU stay (OR, 1.7, 95% CI, 1.06–2.8), pneumonia (OR, 1.9, 9% CI, 1.1–3.6), walking ability (OR, 2.6, 95% CI, 1.5–4.6), cognitive impairment (OR, 1.8, 95%, 1.1–2.9), aphasia (OR, 2.1, 95% CI, 1.2–3.5), nasogastric feeding (OR, 3.7, 95%, 1.9–7.3), age (OR, 1.04, 95% CI, 1–1.1), and creatine kinase (OR, 1.1, 95% CI,0.9–1.2). Conclusions Older age, light weight, severer clinical conditions, cognitive impairment, and significantly decreased levels of albumin, RAG, creatinine, uric acid, red blood cell count, hemoglobin, prealbumin, iron, and creatine kinase are more significantly present in patients with SRS compared with those without SRS.
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Affiliation(s)
- Ruihong Yao
- Medical Imaging Department, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Liqing Yao
- Rehabilitation Medicine Department, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
- *Correspondence: Liqing Yao
| | - Amin Rao
- Rehabilitation Medicine Department, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Jibing Ou
- Rehabilitation Medicine Department, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Wenli Wang
- Rehabilitation Medicine Department, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Qinzhi Hou
- Rehabilitation Medicine Department, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Chunyan Xu
- Rehabilitation Medicine Department, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Bu-Lang Gao
- Medical Imaging Department, The First Affiliated Hospital of Kunming Medical University, Kunming, China
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Hajek A, Kretzler B, König HH. Prevalence and correlates of obesity among the oldest old. A systematic review, meta-analysis and meta-regression. Geriatr Gerontol Int 2022; 22:373-383. [PMID: 35362258 DOI: 10.1111/ggi.14382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 01/14/2022] [Accepted: 03/09/2022] [Indexed: 11/26/2022]
Abstract
Thus far, the prevalence and correlates of obesity among the oldest have been identified in several studies. Nevertheless, there is a lack of a systematic review, meta-analysis and meta-regression synthesizing the existing observational studies. Consequently, our aim was to fill this knowledge gap. Three electronic databases were searched (Medline, PsycINFO, CINAHL) and an additional hand search was performed. Observational studies (both, cross-sectional and longitudinal) determining the prevalence and (preferably) the correlates of obesity in the oldest old (≥80 years) were included. Data extraction covered study design, measurement of obesity, analytical approach, sample characteristics and main results. In total, 19 studies were included. Reported prevalence of obesity in the community varied greatly (range 0.7%-71.5%). The pooled prevalence of obesity was 17.8% (95% CI: 13.3%-22.2%), with significant heterogeneity between studies (I2 = 99.7%, P < 0.001). There is evidence of a publication bias. Meta-regressions showed that some of the heterogeneity was explained by the types of measures of obesity and country of the respective sample. In conclusion, obesity remains a key challenge among the oldest old. Future research in this age bracket is urgently required in regions mostly neglected thus far (e.g., South America, Africa or Asia). Moreover, studies based on longitudinal data are required to clarify the determinants of obesity among the oldest old. Furthermore, studies based on objectively recorded obesity (e.g., waist circumference) are also required. Geriatr Gerontol Int 2022; 22: 373-383.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany
| | - Benedikt Kretzler
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany
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Song J, Zhang J, Fawzi W, Huang Y. Double Burden of Malnutrition among Chinese Women of Reproductive Age and Their Social Determinants. Nutrients 2020; 12:E3102. [PMID: 33053638 PMCID: PMC7601850 DOI: 10.3390/nu12103102] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/30/2020] [Accepted: 10/03/2020] [Indexed: 01/12/2023] Open
Abstract
This study aimed to examine the impact of a wide range of demographic, socioeconomic, and community factors on the double burden of malnutrition among women of reproductive age using longitudinal data. We used data about 11,348 women of reproductive age who participated in the China Health and Nutrition Survey (CHNS), a longitudinal survey, between 1989 and 2015. Nutritional outcomes were categorized into four groups, namely underweight, normal weight, overweight, and obesity, with normal weight as reference. A multinomial logit model was fitted due to geographic clustering and repeated observations of individuals. The prevalence of underweight decreased over time from 1991 but has tended to rise again since 2004, while the prevalence of overweight/obesity continued to rise between 1991 and 2015. Improved individual factors, socioeconomic status, and community urbanization reduced the risk of underweight but elevated the risk of overweight and obesity. The medium levels, rather than the highest levels, of household income and community urbanization are associated with a higher risk of overweight and obesity. The notable increase in underweight prevalence is a cause for concern to be addressed along with efforts to curb the rising tide of overweight. In order to enhance the nutritional status of women of reproductive age, it is essential to improving the community environment, levels of education, and living environment from a wider context. Long-term and targeted plans are urgently needed for nutrition improvements among the different populations.
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Affiliation(s)
- Jingqi Song
- School of Public Health, Peking University Health Science Center, Beijing 100191, China; (J.S.); (J.Z.)
| | - Ji Zhang
- School of Public Health, Peking University Health Science Center, Beijing 100191, China; (J.S.); (J.Z.)
| | - Wafaie Fawzi
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA;
| | - Yangmu Huang
- School of Public Health, Peking University Health Science Center, Beijing 100191, China; (J.S.); (J.Z.)
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Temporal Trends in Dietary Macronutrient Intakes among Adults in Rural China from 1991 to 2011: Findings from the CHNS. Nutrients 2017; 9:nu9030227. [PMID: 28273878 PMCID: PMC5372890 DOI: 10.3390/nu9030227] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 02/16/2017] [Accepted: 02/18/2017] [Indexed: 12/11/2022] Open
Abstract
Few studies have examined nutrition transitions among the rural population of China, even though half of the Chinese population (about 700 million) is living in rural China. To fill this research gap, we examined temporal trends in dietary macronutrient intakes in members of the Chinese rural population aged 18-60 years. The analysis used data from consecutive three-day dietary recalls, collected from the China Health and Nutrition Surveys (CHNS). Mixed-effect models were constructed to obtain adjusted means and to examine temporal trends after adjusting for intra-class correlation within clusters and covariates, including age, sex, geographical region, urbanicity, and income. From 1991 to 2011, a downward trend in daily energy, protein, and carbohydrate intakes was seen in all categories, with a significant reduction among all rural people (p < 0.0001). In contrast, a significant increment in daily fat intake, the proportion of energy from fat, and the proportion of rural people consuming a diet with more than 30% of energy from fat, were observed in the present study (p < 0.0001). These results suggest that adults in rural China have been undergoing a rapid nutrition transition towards a high-fat diet. Therefore, more emphasis should be placed on the quality of fat and maintaining a balanced diet during the process of nutritional education.
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Zeigler-Johnson C, Weber A, Glanz K, Spangler E, Rebbeck TR. Gender- and ethnic-specific associations with obesity: individual and neighborhood-level factors. J Natl Med Assoc 2013; 105:173-82. [PMID: 24079218 DOI: 10.1016/s0027-9684(15)30107-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Gender- and ethnicity-specific groups face different risks for obesity, but little is understood about the factors that predict group-specific risks. We evaluated individual and neighborhood factors in relation to obesity. DESIGN Cross-sectional surveys of adults (ages 18-100 years) from southeastern Pennsylvania were analyzed. Individual- and neighborhood-level factors were included in fully-adjusted regression models to estimate relationships with obesity for specific gender-ethnic groups. The study included 679 Asian women, 655 Asian men, 4190 African-American women, 1568 African-American men, 1248 Hispanic women, 586 Hispanic men, 11791 European American women, and 6547 European American men. RESULTS There were significant differences in the predictors of obesity by gender-ethnic groups. Obesity was differentially associated with age (p < 0.001, positively associated with middle age in African-American men and in all women except Asian; positively associated with older age in European American women but inversely in African-American men and European American men), employment (p < 0.01, positively associated in African-American men and European American men) and poverty (p < 0.001, positively associated in Asian men, African-American women, and European American women). Reporting good/excellent health was differentially associated with less obesity (p < 0.01, no association for African-American men and Asians). Interestingly, neighborhood-level effects, however, did not differ significantly by gender-ethnic group. Inverse neighborhood effects on obesity prevalence were observed in most groups for higher neighborhood education and family income. Direct associations with obesity were observed for neighborhood poverty and neighborhood smoking. CONCLUSIONS We observed that individual- and neighborhood-level variables are associated with obesity. Several individual-level effects differ by gender-ethnic group.
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Affiliation(s)
- Charnita Zeigler-Johnson
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, USA.
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Tian X, Zhao G, Li Y, Wang L, Shi Y. Overweight and Obesity Difference of Chinese Population Between Different Urbanization Levels. J Rural Health 2013; 30:101-12. [DOI: 10.1111/jrh.12041] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Xiangyang Tian
- School of Public Health, Fudan University; Shanghai China
- Chinese Center for Health Education; Beijing China
| | - Genming Zhao
- School of Public Health, Fudan University; Shanghai China
| | - Yinghua Li
- Chinese Center for Health Education; Beijing China
| | - Liang Wang
- Department of Biostatistics and Epidemiology; College of Public Health, East Tennessee State University; Johnson City Tennessee
| | - Ying Shi
- Department of Disease Prevention and Control, the Chinese Ministry of Health; Beijing China
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Malhotra R, Malhotra C, Chan A, Østbye T. Life-course socioeconomic status and obesity among older Singaporean Chinese men and women. J Gerontol B Psychol Sci Soc Sci 2012; 68:117-27. [PMID: 23161348 DOI: 10.1093/geronb/gbs102] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To elucidate the association between life-course socioeconomic status (SES) and obesity among older (aged 60 and older) Singaporean Chinese men and women. METHODS Data from the Social Isolation, Health and Lifestyles Survey (single-stage stratified random sampling design) was utilized. Obesity (body mass index >27.4 kg/m(2)) was assessed for 1,530 men and 2,036 women. Childhood (family financial status while growing up), adult (education), and older adult (housing type) SES indicators were used to define the accumulation of risk (cumulative socioeconomic disadvantage), social mobility (8 trajectories using the 3 SES indicators), and sensitive period (independent effect of each SES indicator) conceptual models. Association between the 3 life-course SES conceptual models and obesity was assessed using logistic regression analysis. RESULTS Among women and men, low childhood SES lowered the odds of obesity. Low adult SES increased the odds of obesity only among women. There was no association between cumulative socioeconomic disadvantage and obesity. Women experiencing upward social mobility had lower odds of obesity relative to both those experiencing low SES and high SES through the life-course. DISCUSSION Association of the life-course SES conceptual models with obesity among older Singaporeans is different from that reported among younger Western populations, suggesting the association to be context specific. The different conceptual models complement each other.
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Affiliation(s)
- Rahul Malhotra
- Health Services and Systems Research, Duke-NUS Graduate Medical School, 8 College Road, Singapore 169857.
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Østbye T, Malhotra R, Chan A. Variation in and Correlates of Body Mass Status of Older Singaporean Men and Women. Asia Pac J Public Health 2011; 25:48-62. [DOI: 10.1177/1010539510393726] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study describes the body mass status of older (≥60 years) Singaporeans, using the international and Asian body mass index (BMI) classifications, assesses sociodemographic correlates of BMI, underweight, obesity, and “high-risk” BMI (≥27.5 kg/m2), and ascertains the relationship between body mass and important health outcomes. Prevalence of underweight, obesity, and high-risk BMI among 4371 older Singaporeans was 6.8%, 7.4%, and 18.6%, respectively. Women (vs men) and Malays and Indians (vs Chinese) were more likely to have obesity or high-risk BMI. Increasing education decreased the odds of obesity and high-risk BMI only among women. Prevalence and odds of various health conditions was similar in corresponding categories of the two BMI classifications. Whereas the prevalence of obesity is lower among elderly in Singapore than in many other countries, the prevalence of high-risk BMI is considerable. It is important to address high-risk BMI among them, with elderly of minority ethnic groups, especially females, being a priority.
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Affiliation(s)
- Truls Østbye
- Duke–National University of Singapore Graduate Medical School, Singapore
- Duke University Medical Centre, Durham, NC, USA
| | - Rahul Malhotra
- Duke–National University of Singapore Graduate Medical School, Singapore
| | - Angelique Chan
- Duke–National University of Singapore Graduate Medical School, Singapore
- National University of Singapore, Singapore
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Da Silva Coqueiro R, Rodrigues Barbosa A, Ferreti Borgatto A. Nutritional status, health conditions and socio-demographic factors in the elderly of Havana, Cuba: data from SABE survey. J Nutr Health Aging 2010; 14:803-8. [PMID: 21125196 DOI: 10.1007/s12603-010-0126-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To assess the association of nutritional status with sex, age, race/color, education, smoking, physical activity, hypertension, diabetes, and hospitalization in older adults residing in the city of Havana, Cuba. METHODS This was a cross-sectional, population-based household survey. A total of 1,905 persons (1,197 women and 708 men; ≥ 60 years) were examined between 1999 and 2000, selected by probabilistic sampling. Nutritional status was assessed by body mass index (BMI): BMI < 22.0 kg/m2 = underweight; BMI > 27.0 kg/m2 = overweight. Multinomial logistic regression analysis (crude and adjusted) was used. RESULTS The estimation of the prevalence of underweight was 33.0% and that of overweight was 29.6%. The adjusted regression model showed that the probability of underweight was higher in older age groups (OR = 1.63, 70-79 years; OR = 2.05, ≥ 80 years) and among smokers (OR = 1.83). There was negative association between underweight, and hypertension and diabetes. Hypertension (OR = 1.99) was positively associated with overweight. The lower likelihood of overweight was observed among men, smokers, and those aged 80 years and more. CONCLUSION The elderly population of Havana presents a vulnerable nutritional status in view of the prevalence of underweight and overweight. Increasing age, smoking, gender, and hypertension are the factors positively associated with vulnerable nutritional status.
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Affiliation(s)
- R Da Silva Coqueiro
- Departamento de Saúde, Universidade Estadual do Sudoeste da Bahia, Jequié, BA, Brazil
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