The relationship between obesity associated weight-adjusted waist index and the prevalence of hypertension in US adults aged ≥60 years: a brief report

Objectives

The main objective was to examine the relationship between weight-adjusted waist index (WWI) and the prevalence of hypertension among individuals aged ≥60 years who participated in the NHANES between 2011 and 2018 years.

Methods

The data for this study were obtained from the National Health and Nutrition Examination Survey (NHANES) 2011-2018. In this population-based study, we focused on participants who were over 60 years old. Data were collected from the aforementioned survey, and the variable of interest was WWI, which was calculated as waist (cm) divided by the square root of body weight (kg). Multivariable logistic regression model was applied to calculate adjusted ORs with 95% CIs in order to explore any possible correlation between WWI and the prevalence of hypertension. Subgroup analysis were used to verify the stability of the relationship between WWI and the prevalence of hypertension. The interaction tests were also conducted in this research.

Results

Results revealed that adults aged ≥60 years who were in the highest WWI quartile had significantly higher chances of developing hypertension when compared to those in the lowest quartile, after adjusting for covariates and potential confounders (p < 0.001).

Conclusion

These findings suggest that there is a strong correlation between elevated levels of WWI and the risk of developing hypertension among older adults. As such, WWI could serve as a unique and valuable biomarker for identifying hypertension risk at an earlier stage in the older adults population.

Resilience is associated with physical activity and sedentary behaviour recommendations attainment in Chinese university students

PURPOSE

To determine the associations of resilience with physical activity (PA) and sedentary behaviour (SB) recommendations attainment among university students by considering the sex of the participants.

METHODS

This cross-sectional study recruited 352 Chinese university students (131 males, 20.8 ± 2.18 years). PA and SB were assessed using the International Physical Activity Questionnaire-Short Form. Resilience was measured using the Chinese version of the Connor-Davidson Resilience Scale with 25 items (CD-RISC-25). Attainment of PA and SB recommendations with different patterns was determined by referring to the global recommendations for adults. Mann-Whitney U tests and generalized linear models (GLMs) were used to determine sex differences in all outcomes and the contribution of resilience to the attainment of PA and SB recommendations, respectively.

RESULTS

The percentage of males who attained all patterns related to vigorous PA (VPA), moderate-to-vigorous PA (MVPA), and SB recommendations was significantly higher than that of females. Males also scored significantly higher than females in the CD-RISC-25 final score (p < .01). GLMs results showed that, after adjusting for key confounders, resilience was a significant predictor of PA recommendations attainment in terms of minimum moderate PA (MPA), minimum MVPA, and adequate MVPA (all p < .05).

CONCLUSION

PA (at more intense levels), SB, and resilience among university students vary by sex, with males outperforming females. Regardless of sex, resilience is an important predictor for the attainment of PA and SB recommendations. Sex-specific resilience-building interventions should be developed to foster a physically active lifestyle among this population group.

Urinary phthalate concentrations and mortality risk: A population-based study

Phthalates are widely used as plasticizers. Laboratory-based mechanistic and epidemiological studies suggest that phthalates are detrimental to human health. Here, we present prospective analyses on phthalate exposure and all-cause, as well as cause-specific, mortality from the National Health and Nutrition Examination Survey (NHANES), a population-based cohort. Between 1999 and 2018, urinary concentrations of 12 phthalate metabolites were measured by high-performance liquid chromatography-electrospray ionization tandem mass spectrometry in spot urine samples of 10,881 adults aged 40-85 years, of which 2382 died over a median duration of 8.9 years after sample provision. Multivariable Cox regression analyses adjusted for a wide range of lifestyle factors and comorbidities showed that higher concentrations of mono-benzyl phthalate (MBzP) and Mono-n-butyl phthalate (MnBP) were associated with increased mortality. The hazard ratios for participants in the highest quartiles of MBzP and MnBP concentrations were at 1.27 [95% confidence interval: 1.08, 1.49; p _{linear trend} = 0.002] and 1.35 [1.13, 1.62; p _{linear trend} = 0.005). These findings reinforce the need for monitoring of phthalate exposure in relation to health outcomes.

Different associations between waist circumference and bone mineral density stratified by gender, age, and body mass index

Introduction

Investigations of the relationship between waist circumference (WC) and bone mineral density (BMD) have inconsistent and incomprehensive results.

We explored the association between WC and BMD at various sites in a large-scale population-based study.

Methods

We screened 5337 participants from National Health and Nutrition Examination Survey (NHANES) database. BMD was measured using dual-energy X-ray absorptiometry at various skeletal sites. The associations of WC with BMD were evaluated by weighted multivariable logistic regression models and conducted subgroup analyses for gender, age, and BMI. A weighted generalized additive model and a smooth curve fitting were performed to address non-linearity.

Results

Adjustments for all confounders, in males, WC was negatively correlated to BMD in different age and BMI groups (all the p < 0.05), except for in the lowest BMI group; in females, overall trends of relationships between WC and BMD were negative. However, statistical differences were insignificant in some cases. Additionally, every 1 cm increase in WC for individuals of all ages with normal BMI (18.5 ≤ BMI < 25) was associated with decrease in BMD at each skeletal site, as was the case for men with BMI ≥ 25 kg/m². For women, the negative association of WC with BMD was evident at the lumbar spine in the youngest age group (8 ≤ Age ≤ 18) with normal BMI.

Conclusions

The nonlinear associations between WC and BMD at various skeletal sites are gender-, age- and BMI-specific in the NHANES (2006–2006).

Supplementary Information

The online version contains supplementary material available at 10.1186/s12891-022-05736-5.

Association between Sensitivity to Thyroid Hormone Indices and Bone Mineral Density in US Males

OBJECTIVES

Thyroid hormone is acknowledged as a pivotal factor in skeletal development and adult bone maintenance. However, available data about the relationship between sensitivity to thyroid hormone and bone mineral density (BMD) remain limited and conflicting. The purpose of the study was to explore the complex relationship between sensitivity to thyroid hormone indices and BMD using cross-sectional analysis.

METHODS

An overall sample of 3,107 males from the National Health and Nutrition Examination Survey (NHANES) was studied in the study. The thyroid hormone sensitivity indices included free triiodothyronine/tree thyroxine (FT3/FT4), thyroid-stimulating hormone index (TSHI), thyrotroph thyroxine resistance index (TT4RI), and thyroid feedback quantile-based index (TFQI). Given the complex study design and sample weights, the correlation between sensitivity to thyroid hormone indices and BMD was evaluated through multivariate linear regression models, and extra subgroup analyses were performed to examine the robustness of the results.

RESULTS

Among the 3,107 participants, we demonstrated that FT3/FT4 was negatively correlated with lumbar BMD (β = -0.0.35, 95% CI: -0.084-0.013, P < 0.05). In the terms of central sensitivity to thyroid hormone, TFQI showed a significant negative relationship with the BMD of the lumbar (β = -0.018, 95% CI: -0.033 to -0.003, P < 0.05), total femur (β = -0.020, 95% CI: -0.035 to -0.006, P < 0.01), and femur neck (β = -0.018, 95% CI: -0.031 to -0.005, P < 0.01). In the subgroup analyses stratified by body mass index (BMI), the significant negative correlation between TFQI and lumbar BMD remained in the male participants with BMI between 18.5 and 24.9 kg/m².

CONCLUSIONS

Decreased indices of sensitivity to thyroid hormones are strongly associated with increased lumbar BMD, suggesting that the dysfunction of peripheral and central response to thyroid hormone might contribute to bone loss. In addition, FT3/FT4 and TFQI were considered to be the preferable indicators to guide the prevention and clinical treatment of osteoporosis.

Perceived Gender Match and Accepting Alcohol Offers From Peers in Emerging Adulthood

AIMS

Emerging adulthood (ages 18-25) has been associated with elevated alcohol use, yet little is known regarding gender identity and drinking contexts in this population. Our goals were to examine the effects of perceived gender match on alcohol use decision-making in social settings among emerging adults.

METHODS

Participants (N = 135; 64% white, 11 transgender) completed measures of alcohol consumption, alcohol expectancies and motives, and the Collegiate-Simulated Intoxication Digital Elicitation using an established Internet panel. We conducted a series of univariate analyses to examine the relation between perceived gender match and behavioral willingness (BW) to accept alcohol in a social context.

RESULTS

Participants identifying as men were significantly more likely to accept offers of alcohol when compared with women. While men and women did not differ in terms of BW when participants perceived a gender-matched actor making the offer, when there was a gender mismatch, women had significantly lower BW when compared with men. Though transgender participants were more likely to endorse hazardous drinking behaviors, there were no observable effects of transgender identity on BW.

CONCLUSION

In this sample, we found that men have a higher BW for alcohol than women and that trans identified persons are at increased risk for alcohol misuse. These findings support the need for more research examining the effect of gender identity on patterns of alcohol use and decision-making in mixed-gender contexts for emerging adults.

Glaucoma and mortality risk: findings from a prospective population-based study

Glaucoma is a neurodegenerative disease with a structural change of the optic nerve head, leading to visual field defects and ultimately blindness. It has been proposed that glaucoma is associated with increased mortality, but previous studies had methodological limitations (selective study samples, lack of data on potential confounders, self-reported or secondary data on glaucoma diagnoses). We evaluated the association between diagnosed glaucoma and mortality in the population-based National Health and Nutrition Examination Survey (NHANES), a representative health survey in the United States. The survey cycles 2005-2006 and 2007-2008 included an extensive ophthalmic examination with fundus photography, which were used to derive standardized glaucoma diagnoses. Risk of all-cause mortality was assessed with multivariable Cox proportional hazards regression models accounting for the complex survey design of NHANES. Time to death was calculated from the examination date to date of death or December 31, 2015 whichever came first. 5385 participants (52.5% women) were eligible, of which 138 had glaucoma at baseline, and 833 died during follow-up. Participants with glaucoma were more likely to be older than those without glaucoma (mean age 69.9 vs. 56.0 years). Mean follow-up time was 8.4 years for participants with glaucoma, and 8.6 years for participants without glaucoma. Glaucoma was associated with increased mortality in an unadjusted Cox regression model (hazard ratio 2.06, 95% confidence interval 1.16 to 3.66), but the association was no longer statistically significant after adjusting for age and sex (hazard ratio 0.74, 95% confidence interval 0.46 to 1.17). Additional adjustment for a range of potential confounders did not significantly change the results. In this representative population-based study, we found no evidence of increased mortality risk in glaucoma patients.

Vitamin B6 Status among Vegetarians: Findings from a Population-Based Survey

Vitamin B6 from plant foods may have lower bioavailability than vitamin B6 from animal foods, but studies on objectively measured vitamin B6 status among vegetarians compared to non-vegetarians are lacking. Thus, the vitamin B6 status among vegetarians, but also pescatarians, and flexitarians, compared to meat-eaters was assessed in the population-based NHANES study (cycles 2007–2008 and 2009–2010). Data on serum pyridoxal-5′-phosphate (PLP) and 4-pyridoxic acid (4-PA) measured by high-performance liquid chromatography (HPLC) as well as dietary intakes from 24-h recalls were available for 8968 adults aged 20–80 years. Geometric mean (±standard error) PLP concentrations were 58.2 ± 6.0, 52.1 ± 3.7, 49.2 ± 4.6 and 51.0 ± 1.1 nmol/L among vegetarians, pescatarians, flexitarians, and meat-eaters. The 4-PA concentrations were 32.7 ± 4.0, 29.0 ± 2.5, 34.8 ± 5.6 and 33.0 ± 0.7, respectively. There were no statistically significant differences in PLP, 4-PA, and their ratio across the groups in multivariable linear regression models. Overall, the use of vitamin B6 supplements was the strongest predictor of the vitamin B6 status, followed by the dietary vitamin B6 intake. Interestingly, several other covariates were significantly associated with vitamin B6 biomarker levels, particularly serum albumin, creatinine and alkaline phosphatase, and should be considered when assessing the vitamin B6 status. In summary, our findings suggest that a vegetarian diet does not pose a risk for vitamin B6 deficiency.

Factors Associated with Women's Unwillingness to Decrease Alcohol Intake to Decrease Breast Cancer Risk

OBJECTIVE

Alcohol intake is a known risk factor for breast cancer. National organizations recommend that women consume no more than one serving of alcohol per day, if at all; however, many women exceed this recommendation, and some are unwilling to decrease consumption. Our study sought to identify factors associated with women's unwillingness to decrease their alcohol intake to decrease their breast cancer risk.

METHODS

942 women in a screening mammography cohort were asked questions about their demographics, personal and family health history, lifestyle factors, and willingness/unwillingness to decrease alcohol intake to decrease their breast cancer risk. Univariate and multivariate analyzes of their responses were performed.

RESULTS

13.2% of women in our cohort indicated they were unwilling to decrease their alcohol intake to reduce their breast cancer risk. After adjusting for potential confounders, women who were 60 years and older were more than twice as unwilling to decrease their alcohol intake compared to their younger counterparts (P = .0002). Women who had an annual household income of more than $200,000 were 1.75 times more unwilling to decrease their alcohol intake compared to their less affluent counterparts (P = .033). Unwillingness was not significantly associated with race/ethnicity, education, having a first-degree family member with cancer, health perception, breast cancer risk perception, or BMI.

CONCLUSIONS

Levels of unwillingness to decrease alcohol intake differed by age and household income. An opportunity is present to potentially decrease breast cancer risk in the community by educating women, especially older and more affluent women, about alcohol as a risk factor for breast cancer and the importance of limiting one's alcohol intake.

Association of leisure sedentary time with common chronic disease risk factors: A longitudinal study of China Health and Nutrition Surveys

BACKGROUND

Although the common risk factors were identified and controlled for many years, the overall prevalence of chronic diseases continued to increase in China.

OBJECTIVE

We presumed the leisure sedentariness as a latent but pivotal factor of chronic diseases, and examined its distribution and changing trend, analysed its interaction effects on common risk factors, which could provide a new perspective for the prevention and management.

METHODS

A total of 5013 participants were screened out from China Health and Nutrition Survey. Random-effects ordered logistic models were used for ordinal dependent variables, and fixed-effects or random-effects logit models were used for binary dependent variables.

RESULTS

From 2004 to 2011, the prevalence of high leisure sedentary time (LSED) increased by 58.58%. Members of the high LSED group were likely to choose fast food, salty snacks, soft drinks and more likely to smoke or drink alcohol compared with those of the low LSED group. However, they preferred walking, sports and body building more than those of the low LSED group.

CONCLUSIONS

For the unhealthy dietary, tobacco and alcohol consumption, more targeted introduction and guidance related to sedentary time should be promoted. Meanwhile, the appeal for physical exercise as well as adequate facilities should be initiated.

Body weight and self-perception are associated with depression: Results from the National Health and Nutrition Examination Survey (NHANES) 2005-2016

BACKGROUND

Despite evidence suggesting that perceptual body image measurements are strongly associated with depression, few studies examined the association between perceptual body image and depression in adults. This study aimed to investigate the association of different measures of perceptual body image measurements with depression.

METHODS

We analyzed data of 22,735 adults participating in the National Health and Nutrition Examination Survey between 2005 and 2016. Depression was ascertained using the validated Patient Health Questionnaire (PHQ-9) and depression was defined as PHQ score ≥10. The associations of measured body mass index (BMI) and body image (i.e., self-reported BMI, BMI discordance, perceived weight, and desired weight) with depression were assessed using logistic regression.

RESULTS

Women perceiving themselves as overweight or reporting their BMI as obese had significantly higher odds of depression (odds ratio [OR] 1.48, 95% confidence interval [CI] 1.17-1.72 and 1.29, 1.04-1.60, respectively) compared to women perceiving themselves as about the right weight or reporting their BMI as normal. The association between perceived overweight and depression was independent of measured BMI (OR 1.37, 95% CI 1.09-1.72). Men perceiving themselves as underweight had higher odds of depression (OR 1.50, 95% CI 1.06-2.11) than men perceiving themselves as about the right weight. In women, but not in men, measured obesity was associated with higher odds of depression.

LIMITATIONS

The study's cross-sectional design and missing information on comorbidities.

CONCLUSION

Weight perception (in women and men), measured BMI and BMI discordance in women are associated with depression..

The effect of self-perceived stress, the history of smoking and drinking on weight status in Chinese adults - evidence from the 2015 China Health and Nutrition Survey: A cross-sectional study in Chongqing, China

Being overweight and obese is a serious public health issues in China. However, the effects of substance use and mental factors on weight changes remain unclear. In this study, we aimed to investigate the association among self-perceived stress, history of smoking and drinking, and weight status by using data from the China Health and Nutrition Survey in 2015.A total of 8028 adults were selected from China Health and Nutrition Survey in 2015. The self-reported data primarily included sociodemographic data, self-perceived stress scores, and history of smoking and drinking. Physical measurements including height and weight were logged to calculate body mass index. Multivariate and multinomial regression models were used to estimate effects of substance and perceived stress on weight status.The prevalence of underweight and overweight/obese people were 4.52% and 51.51% in Chinese adults, respectively. Adults with high perceived stress were negatively associated with being overweight and obese (OR = 0.80, 95% CI = 0.66-0.97 in the middle level and OR = 0.69, 95%CI = 0.55-0.88 in the high level). Adults with history of smoking had low risk of being overweight/obese (OR = 0.71, 95% CI = 0.62-0.82). Adults with history of drinking had high risk of overweight/obese (OR = 1.22, 95% CI = 1.06-1.40). In addition, the association between drinking and overweight/obese was affected by different levels of perceived stress (OR = 1.15, 95%CI = 0.83-1.59 in low-stress group and OR = 1.42, 95%CI = 1.04-1.94 in high-stress group).The effects of self-perceived stress and history of smoking as well as drinking on weight status were significant in this study. The government and healthcare policymakers should strengthen early psychological factor and behavioral intervention to decrease the prevalence of abnormal-weight status.

Differences in Bone Mineral Density between Adult Vegetarians and Nonvegetarians Become Marginal when Accounting for Differences in Anthropometric Factors

BACKGROUND

Persons following plant-based diets have lower bone mineral density (BMD) and higher fracture risk, possibly due to suboptimal nutrient supply. However, anthropometric measures were not considered as potential confounders in many previous studies, and body mass index (BMI) is positively associated with BMD but also generally lower among vegans and vegetarians.

OBJECTIVES

Our objective was to investigate if BMD measurements differ between vegetarians and nonvegetarians from the adult general population when accounting for important determinants of BMD, especially BMI and waist circumference.

METHODS

Using data from the NHANES (cycles 2007-2008 and 2009-2010), we evaluated the differences in BMD (femoral neck, total femoral, and total lumbar spine) between adult vegetarians and nonvegetarians. Linear regression models were used to determine the associations between BMD and diet. Statistical models were adjusted for important factors, i.e., age, sex, race/ethnicity, smoking status, alcohol consumption, serum vitamin D and calcium concentrations, waist circumference, and BMI.

RESULTS

In statistical models adjusted for age, sex, race/ethnicity, menopausal status, and education level, BMD values were significantly lower among vegetarians than among nonvegetarians (P < 0.001). These differences were attenuated upon adjustment for lifestyle factors, and became statistically nonsignificant upon adjustment for anthropometric variables (BMI and waist circumference) for femoral neck (0.77 compared with 0.79 g/cm2 among vegetarians versus nonvegetarians, P = 0.10) and total femoral BMD (0.88 compared with 0.90 g/cm2, P = 0.12). A small but statistically significant difference remained for total lumbar spine BMD (1.01 compared with 1.04 g/cm2, P = 0.005).

CONCLUSIONS

These findings suggest that lower BMD among adult vegetarians is in larger parts explained by lower BMI and waist circumference.

Randomized clinical trial of exercise for nontreatment seeking adults with alcohol use disorder

The vast majority of individuals with alcohol use disorder (AUD) do not seek professional help despite its significant consequences upon the individual and society. Current interventions for nontreatment seeking individuals with AUD (e.g., screening, brief intervention, and referral to treatment [SBIRT]) have limited efficacy and alternative nonstigmatizing approaches are needed. This randomized clinical trial examined the utility of exercise as an intervention for sedentary nontreatment seeking adults with AUD. Participants (N = 66) were randomized to receive (a) a 4-month YMCA gym membership only (MO) or (b) a 4-month YMCA gym membership plus a 16-week integrated motivational intervention for exercise consisting of motivational interviewing and contingency management (MI + CM). Participants in both study conditions significantly increased their exercise behavior compared to baseline, and the MI + CM participants exercised significantly more often and an overall larger volume of exercise than the MO participants (ds > 2.0). Significant reductions in drinking and alcohol-related consequences were noted over time but did not differ significantly by study condition and were not related to changes in exercise. Future interventions using exercise as an intervention for AUD may want to frame this type of intervention as "wellness," directly link the 2 behaviors, and compare this intervention to SBIRT. (PsycINFO Database Record (c) 2020 APA, all rights reserved).