Targeting policy for obesity prevention: identifying the critical age for weight gain in women

Transition von der Kindheit in das Erwachsenenalter bei chronischen Krankheiten

Dank des medizinischen Fortschritts erleben zunehmend mehr Kinder mit chronischen Erkrankungen das Erwachsenenalter. Patienten mit angeborenen Stoffwechselkrankheiten stellen nur eine, jedoch in ihrer Größe und Problematik besondere Gruppe heranwachsender Patienten dar. Allerdings fehlen vielfach begleitende Strukturen im Gesundheitssystem, um eine erfolgreiche Transition zu ermöglichen. Dies kann zu erheblicher Beeinträchtigung der Gesundheit der Betroffenen führen. Der Artikel beschreibt den Transitionsprozess des gesunden Adoleszenten zum jungen Erwachsenen sowie die Schwierigkeiten dieses Prozesses für chronisch kranke junge Menschen mit erhöhtem Bedarf an Gesundheitsbetreuung, die zusätzlich den Übergang aus der pädiatrischen Medizin in die Erwachsenenmedizin zu bewältigen haben.

Dietary intake of 20 polyphenol subclasses in a cohort of UK women

BACKGROUND

Establishing and linking the proposed health benefits of dietary polyphenols to their consumption requires measurement of polyphenol intake in appropriate samples and an understanding of factors that influence their intake in the general population.

METHODS

This study examined polyphenol intake estimated from 3- and 7-day food diaries in a sample of 246 UK women aged 18-50 years. Estimation of the intake of 20 polyphenol subclasses commonly present in foods consumed by the sample studied was done using Phenol-Explorer(®) and USDA polyphenol databases. Women were participants in the Leeds Women's Wellbeing Study (LWW) (n = 143), a dietary intervention study aimed at overweight women (mean age 37.2 ± 9.4 years; mean BMI 30.8 ± 3.1 kg/m(2)), and the Diet and Health Study (DH) (n = 103) which aimed to examine the relationship between polyphenol intake and cognitive function (mean age 25.0 ± 9.0 years; mean BMI 24.5 ± 4.6 kg/m(2)).

RESULTS

The estimated intake of polyphenol subclasses was significantly different between the two samples (p < 0.01) with consumption of 1292 ± 844 and 808 ± 680 mg/day for the LWW and DH groups, respectively. Flavanols and hydroxycinnamic acids were the most important contributors to the polyphenols consumed by both groups, owing to tea and coffee consumption. Other major polyphenol food sources included fruits, vegetables and processed foods.

CONCLUSION

Older women consumed more polyphenol-containing foods and beverages, which was due to the higher coffee and tea consumption amongst the LWW participants.

BMI, overweight status and obesity adjusted by various factors in all age groups in the population of a city in Northeastern Brazil

OBJECTIVE

In Brazil, demographic, socioeconomic and epidemiological changes over time have led to a transition in nutritional standards, resulting in a gradual reduction of malnutrition and an increased prevalence of overweight and obese individuals, similar to the situation in developed countries in previous decades. This study assessed the body mass index (BMI) and the prevalence of an overweight status and obesity, adjusted for various factors, in a population in northeastern Brazil including all age groups.

METHODS

This is a cross-sectional population-based epidemiological study using single sampling procedure composed of levels. Given the heterogeneity of the variable "income" and the relationship between income, prevalence of diseases and nutrition, a stratified sampling on blocks in the first level was used. In this, city districts were classified by income into 10 strata, according to information obtained from IBGE. A systematic sampling was applied on randomly selected blocks in order to choose the residences that would be part of the sample (second level), including 1165 participants from all age groups.

RESULTS AND DISCUSSION

The prevalence of an overweight status or obesity was adjusted for demographic, socioeconomic and lifestyle variables. When the Chi-square test was applied, a relationship was observed between the prevalence of an overweight status or obesity and the age group, gender, educational level and income of the participants. Regarding lifestyle parameters, only smoking was associated with the prevalence of an overweight status or obesity, in both adults and in the total sample. The results for the following groups were significant (p < 0.05): the age group from 20 to 59 years, when the individual presented an educational level greater than or equal to high school; and the age group ≥ 60 years, when the individual was female. It is noteworthy that educational level and being female were significant in adjusting for the total population as major factors influencing an increased BMI, followed by the variables physical activity and family income.

CONCLUSIONS

The adjusted results justify the adoption of intervention and prevention policies to combat these clinical conditions for the study population as a whole, particularly directed toward adults with higher education level as well as elderly females.

Women's satisfaction with body image before pregnancy and body mass index 4 years after delivery in the mothers of generation XXI

BACKGROUND

Body image satisfaction (BIS) influences body weight regulation and may contribute to long-term healthier lifestyle after pregnancy. Thus, we aimed to assess the association between BIS before pregnancy and body mass index (BMI) 4 years after the index pregnancy.

METHODS

As part of the follow-up of a birth cohort, 3612 women with prepregnancy BMI >18.5 kg/m(2) were reevaluated 4 years after the birth of a child. BIS was defined as the difference between perceived and ideal body size before pregnancy, assessed by Stunkard Silhouettes after birth. The associations of BIS with BMI change (continuous) and BMI classes at 4 years, based on measured weight and height, were estimated using linear and multinomial regression, respectively.

RESULTS

Among women with normal prepregnancy BMI, those who felt too small, regarding their ideal, had a 0.25 kg/m(2) smaller increase in BMI within 4 years and a lower likelihood of becoming overweight or obese [multivariate-adjusted odds ratio (OR) = 0.63; 95% confidence interval (95%CI): 0.44-0.91 and OR = 0.21; 95%CI: 0.05-0.91, respectively) than those satisfied with body image. Feeling too large was associated with a 0.41 kg/m(2) larger increase in BMI and a higher risk of becoming overweight or obese (OR = 2.12; 95%CI:1.73-2.59 and OR = 3.42; 95%CI:2.02-5.79, respectively). A similar, non-significant, trend was observed for overweight women. Obese women who felt too large had a non-significant decrease in BMI.

CONCLUSIONS

BIS plays a role in maternal body weight after delivery. Realistic body size goals may promote the motivation to lose weight and contribute to higher success in attaining them.