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Mujica FP, Candio P. Taking a health economic perspective in monitoring health inequalities: A focus on excess weight. Health Policy 2024; 148:105144. [PMID: 39141983 DOI: 10.1016/j.healthpol.2024.105144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 07/25/2024] [Accepted: 08/01/2024] [Indexed: 08/16/2024]
Abstract
BACKGROUND Traditional approaches to monitoring health inequalities predominantly rely on headcount methods. However, these methods fail to reflect the non-linear health economic implications of changes in disease severity. Alternative, distribution-sensitive metrics are available which could more adequately inform financial planning and policy decision making. METHODS We describe the design of the Foster-Greer-Thorbecke (FGT) index, and discuss its relative merits as a summary monitoring metric of health inequalities in the population, compared to the Erreygers concentration index. We illustrate the FGT index by conducting a comparative longitudinal analysis of adult excess inequalities in England using Health Survey for England data from 2009 to 2019. FINDINGS Excess weight inequalities have steadily increased in the English adult population, especially over the last five years. Going beyond headcount, the FGT index analyses revealed that, unlike the rest of the population, the average overweight adult from the most socio-economically deprived group is either obese (30.3 BMI for females) or at the brink of obesity (29.1 BMI for males). These results underscore a deepening divide in obesity severity between communities, with the most socioeconomically deprived groups being increasingly and disproportionally affected. CONCLUSIONS The FGT index can address some shortcomings of traditional approaches to inequality measurement and local governments should consider adopting it as an alternative population health metric. Future research should apply and develop more refined distribution-sensitive measures of health inequality.
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Affiliation(s)
- Fiorella Parra Mujica
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, the Netherlands
| | - Paolo Candio
- Department of Economics and Management, University of Trento, Italy.
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Chen Y, Ma L, Han Z, Xiong P. The global burden of disease attributable to high body mass index in 204 countries and territories: Findings from 1990 to 2019 and predictions to 2035. Diabetes Obes Metab 2024; 26:3998-4010. [PMID: 38957939 DOI: 10.1111/dom.15748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 06/04/2024] [Accepted: 06/12/2024] [Indexed: 07/04/2024]
Abstract
AIM Our study aims to provide an updated estimate of age- and sex-specific deaths and disability-adjusted life years (DALYs) associated with high body mass index (BMI) from 1990 to 2019 at the global, regional and national levels, and to forecast the global burden of disease attributed to high BMI from 2020 to 2035. METHODS We used the data for the number of deaths, DALYs, age-standardized rate (per 100 000 population), percentage change and population attributable fraction from the Global Burden of Disease Study 2019 (GBD 2019) to examine the disease burden attributable to high BMI. We further applied an autoregressive integrated moving average (ARIMA) model to predict the disease burden for the period 2020-2035. RESULTS From 1990 to 2019, the deaths and DALYs attributable to high BMI increased by 148% and 155.86% for men, and by 111.67% and 121.78% for women, respectively. In 2019, high BMI directly accounted for 8.52% [95% uncertainty intervals (UI) 0.05, 0.12] of all-cause deaths and 5.89% (95% UI 0.04, 0.08) of global DALYs. The highest death rates were observed in men aged 65-69 and women aged 75-79. The highest DALY rates were observed in the age group of 60-64 for both sexes. In 2019, the highest age-standardized deaths and DALY rates were observed in the Central Asia region [163.15 (95% UI 107.72, 223.58) per 100 000 people] and the Oceania region [4643.33 (95% UI 2835.66, 6902.6) per 100 000 people], respectively. Fiji [319.08 (95% UI 213.77, 444.96) per 100 000 people] and Kiribati [10 000.58 (95% UI 6266.55, 14159.2) per 100 000 people] had the highest age-standardized deaths and DALY rates, respectively. In 2019, the highest age-standardized rates of high BMI-related deaths and DALYs were observed in the middle-high socio-demographic index quintile and in the middle socio-demographic index quintile. The age-standardized deaths and DALY rates attributable to high BMI are projected to increase in both sexes from 2020 to 2035. The death rates are projected to rise from 62.79 to 64.31 per 100 000 people, while the DALY rates are projected to rise from 1946 to 2099.54 per 100 000 people. CONCLUSIONS High BMIs significantly contribute to the global disease burden. The projected rise in deaths and DALY rates attributable to high BMI by 2035 highlights the critical need to address the impact of obesity on public health. Our study provides policymakers with up-to-date and comprehensive information.
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Affiliation(s)
- Yuhan Chen
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Li Ma
- Biomedical Innovation and Entrepreneurship Laboratory, Jinan University, Guangzhou, China
| | - Zhigang Han
- Guangzhou Centre for Disease Control and Prevention, Guangzhou, China
| | - Peng Xiong
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
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Fatoye F, Gebrye T, Nherera L, Trueman P. Adoption of a Societal Perspective in Economic Evaluations of Musculoskeletal Disorders: A Conceptual Paper. JOURNAL OF MARKET ACCESS & HEALTH POLICY 2024; 12:216-223. [PMID: 39193540 PMCID: PMC11348208 DOI: 10.3390/jmahp12030018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 07/15/2024] [Accepted: 07/25/2024] [Indexed: 08/29/2024]
Abstract
Economic evaluations are used to compare the costs and consequences of healthcare interventions, including those for musculoskeletal (MSK) disorders, which are very common and a major source of morbidity and absence from work. Reimbursement decisions for interventions for MSK disorders by decision-makers rely on the findings of economic evaluations, the design and results of which depend largely on the perspective adopted. Despite methodological advancements in economic evaluations, there are no clear guidelines on the perspective to adopt. This paper explores the adoption of a societal perspective in economic evaluations of MSK disorders. Within health economics evaluations, the most commonly used perspectives include the payer perspective, the healthcare perspective, and the societal perspective. To facilitate optimal resource allocation decisions in order to reduce the significant economic burden of MSK disorders and improve the health outcomes of individuals with these disorders, all costs and benefits associated with interventions for them should be included. Thus, the societal perspective is arguably a preferable option to the others for economic evaluations of interventions for MSK disorders.
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Affiliation(s)
- Francis Fatoye
- Department of Health Professions, Faculty of Health and Education, Brooks Building I Manchester Metropolitan University, Manchester M15 6GX, UK;
| | - Tadesse Gebrye
- Department of Health Professions, Faculty of Health and Education, Brooks Building I Manchester Metropolitan University, Manchester M15 6GX, UK;
| | - Leo Nherera
- Smith + Nephew Inc., Global Market Access, 5600 Clearfork Main St, Fort Worth, TX 76109, USA; (L.N.); (P.T.)
| | - Paul Trueman
- Smith + Nephew Inc., Global Market Access, 5600 Clearfork Main St, Fort Worth, TX 76109, USA; (L.N.); (P.T.)
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Swamy AM. Obesity: Post-Pandemic Weight Management. Pediatr Clin North Am 2024; 71:645-652. [PMID: 39003007 DOI: 10.1016/j.pcl.2024.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/15/2024]
Abstract
Societal changes secondary to the coronavirus disease 2019 pandemic led to increased prevalence of adolescents with obesity and heightened awareness of weight stigma and size bias. During this time the American Academy of Pediatrics published its first clinical practice guidelines, and the Food and Drug Administration approved new weight loss drugs for adolescents, but insurance coverage is largely unavailable.
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Affiliation(s)
- Annemarie McCartney Swamy
- Adolescent Medicine, Department of Pediatrics, Charleston Area Medical Center, 830 Pennsylvania Avenue, Suite 401, Charleston, WV 25302, USA; West Virginia University.
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Kazi T, McKechnie T, Lee Y, Alsayari R, Talwar G, Doumouras A, Hong D, Eskicioglu C. The impact of obesity on postoperative outcomes following surgery for colorectal cancer: analysis of the National Inpatient Sample 2015-2019. ANZ J Surg 2024; 94:1305-1312. [PMID: 38888262 DOI: 10.1111/ans.19135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 06/05/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND The global burden of obesity has reached epidemic proportions, placing great strain on the North American healthcare system. We designed a retrospective cohort database study comparing postoperative morbidity and healthcare resource utilization between patients living with and without obesity undergoing surgery for colorectal cancer. METHODS Adult patients undergoing resection for colorectal cancer were identified from the 2015 to 2019 National Inpatient Sample database. Patients were stratified according to obesity status (i.e., body mass index of 30 kg/m2). Propensity score matching (PSM) with 1:1 nearest-neighbour matching was performed according to demographic, operative, and hospital characteristics. The primary outcome was postoperative morbidity. Secondary outcomes included system-specific postoperative complications, postoperative mortality, length of stay, total admission healthcare cost, and post-discharge disposition. McNemar's and Wilcoxon matched pairs signed rank tests were performed. RESULTS After PSM, 7565 non-obese and 7565 obese patients were included. Patients with obesity had a 10% increase in relative risk of overall in-hospital postoperative morbidity (23.1% versus 25.6%, P = 0.0015) and a $4564 increase in hospitalization cost ($70 248 USD versus $74 812 USD, P = 0.0004). Patients with obesity were more likely to require post-operative ICU admission (5.0% versus 8.0%, P < 0.0001) and less likely to be discharged home after their index operation (68.3% versus 64.2%, P = 0.0022). CONCLUSION Patients with obesity undergoing surgery for colorectal cancer may be at an increased risk of in-hospital postoperative morbidity. They may also be more likely to have increased hospitalization costs, post-operative ICU admissions, and to not be discharged directly home. Preoperative optimization via weight loss strategies should be further explored.
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Affiliation(s)
- Tania Kazi
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Tyler McKechnie
- Division of General Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Yung Lee
- Division of General Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
| | - Rehab Alsayari
- Division of General Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Gaurav Talwar
- Division of General Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Aristithes Doumouras
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
- Division of General Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
| | - Dennis Hong
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
- Division of General Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Cagla Eskicioglu
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
- Division of General Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
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Luah XW, Holst-Hansen T, Lübker C. The association between body mass index and health-related quality of life in the 2017 and 2018 health survey of England data: A cross-sectional observational analysis. Diabetes Obes Metab 2024; 26:2318-2328. [PMID: 38499493 DOI: 10.1111/dom.15546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 02/16/2024] [Accepted: 02/26/2024] [Indexed: 03/20/2024]
Abstract
AIM To provide an updated estimate of the association between body mass index (BMI) and health-related quality of life (HRQoL) among the general population in England and to identify population subgroups with the highest potential utility gains from obesity interventions. MATERIALS AND METHODS The sample included 12 158 adults with valid HRQoL and BMI data from the 2017 and 2018 Health Survey for England. Robust standard error linear regression, controlling for demographic and socioeconomic characteristics, lifestyle behaviours and obesity-related comorbidities, was used for the baseline analysis. Robustness checks assessed the impact of (a) estimator selection; (b) model specifications; (c) statistical outliers at high BMI; (d) potential BMI measurement error; and (e) data pooling. RESULTS The study found a significant association between HRQoL and BMI, which exhibited an inverted U-shaped relationship. The mean HRQoL peaked at 25.7 kg/m2 in men and 22.6 kg/m2 in women and was reduced in the underweight, overweight and obesity BMI ranges. Sensitivity analyses reported similar coefficients, suggesting a robust model specification. CONCLUSIONS Reduced HRQoL beyond optimal BMI underlines the importance of maintaining a normal BMI range for overall health. The rising prevalence of class III obesity is a major public health concern given its disproportionate impact on health, health care utilization and costs. Obesity management is key to preventing the reduction in HRQoL associated with obesity-related comorbidities, and this analysis supports the development of targeted policies and population health initiatives for people with class III obesity.
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Affiliation(s)
- Xiao Wen Luah
- Department of Economics and Related Studies, University of York, York, UK
- Novo Nordisk A/S, Søborg, Denmark
| | | | - Christopher Lübker
- Novo Nordisk A/S, Søborg, Denmark
- Department of Health Sciences, University of York, York, UK
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Lynch M, Bucknall M, Jagger C, Kingston A, Wilkie R. Demographic, health, physical activity, and workplace factors are associated with lower healthy working life expectancy and life expectancy at age 50. Sci Rep 2024; 14:5936. [PMID: 38467680 PMCID: PMC10928117 DOI: 10.1038/s41598-024-53095-z] [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: 07/31/2023] [Accepted: 01/27/2024] [Indexed: 03/13/2024] Open
Abstract
Although retirement ages are rising in the United Kingdom and other countries, the average number of years people in England can expect to spend both healthy and work from age 50 (Healthy Working Life Expectancy; HWLE) is less than the number of years to the State Pension age. This study aimed to estimate HWLE with the presence and absence of selected health, socio-demographic, physical activity, and workplace factors relevant to stakeholders focusing on improving work participation. Data from 11,540 adults in the English Longitudinal Study of Ageing were analysed using a continuous time 3-state multi-state model. Age-adjusted hazard rate ratios (aHRR) were estimated for transitions between health and work states associated with individual and combinations of health, socio-demographic, and workplace factors. HWLE from age 50 was 3.3 years fewer on average for people with pain interference (6.54 years with 95% confidence interval [6.07, 7.01]) compared to those without (9.79 [9.50, 10.08]). Osteoarthritis and mental health problems were associated with 2.2 and 2.9 fewer healthy working years respectively (HWLE for people without osteoarthritis: 9.50 years [9.22, 9.79]; HWLE with osteoarthritis: 7.29 years [6.20, 8.39]; HWLE without mental health problems: 9.76 years [9.48, 10.05]; HWLE with mental health problems: 6.87 years [1.58, 12.15]). Obesity and physical inactivity were associated with 0.9 and 2.0 fewer healthy working years respectively (HWLE without obesity: 9.31 years [9.01, 9.62]; HWLE with obesity: 8.44 years [8.02, 8.86]; HWLE without physical inactivity: 9.62 years [9.32, 9.91]; HWLE with physical inactivity: 7.67 years [7.23, 8.12]). Workers without autonomy at work or with inadequate support at work were expected to lose 1.8 and 1.7 years respectively in work with good health from age 50 (HWLE for workers with autonomy: 9.50 years [9.20, 9.79]; HWLE for workers lacking autonomy: 7.67 years [7.22, 8.12]; HWLE for workers with support: 9.52 years [9.22, 9.82]; HWLE for workers with inadequate support: 7.86 years [7.22, 8.12]). This study identified demographic, health, physical activity, and workplace factors associated with lower HWLE and life expectancy at age 50. Identifying the extent of the impact on healthy working life highlights these factors as targets and the potential to mitigate against premature work exit is encouraging to policy-makers seeking to extend working life as well as people with musculoskeletal and mental health conditions and their employers. The HWLE gaps suggest that interventions are needed to promote the health, wellbeing and work outcomes of subpopulations with long-term health conditions.
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Affiliation(s)
- Marty Lynch
- School of Medicine, Keele University, David Weatherall Building, Newcastle under Lyme, ST5 5BG, UK.
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK.
| | - Milica Bucknall
- School of Medicine, Keele University, David Weatherall Building, Newcastle under Lyme, ST5 5BG, UK
| | - Carol Jagger
- Population Health Sciences Institute, Newcastle University, Newcastle, UK
| | - Andrew Kingston
- Population Health Sciences Institute, Newcastle University, Newcastle, UK
| | - Ross Wilkie
- School of Medicine, Keele University, David Weatherall Building, Newcastle under Lyme, ST5 5BG, UK
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
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Galekop MMJ, Uyl-de Groot C, Redekop WK. Economic Evaluation of a Personalized Nutrition Plan Based on Omic Sciences Versus a General Nutrition Plan in Adults with Overweight and Obesity: A Modeling Study Based on Trial Data in Denmark. PHARMACOECONOMICS - OPEN 2024; 8:313-331. [PMID: 38113009 PMCID: PMC10883904 DOI: 10.1007/s41669-023-00461-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/26/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND Since there is no diet that is perfect for everyone, personalized nutrition approaches are gaining popularity to achieve goals such as the prevention of obesity-related diseases. However, appropriate choices about funding and encouraging personalized nutrition approaches should be based on sufficient evidence of their effectiveness and cost-effectiveness. In this study, we assessed whether a newly developed personalized plan (PP) could be cost-effective relative to a non-personalized plan in Denmark. METHODS Results of a 10-week randomized controlled trial were combined with a validated obesity economic model to estimate lifetime cost-effectiveness. In the trial, the intervention group (PP) received personalized home-delivered meals based on metabolic biomarkers and personalized behavioral change messages. In the control group these meals and messages were not personalized. Effects were measured in body mass index (BMI) and quality of life (EQ-5D-5L). Costs [euros (€), 2020] were considered from a societal perspective. Lifetime cost-effectiveness was assessed using a multi-state Markov model. Univariate, probabilistic sensitivity, and scenario analyses were performed. RESULTS In the trial, no significant differences were found in the effectiveness of PP compared with control, but wide confidence intervals (CIs) were seen [e.g., BMI (-0.07, 95% CI -0.51, 0.38)]. Lifetime estimates showed that PP increased costs (€520,102 versus €518,366, difference: €1736) and quality-adjusted life years (QALYs) (15.117 versus 15.106, difference: 0.011); the incremental cost-utility ratio (ICUR) was therefore high (€158,798 to gain one QALY). However, a 20% decrease in intervention costs would reduce the ICUR (€23,668 per QALY gained) below an unofficial gross domestic product (GDP)-based willingness-to-pay threshold (€47,817 per QALY gained). CONCLUSION On the basis of the willingness-to-pay threshold and the non-significant differences in short-term effectiveness, PP may not be cost-effective. However, scaling up the intervention would reduce the intervention costs. Future studies should be larger and/or longer to reduce uncertainty about short-term effectiveness. TRIAL REGISTRATION NUMBER ClinicalTrials.gov registry (NCT04590989).
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Affiliation(s)
| | - Carin Uyl-de Groot
- Erasmus Universiteit Rotterdam, Erasmus School of Health Policy and Management, Rotterdam, The Netherlands
| | - William Ken Redekop
- Erasmus Universiteit Rotterdam, Erasmus School of Health Policy and Management, Rotterdam, The Netherlands
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Viinikainen J, Böckerman P, Willage B, Elovainio M, Kari JT, Lehtimäki T, Pehkonen J, Pitkänen N, Raitakari O. Effect of weight on depression using multiple genetic instruments. PLoS One 2024; 19:e0297594. [PMID: 38394117 PMCID: PMC10889664 DOI: 10.1371/journal.pone.0297594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 01/09/2024] [Indexed: 02/25/2024] Open
Abstract
A striking global health development over the past few decades has been the increasing prevalence of overweight and obesity. At the same time, depression has become increasingly common in almost all high-income countries. We investigated whether body weight, measured by body mass index (BMI), has a causal effect on depression symptoms in Finland. Using data drawn from the Cardiovascular Risk in Young Finns Study (N = 1,523, mean age 41.9, SD 5), we used linear regression to establish the relationship between BMI and depression symptoms measured by 21-item Beck's Depression Inventory. To identify causal relationships, we used the Mendelian randomization (MR) method with weighted sums of genetic markers (single nucleotide polymorphisms, SNPs) as instruments for BMI. We employ instruments (polygenic risk scores, PGSs) with varying number of SNPs that are associated with BMI to evaluate the sensitivity of our results to instrument strength. Based on linear regressions, higher BMI was associated with a higher prevalence of depression symptoms among females (b = 0.238, p = 0.000) and males (b = 0.117, p = 0.019). However, the MR results imply that the positive link applies only to females (b = 0.302, p = 0.007) but not to males (b = -0.070, p = 0.520). Poor instrument strength may explain why many previous studies that have utilized genetic instruments have been unable to identify a statistically significant link between BMI and depression-related traits. Although the number of genetic markers in the instrument had only a minor effect on the point estimates, the standard errors were much smaller when more powerful instruments were employed.
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Affiliation(s)
- Jutta Viinikainen
- Jyväskylä University School of Business and Economics, University of Jyväskylä, Jyväskylä, Finland
| | - Petri Böckerman
- Jyväskylä University School of Business and Economics, University of Jyväskylä, Jyväskylä, Finland
- Labour Institute for Economic Research LABORE, Helsinki, Finland
- IZA Institute of Labor Economics, Bonn, Germany
| | - Barton Willage
- Department of Economics, University of Colorado—Denver, Denver, Colorado, United States of America
| | - Marko Elovainio
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Jaana T. Kari
- Jyväskylä University School of Business and Economics, University of Jyväskylä, Jyväskylä, Finland
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Finnish Cardiovascular Research Center Tampere, Tampere University, Tampere, Finland
| | - Jaakko Pehkonen
- Jyväskylä University School of Business and Economics, University of Jyväskylä, Jyväskylä, Finland
| | - Niina Pitkänen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Olli Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
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10
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Almoraie NM, Shatwan IM. The Potential Effects of Dietary Antioxidants in Obesity: A Comprehensive Review of the Literature. Healthcare (Basel) 2024; 12:416. [PMID: 38391792 PMCID: PMC10887832 DOI: 10.3390/healthcare12040416] [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: 12/19/2023] [Revised: 01/19/2024] [Accepted: 02/03/2024] [Indexed: 02/24/2024] Open
Abstract
Obesity has become a global health concern, with its prevalence steadily increasing in recent decades. It is associated with numerous health complications, including cardiovascular diseases, diabetes, and certain types of cancer. The aetiology of obesity is multifactorial, involving genetic, environmental, and lifestyle factors. In recent years, oxidative stress has emerged as a potential contributor to obesity and its related metabolic disorders. Dietary antioxidants, which can counteract oxidative stress, have gained significant attention for their potential role in preventing and managing obesity. This comprehensive review aims to explore the impact of dietary antioxidants on obesity and its associated metabolic dysregulations, discussing the underlying mechanisms and highlighting the potential therapeutic implications.
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Affiliation(s)
- Noha M Almoraie
- Food and Nutrition Department, Faculty of Human Sciences and Design, King Abdulaziz University, Building 43, Room 233, Level 2, Jeddah 3270, Saudi Arabia
| | - Israa M Shatwan
- Food and Nutrition Department, Faculty of Human Sciences and Design, King Abdulaziz University, Building 43, Room 233, Level 2, Jeddah 3270, Saudi Arabia
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11
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Otsubo T, Kinjo A, Kuwabara Y, Hongja K, Osaki Y. Lifestyle factors associated with presenteeism among city government office workers: a cross-sectional study. J Occup Health 2024; 66:uiad012. [PMID: 38258943 DOI: 10.1093/joccuh/uiad012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 10/31/2023] [Accepted: 11/23/2023] [Indexed: 01/24/2024] Open
Abstract
OBJECTIVES Presenteeism is a critical issue in occupational health. This study aimed to examine the association between presenteeism and subjective sleep quality, smoking status, and alcohol consumption. METHODS Anonymous data of 777 workers in a Japanese city were retrospectively obtained from City Government Office A. They included variables like absolute presenteeism scores (measured using the Japanese version of the World Health Organization Health and Work Performance Questionnaire short form), gender, age, family status, subjective sleep quality, smoking status, and alcohol consumption. A binary logistic regression analysis was performed with gender, age, family status, subjective sleep quality, smoking status, and alcohol consumption as the independent variables, and absolute presenteeism scores equal to or below 40 as the dependent variable. A gender-stratified binary logistic regression analysis was also performed. RESULTS The logistic regression analysis results revealed that absolute presenteeism was positively associated with poor subjective sleep quality among all respondents (odds ratio [OR], 1.70; 95% CI, 1.18-2.44) and men (OR, 1.85; 95% CI, 1.12-3.05) and with current drinkers among women (OR, 3.49; 95% CI, 1.36-8.92); it was negatively associated with age among those who were ≥50 years old (OR, 0.50; 95% CI, 0.27-0.93) and with current drinkers among men (OR, 0.43; 95% CI, 0.20-0.92). CONCLUSIONS The factors associated with presenteeism differed between men and women office workers, suggesting that gender differences need to be considered when working toward improving workers' productivity.
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Affiliation(s)
- Tsubasa Otsubo
- Division of Environmental and Preventive Medicine, Faculty of Medicine, Tottori University, Tottori, 683-8503, Japan
| | | | - Yuki Kuwabara
- Division of Environmental and Preventive Medicine, Faculty of Medicine, Tottori University, Tottori, 683-8503, Japan
| | - Ki Hongja
- Division of Environmental and Preventive Medicine, Faculty of Medicine, Tottori University, Tottori, 683-8503, Japan
| | - Yoneatsu Osaki
- Division of Environmental and Preventive Medicine, Faculty of Medicine, Tottori University, Tottori, 683-8503, Japan
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Coutinho W, Halpern B. Pharmacotherapy for obesity: moving towards efficacy improvement. Diabetol Metab Syndr 2024; 16:6. [PMID: 38172940 PMCID: PMC10763391 DOI: 10.1186/s13098-023-01233-4] [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: 08/16/2023] [Accepted: 11/25/2023] [Indexed: 01/05/2024] Open
Abstract
Obesity is a chronic, recurring, progressive disease and a major public health problem associated with several other diseases that lead to disability, morbidity, and mortality. The prevalence of obesity has increased at pandemic levels, along with increasing weight-related comorbidities and deaths worldwide. Lifestyle interventions alone provide clinically significant long-term weight loss in only a small proportion of individuals, and bariatric surgery is not suitable or desirable for all patients. Historically, anti-obesity medications achieved a mean efficacy with weight loss between 5 and 10%, which significantly impacted several comorbidities and risk factors, but the average efficacy of these medications remained lower than that expected by both patients and health care professionals and eventually curbed long-term use. Moreover, there is no direct evidence on the impact of anti-obesity medications on cardiovascular outcomes. Semaglutide is a newer anti-obesity medication that changes the overall landscape, as phase 3 studies show a mean weight loss near the 15% threshold and significant proportions of patients with a weight loss of greater than 20%. In this review, we focus on the currently available anti-obesity medications, discuss the results of semaglutide, and present perspectives on the future of obesity treatment after semaglutide.
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Affiliation(s)
- Walmir Coutinho
- State Institute of Diabetes and Endocrinology, Rua Moncorvo Filho, 90, Rio de Janeiro, RJ, 20211-340, Brazil.
- Department of Medicine, Pontifical Catholic University of Rio de Janeiro, Rua Marquês de São Vicente, 225, Gávea, Rio de Janeiro, RJ, 22541-041, Brazil.
| | - Bruno Halpern
- Department of Endocrinology, Obesity Unit, Hospital das Clínicas Faculdade de Medicina da Universidade de São Paulo. Av. Dr. Enéas de Carvalho Aguiar, 255, 7Th Floor, Room 7037, São Paulo, SP, 05403-000, Brazil
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13
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Vitale E, Mea R. Comorbidity, Eating Behaviors and Smartphone Addiction in Italian Nurses' Characteristics. Endocr Metab Immune Disord Drug Targets 2024; 24:1431-1444. [PMID: 38317462 DOI: 10.2174/0118715303271067231129103920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/17/2023] [Accepted: 11/10/2023] [Indexed: 02/07/2024]
Abstract
BACKGROUND Evidence suggested how nurses experienced worse lifestyles than the general population by recording deterioration rates in healthy conditions. AIM To assess differences between comorbidity, eating behavior, and smartphone addiction according to sex, Body Mass Index (BMI), age, work experience, shift, alcohol assumption, and physical activity in Italian nurses. METHODS An online questionnaire was spread through some professional internet pages. Data included demographic characteristics, the Charlson Comorbidity Index (CCI), the Italian Version of the Dutch Eating Behavior Questionnaire, and the Smartphone Addiction Scale (SAS-SV). RESULTS A total of 456 nurses were recruited. Significant differences were registered in the smartphone addiction score (p=0.030) and BMI scores and work experience (p=0.001), as underweight participants reported higher scores in the smartphone addiction attitude (2.4714 ± 1.25812) than the other subjects and also participants with the highest number of years in work experience also reported higher smartphone addiction scores (2.8074 ± 1.2022). Significant difference was reported in the CCI scores according to age (p<0.001): subjects aged over 61 years recorded higher scores in the CCI (1.67 ± 1.528) and also according to work experience and CCI scores (p<0.001), as participants employed between 21 and 30 years reported higher scores in the CCI (1.27 ± 1.382) and also to night shift (p=0.037), as participants who worked during the night shift also reported higher scores in the CCI. A significant difference was reported only for restrained eating attitude (p=0.034), as participants who declared to assume alcohol 2-3 times per month recorded higher levels in this eating attitude aspect (32.32 ± 7.181). CONCLUSION Female nurses, overweight and obese nurses with low physical activity practice, seemed to spend more time with their smartphones. Healthcare organizations should consider findings to prevent unhealthy lifestyles among nurses, which could negatively influence the whole healthcare system.
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Affiliation(s)
- Elsa Vitale
- Centre of Mental Health, Modugno, Local Health Company Bari, Bari, Italy
| | - Rocco Mea
- Department of Cardiology, San Carlo Hospital, Potenza, Italy
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14
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Nagi MA, Ahmed H, Rezq MAA, Sangroongruangsri S, Chaikledkaew U, Almalki Z, Thavorncharoensap M. Economic costs of obesity: a systematic review. Int J Obes (Lond) 2024; 48:33-43. [PMID: 37884664 DOI: 10.1038/s41366-023-01398-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 09/18/2023] [Accepted: 10/10/2023] [Indexed: 10/28/2023]
Abstract
INTRODUCTION Obesity is a growing public health problem leading to substantial economic impact. This study aimed to summarize the economic impact of obesity and to critically analyze the methods used in the cost-of-illness (COI) studies on obesity. METHODS We conducted systematic search in PubMed and Scopus from September 1, 2016, to July 22, 2022. Original COI studies estimating the economic cost of obesity and/or overweight in at least one country, published in English were included. To facilitate the comparison of estimates across countries, we converted the cost estimates of different years to 2022 purchasing power parity (PPP) values using each country's consumer price index (CPI) and PPP conversion rate. RESULTS Nineteen studies were included. All studies employed a prevalence-based approach using Population Attributable Fraction (PAF) methodology. About half of the included studies (53%) were conducted in high-income countries while the others (47%) were conducted in middle-income countries. The economic burden of obesity ranged between PPP 15 million in Brazil to PPP 126 billion in the USA, in the year 2022. Direct medical costs accounted for 0.7% to 17.8% of the health system expenditure. Furthermore, the total costs of obesity ranged from 0.05% to 2.42% of the country's gross domestic product (GDP). Of the seven studies that estimated both direct and indirect costs, indirect costs accounted for the largest portion of five studies. Nevertheless, a variety in methodology across studies was identified. The number of co-morbidities included in the analysis varied across studies. CONCLUSIONS Although there was a variety of methodologies across studies, consistent evidence indicated that the economic burden of obesity was substantial. Obesity prevention and control should be a public health priority, especially among countries with high prevalence of obesity.
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Affiliation(s)
- Mouaddh Abdulmalik Nagi
- Doctor of Philosophy Program in Social, Economic and Administrative Pharmacy, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
- Faculty of Medical Sciences, Aljanad University for Science and Technology, Taiz, Yemen
| | - Hanan Ahmed
- Faculty of Medical Sciences, Aljanad University for Science and Technology, Taiz, Yemen
- Master of Public Health, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Mustafa Ali Ali Rezq
- Master of Public Health, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Faculty of Pharmacy, Sana'a University, Sana'a, Yemen
| | - Sermsiri Sangroongruangsri
- Social and Administrative Pharmacy Excellence Research (SAPER) unit, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
| | - Usa Chaikledkaew
- Social and Administrative Pharmacy Excellence Research (SAPER) unit, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
| | - Ziyad Almalki
- Prince Sattam Bin Abdulaziz University, Department of Clinical Pharmacy, Al-Kharj, Riyadh, Saudi Arabia
| | - Montarat Thavorncharoensap
- Social and Administrative Pharmacy Excellence Research (SAPER) unit, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand.
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15
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Kotsopoulos N, Connolly MP. Assessing the Fiscal Burden of Obesity in Canada by Applying a Public Economic Framework. Adv Ther 2024; 41:379-390. [PMID: 37979088 PMCID: PMC10796418 DOI: 10.1007/s12325-023-02718-4] [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: 08/30/2023] [Accepted: 10/20/2023] [Indexed: 11/19/2023]
Abstract
INTRODUCTION Rising obesity prevalence is a health priority for many governments because of its impact on population health and economic consequences. We sought to estimate the broader consequences of obesity in Canada by applying a government perspective framework that captures lost tax revenues and increased government spending on social benefit programs. METHODS An age-specific prevalence-based model was built to quantify the fiscal burden of disease for government attributed to people living with obesity. The model was populated with age-specific wages, employment activity and government benefits received to estimate taxes and transfer costs. A targeted literature search was conducted to identify modifiers of employment status, wages and disability status attributed to people with obesity, and applied to employment and epidemiological projections which enabled us to estimate government costs and tax losses. Government tax revenue and costs attributed to obesity were projected over a 10-year period and discounted at 3%. RESULTS The fiscal burden of obesity in Canada is estimated at CAD$22,974 million (2021). This figure consists of obesity-attributed revenue losses of CAD$9404 million from direct taxes due to decreased employment activity and CAD$2374 million from indirect tax revenue losses due to reduced consumption taxes. Healthcare costs are estimated at CAD$7881 million annually and disability costs of CAD$3686 million annually. This fiscal burden of disease distributed amongst taxpayers in 2021 is estimated to be CAD$752 per capita. We estimate for every 1% reduction in obesity prevalence, CAD$229.7 million net fiscal gains can be achieved annually. CONCLUSIONS Obesity is associated with substantial clinical and economic burden not only to the healthcare system but also to wider government budgets as demonstrated using fiscal analysis. Reductions in obesity prevalence are likely to have positive fiscal gains for government from reduced spending on public benefits and increased tax revenue attributed to employment changes.
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Affiliation(s)
- Nikos Kotsopoulos
- Global Market Access Solutions Sarl, Health Economics Unit, 1162, St-Prex, Switzerland
- University of Athens MBA, University of Athens, Athens, Greece
| | - Mark P Connolly
- Global Market Access Solutions Sarl, Health Economics Unit, 1162, St-Prex, Switzerland.
- University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
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Stubelj M, Širok K, Laporšek S, Perčič S. Factors Influencing the Degree of Employee Involvement in Preventive Nutrition and Physical Activity Web-Based Programs in Medium and Small Enterprises. Nutrients 2023; 15:5129. [PMID: 38140388 PMCID: PMC10747149 DOI: 10.3390/nu15245129] [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: 11/05/2023] [Revised: 12/15/2023] [Accepted: 12/15/2023] [Indexed: 12/24/2023] Open
Abstract
This cross-sectional study was part of a comprehensive workplace health promotion program (WHPP) implemented in the work environment of small- and medium-sized enterprises (SMEs) in Western Slovenia, which included web-based educational campaigns aimed at promoting positive lifestyle changes among workers, including healthy eating habits and physical activity. As part of this program, which included campaigns in the areas of stress management, ergonomics, sleep hygiene, communication, work climate, and absenteeism, we developed and examined the engagement frequency in web-based content on healthy eating and physical activity for the companies included in the WHPP. This part of the project lasted from 2020 to 2022. Prior to the educational campaign, participants voluntarily completed a screening questionnaire. We analyzed the patterns of 370 workers in terms of their job classification (predominantly sedentary, predominantly standing, or predominantly physical), body mass index (BMI), gender, age, and selected indicators of diet and physical activity. Of the 88 companies participating in the WHPP, 26 took part in our web-based educational campaigns on nutrition and physical activity. Through an empirical analysis using descriptive and inferential statistics and a linear regression, we found that, on average, the engagement frequency (i.e., proportion of educational personal e-mails read) was highest among men with sedentary work, with older employees participating more actively than expected. Moreover, workers with good dietary habits and a favorable BMI proved to be the most avid readers of the web-based campaigns. Despite the overall low participant engagement frequency, it is clear that web-based educational campaigns are more appealing to workers with sedentary jobs and good dietary habits. This study provides valuable information on the potential effectiveness of appropriate workplace health promotion campaigns for SMEs and public health practices.
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Affiliation(s)
- Mojca Stubelj
- Faculty of Health Sciences, University of Primorska, 6310 Izola, Slovenia; (M.S.); (K.Š.)
| | - Klemen Širok
- Faculty of Health Sciences, University of Primorska, 6310 Izola, Slovenia; (M.S.); (K.Š.)
| | - Suzana Laporšek
- Faculty of Management, University of Primorska, 6000 Koper, Slovenia;
| | - Simona Perčič
- National Institute of Public Health Ljubljana, 1000 Ljubljana, Slovenia
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17
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Gallagher C, Ording J. A Comprehensive Obesity Benefit as a Guide for Employers on the Core Components of Obesity Care: Guidance From the American College of Occupational and Environmental Medicine (ACOEM) Roundtable on Obesity. J Occup Environ Med 2023; 65:e808-e811. [PMID: 37800332 DOI: 10.1097/jom.0000000000002987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
OBJECTIVE The need to confront the obesity epidemic and its impact on employers requires a serious look at how we address the treatment of obesity. This article focuses on the core components of obesity care and the need for employers to offer a comprehensive obesity benefit (COB) as part of employee insurance coverage. METHODS In May 2022, the American College of Occupational and Environmental Medicine convened a roundtable meeting, which brought together five corporate medical directors and representatives from aerospace/defense and energy industries to learn about the disease of obesity and provide clinical insights regarding health and safety in their respective industries. The goals of the program were to provide awareness of benefits for the treatment of obesity and identify the feasibility for employers of implementing a COB for their employees. Participants learned how a comprehensive approach to covering obesity treatments is necessary, and what benefits should be offered to employees. RESULTS Participants were invited to review the insurance benefits they currently offer to employees and compare them to the COB. Outcomes were limited by a lack of participation by the employers invited to participate. Participants identified actions that need to be addressed for employers to develop a more comprehensive approach to obesity care. CONCLUSION Implementing a COB can help employers increase access and utilization of comprehensive obesity care by employees.
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Affiliation(s)
- Christine Gallagher
- George Washington University, Washington, DC; and American College of Occupational and Environmental Medicine, Elk Grove Village, IL
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18
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Desalegn BB, Diddana TZ, Daba AK, Tafese TA. Overnutrition in adolescents and its associated factors in Dale district schools in Ethiopia: a cross-sectional study. PeerJ 2023; 11:e16229. [PMID: 37868052 PMCID: PMC10590108 DOI: 10.7717/peerj.16229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 09/12/2023] [Indexed: 10/24/2023] Open
Abstract
Background Adolescence is the critical stage of an individual's growth and development that determines their nutritional status in the future. Adolescent overnutrition has become an increasing public health concern in developing countries like Ethiopia. Objective This study was designed to determine the magnitude and determinants of overnutrition among school-going adolescents in Dale District of Ethiopia. Methods An institution-based cross-sectional study was done between November and December 2020. A total of 333 school-going adolescents aged 10-19 years participated in this study. Socio-demographic, lifestyle, physical activity level, dietary energy intake, and height and weight data were collected. Body Mass Index for age Z-score (BAZ) was computed. Binary and multivariable logistic regression models were used to determine the association of outcome variable with explanatory variables, and results were reported using adjusted odds ratio (AOR) with 95% confidence interval. Results The magnitude of overnutrition was 7.2% (10.8% in the urban versus. 3.6% of rural schools). Overnutrition was positively associated with lack of sufficient play area within the school (AOR = 2.53, 95% CI [1.02-6.26]), being an urban resident (AOR = 3.05, 95% CI [1.12-8.29]), positive energy balance (AOR = 9.47, 95% CI [1.58-56.80]), consuming fast foods within a month before the survey date (AOR = 2.60, 95% CI [1.93-6.83]), having moderate (AOR = 9.28, 95% CI [6.70-71.63]) or low physical activity (PA) (AOR = 7.95, 95% CI [1.12-56.72]), and consuming snack within last one week before the survey date (AOR = 3.32, 95% CI [1.15-9.58]). Conclusion The magnitude of overnutrition among school-going adolescents was suboptimal. Sedentary lifestyles, excess calorie intake, having inadequate play areas within the school, and having snack and fast foods were determinants for overnutrition in the study area.
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Affiliation(s)
- Beruk Berhanu Desalegn
- School of Nutrition, Food Science and Technology, College of Agriculture, Hawassa University, Hawassa, Sidama, Ethiopia
| | - Tona Zema Diddana
- School of Nutrition, Food Science and Technology, College of Agriculture, Hawassa University, Hawassa, Sidama, Ethiopia
| | - Alemneh Kabeta Daba
- School of Nursing, College of Medicine and Health Science, Hawassa University, Hawassa, Sidama, Ethiopia
| | - Tagel Alemu Tafese
- School of Nutrition, Food Science and Technology, College of Agriculture, Hawassa University, Hawassa, Sidama, Ethiopia
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19
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Melián-Fleitas L, Franco-Pérez Á, Sanz-Valero J, Wanden-Berghe C. Population Interest in Information on Obesity, Nutrition, and Occupational Health and Its Relationship with the Prevalence of Obesity: An Infodemiological Study. Nutrients 2023; 15:3773. [PMID: 37686805 PMCID: PMC10489826 DOI: 10.3390/nu15173773] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 08/24/2023] [Accepted: 08/28/2023] [Indexed: 09/10/2023] Open
Abstract
OBJECTIVE To identify and analyze population interest in obesity, nutrition, and occupational health and safety and its relationship with the worldwide prevalence of obesity through information search trends. METHOD In this ecological study, data were obtained through online access to Google Trends using the topics "obesity", "nutrition", and "occupational health and safety". Obesity data were obtained from the World Health Organization (WHO) website for crude adult prevalence and estimates by region. The variables studied were relative search volume (RSV), temporal evolution, milestone, trend, and seasonality. The temporal evolution of the search trends was examined by regression analysis (R2). To assess the relationship between quantitative variables, the Spearman correlation coefficient (Rho) was used. Seasonality was verified using the augmented Dickey-Fuller (ADF) test. RESULTS The RSV trends were as follows: obesity (R2 = 0.04, p = 0.004); nutrition (R2 = 0.42, p < 0.001); and occupational health and safety (R2 = 0.45, p < 0.001). The analysis of seasonality showed the absence of a temporal pattern (p < 0.05 for all terms). The associations between world obesity prevalence (WOP) and the different RSVs were as follows: WOP versus RSV obesity, Rho = -0.79, p = 0.003; WOP versus RSV nutrition, Rho = 0.57, p = 0.044; and WOP versus RSV occupational health and safety, Rho = -0.93, p = 0.001. CONCLUSIONS Population interest in obesity continues to be a trend in countries with the highest prevalence, although there are clear signs popularity loss in favor of searches focused on possible solutions and treatments, with a notable increase in searches related to nutrition and diet. Despite the fact that most people spend a large part of their time in the workplace and that interventions including various strategies have been shown to be useful in combating overweight and obesity, there has been a decrease in the population's interest in information related to obesity in the workplace. This information can be used as a guide for public health approaches to obesity and its relationship to nutrition and a healthy diet, approaches that are of equal utility and applicability in occupational health.
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Affiliation(s)
- Liliana Melián-Fleitas
- Nutrition Department, University of Granada, 18012 Granada, Spain;
- Geriatric Service, Insular Hospital, Health Services Management of the Health Area of Lanzarote, 35500 Arrecife, Spain
| | - Álvaro Franco-Pérez
- Playa Blanca Health Center, Health Services Management of the Health Area of Lanzarote, 35580 Playa Blanca, Spain
| | - Javier Sanz-Valero
- National School of Occupational Medicine, Carlos III Health Institute, 28029 Madrid, Spain;
| | - Carmina Wanden-Berghe
- Health and Biomedical Research Institute of Alicante (ISABIAL), University General Hospital, 03010 Alicante, Spain;
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20
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Seifert G, Fagnocchi L, Edozie M, Herrmann S, Baumann H, Panzeri I, Mewes S, Aicher D, Runkel M, Lässle C, Fink J, Marjanovic G, Fichtner-Feigl S, Pospisilik JA. The DECON pilot project investigates predictive markers for successful bariatric surgery. Sci Rep 2023; 13:13401. [PMID: 37591977 PMCID: PMC10435485 DOI: 10.1038/s41598-023-40452-7] [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: 10/04/2022] [Accepted: 08/10/2023] [Indexed: 08/19/2023] Open
Abstract
Obesity is a chronic, multifactorial disease which is linked to a number of adverse endocrinological and metabolic conditions. Currently, bariatric surgery is one of the most effective treatments for individuals diagnosed with severe obesity. However, the current indications for bariatric surgery are based on inadequate metrics (i.e., BMI) which do not account for the complexity of the disease, nor the heterogeneity among the patient population. Moreover, there is a lack of understanding with respect to the biological underpinnings that influence successful and sustained weight loss post-bariatric surgery. Studies have implicated age and pre-surgery body weight as two factors that are associated with favorable patient outcomes. Still, there is an urgent medical need to identify other potential factors that could improve the specificity of candidate selection and better inform the treatment plan of patients with obesity. In this report, we present and describe the cohort of the DECON pilot project, a multicenter study which aims to identify predictive biomarkers of successful weight loss after bariatric surgery.
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Affiliation(s)
- Gabriel Seifert
- Department of General and Visceral Surgery, University Medical Center Freiburg, University of Freiburg, Freiburg,, Germany.
| | | | | | - Stephan Herrmann
- Department of General and Visceral Surgery, University Medical Center Freiburg, University of Freiburg, Freiburg,, Germany
| | - Hannah Baumann
- Department of General and Visceral Surgery, University Medical Center Freiburg, University of Freiburg, Freiburg,, Germany
| | - Ilaria Panzeri
- Van Andel Institute, Grand Rapids, MI, 49503, USA
- Max Planck Institute of Immunobiology and Epigenetics, 79108, Freiburg, Germany
| | - Stephanie Mewes
- Department of General and Visceral Surgery, University Medical Center Freiburg, University of Freiburg, Freiburg,, Germany
| | - David Aicher
- Department of General and Visceral Surgery, University Medical Center Freiburg, University of Freiburg, Freiburg,, Germany
| | - Mira Runkel
- Department of General and Visceral Surgery, University Medical Center Freiburg, University of Freiburg, Freiburg,, Germany
| | - Claudia Lässle
- Department of General and Visceral Surgery, University Medical Center Freiburg, University of Freiburg, Freiburg,, Germany
| | - Jodok Fink
- Department of General and Visceral Surgery, University Medical Center Freiburg, University of Freiburg, Freiburg,, Germany
| | - Goran Marjanovic
- Department of General and Visceral Surgery, University Medical Center Freiburg, University of Freiburg, Freiburg,, Germany
| | - Stephan Fichtner-Feigl
- Department of General and Visceral Surgery, University Medical Center Freiburg, University of Freiburg, Freiburg,, Germany
| | - J Andrew Pospisilik
- Van Andel Institute, Grand Rapids, MI, 49503, USA.
- Max Planck Institute of Immunobiology and Epigenetics, 79108, Freiburg, Germany.
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Holford D, Tognon G, Gladwell V, Murray K, Nicoll M, Knox A, McCloy R, Loaiza V. Planning engagement with web resources to improve diet quality and break up sedentary time for home-working employees: A mixed methods study. J Occup Health Psychol 2023; 28:224-238. [PMID: 37578780 PMCID: PMC10424491 DOI: 10.1037/ocp0000356] [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: 10/25/2022] [Revised: 05/09/2023] [Accepted: 05/10/2023] [Indexed: 08/15/2023]
Abstract
As home working becomes more common, employers may struggle to provide health promotion interventions that can successfully bridge the gap between employees' intentions to engage in healthier behaviors and actual action. Based on past evidence that action planning can successfully encourage the adoption of healthier behaviors, this mixed-methods study of a web-based self-help intervention incorporated a randomized planning trial that included quantitative measures of engagement and follow-up qualitative interviews with a subsample of participants. Participants either (a) selected a movement plan for incorporating a series of 2-min exercise videos into their work week to break up sedentary time and a balanced meal plan with recipe cards for a week's lunches and dinners or (b) received access to these resources without a plan. Selecting a movement plan was more effective at increasing engagement with the web resources compared to the no-plan condition. In the follow-up interviews, participants indicated that the plan helped to remind participants to engage with the resources and made it simpler for them to follow the guidance for exercises and meals. Ease of use and being able to fit exercises and meals around work tasks were key factors that facilitated uptake of the resources, while lack of time and worries about how colleagues would perceive them taking breaks to use the resources were barriers to uptake. Participants' self-efficacy was associated with general resource use but not plan adherence. Overall, including plans with online self-help resources could enhance their uptake. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
| | | | - Valerie Gladwell
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex
| | - Kelly Murray
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex
| | | | | | - Rachel McCloy
- School of Psychology and Clinical Language Sciences, University of Reading
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22
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Garibay-Lagos CS, Martos-Boira MI, Landeta-Iza E, Contreras-González GB, Wanden-Berghe C, Sanz-Valero J. Occupational Health of Health-Care Workers with Overnutrition: Scoping Review with Meta-Analysis. Nutrients 2023; 15:3416. [PMID: 37571353 PMCID: PMC10421247 DOI: 10.3390/nu15153416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 07/25/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023] Open
Abstract
(1) Objective: To review the scientific literature on the impact of interventions to enhance the occupational health of health-care workers with overnutrition. (2) Methods: Scoping review with meta-analysis. Data were obtained by consulting the following bibliographic databases: MEDLINE (via PubMed), Embase, Cochrane Library, Scopus, Web of Science, Latin American and Caribbean Literature on Health Sciences (LILACS), and Medicina en Español (MEDES). The terms used as descriptors and as text in the title and abstract fields of the records were "health workers", "overnutrition", and "occupational health", using the filters "human", "adult": 19+ years", and "clinical trial". The search update date was January 2023. The documentary quality of the articles was evaluated using the CONSORT questionnaire and the presence of bias was assessed using the Rob 2.0 tool. (3) Results: From the 611 digitally retrieved references, 17 clinical trials were selected after applying the inclusion and exclusion criteria. CONSORT scores ranged from a minimum of 14.6% to a maximum of 91.7%, with a median of 68.8%. According to the SIGN criteria, this review provided "1" evidence with a grade B recommendation. Six different types of intervention were tested, grouped into strategies ranging from a single intervention to a combination of four interventions. The summary effect of the meta-analysis showed significant weight loss, but no association with reduced body mass index. (4) Conclusions: While workplace interventions have been shown to be potentially effective, and strategies using different types of interventions have been proven to be useful in tackling overnutrition, an effective and sustainable solution for changing the behavior of health professionals to tackle overweight and obesity has yet to be identified.
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Affiliation(s)
| | | | | | | | - Carmina Wanden-Berghe
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Health and Biomedical Research Institute of Alicante (ISABIAL), 03010 Alicante, Spain;
| | - Javier Sanz-Valero
- Carlos III Health Institute, National School of Occupational Medicine, 28029 Madrid, Spain
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Ebner DW, Burger KN, Broderick B, Mahoney DW, Kellogg TA, Acosta A, Kisiel JB. Positive Predictive Value for Multitarget Stool DNA After Bariatric and Metabolic Surgery. GASTRO HEP ADVANCES 2023; 2:902-910. [PMID: 37876832 PMCID: PMC10597571 DOI: 10.1016/j.gastha.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 06/16/2023] [Indexed: 10/26/2023]
Abstract
BACKGROUND AND AIMS Bariatric and metabolic surgery (BMS) may adversely affect noninvasive stool tests for colorectal cancer (CRC) screening through several mechanisms. Multitarget stool DNA (mt-sDNA) is approved for CRC screening; however, performance in post-BMS patients is unknown. As the rates of BMS are anticipated to increase with rising incidence of obesity, it is important to evaluate mt-sDNA test performance among these patients. METHODS In a multisite academic and community-based practice, we obtained mt-sDNA results from 10/2014 to 12/2019 through electronic records and an institutional BMS registry. Average CRC risk patients with BMS prior to a positive mt-sDNA underwent a detailed chart review. Follow-up colonoscopy findings were compared to those among BMS patients screened with colonoscopy alone and a historical cohort of patients without BMS, screened by mt-sDNA. The primary study endpoint was the positive predictive value (PPV) for advanced colorectal neoplasia. RESULTS Among 336 average-risk patients who had mt-sDNA after BMS, mt-sDNA was positive in 49 (14.6%), 47/49 (96%) underwent follow-up colonoscopy, and the PPV for advanced neoplasia was 12/47 (25.5%). This is similar to the PPV for advanced colorectal neoplasia (425/1542, 28%) in a historical cohort of persons without prior BMS, screened by mt-sDNA at our center (P = .86). Among those who had prior BMS, the rate of advanced neoplasia was higher after mt-sDNA compared to screening colonoscopy alone. CONCLUSION Despite anatomic and physiologic mechanisms that could alter blood or DNA content in stool, BMS does not appear to adversely affect the PPV of mt-sDNA.
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Affiliation(s)
- Derek W. Ebner
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Kelli N. Burger
- Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, Minnesota
| | - Brendan Broderick
- Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, Minnesota
| | - Douglas W. Mahoney
- Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, Minnesota
| | - Todd A. Kellogg
- Division of Endocrine & Metabolic Surgery, Mayo Clinic, Rochester, USA Minnesota
| | - Andres Acosta
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - John B. Kisiel
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
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Ishida M, D'Souza M, Zhao Y, Pan T, Carman W, Haregu T, Lee JT. The association between obesity, health service use, and work productivity in Australia: a cross-sectional quantile regression analysis. Sci Rep 2023; 13:6696. [PMID: 37095191 PMCID: PMC10126067 DOI: 10.1038/s41598-023-33389-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 04/12/2023] [Indexed: 04/26/2023] Open
Abstract
The burden of disease attributable to obesity is rapidly increasing and becoming a public health challenge globally. Using a nationally representative sample in Australia, this study aims to examine the association of obesity with healthcare service use and work productivity across outcome distributions. We used Household, Income and Labour Dynamics Australia (HILDA) Wave 17 (2017-2018), including 11,211 participants aged between 20 and 65 years. Two-part models using multivariable logistic regressions and quantile regressions were employed to understand variations in the association between obesity levels and the outcomes. The prevalence of overweight and obesity was 35.0% and 27.6%, respectively. After adjusting for socio-demographic factors, low socioeconomic status was associated with a higher probability of overweight and obesity (Obese III: OR = 3.79; 95% CI 2.53-5.68) while high education group was associated with a lower likelihood of being high level of obesity (Obese III OR = 0.42, 95% CI 0.29-0.59). Higher levels of obesity were associated with higher probability of health service use (GP visit Obese, III: OR = 1.42 95% CI 1.04-1.93,) and work productivity loss (number of paid sick leave days, Obese III: OR = 2.40 95% CI 1.94-2.96), compared with normal weight. The impacts of obesity on health service use and work productivity were larger for those with higher percentiles compared to lower percentiles. Overweight and obesity are associated with greater healthcare utilisation, and loss in work productivity in Australia. Australia's healthcare system should prioritise interventions to prevent overweight and obesity to reduce the cost on individuals and improve labour market outcomes.
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Affiliation(s)
- Marie Ishida
- School of Population and Global Health, Nossal Institute for Global Health, University of Melbourne, Melbourne, Australia.
| | - Monique D'Souza
- School of Population and Global Health, Nossal Institute for Global Health, University of Melbourne, Melbourne, Australia
| | - Yang Zhao
- The George Institute for Global Health at Peking University Health Science Center, Beijing, China
- The George Institute for Global Health at University of New South Wales, Sydney, Australia
| | - Tianxin Pan
- School of Population and Global Health, Nossal Institute for Global Health, University of Melbourne, Melbourne, Australia
| | - Will Carman
- School of Population and Global Health, Nossal Institute for Global Health, University of Melbourne, Melbourne, Australia
| | - Tilahun Haregu
- School of Population and Global Health, Nossal Institute for Global Health, University of Melbourne, Melbourne, Australia
| | - John Tayu Lee
- School of Population and Global Health, Nossal Institute for Global Health, University of Melbourne, Melbourne, Australia
- Department of Primary Care and Public Health, Faculty of Medicine, Imperial College London, London, UK
- Department of Health Service Research, Faculty of Medicine, Australian National University, Canberra, Australia
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da Silva Santos B, Bortolini J, de Sousa ÁFL, Andrade DD, Valim MD. Productivity Loss and Musculoskeletal Symptoms in Brazilian Presenteeism: A Cross-sectional Study. Open Nurs J 2023. [DOI: 10.2174/18744346-v17-230223-2022-78] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
Background:
The work has been brought to nursing professionals, denoting an increase in illness and consequent decrease in productivity.
Objective:
This study aims to verify the relationship between productivity and the presence of musculoskeletal symptoms in presenteeism.
Methods:
This is a cross-sectional and analytical study conducted with 305 Nursing workers from an emergency hospital in the Brazilian Midwest region. For data collection, four self-applied instruments were used, namely: the Sociodemographic Work and Health Conditions Questionnaire (QSCTS), the Stanford Presenteeism Scale (SPS-6), the Work Limitations Questionnaire (WLQ), and the Brazilian version of the Nordic Musculoskeletal Questionnaire (NMQ), Nordic Musculoskeletal Symptom Questionnaire (QNSO). The “presenteeism” and “presenteeism degree” dependent variables were related to the independent variables using the logistic regression model.
Results:
Presenteeism was identified in 134 (43.8%) workers. Overall productivity loss was 8.8%. Regarding the relationship between presenteeism and the occurrence of musculoskeletal symptoms, workers with problems in the upper back, knees, and neck in the last year were 6.5, 2.7, and 2.2 more likely to be presenteeism, respectively.
Conclusion:
The study confirmed the relationship between greater productivity losses and the incidence of musculoskeletal symptoms with presenteeism events in the Nursing team.
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La Foucade A, Laptiste C, Alcaraz A, Theodore K, Cumberbatch A, Gittens-Baynes KA, Beharry V, Gabriel S, Metivier C, Edwards-Wescott P, Bethelmie D. The health and economic burden associated with sugar-sweetened beverage consumption in Trinidad and Tobago. Nutr Health 2023:2601060231156117. [PMID: 36775945 DOI: 10.1177/02601060231156117] [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: 02/14/2023]
Abstract
BACKGROUND In Trinidad and Tobago, non-communicable diseases (NCDs) are the leading cause of death. Unhealthy diet is one modifiable NCD risk factor, which contributes to the NCD burden. The consumption of sugar-sweetened beverages (SSBs) has been associated with an increased risk of NCDs. AIM The aim of this paper is to estimate the burden of disease and economic costs associated with the consumption of SSBs in Trinidad and Tobago as evidence to support the implementation of health and fiscal policies on SSB consumption. METHODS The results of this study were obtained through the use of a mathematical model which used a comparative risk assessment approach to estimate the health and economic burden associated with SSB intake, by sex and age. RESULTS Estimates for one year showed that SSB consumption was associated with approximately 15,000 cases of overweight and obesity in adults and 11,700 cases in children, 28% of all the cases of diabetes and overall, an estimated 387 deaths and 9000 years of healthy life were lost due to premature death and disability. Approximately US$23.1 million was spent in the public healthcare system to treat diseases associated with consumption of sugary beverages. CONCLUSIONS The consumption of SSBs is associated with increases in diseases, deaths and rising healthcare costs in Trinidad and Tobago. It is hoped that the results of this study will provide an added rationale and impetus for the implementation of policies to reduce the consumption of SSBs.
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Affiliation(s)
- Althea La Foucade
- HEU, Centre for Health Economics, 37612The University of the West Indies St Augustine Campus, St Augustine, Trinidad and Tobago
| | - Christine Laptiste
- HEU, Centre for Health Economics, 37612The University of the West Indies St Augustine Campus, St Augustine, Trinidad and Tobago
| | - Andrea Alcaraz
- 172472Instituto de Efectividad Clínica y Sanitaria (IECS), Buenos Aires, Argentina
| | - Karl Theodore
- HEU, Centre for Health Economics, 37612The University of the West Indies St Augustine Campus, St Augustine, Trinidad and Tobago
| | - Anton Cumberbatch
- HEU, Centre for Health Economics, 37612The University of the West Indies St Augustine Campus, St Augustine, Trinidad and Tobago
| | - Kimberly-Ann Gittens-Baynes
- HEU, Centre for Health Economics, 37612The University of the West Indies St Augustine Campus, St Augustine, Trinidad and Tobago
| | - Vyjanti Beharry
- HEU, Centre for Health Economics, 37612The University of the West Indies St Augustine Campus, St Augustine, Trinidad and Tobago
| | - Samuel Gabriel
- HEU, Centre for Health Economics, 37612The University of the West Indies St Augustine Campus, St Augustine, Trinidad and Tobago
| | - Charmaine Metivier
- HEU, Centre for Health Economics, 37612The University of the West Indies St Augustine Campus, St Augustine, Trinidad and Tobago
| | - Patricia Edwards-Wescott
- HEU, Centre for Health Economics, 37612The University of the West Indies St Augustine Campus, St Augustine, Trinidad and Tobago
| | - Don Bethelmie
- HEU, Centre for Health Economics, 37612The University of the West Indies St Augustine Campus, St Augustine, Trinidad and Tobago
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Olejniczak D, Olearczyk A, Swakowska K, Staniszewska A, Zakrzewska K. Sickness Presence among Teachers, Nurses and Private Sector Office Workers. Healthcare (Basel) 2023; 11:512. [PMID: 36833046 PMCID: PMC9956123 DOI: 10.3390/healthcare11040512] [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: 11/30/2022] [Revised: 01/27/2023] [Accepted: 02/07/2023] [Indexed: 02/12/2023] Open
Abstract
INTRODUCTION Sickness presence is used to denote an employee who feels unwell but still attends work, thus avoiding absence. The intention of this paper is to compare sickness presence in a group of the following professions: teachers, nurses and private sector office workers. MATERIAL AND METHODS For the purpose of this study, a survey based on the original PAPI form (Paper-and-Pen Personal Interview) was carried out. Non-probability sampling, the snowball method (N = 507: teachers n = 174, nurses n = 165 and private sector office workers n = 168), covering the whole of Poland, was adopted. Non-parametric hypotheses were verified using the chi-squared test with a statistical significance α = 0.05. RESULTS Compared to nurses and private sector office workers, teachers more frequently attended work when sick (p < 0.05). Out of the reported ailments that respondents worked with, teachers more often indicated rhinitis (p < 0.05), sore throat and cough (p < 0.05) and increased temperature (p < 0.05). This may be associated with a threat to the health of individuals in their charge. Teachers commonly complained about joint and bone pain (p < 0.05) and gastrointestinal disorders (p < 0.05). Contrary to nurses and private sector office workers, teachers did not point to 'lack of a replacement' as the reason for their presence at work when sick (p < 0.05). Exclusively, teachers added financial issues and difficulties in access to healthcare if they are working fewer hours to the list of reasons for attending work when sick. CONCLUSIONS Results suggest that there is a need for further studies on the presence of sick employees in the workplace, especially for teachers. The sickness presence of teachers and nurses may be a threat from a public health perspective. The workplace itself is a significant place to prevent many diseases.
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Affiliation(s)
- Dominik Olejniczak
- Chair and Department of Public Health, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Agata Olearczyk
- Chair and Department of Public Health, Medical University of Warsaw, 02-091 Warsaw, Poland
| | | | - Anna Staniszewska
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Karolina Zakrzewska
- Department of Epidemiology and Biostatistics, Medical University of Warsaw, 02-091 Warsaw, Poland
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Vesikansa A, Mehtälä J, Mutanen K, Lundqvist A, Laatikainen T, Ylisaukko-oja T, Saukkonen T, Pietiläinen KH. The association between body mass index groups and metabolic comorbidities with healthcare and medication costs: a nationwide biobank and registry study in Finland. JOURNAL OF MARKET ACCESS & HEALTH POLICY 2023; 11:2166313. [PMID: 36684852 PMCID: PMC9858397 DOI: 10.1080/20016689.2023.2166313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 12/23/2022] [Accepted: 01/03/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND The increasing prevalence of obesity imposes a significant cost burden on individuals and societies worldwide. OBJECTIVE In this nationally representative study, the association between body mass index (BMI) groups and the number of metabolic comorbidities (MetC) with total direct costs was investigated in the Finnish population. STUDY DESIGN, SETTING, AND PARTICIPANTS The study cohort included 5,587 adults with BMI ≥18.5 kg/m2 who participated in the cross-sectional FinHealth 2017 health examination survey conducted by the Finnish Institute for Health and Welfare. Data on healthcare resource utilization (HCRU) and drug purchases were collected from national healthcare and drug registers. MAIN OUTCOME MEASURE The primary outcome was total direct costs (costs of primary and secondary HCRU and prescription medications). RESULTS Class I (BMI 30.0-34.9 kg/m2) and class II - III (BMI ≥35.0 kg/m2) obesity were associated with 43% and 40% higher age- and sex-adjusted direct costs, respectively, compared with normal weight, mainly driven by a steeply increased comorbidity in the higher BMI groups. In all BMI groups combined, individuals with ≥2 MetCs comprised 39% of the total study population and 60% of the total costs. CONCLUSION To manage the cost burden of obesity, treatment should be given equal consideration as other chronic diseases, and BMIs ≥30.0 kg/m2 should be considered in treatment decisions.
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Affiliation(s)
| | | | | | | | - Tiina Laatikainen
- Finnish Institute for Health and Welfare, Helsinki, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Joint Municipal Authority for North Karelia Social andHealth Services (Siun Sote), Joensuu, Finland
| | - Tero Ylisaukko-oja
- MedEngine Oy, Helsinki, Finland
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | | | - Kirsi H. Pietiläinen
- Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki,Helsinki, Finland & Obesity Center, Abdominal Center, Endocrinology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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Kavaliotis E, Boardman JM, Clark JW, Ogeil RP, Verdejo-García A, Drummond SPA. The relationship between sleep and appetitive conditioning: A systematic review and meta-analysis. Neurosci Biobehav Rev 2023; 144:105001. [PMID: 36529310 DOI: 10.1016/j.neubiorev.2022.105001] [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: 08/23/2022] [Revised: 11/24/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022]
Abstract
This systematic review and meta-analysis (PROSPERO registration animal/human studies: CRD42021234793/CRD42021234790) examined the relationship between sleep and appetitive conditioning. Inclusion criteria included: a) appetitive conditioning paradigm; b) measure of conditioning; c) sleep measurement and/or sleep loss; d) human and/etor non-human animal samples; and e) written in English. Searches of seven databases returned 3777 publications. The final sample consisted of 42 studies using primarily animal samples and involving food- and drug-related conditioning tasks. We found sleep loss disrupted appetitive conditioning of food rewards (p < 0.001) but potentiated appetitive conditioning of drug rewards (p < 0.001). Furthermore, sleep loss negatively impacted extinction learning irrespective of the reward type. Post-learning sleep was associated with increases in REM sleep (p = 0.02). Findings suggest sleep loss potentiates the impact of psychoactive substances in a manner likely to produce an increased risk of problematic substance use. In obese/overweight populations, sleep loss may be associated with deficits in the conditioning and extinction of reward-related behaviours. Further research should assess the relationship between sleep and appetitive conditioning in humans.
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Affiliation(s)
- Eleni Kavaliotis
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria 3800, Australia
| | - Johanna M Boardman
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria 3800, Australia
| | - Jacob W Clark
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria 3800, Australia
| | - Rowan P Ogeil
- Eastern Health Clinical School and Monash Addiction Research Centre, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria 3800, Australia; Turning Point, Eastern Health, Victoria 3121, Australia
| | - Antonio Verdejo-García
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria 3800, Australia
| | - Sean P A Drummond
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria 3800, Australia.
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Akksilp K, Isaranuwatchai W, Teerawattananon Y, Chen C. The association between health costs and physical inactivity; analysis from the Physical Activity at Work study in Thailand. Front Public Health 2023; 11:1037699. [PMID: 36960361 PMCID: PMC10027789 DOI: 10.3389/fpubh.2023.1037699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 02/08/2023] [Indexed: 03/09/2023] Open
Abstract
Introduction Physical inactivity increases the risks of several common yet serious non-communicable diseases, costing a tremendous amount of health expenditure globally. This study aimed to estimate the association between health costs and physical inactivity in Thailand. Methods Data from the Physical Activity at Work cluster randomized controlled trial participants with valid objective physical activity data were extracted. Health costs were collected using the Health and Welfare Survey and the Work Productivity and Activity Impairment Questionnaire and were categorized into past-month outpatient illness, past-year inpatient illness, and past-week presenteeism and absenteeism. Time spent in moderate-to-vigorous physical activity was used to determine the activity level according to the current guideline (i.e., ≥150 minutes moderate-intensity or ≥75 minutes vigorous-intensity equivalent physical activity per week). The primary analysis evaluated the association between direct cost (treatment and travel costs) and societal cost (direct cost plus absenteeism due to the illness) of past-month outpatient illness and physical inactivity using a two-part model. Results In total, 277 participants with a mean age of 38.7 were included. Average direct and societal cost due to past-month outpatient illness were 146 THB (3.99 USD) (SD = 647 THB) and 457 THB (12.5 USD) (SD = 1390 THB), respectively. Compared to active participants, direct and societal cost of past-month outpatient illness were 153 THB (4.18 USD) (95%CI: -54.7 to 360 THB) and 426 THB (11.7 USD) (95%CI: 23.3 to 829 THB) higher in physically inactive individuals, respectively, adjusted for covariates. The additional societal cost of past-month outpatient illness was 145% higher in physically inactive participants compared to active participants. On the other hand, there was no significant association in direct and societal cost of past-year inpatient illness nor past-week indirect costs between physically active and non-active participants. Discussion Results were similar to recent findings in different countries. However, the findings should be generalized with caution due to the small sample size and potential bias from reverse causation. Future research is crucial for clarifying the health costs of physical inactivity in Thailand and other countries.
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Affiliation(s)
- Katika Akksilp
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Health Intervention and Technology Assessment Programme, Ministry of Public Health, Bangkok, Thailand
- *Correspondence: Katika Akksilp
| | - Wanrudee Isaranuwatchai
- Health Intervention and Technology Assessment Programme, Ministry of Public Health, Bangkok, Thailand
| | - Yot Teerawattananon
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Health Intervention and Technology Assessment Programme, Ministry of Public Health, Bangkok, Thailand
| | - Cynthia Chen
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
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Mohan A, Raveendiran A, Pradeepa R, Ulagamathesan V, Chambers J, Mohan V, Venkatasubramanian P. Prevalence of and risk factors for diabesity in urban Chennai. JOURNAL OF DIABETOLOGY 2023. [DOI: 10.4103/jod.jod_121_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023] Open
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Woodman A, Jaoua N, Al Zahrani EM, Alfahad OA, Quiambao JV, Withers M. Factors of Overweight and Obesity Among Employees of Petrochemical Manufacturing Companies. J Community Health 2022; 48:381-389. [DOI: 10.1007/s10900-022-01177-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2022] [Indexed: 12/14/2022]
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Mavragani A, Yamaguchi M, Nishi N, Araki M, Wee LH. Predicting Overweight and Obesity Status Among Malaysian Working Adults With Machine Learning or Logistic Regression: Retrospective Comparison Study. JMIR Form Res 2022; 6:e40404. [PMID: 36476813 PMCID: PMC9773027 DOI: 10.2196/40404] [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: 06/20/2022] [Revised: 10/09/2022] [Accepted: 10/11/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Overweight or obesity is a primary health concern that leads to a significant burden of noncommunicable disease and threatens national productivity and economic growth. Given the complexity of the etiology of overweight or obesity, machine learning (ML) algorithms offer a promising alternative approach in disentangling interdependent factors for predicting overweight or obesity status. OBJECTIVE This study examined the performance of 3 ML algorithms in comparison with logistic regression (LR) to predict overweight or obesity status among working adults in Malaysia. METHODS Using data from 16,860 participants (mean age 34.2, SD 9.0 years; n=6904, 41% male; n=7048, 41.8% with overweight or obesity) in the Malaysia's Healthiest Workplace by AIA Vitality 2019 survey, predictor variables, including sociodemographic characteristics, job characteristics, health and weight perceptions, and lifestyle-related factors, were modeled using the extreme gradient boosting (XGBoost), random forest (RF), and support vector machine (SVM) algorithms, as well as LR, to predict overweight or obesity status based on a BMI cutoff of 25 kg/m2. RESULTS The area under the receiver operating characteristic curve was 0.81 (95% CI 0.79-0.82), 0.80 (95% CI 0.79-0.81), 0.80 (95% CI 0.78-0.81), and 0.78 (95% CI 0.77-0.80) for the XGBoost, RF, SVM, and LR models, respectively. Weight satisfaction was the top predictor, and ethnicity, age, and gender were also consistent predictor variables of overweight or obesity status in all models. CONCLUSIONS Based on multi-domain online workplace survey data, this study produced predictive models that identified overweight or obesity status with moderate to high accuracy. The performance of both ML-based and logistic regression models were comparable when predicting obesity among working adults in Malaysia.
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Affiliation(s)
| | - Miwa Yamaguchi
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Nobuo Nishi
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Michihiro Araki
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Lei Hum Wee
- Centre for Community Health Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.,Faculty of Health and Medical Sciences, School of Medicine, Taylor's University, Selangor, Malaysia
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Mears R, Leadbetter S, Candler T, Sutton H, Sharp D, Shield JPH. Cross-sectional survey of child weight management service provision by acute NHS trusts across England in 2020/2021. BMJ Open 2022; 12:e061971. [PMID: 36356995 PMCID: PMC9670955 DOI: 10.1136/bmjopen-2022-061971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE With one in five children in England living with obesity, we mapped the geographical distribution and format of child weight management services provided by acute National Health Service (NHS) trusts across England, to identify breadth of service provision. DESIGN A cross-sectional survey. SETTING The survey was sent to acute NHS trusts (n=148) in England in 2020, via a freedom of information request. PARTICIPANTS Responses were received from 139 of 148 (94%) acute NHS trusts, between March 2020 to March 2021. OUTCOME MEASURES The survey asked each acute NHS trust whether they provide a weight management service for children living with obesity. For those trusts providing a service, data were collected on eligibility criteria, funding source, personnel involved, number of new patients seen per year, intervention duration, follow-up length and outcome measures. Service characteristics were reported using descriptive statistics. Service provision was analysed in the context of ethnicity and Index of Multiple Deprivation score of the trust catchment area. RESULTS From the 139 survey respondents, 23% stated that they provided a weight management service for children living with obesity. There were inequalities in the proportion of acute NHS trusts providing a service across the different regions of England, ranging from 4% (Midlands) to 36% (London). For trusts providing a service, there was variability in the number of new cases seen per year, eligibility criteria, funding source, intervention format and outcome measures collected. A multidisciplinary approach was not routinely provided, with only 41% of services reporting ≥3 different staff disciplines. CONCLUSION In 2020/2021, there were geographical inequalities in weight management service provision by acute NHS trusts for children living with obesity. Services provided lacked standardisation, did not routinely offer children multidisciplinary care and were insufficient in size to meet need.
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Affiliation(s)
- Ruth Mears
- Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Bristol, UK
- Centre for Exercise Nutrition and Health Sciences, University of Bristol, Bristol, UK
| | - Sofia Leadbetter
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
- Faculty of Health Sciences, University of Bristol, Bristol, UK
| | - Toby Candler
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
- Faculty of Health Sciences, University of Bristol, Bristol, UK
| | - Hannah Sutton
- Faculty of Health Sciences, University of Bristol, Bristol, UK
| | - Deborah Sharp
- Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Bristol, UK
| | - Julian P H Shield
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
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Song Q, Li N, Sun C, Li Y, King B, Lowe S, Bentley R, Su W, Wang H, Guo X, Liang Q, Liang M, Qu G, Liu H, Ding X, Sun Y. Famine exposure in adolescence is associated with a higher risk of overweight/obesity and abdominal obesity in adulthood: A meta-analysis. Nutr Res 2022; 107:128-138. [PMID: 36215886 DOI: 10.1016/j.nutres.2022.09.005] [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: 06/06/2022] [Revised: 09/07/2022] [Accepted: 09/12/2022] [Indexed: 12/27/2022]
Abstract
Some studies have shown that famine exposure during adolescence can increase cardiovascular disease and diabetes susceptibility in later life. The association between famine exposure in adolescence and overweight/obesity and abdominal obesity in adulthood has been inconsistent. Based on previous studies, we hypothesized that famine exposure in adolescence increases the risk of overweight/obesity and abdominal obesity in adulthood. Eight databases, including PubMed, Embase, Cochrane Library, and Web of Science, were searched from their inception until November 2021. We initially identified 3982 records and finally included 7 articles after screening. The included articles were of moderate to high quality, containing 16 estimates of overweight/obesity and 3 estimates of abdominal obesity. Pooled odds ratios (ORs) with 95% CIs were used to estimate the association between them. The random effects model was adopted as the pooling method. There was a significant association between famine exposure in adolescence and overweight/obesity in adulthood (OR, 1.17; 95% CI, 1.02-1.33). Adolescents exposed to famine had a greater risk of abdominal obesity in adulthood than their unexposed counterparts (OR, 1.35; 95% CI, 1.03-1.76). These results were more pronounced in females than in males. In summary, our meta-analysis indicates that famine exposure during adolescence increases the risk of overweight/obesity and abdominal obesity in adulthood. This suggests that we need to pay timely attention to the nutritional status of adolescents to prevent adverse health consequences of malnutrition. More high-quality studies are needed to confirm these conclusions, given the limitations of this study.
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Affiliation(s)
- Qiuxia Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Ning Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Chenyu Sun
- AMITA Health Saint Joseph Hospital Chicago, Chicago, IL 60657, USA
| | - Yaru Li
- College of Osteopathic Medicine, Des Moines University, Des Moines, IA, 50312, USA; Internal Medicine, Swedish Hospital, Chicago, IL 60625, USA
| | - Bethany King
- College of Osteopathic Medicine, Des Moines University, Des Moines, IA, 50312, USA; Internal Medicine, MercyOne Des Moines Medical Center, Des Moines, Iowa 50314, USA
| | - Scott Lowe
- College of Osteopathic Medicine, Kansas City University, Kansas City, MO 64106, USA
| | - Rachel Bentley
- College of Osteopathic Medicine, Kansas City University, Kansas City, MO 64106, USA
| | - Wanying Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Hao Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Xianwei Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Qiwei Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Children's Hospital of Anhui Medical University, Hefei 238006, Anhui, China
| | - Mingming Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Guangbo Qu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Haixia Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Xiuxiu Ding
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China
| | - Yehuan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Chaohu Hospital, Anhui Medical University, Hefei 238006, Anhui, China.
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Saintila J, Calizaya-Milla YE, Calizaya-Milla SE, Elejabo-Pacheco AA, Sandoval-Valentin GA, Rodriguez-Panta SG. Association Between Nutritional Knowledge, Dietary Regimen, and Excess Body Weight in Primary School Teachers. J Multidiscip Healthc 2022; 15:2331-2339. [PMID: 36267850 PMCID: PMC9578462 DOI: 10.2147/jmdh.s385713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 09/27/2022] [Indexed: 11/05/2022] Open
Abstract
Introduction Peru is one of the developing countries with the highest prevalence of overweight and obesity in Latin America and Caribbean region. Primary school teachers are identified as a high-risk group for overweight and obesity. However, studies conducted in this population group are limited. This study evaluated the association between nutritional knowledge, dietary regimen, and excess body weight in primary school teachers. Methods This was a cross-sectional study that included 151 teachers from two state schools in the eastern region of Lima, Peru. The level of nutritional knowledge was assessed using a validated questionnaire. Dietary regimen was also determined. The body mass index (BMI) was determined through self-reported weight and height. Logistic regression analysis was used to assess the association between possible risk factors with excess body weight among teachers. Results Inadequate nutritional knowledge level (AOR = 5.21, 95% CI: 1.31–20.93), being male teachers (AOR = 2.25, 95% CI: 1.13–4.45), and being married (AOR = 2.49, 95% CI: 1.17–5.30) were the significant predictors of excess body weight. In contrast, vegetarian teachers were less likely to have excess body weight (AOR = 0.35, 95% CI: 0.47–0.97). Conclusion Future intervention programs should include improving nutritional knowledge with greater attention to male and married teachers to decrease the risk of excess body weight.
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Affiliation(s)
- Jacksaint Saintila
- Medical School, Señor De Sipán University, Chiclayo, Peru,Correspondence: Jacksaint Saintila, Medical School, Señor De Sipán University, Km 5, Carretera a Pimentel, Chiclayo, 14001, Peru, Email
| | - Yaquelin E Calizaya-Milla
- Research Group for Nutrition and Lifestyle, Human Nutrition School, Peruvian Union University, Lima, Peru,Yaquelin E Calizaya-Milla, Research Group for Nutrition and Lifestyle, Human Nutrition School, Peruvian Union University, Km 19, Carretera Central, Lima, 15033, Peru, Email
| | - Sergio E Calizaya-Milla
- Research Group for Nutrition and Lifestyle, Human Nutrition School, Peruvian Union University, Lima, Peru
| | - Ashly A Elejabo-Pacheco
- Research Group for Nutrition and Lifestyle, Human Nutrition School, Peruvian Union University, Lima, Peru
| | | | - Shirley G Rodriguez-Panta
- Research Group for Nutrition and Lifestyle, Human Nutrition School, Peruvian Union University, Lima, Peru
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Diamantis DV, Karatzi K, Kantaras P, Liatis S, Iotova V, Bazdraska Y, Tankova T, Cardon G, Wikström K, Rurik I, Antal E, Ayala-Marín AM, Legarre NG, Makrilakis K, Manios Y. Prevalence and Socioeconomic Correlates of Adult Obesity in Europe: The Feel4Diabetes Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12572. [PMID: 36231871 PMCID: PMC9566241 DOI: 10.3390/ijerph191912572] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 09/27/2022] [Accepted: 09/27/2022] [Indexed: 06/16/2023]
Abstract
To effectively tackle obesity, it is necessary to identify all specific socioeconomic factors which contribute to its development. We aimed to highlight the prevalence of adult overweight/obesity in European countries and investigate the association of various socioeconomic factors and their accumulative effect on overweight/obesity status. Cross-sectional data from the Feel4Diabetes study for 24,562 adults residing in low socioeconomic areas were collected, representing Belgium, Finland, Greece, Spain, Bulgaria, and Hungary. Socioeconomic Burden Score (SEBS) was created, accounting for unemployment, financial insecurity, and education ≤ 12 years. Data were analyzed using analysis of variance and logistic regression. In total, 19,063 adults with complete data were included (34.5% overweight and 15.8% obese). The highest overweight/obesity rates occurred in Greece (37.5%/17.8%) and Hungary (35.4%/19.7%). After adjusting for confounders, age of <45 years and female sex were inversely associated with overweight/obesity, while low educational level (≤12 years), unemployment, and financial insecurity were positively associated. The increase in SEBS (clustering of socioeconomic disadvantages) was associated with increased overweight/obesity likelihood. This association of SEBS scores with overweight/obesity was evident for males and females across all examined countries, excluding males in low-income countries (Bulgaria and Hungary), where the highest SEBS score was inversely associated with overweight/obesity. The clustering burden of socioeconomic disadvantages on overweight/obesity was found to be influenced by the countries' economic state and sex.
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Affiliation(s)
- Dimitrios V. Diamantis
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece
| | - Kalliopi Karatzi
- Laboratory of Dietetics and Quality of Life, Department of Food Science & Human Nutrition, School of Food and Nutritional Sciences, Agricultural University of Athens, 11855 Athens, Greece
| | - Paris Kantaras
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece
| | - Stavros Liatis
- Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Violeta Iotova
- Department of Paediatrics, Medical University of Varna, 9010 Varna, Bulgaria
| | - Yulia Bazdraska
- Department of Paediatrics, Medical University of Varna, 9010 Varna, Bulgaria
| | - Tsvetalina Tankova
- Clinical Center of Endocrinology and Gerontology, Medical University of Sofia, 1431 Sofia, Bulgaria
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, 9000 Ghent, Belgium
| | - Katja Wikström
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, 00271 Helsinki, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, 70210 Kuopio, Finland
| | - Imre Rurik
- Department of Family Medicine Hungarian Society of Nutrition, Semmelweis University, 1085 Budapest, Hungary
| | - Emese Antal
- Hungarian Society of Nutrition, 1088 Budapest, Hungary
| | - Alelí M. Ayala-Marín
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Facultad de Ciencias de la Salud, Universidad de Zaragoza, 50009 Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50013 Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), 50009 Zaragoza, Spain
| | - Natalia Giménez Legarre
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Facultad de Ciencias de la Salud, Universidad de Zaragoza, 50009 Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50013 Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), 50009 Zaragoza, Spain
| | | | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece
- Institute of Agri-Food and Life Sciences, Hellenic Mediterranean University Research Centre, 71410 Heraklion, Greece
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Swancutt D, Tarrant M, Ingram W, Baldrey S, Burns L, Byng R, Calitri R, Creanor S, Dean S, Evans L, Gill L, Goodwin E, Hawkins L, Hayward C, Hind S, Hollands L, Hosking J, Lloyd J, Moghadam S, Neilens H, O’Kane M, Perry S, Sheaff R, Spencer A, Taylor A, Ward T, Watkins R, Wilding J, Pinkney J. A group-based behavioural intervention for weight management (PROGROUP) versus usual care in adults with severe obesity: a feasibility randomised controlled trial protocol. Pilot Feasibility Stud 2022; 8:206. [PMID: 36088457 PMCID: PMC9463813 DOI: 10.1186/s40814-022-01167-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 08/25/2022] [Indexed: 11/24/2022] Open
Abstract
Background Approximately 15 million people in the UK live with obesity, around 5 million of whom have severe obesity (body mass index (BMI) ≥35kg/m2). Having severe obesity markedly compromises health, well-being and quality of life, and substantially reduces life expectancy. These adverse outcomes are prevented or ameliorated by weight loss, for which sustained behavioural change is the cornerstone of treatment. Although NHS specialist ‘Tier 3’ Weight Management Services (T3WMS) support people with severe obesity, using individual and group-based treatment, the current evidence on optimal intervention design and outcomes is limited. Due to heterogeneity of severe obesity, there is a need to tailor treatment to address individual needs. Despite this heterogeneity, there are good reasons to suspect that a structured group-based behavioural intervention may be more effective and cost-effective for the treatment of severe obesity compared to usual care. The aims of this study are to test the feasibility of establishing and delivering a multi-centre randomised controlled clinical trial to compare a group-based behavioural intervention versus usual care in people with severe obesity. Methods This feasibility randomised controlled study is a partially clustered multi-centre trial of PROGROUP (a novel group-based behavioural intervention) versus usual care. Adults ≥18 years of age who have been newly referred to and accepted by NHS T3WMS will be eligible if they have a BMI ≥40, or ≥35 kg/m2 with comorbidity, are suitable for group-based care and are willing to be randomised. Exclusion criteria are participation in another weight management study, planned bariatric surgery during the trial, and unwillingness or inability to attend group sessions. Outcome assessors will be blinded to treatment allocation and success of blinding will be evaluated. Clinical measures will be collected at baseline, 6 and 12 months post-randomisation. Secondary outcome measures will be self-reported and collected remotely. Process and economic evaluations will be conducted. Discussion This randomised feasibility study has been designed to test all the required research procedures and additionally explore three key issues; the feasibility of implementing a complex trial at participating NHS T3WMS, training the multidisciplinary healthcare teams in a standard intervention, and the acceptability of a group intervention for these particularly complex patients. Trial registration ISRCTN number 22088800. Supplementary Information The online version contains supplementary material available at 10.1186/s40814-022-01167-0.
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Gorasso V, Moyersoen I, Van der Heyden J, De Ridder K, Vandevijvere S, Vansteelandt S, De Smedt D, Devleesschauwer B. Health care costs and lost productivity costs related to excess weight in Belgium. BMC Public Health 2022; 22:1693. [PMID: 36068519 PMCID: PMC9450378 DOI: 10.1186/s12889-022-14105-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 08/16/2022] [Indexed: 11/10/2022] Open
Abstract
Background This study aimed to estimate annual health care and lost productivity costs associated with excess weight among the adult population in Belgium, using national health data. Methods Health care costs and costs of absenteeism were estimated using data from the Belgian national health interview survey (BHIS) 2013 linked with individual health insurance data (2013–2017). Average yearly health care costs and costs of absenteeism were assessed by body mass index (BMI) categories – i.e., underweight (BMI < 18.5 kg/m2), normal weight (18.5 ≤ BMI < 25 kg/m2), overweight (25 ≤ BMI < 30 kg/m2) and obesity (BMI ≥ 30 kg/m2). Health care costs were also analysed by type of cost (i.e. ambulatory, hospital, reimbursed medication). The cost attributable to excess weight and the contribution of various other chronic conditions to the incremental cost of excess weight were estimated using the method of recycled prediction (a.k.a. standardisation). Results According to BHIS 2013, 34.7% and 13.9% of the Belgian adult population were respectively affected by overweight or obesity. They were mostly concentrated in the age-group 35–65 years and had significantly more chronic conditions compared to the normal weight population. Average total healthcare expenses for people with overweight and obesity were significantly higher than those observed in the normal weight population. The adjusted incremental annual health care cost of excess weight in Belgium was estimated at €3,329,206,657 (€651 [95% CI: €144-€1,084] and €1,015 [95% CI: €343–€1,697] per capita for individuals with overweight and obesity respectively). The comorbidities identified to be the main drivers for these incremental health care costs were hypertension, high cholesterol, serious gloom and depression. Mean annual incremental cost of absenteeism for overweight accounted for €242 per capita but was not statistically significant, people with obesity showed a significantly higher cost (p < 0.001) compared to the normal weight population: €2,015 [95% CI: €179–€4,336] per capita. The annual total incremental costs due to absenteeism of the population affected by overweight and obesity was estimated at €1,209,552,137. Arthritis, including rheumatoid arthritis and osteoarthritis, was the most important driver of the incremental cost of absenteeism in individuals with overweight and obesity, followed by hypertension and low back pain. Conclusions The mean annual incremental cost of excess weight in Belgium is of concern and stresses the need for policy actions aiming to reduce excess body weight. This study can be used as a baseline to evaluate the potential savings and health benefits of obesity prevention interventions. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14105-9.
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Affiliation(s)
- Vanessa Gorasso
- Department of Epidemiology and Public Health, Sciensano, Rue J Wytsman 14, 1050, Brussels, Belgium. .,Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
| | - Isabelle Moyersoen
- Department of Epidemiology and Public Health, Sciensano, Rue J Wytsman 14, 1050, Brussels, Belgium
| | - Johan Van der Heyden
- Department of Epidemiology and Public Health, Sciensano, Rue J Wytsman 14, 1050, Brussels, Belgium
| | - Karin De Ridder
- Department of Epidemiology and Public Health, Sciensano, Rue J Wytsman 14, 1050, Brussels, Belgium
| | - Stefanie Vandevijvere
- Department of Epidemiology and Public Health, Sciensano, Rue J Wytsman 14, 1050, Brussels, Belgium
| | - Stijn Vansteelandt
- Department of Applied Mathematics and Statistics, Ghent University, Ghent, Belgium.,Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Delphine De Smedt
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Rue J Wytsman 14, 1050, Brussels, Belgium.,Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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Okunogbe A, Nugent R, Spencer G, Powis J, Ralston J, Wilding J. Economic impacts of overweight and obesity: current and future estimates for 161 countries. BMJ Glob Health 2022; 7:e009773. [PMID: 36130777 PMCID: PMC9494015 DOI: 10.1136/bmjgh-2022-009773] [Citation(s) in RCA: 63] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 08/13/2022] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION The scope of the challenge of overweight and obesity (OAO) has not been fully realised globally, in part because much of what is known about the economic impacts of OAO come from high-income countries (HICs) and are not readily comparable due to methodological differences. Our objective is to estimate the current and future national economic impacts of OAO globally. METHODS We estimated economic impacts of OAO for 161 countries using a cost-of-illness approach. Direct and indirect costs of OAO between 2019 and 2060 were estimated from a societal perspective. We assessed the effect of two hypothetical scenarios of OAO prevalence projections. Country-specific data were sourced from published studies and global databases. RESULTS The economic impact of OAO in 2019 is estimated at 2.19% of global gross domestic product (GDP) ranging on average from US$20 per capita in Africa to US$872 per capita in the Americas and from US$6 in low-income countries to US$1110 in HICs.If current trends continue, by 2060, the economic impacts from OAO are projected to rise to 3.29% of GDP globally. The biggest increase will be concentrated in lower resource countries with total economic costs increasing by fourfold between 2019 and 2060 in HICs, whereas they increase 12-25 times in low and middle-income countries. Reducing projected OAO prevalence by 5% annually from current trends or keeping it at 2019 levels will translate into average annual reductions of US$429 billion or US$2201 billion in costs, respectively, between 2020 and 2060 globally. CONCLUSION This study provides novel evidence on the economic impact of OAO across different economic and geographic contexts. Our findings highlight the need for concerted and holistic action to address the global rise in OAO prevalence, to avert the significant risks of inaction and achieve the promise of whole-of-society gains in population well-being.
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Affiliation(s)
| | - Rachel Nugent
- Center for GlobalNoncommunicable Diseases, RTI International, Research Triangle Park, North Carolina, USA
| | - Garrison Spencer
- Center for GlobalNoncommunicable Diseases, RTI International, Research Triangle Park, North Carolina, USA
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King WC, Hinerman AS, White GE. A 7-Year Study of the Durability of Improvements in Pain, Physical Function, and Work Productivity After Roux-en-Y Gastric Bypass and Sleeve Gastrectomy. JAMA Netw Open 2022; 5:e2231593. [PMID: 36103179 PMCID: PMC9475385 DOI: 10.1001/jamanetworkopen.2022.31593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
IMPORTANCE Bariatric surgical procedures are associated with clinically important improvements (CIIs) in pain and physical function. However, there are declines in initial improvement by the third postoperative year, and the long-term durability of improvements are not well-described. OBJECTIVE To evaluate the durability of improvements in pain and physical function through 7 years after Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG). DESIGN, SETTING, AND PARTICIPANTS This study is part of the Longitudinal Assessment of Bariatric Surgery-2 (LABS-2), a cohort study at 10 US hospitals. Adults with severe obesity (ie, body mass index of 35 or greater) undergoing bariatric surgery were assessed preoperatively (2006-2009) and followed up annually for as long as 7 years or until 2015. Of 1829 participants who underwent RYGB or SG in LABS-2, 338 were excluded from this study because they had a follow-up period of less than 5 years. Analysis of participants who underwent RYGB or SG and completed research assessments preoperatively and postoperatively for 5 to 7 years was conducted from March to April 2022. MAIN OUTCOMES AND MEASURES Preoperative-to-postoperative CIIs in pain and physical function scores from the 36-Item Short Form Health Survey and the Western Ontario McMaster Osteoarthritis Index, and 400-meter walk time, using previously established thresholds; and remission of mobility deficit, ie, inability to walk 400 meters in 7 minutes or less. RESULTS A total of 1491 individuals were included, with 1194 (80%) women; 59 (4%) Hispanic, 164 (11%) non-Hispanic Black, and 1205 (82%) non-Hispanic White individuals; a preoperative median (IQR) age of 47 (38-55) years; and a preoperative median (IQR) body mass index of 47 (42-52). Between 3 and 7 years after surgery, the percentage of participants with preoperative-to-postoperative CIIs in bodily pain decreased from 50% (95% CI, 48%-53%) to 43% (95% CI, 40%-46%), in physical function from 75% (95% CI, 73%-77%) to 64% (95% CI, 61%-68%), and in 400-meter walk time from 61% (95% CI, 56%-65%) to 50% (95% CI, 45%-55%). Among participants with a preoperative mobility deficit, remission decreased from 50% (95% CI, 42%-57%) to 41% (95% CI, 32%-49%), and among participants with severe knee or hip pain or disability, the percentage with CIIs in knee and hip pain and function decreased (eg, hip pain: from 77% [95% CI, 72%-82%] to 65% [95% CI, 58%-72%]; knee function: from 77% [95% CI, 73%-82%] to 72% [95% CI, 67%-77%]). CONCLUSIONS AND RELEVANCE In this cohort study, despite decreases in preoperative-to-postoperative improvements across follow-up, CIIs in perceived bodily and joint-specific pain and in self-reported and objectively measured physical function ranged from 41% to 72%, depending on the measure and subgroup, 7 years after surgery, suggesting that RYGB and SG are commonly associated with long-term CIIs in pain and physical function.
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Affiliation(s)
- Wendy C. King
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Amanda S. Hinerman
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Gretchen E. White
- Division of General Internal Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
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Asare BYA, Makate M, Powell D, Kwasnicka D, Robinson S. Cost of Health-Related Work Productivity Loss among Fly-In Fly-Out Mining Workers in Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10056. [PMID: 36011689 PMCID: PMC9408090 DOI: 10.3390/ijerph191610056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 08/10/2022] [Accepted: 08/12/2022] [Indexed: 06/15/2023]
Abstract
Sufficient knowledge on the work productivity impact of the health of fly-in fly-out (FIFO) workers in the mining sector in Australia is lacking. This study examined the impact of health and lifestyle behaviours on the work productivity of FIFO workers in the mining industry in Australia. FIFO workers completed an online questionnaire on health and work productivity loss measures. Linear regressions were used to model annual work productivity losses through absenteeism, presenteeism and total productivity loss. Workers with a high risk for health conditions were, on average, associated with 3.87% more productivity loss (absenteeism: 1.27% and presenteeism: 2.88%) than those with low risk. Workers who had multiple health risks classified as medium (3-4 health conditions) and high (5 or more health conditions) reported 1.75% and 7.46% more total productivity loss, respectively, than those with fewer multiple health risks (0-2 health conditions). Health conditions were estimated to account for an annual additional productivity cost due to absenteeism of AUD 8.82 million, presenteeism of AUD 14.08 million and a total productivity loss of AUD 20.96 million per 1000 workers. FIFO workers with high health risks experience more absenteeism, presenteeism and overall productivity loss. These measures provide strong economic justifications that could support the need for targeted workplace health interventions.
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Affiliation(s)
- Bernard Yeboah-Asiamah Asare
- Curtin School of Population Health, Curtin University, Kent Street, Perth 6102, Australia
- Health Psychology, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen AB25 2ZD, UK
| | - Marshall Makate
- Curtin School of Population Health, Curtin University, Kent Street, Perth 6102, Australia
| | - Daniel Powell
- Health Psychology, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen AB25 2ZD, UK
- Rowett Institute, University of Aberdeen, Aberdeen AB25 2ZD, UK
| | - Dominika Kwasnicka
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Aleksandra Ostrowskiego 30b, 53-238 Wroclaw, Poland
- NHMRC CRE in Digital Technology to Transform Chronic Disease Outcomes, Melbourne School of Population and Global Health, University of Melbourne, 333 Exhibition Street, Melbourne 3000, Australia
| | - Suzanne Robinson
- Curtin School of Population Health, Curtin University, Kent Street, Perth 6102, Australia
- Deakin Health Economics, Faculty of Health, Deakin University, Burwood 3125, Australia
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Bagheri P, Salimi Y, Abdoli G, Najafi F. Validity and Reliability of the Persian Version of the Sedentary Behavior Questionnaire Among Office Employees. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2022:1-6. [PMID: 35946579 DOI: 10.1080/10803548.2022.2111879] [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: 10/15/2022]
Abstract
Purpose: This study aimed to evaluate the validity and reliability of the Persian version of the sedentary behavior questionnaire (SBQ) among university office employees in Kermanshah province in the west of Iran.Method: A validation study was performed among 701 university office employees in Kermanshah province. The content validation process was conducted using interviews with content and lay experts. The intraclass correlation coefficient (ICC) was calculated as test-retest reliability. In addition, exploratory and confirmatory factor analyses were used to assess the validity of the questionnaire structure.Results: The scale content validity indices using two general agreement approaches and the mean approach were 88.88 and 97.77%, respectively. The ICC was estimated at 1.00 [95% CI:0.99, 1.00]. The exploratory factor analyses suggested nine-factor solutions, and in the independent sample, the confirmatory factor analysis fit indices showed that the model had an acceptable fit to the data.Conclusion: The Persian version of the SBQ had acceptable reliability and validity for assessing SBs among office employees. This questionnaire is a simple and self-report tool for measuring SB in daily life and would be useful in the design and evaluation of preventive programs among administrative staff and high-risk population surveillance.
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Affiliation(s)
- Parnia Bagheri
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Yahya Salimi
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Gholamreza Abdoli
- Department of Epidemiology, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Farid Najafi
- Research center for environmental determinants of health, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Fideles IC, Akutsu RDCCDA, Costa PRDF, Souza JC, Barroso RDRF, Botelho RBA, Han H, Raposo A, Ariza-Montes A, Vega-Muñoz A, Zandonadi RP. Brazilian Food Handlers' Years of Work in the Foodservice and Excess Weight: A Nationwide Cross-Sectional Study. Front Public Health 2022; 10:869684. [PMID: 35707054 PMCID: PMC9189379 DOI: 10.3389/fpubh.2022.869684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 05/09/2022] [Indexed: 11/20/2022] Open
Abstract
This study aimed to evaluate the association between the years of work of food handlers in the foodservice and excess weight among Brazilian low-income food handlers. A total of 559 food handlers from all Brazilian regions were characterized using a questionnaire. Weight and height were measured to estimate the Body Mass Index and classify the individuals. The association between food handlers' years of work in the foodservice, anthropometric status, and other variables (gender, age group, educational level, participation in a government program and per capita income at home and energetic consumption) were performed using Pearson's chi-square test (p < 0.05). Multinomial logistic regression analyses were performed (p < 0.05) as well as sensitivity tests using the outcome continuously and transformed, excluding underweight individuals, in a multivariate linear regression model. Most of the sample was female (63.1%), aged between 21 and 40 years old (63.5%), and 53.3% had studied up to complete elementary school. Almost 41% of the food handlers had less than half the minimum wage per capita income. Of the evaluated individuals, 59.9% presented excess weight. There was an association with family per capita income (Odds Ratio - OR: 1.73; Confidence interval - CI95%: 1.09-2.75); handlers whose per capita income was ≤0.5 minimum wage had a 73% higher chance of obesity than those with higher income. Working in foodservive ≥3 years increased the chance of being overweight by 96% compared to those who work for <3 years (OR: 1.96; CI95%: 1.11-3.49). No significant association was found between the years of work of food handlers in the foodservice and obesity. Since work-related factors may contribute to the high prevalence of excess weight, including working in a food handling environment, the government and employers should consider workplace interventions. These would guide the food handlers in avoiding high rates of excess weight and their consequences on public health. Excess weight is an important driver of costs in the workplace associated with absenteeism, job change, and diseases. More studies are necessary to clarify the relationship between the factors related to work and the anthropometric status of food handlers since excess weight is multifactorial.
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Affiliation(s)
- Ingrid C. Fideles
- Department of Food Science, School of Nutrition, Federal University of Bahia, Salvador, Brazil
| | | | - Priscila R. de F. Costa
- Department of Science Nutrition, School of Nutrition, Federal University of Bahia, Salvador, Brazil
| | - Jamacy C. Souza
- Department of Food Science, School of Nutrition, Federal University of Bahia, Salvador, Brazil
| | | | - Raquel B. A. Botelho
- Department of Nutrition, Faculty of Health Sciences, University of Brazilia, Brazilia, Brazil
| | - Heesup Han
- College of Hospitality and Tourism Management, Sejong University, Seoul, South Korea
| | - António Raposo
- CBIOS (Research Center for Biosciences and Health Technologies), Universidade Lusófona de Humanidades e Tecnologias, Lisboa, Portugal
| | - Antonio Ariza-Montes
- Social Matters Research Group, Universidad Loyola Andalucía, C/Escritor Castilla Aguayo, Córdoba, Spain
| | | | - Renata P. Zandonadi
- Department of Nutrition, Faculty of Health Sciences, University of Brazilia, Brazilia, Brazil
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45
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Faber A, Jung CA, Daumann F. An analysis of the effects on labour market success based on weight class membership, with evidence from Germany. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-022-01711-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Liwin LK. Shifting educational gradients in body mass index trajectories of Indonesians: an age period cohort analysis. BMC Public Health 2022; 22:1004. [PMID: 35585591 PMCID: PMC9115941 DOI: 10.1186/s12889-022-13379-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 05/05/2022] [Indexed: 12/13/2022] Open
Abstract
Background Globally, the number of obese adults has increased rapidly in many developing countries. The links between increased educational attainment and lower risks of overweight/obesity have been studied in a number of high-income contexts. However, educational attainment can have a different association with obesity at different levels of economic development and different stages of the nutritional transition, and these associations may vary by period and cohort. This study aims to provide evidence on the shifting of educational gradients in overweight/obesity in Indonesia, a low middle income country. Methods Using five waves of Indonesian Family Life Survey (IFLS), this study examines the Body Mass Index (BMI) trajectories of 14,810 individuals from 1993 to 2014. This study analyses how educational gradients in BMI have shifted over time and across cohorts using a hierarchical age-period-cohort (HAPC) model to account for the effects of age and the changes in historical periods (social and environmental contexts). Results In older generations, higher educational attainment is associated with higher BMI, but the gap between educational groups shrinks in more recently-born cohorts. The BMI of lower educational groups is catching up with that of the tertiary educated, leading to an increased risk of overweight/obesity among low educated individuals. Having tertiary education lowers the risk of weight gain (-0.04 point) among recently-born cohort of women, but it still increases the risk (+ 0.04 point) for men. Conclusion Changes in access to education and the ongoing nutritional transition in Indonesia are leading to a shifting of educational gradients in overweight/obesity over time. The rising trends in BMI among low-educated and younger individuals are of substantial concern for Indonesian public health due to their implications for the risk of communicable and non-communicable diseases in the future. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13379-3.
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Affiliation(s)
- Lilipramawanty Kewok Liwin
- School of Demography, The Australian National University, Canberra, Australian Capital Territory, Australia.
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47
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Destri K, Alves J, Gregório MJ, Dias SS, Henriques AR, Mendonça N, Canhão H, Rodrigues AM. Obesity- attributable costs of absenteeism among working adults in Portugal. BMC Public Health 2022; 22:978. [PMID: 35568836 PMCID: PMC9107744 DOI: 10.1186/s12889-022-13337-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 04/25/2022] [Indexed: 12/23/2022] Open
Abstract
Background Obesity leads to poor health outcomes and may adversely affect work productivity. This study, aimed to investigate the obesity- attributable costs of absenteeism among working adults in Portugal. Methods The study population included individuals actively working at baseline from the Epidemiology of Chronic Diseases Cohort (EpiDoC), a large Portuguese population-based prospective study. Body mass index was measured at baseline and in two follow-up interviews. Absenteeism in each wave of the EpiDoC was assessed by the question “Did you have a sick leave in the previous 12 months? yes/no”, followed by “How many days did you miss work due to sickness in the previous twelve months?”. Body mass index (BMI) was classified into underweight, normal weight, overweight, and obese, based on the standard World Health Organization definition. Association between obesity and absenteeism was estimated with the negative binomial regression model adjusted for BMI, chronic diseases, and lifestyle. Obesity- attributable costs were calculated using lost gross income during the time absent from work, through the human-capital approach. Results The EpiDoC included 4338 working adults at baseline. Of these, 15.2% were obese at the beginning of the study and 22.7% of the population had been absent from work in the last 12 months. Participants with obesity missed 66% more days at work (IRR: 1.66; CI 95%:1.13–2.44; (p = 0.009.) than those with normal weight. The odds of having been absent from work were 1.4 times higher in obese compared to non-obese individuals (CI 95%: 1.18–1.67; p < 0.01) adjusted to sex and type of work. Obese individuals missed 3.8 more days per year than those with normal weight (95%CI: 3.1–4.5). Extrapolating to the entire Portuguese working population, absenteeism due to obesity incurred an additional cost of €238 million per year. Conclusion Obesity imposes a financial burden due to absenteeism in Portugal. Employers and national health regulators should seek effective ways to reduce these costs. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13337-z.
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Affiliation(s)
- Kelli Destri
- Comprehensive Health Research Centre, NOVA Medical School, Universidade Nova de Lisboa, 1169-056, Lisboa, Portugal. .,EpiDoC Unit, CEDOC, NOVA Medical School, Universidade Nova de Lisboa, Lisboa, Portugal.
| | - Joana Alves
- Comprehensive Health Research Center (CHRC), NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Maria João Gregório
- Comprehensive Health Research Centre, NOVA Medical School, Universidade Nova de Lisboa, 1169-056, Lisboa, Portugal.,Programa Nacional Para a Promoção da Alimentação Saudável, Direção-Geral da Saúde, Lisbon, Portugal.,Faculdade de Ciências da Nutrição E Alimentação, Universidade Do Porto, Porto, Portugal
| | - Sara Simões Dias
- Comprehensive Health Research Centre, NOVA Medical School, Universidade Nova de Lisboa, 1169-056, Lisboa, Portugal.,Center for Innovative Care and Health Technology, CiTechCare, Instituto Politécnico de Leiria/Escola Superior de Saúde, Leiria, Portugal
| | - Ana Rita Henriques
- Comprehensive Health Research Centre, NOVA Medical School, Universidade Nova de Lisboa, 1169-056, Lisboa, Portugal.,EpiDoC Unit, CEDOC, NOVA Medical School, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Nuno Mendonça
- Comprehensive Health Research Centre, NOVA Medical School, Universidade Nova de Lisboa, 1169-056, Lisboa, Portugal.,EpiDoC Unit, CEDOC, NOVA Medical School, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Helena Canhão
- Comprehensive Health Research Centre, NOVA Medical School, Universidade Nova de Lisboa, 1169-056, Lisboa, Portugal.,EpiDoC Unit, CEDOC, NOVA Medical School, Universidade Nova de Lisboa, Lisboa, Portugal.,National School of Public Health, UNL, Lisboa, Portugal
| | - Ana Maria Rodrigues
- Comprehensive Health Research Centre, NOVA Medical School, Universidade Nova de Lisboa, 1169-056, Lisboa, Portugal.,EpiDoC Unit, CEDOC, NOVA Medical School, Universidade Nova de Lisboa, Lisboa, Portugal.,Hospital Dos Lusíadas, Lisboa, Portugal
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Estimating the benefits of obesity prevention on productivity: an Australian perspective. Int J Obes (Lond) 2022; 46:1463-1469. [PMID: 35546611 PMCID: PMC9092329 DOI: 10.1038/s41366-022-01133-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 04/25/2022] [Accepted: 04/27/2022] [Indexed: 11/16/2022]
Abstract
Background/objectives Obesity poses one of the biggest public health challenges globally. In addition to the high costs of obesity to the healthcare system, obesity also impacts work productivity. We aimed to estimate the benefits of preventing obesity in terms of years of life, productivity-adjusted life years (PALYs) and associated costs over 10 years. Subjects/methods Dynamic life table models were constructed to estimate years of life and PALYs saved if all new cases of obesity were prevented among Australians aged 20–69 years from 2021 to 2030. Life tables were sex specific and the population was classified into normal weight, overweight and obese. The model simulation was first undertaken assuming currently observed age-specific incidences of obesity, and then repeated assuming all new cases of obesity were reduced by 2 and 5%. The differences in outcomes (years of life, PALYs, and costs) between the two modelled outputs reflected the potential benefits that could be achieved through obesity prevention. All outcomes were discounted by 5% per annum. Results Over the next 10 years, 132 million years of life and 81 million PALYs would be lived by Australians aged 20–69 years, contributing AU$17.0 trillion to the Australian economy in terms of GDP. A 5% reduction in new cases of obesity led to a gain of 663 years of life and 1229 PALYs, equivalent to AU$262 million in GDP. Conclusions Prevention of obesity is projected to result in substantial economic gains due to improved health and productivity. This further emphasises the need for public health prevention strategies to reduce this growing epidemic.
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Kassotis CD, Vom Saal FS, Babin PJ, Lagadic-Gossmann D, Le Mentec H, Blumberg B, Mohajer N, Legrand A, Munic Kos V, Martin-Chouly C, Podechard N, Langouët S, Touma C, Barouki R, Kim MJ, Audouze K, Choudhury M, Shree N, Bansal A, Howard S, Heindel JJ. Obesity III: Obesogen assays: Limitations, strengths, and new directions. Biochem Pharmacol 2022; 199:115014. [PMID: 35393121 PMCID: PMC9050906 DOI: 10.1016/j.bcp.2022.115014] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 03/14/2022] [Accepted: 03/15/2022] [Indexed: 12/11/2022]
Abstract
There is increasing evidence of a role for environmental contaminants in disrupting metabolic health in both humans and animals. Despite a growing need for well-understood models for evaluating adipogenic and potential obesogenic contaminants, there has been a reliance on decades-old in vitro models that have not been appropriately managed by cell line providers. There has been a quick rise in available in vitro models in the last ten years, including commercial availability of human mesenchymal stem cell and preadipocyte models; these models require more comprehensive validation but demonstrate real promise in improved translation to human metabolic health. There is also progress in developing three-dimensional and co-culture techniques that allow for the interrogation of a more physiologically relevant state. While diverse rodent models exist for evaluating putative obesogenic and/or adipogenic chemicals in a physiologically relevant context, increasing capabilities have been identified for alternative model organisms such as Drosophila, C. elegans, zebrafish, and medaka in metabolic health testing. These models have several appreciable advantages, including most notably their size, rapid development, large brood sizes, and ease of high-resolution lipid accumulation imaging throughout the organisms. They are anticipated to expand the capabilities of metabolic health research, particularly when coupled with emerging obesogen evaluation techniques as described herein.
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Affiliation(s)
- Christopher D Kassotis
- Institute of Environmental Health Sciences and Department of Pharmacology, Wayne State University, Detroit, MI 48202, United States.
| | - Frederick S Vom Saal
- Division of Biological Sciences, The University of Missouri, Columbia, MO 65211, United States
| | - Patrick J Babin
- Department of Life and Health Sciences, University of Bordeaux, INSERM, Pessac, France
| | - Dominique Lagadic-Gossmann
- Univ Rennes, Inserm, EHESP, Irset (Research Institute for Environmental and Occupational Health) - UMR_S 1085, 35 000 Rennes, France
| | - Helene Le Mentec
- Univ Rennes, Inserm, EHESP, Irset (Research Institute for Environmental and Occupational Health) - UMR_S 1085, 35 000 Rennes, France
| | - Bruce Blumberg
- Department of Developmental and Cell Biology, The University of California, Irvine, Irvine CA 92697, United States
| | - Nicole Mohajer
- Department of Developmental and Cell Biology, The University of California, Irvine, Irvine CA 92697, United States
| | - Antoine Legrand
- Univ Rennes, Inserm, EHESP, Irset (Research Institute for Environmental and Occupational Health) - UMR_S 1085, 35 000 Rennes, France
| | - Vesna Munic Kos
- Department of Physiology and Pharmacology, Karolinska Institute, Solna, Sweden
| | - Corinne Martin-Chouly
- Univ Rennes, Inserm, EHESP, Irset (Research Institute for Environmental and Occupational Health) - UMR_S 1085, 35 000 Rennes, France
| | - Normand Podechard
- Univ Rennes, Inserm, EHESP, Irset (Research Institute for Environmental and Occupational Health) - UMR_S 1085, 35 000 Rennes, France
| | - Sophie Langouët
- Univ Rennes, Inserm, EHESP, Irset (Research Institute for Environmental and Occupational Health) - UMR_S 1085, 35 000 Rennes, France
| | - Charbel Touma
- Univ Rennes, Inserm, EHESP, Irset (Research Institute for Environmental and Occupational Health) - UMR_S 1085, 35 000 Rennes, France
| | - Robert Barouki
- Department of Biochemistry, University of Paris, INSERM, Paris, France
| | - Min Ji Kim
- Sorbonne Paris Nord University, Bobigny, INSERM U1124 (T3S), Paris, France
| | | | - Mahua Choudhury
- Department of Pharmaceutical Sciences, Texas A & M University, College Station, TX 77843, United States
| | - Nitya Shree
- Department of Pharmaceutical Sciences, Texas A & M University, College Station, TX 77843, United States
| | - Amita Bansal
- College of Health & Medicine, Australian National University, Canberra, ACT, 2611, Australia
| | - Sarah Howard
- Healthy Environment and Endocrine Disruptor Strategies, Commonweal, Bolinas, CA 92924, United States
| | - Jerrold J Heindel
- Healthy Environment and Endocrine Disruptor Strategies, Commonweal, Bolinas, CA 92924, United States
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Bezzina A, Ashton L, Watson T, James CL. Workplace wellness programs targeting weight outcomes in men: A scoping review. Obes Rev 2022; 23:e13410. [PMID: 35076133 DOI: 10.1111/obr.13410] [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: 09/21/2021] [Revised: 11/25/2021] [Accepted: 11/28/2021] [Indexed: 11/28/2022]
Abstract
Workplaces have been identified as a priority setting for the delivery of wellness programs to address risk factors for overweight and obesity. Men in particular may benefit greatly from these types of programs as they are typically harder to engage in health promotion. A scoping review was performed to provide an overview of interventions that have been implemented within the workplace that target weight outcomes in men. A searched of six electronic databases (Medline, Embase, CINAHL, Scopus, Cochrane Database of Systematic Review, and Business Source Ultimate) was conducted from January 2010 to August 2020. Of the 2191 articles identified, 25 were included. The majority took place in North America or Europe (72%). Over half (n = 17, 68%) utilized both a nutrition and physical activity component. Thirteen of the 19 articles (68%) that reported weight as an outcome showed the program to be efficacious in reducing weight. Overall, only seven articles were solely focused on an all-male population. Workplace wellness programs targeting weight outcomes in men have been conducted to some extent, with majority being successful in reducing weight. However, there is a need for more randomized controlled trials (RCTs), long-term follow-up, and male-only programs.
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Affiliation(s)
- Aaron Bezzina
- Centre for Resources Health and Safety, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia.,School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
| | - Lee Ashton
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia.,Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia.,School of Education, College of Human and Social Futures, University of Newcastle, Callaghan, Australia
| | - Trent Watson
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia.,Ethos Health, Newcastle West, Australia
| | - Carole L James
- Centre for Resources Health and Safety, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia.,School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
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