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Doan DNT, Kim K, Kim SG, Lee S, Lee KH, Kim J. Segmental bioelectrical impedance analysis for Korean older population with cold pattern. Front Nutr 2022; 9:975464. [PMID: 36532528 PMCID: PMC9751898 DOI: 10.3389/fnut.2022.975464] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 11/18/2022] [Indexed: 06/26/2024] Open
Abstract
OBJECTIVE This study examined the association of whole-body composition and segmental bioimpedance variables with cold pattern (CP) in different sexes. METHODS We assigned 667 older individuals to a CP group (n = 488) and a non-CP group (n = 179) by using an eight-item self-administered questionnaire. Seven body composition variables and three pairs of segmental bioimpedance variables for the upper and lower extremities, which were obtained from a segmental multifrequency bioimpedance analyzer, were employed to investigate their association with CP. Participants' characteristics were first described. Then we compared the selected body composition and bioimpedance variables between the CP and non-CP groups. Finally, their association with CP was investigated using univariate and multivariate regression analyses. All analyses were performed separately for women and men. RESULTS Both women and men exhibited a comparable mean age in the CP and non-CP groups; however, women with CP had significantly lower blood pressures, whereas men with CP showed a higher proportion of osteoarthritis than those without CP. Compared with the non-CP group, individuals with CP exhibited significantly smaller body sizes indicated by shorter height and smaller weight, lower body mass index, and smaller volume-to-body surface area ratio in both sexes. After controlling for age, height, weight, and other covariates, we found significant reductions in body lean mass such as fat-free mass and body cell mass, basal metabolic rate per unit mass, total body water, and intra-to-extracellular water ratio in the CP group. With regard to segmental bioimpedance analysis, the resistance ratios and phase angles in the upper and lower extremities yield significant associations with CP incidence, as demonstrated by the odds ratio (95% confidence interval) of 1.72 (1.16-2.57), 1.69 (1.18-2.48), 0.60 (0.40-0.89), and 0.57 (0.39-0.82), respectively. However, these results did not emerge in men. CONCLUSION Abnormal cellular water distribution and deterioration in body cell mass and/or cell strength are associated with CP prevalence, regardless of age, height, weight. These findings are similar in the upper and lower extremities and are more pronounced in women. The abovementioned patterns may be considered effective indicators for identifying CP in the older adult population.
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Affiliation(s)
- Dieu Ni Thi Doan
- Digital Health Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
- School of Korean Convergence Medical Science, University of Science and Technology, Daejeon, South Korea
| | - Kahye Kim
- School of Korean Convergence Medical Science, University of Science and Technology, Daejeon, South Korea
| | - Seul Gee Kim
- School of Korean Convergence Medical Science, University of Science and Technology, Daejeon, South Korea
| | - Siwoo Lee
- School of Korean Convergence Medical Science, University of Science and Technology, Daejeon, South Korea
| | - Kun Ho Lee
- Gwangju Alzheimer’s Disease and Related Dementias (GARD) Cohort Research Center, Chosun University, Gwangju, South Korea
- Department of Biomedical Science, Chosun University, Gwangju, South Korea
- Dementia Research Group, Korea Brain Research Institute, Daegu, South Korea
| | - Jaeuk Kim
- Digital Health Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
- School of Korean Convergence Medical Science, University of Science and Technology, Daejeon, South Korea
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Park HK, Shim YS, Lee HS, Hwang JS. Reference Ranges of Body Composition Using Dual-Energy X-Ray Absorptiometry and Its Relation to Tri-Ponderal Mass Index. J Clin Densitom 2022; 25:433-447. [PMID: 36114107 DOI: 10.1016/j.jocd.2022.08.006] [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: 07/06/2022] [Accepted: 08/14/2022] [Indexed: 11/21/2022]
Abstract
Introduction/background Increased body fat is related to obesity and its comorbidities later in life. To determine the amount of body fat in children and adolescents, reference intervals should be applied. Dual-energy X-ray absorptiometry (DXA) is a good tool for accurately measuring body composition. Methodology The body composition reference ranges in Korean children and adolescents were determined using nationally representative cross-sectional data. The performances of the body mass index (BMI) and tri-ponderal mass index (TMI) in measuring body fat were compared using the reference percentiles derived from this analysis. Results A total of 1,661 subjects (891 boys and men and 770 girls and women) were included. Age- and sex-specific percentiles and the corresponding LMS variables for DXA-assessed parameters for the whole body and the trunk were determined. The coefficients of determination of the whole body FM SDS and FMI SDS for the BMI SDS were 0.783 and 0.784, respectively, and those for the TMI SDS were 0.685 and 0.769, respectively. Conclusion Based on the reference values for body composition, the correlation coefficients of TMI for adjusted FM measured by DXA were comparable to those of BMI. TMI estimated body fat levels more accurately than BMI in this study population.
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Affiliation(s)
- Hong Kyu Park
- Department of Pediatrics, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Young Suk Shim
- Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea.
| | - Hae Sang Lee
- Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea
| | - Jin Soon Hwang
- Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea
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Witkam R, Gwinnutt JM, Humphreys J, Gandrup J, Cooper R, Verstappen SM. Do associations between education and obesity vary depending on the measure of obesity used? A systematic literature review and meta-analysis. SSM Popul Health 2021; 15:100884. [PMID: 34401462 PMCID: PMC8350379 DOI: 10.1016/j.ssmph.2021.100884] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 07/26/2021] [Accepted: 07/26/2021] [Indexed: 01/22/2023] Open
Abstract
Background Consistent evidence suggests a relationship between lower educational attainment and total obesity defined using body mass index (BMI); however, a comparison of the relationships between educational attainment and total obesity (BMI ≥30 kg/m2) and central obesity (waist circumference (WC) > 102 cm for men and WC > 88 cm for women) has yet to be carried out. This systematic literature review (SLR) and meta-analyses aimed to understand whether i) the associations between education and obesity are different depending on the measures of obesity used (BMI and WC), and ii) to explore whether these relationships differ by gender and region. Methods Medline, Embase and Web of Science were searched to identify studies investigating the associations between education and total and central obesity among adults in the general population of countries in the Organisation for Economic Co-operation and Development (OECD). Meta-analyses and meta-regression were performed in a subset of comparable studies (n=36 studies; 724,992 participants). Results 86 eligible studies (78 cross-sectional and eight longitudinal) were identified. Among women, most studies reported an association between a lower education and total and central obesity. Among men, there was a weaker association between lower education and central than total obesity (OR central vs total obesity in men 0.79 (95% CI 0.60, 1.03)). The association between lower education and obesity was stronger in women compared with men (OR women vs men 1.66 (95% CI 1.32, 2.08)). The relationship between lower education and obesity was less strong in women from Northern than Southern Europe (OR Northern vs Southern Europe in women 0.37 (95% CI 0.27, 0.51)), but not among men. Conclusions Associations between education and obesity differ depending on whether total or central obesity is used among men, but not in women. These associations are stronger among women than men, particularly in Southern European countries.
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Affiliation(s)
- Rozemarijn Witkam
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, The University of Manchester, UK
| | - James M. Gwinnutt
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, The University of Manchester, UK
| | - Jennifer Humphreys
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, The University of Manchester, UK
- NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, UK
| | - Julie Gandrup
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, The University of Manchester, UK
| | - Rachel Cooper
- Department of Sport and Exercise Sciences, Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, UK
| | - Suzanne M.M. Verstappen
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, The University of Manchester, UK
- NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, UK
- Corresponding author. Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
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Life course socioeconomic position and body composition in adulthood: a systematic review and narrative synthesis. Int J Obes (Lond) 2021; 45:2300-2315. [PMID: 34316000 PMCID: PMC8528709 DOI: 10.1038/s41366-021-00898-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 05/24/2021] [Accepted: 06/30/2021] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Multiple systematic reviews have investigated the relation between socioeconomic position (SEP) and body mass index (BMI) throughout the life course. However, BMI does not capture quantity and distribution of fat and muscle, which are better indicators of obesity than BMI, and have been independently linked to adverse health outcomes. Less is known about the relation between SEP and body composition, and the literature has not been reviewed. We therefore systematically reviewed the literature on the association between life course SEP and body composition in adulthood. METHODS A protocol was registered on PROSPERO (CRD42019119937), and the review followed PRISMA guidelines. An electronic search of three databases (MEDLINE, Embase Classic + Embase and SPORTDiscus) was conducted. Original studies in the English language were included that examine the association between any recognised measure of SEP at any age and body composition (fat mass, fat-free mass, ratio and distribution) in adulthood, measured using a direct technique, i.e., not an anthropometric measure. A narrative synthesis was conducted. RESULTS A total of 47 papers were included in the final review, none were from low-income countries (LICs). Greater advantage in childhood and adulthood was associated with lower fat levels in high-income countries (HICs). Associations in the opposite direction were found exclusively in middle-income countries (MICs). No studies in MICs reported associations for childhood SEP. For measures of lean mass, the majority of papers reported no association, or greater advantage in adulthood associated with higher lean mass, with little variation between HICs and MICs. Associations in HICs are more often observed in women than men. CONCLUSION The results indicate that fat measures follow similar patterns to those seen for BMI, and that women in HICs are more likely to experience inequalities in both fat and lean measures. Further research in LICs and MICs is needed.
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França AP, Marucci MDFN, Silva MDLDND, Roediger MDA. [Factors associated with general obesity and the percentage of body fat of women during the menopause in the city of São Paulo, Brazil]. CIENCIA & SAUDE COLETIVA 2018; 23:3577-3586. [PMID: 30427431 DOI: 10.1590/1413-812320182311.26492016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 12/15/2016] [Indexed: 11/22/2022] Open
Abstract
To verify the association between obesity and demographic, clinical and lifestyle variables in climacteric women, a cross-sectional study was conducted in outpatient clinics, with 469 women aged 40 to 65 years in the city of São Paulo, Brazil. The dependent variables were: obesity according to body mass index (BMI) and obesity according to percentage of body fat (% BF). The main explanatory variable was: climacteric phase (pre or postmenopausal); and control variables were: age; years of formal study; parity; menopausal hormone therapy (MHT) use; physical activity practice and smoking habit. Multiple regression analysis was performed using the Stata 9.2 software. According to the BMI, obesity was positively associated with parity (RR = 1.62, 95% CI = 1.11-2.37) and, negatively, with years of formal study (RP = 0.71, CI 95% = 0.55-0.91) and with physical activity practice (PR = 0.45, 95% CI = 0.33-0.61). According to the % BF, obesity was positively associated with parity (PR = 1.60, 95% CI = 1.03-2.49) and negatively with physical activity practice (PR = 0.43; 95% CI = 0.29-0.63). While being active physically was protective, multiparity was a risk factor for developing obesity for women in this study.
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Affiliation(s)
- Ana Paula França
- Faculdade de Saúde Pública, Universidade de São Paulo. Av. Dr. Arnaldo 715, Cerqueira César. 01246-904 São Paulo SP Brasil.
| | - Maria de Fátima Nunes Marucci
- Faculdade de Saúde Pública, Universidade de São Paulo. Av. Dr. Arnaldo 715, Cerqueira César. 01246-904 São Paulo SP Brasil.
| | | | - Manuela de Almeida Roediger
- Faculdade de Saúde Pública, Universidade de São Paulo. Av. Dr. Arnaldo 715, Cerqueira César. 01246-904 São Paulo SP Brasil.
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Rakić JG, Maksimović M, Janković J, Vlajinac H, Marinković J. Relationship between socioeconomic and nutritional status in the Serbian adult population: a cross-sectional study. SAO PAULO MED J 2018; 136:310-318. [PMID: 30110075 PMCID: PMC9881700 DOI: 10.1590/1516-3180.2018.0038170418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 04/04/2018] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Socioeconomic status is a well-known risk factor for obesity. The aim of this study was to assess the relationship between socioeconomic and nutritional status in the Serbian adult population. DESIGN AND SETTING Cross-sectional study on data from the 2013 National Health Survey performed in Serbia. METHODS The study population consisted of adults aged ≥ 20 years. Face-to-face interviews and anthropometric measurements were conducted by trained staff. Associations between body mass index and sociodemographic variables were analyzed using multivariable logistic regression analyses. RESULTS Out of 12,461 subjects of both sexes, 36.4% were overweight and 22.4% were obese. The prevalences of overweight and obesity differed significantly between the sexes, regarding all sociodemographic characteristics. Among women, educational attainment was associated with lower risk of being overweight (odds ratio, OR = 0.82; 95% confidence interval, CI: 0.69-0.98 for medium-level and OR = 0.77; CI: 0.62-0.97 for higher education) or obese (OR = 0.68; CI: 0.57-0.82 for medium-level and OR = 0.41; CI: 0.31-0.54 for higher education). In contrast, medium-level (OR = 1.28; CI: 1.08-1.52) and highly educated men (OR = 1.39; CI: 1.11-1.74) were more frequently overweight than were those with low education. Among men, grade I obesity was positively related to the richest wealth index group (OR = 1.27), while the opposite was true for grade II obesity among women (OR = 0.61). CONCLUSION This study showed significant socioeconomic inequalities in nutritional status between men and women. Continuous monitoring of socioeconomic patterns relating to weight is important, especially with further exploration of the link between education and obesity.
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Affiliation(s)
- Jelena Gudelj Rakić
- MD, PhD. Medical Doctor, Institute of Public Health of Serbia “Dr Milan Jovanović Batut”, Belgrade, Serbia.
| | - Miloš Maksimović
- MD. Professor, Institute of Hygiene and Medical Ecology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
| | - Janko Janković
- MD. Associate Professor, Institute of Social Medicine, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
| | - Hristina Vlajinac
- MD. Professor, Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
| | - Jelena Marinković
- PhD. Statistician and Professor, Institute of Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
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Santana CCA, Hill JO, Azevedo LB, Gunnarsdottir T, Prado WL. The association between obesity and academic performance in youth: a systematic review. Obes Rev 2017; 18:1191-1199. [PMID: 28742946 DOI: 10.1111/obr.12582] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 05/22/2017] [Accepted: 05/24/2017] [Indexed: 01/24/2023]
Abstract
Previous studies have found that obesity could influence academic performance. The aim of this study was to systematically review the scientific evidence on the association between obesity and academic performance in school children. A systematic review of English articles was undertaken by using databases PubMed/Medline, ERIC, LILACS, SciELO and Web of Science. Cross-sectional and longitudinal studies examining the association between obesity and academic performance in children and adolescents, published between January 1990 and December 2016, were included. Risk of bias was assessed by using Strengthening the Reporting of Observational Studies in Epidemiology. Thirty-four studies (23 cross-sectional and 11 longitudinal) matched all inclusion criteria and were included. Seven studies were classified as low risk of bias, 23 as medium risk and four as high risk. After controlling for covariates such as socio-economic status, parental education and physical activity, the association between obesity and academic performance becomes uncertain for most of the studies (55.9%). Therefore, at present, there is insufficient evidence to support a direct link between obesity and poor academic performance in school age children. In order to clarify this issue, we need more longitudinal studies with adequate sample sizes and that control for potential confounders.
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Affiliation(s)
- C C A Santana
- Physical Education Post Graduate Program, University of Pernambuco, Recife, Brazil
| | - J O Hill
- Anschutz Center for Health and Wellness, University of Colorado, Denver, CO, USA
| | - L B Azevedo
- School of Health and Social Care, Teesside University, Middlesbrough, UK
| | - T Gunnarsdottir
- Department of Psychiatry, Washington University, St. Louis, MO, USA
| | - W L Prado
- Physical Education Post Graduate Program, University of Pernambuco, Recife, Brazil.,Department of Human Movement Sciences, Federal University of São Paulo, Santos, Brazil
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Pei L, Cheng Y, Kang Y, Yuan S, Yan H. Association of obesity with socioeconomic status among adults of ages 18 to 80 years in rural Northwest China. BMC Public Health 2015; 15:160. [PMID: 25886538 PMCID: PMC4349793 DOI: 10.1186/s12889-015-1503-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Accepted: 02/03/2015] [Indexed: 03/09/2023] Open
Abstract
Background Understanding social disparities in obesity are presently an essential element in establishing public health priorities. However, the association between socioeconomic status (SES) and obesity has not been assessed in rural Northwest China. This study aims to explore the effect of SES on overweight/obesity and abdominal obesity by gender and age in rural Northwest China. Methods A total of 3030 participants between the ages of 18 to 80 years from rural Hanzhong, Shaanxi province, Northwest China were enrolled in our study using a two-level stratified random cluster sampling technique. Adjusted odds ratio (AOR) were used to assess the relationship between socioeconomic status and obesity after controlling for confounding factors using logistic regression. Results Our results indicated that the prevalence of abdominal obesity (38.8%) was the highest in rural Northwest China when compared with overweight (27.8%) and obesity (5.7%). When adjusting for possible risk factors, there were significant gender disparities in SES-obesity association. In men, the likelihoods of overweight/obesity and abdominal obesity were higher in the high SES groups when compared to the low SES groups. However, women with a high level of education were less likely to have overweight/obesity (AOR:0.78, 95% CI: 0.62, 0.98) than their counterparts with a low level of education. After the inclusion of multiple lifestyle factors, we still observed a strong positive association between age and obesity in the population. Conclusions Both gender and age differences in SES-obesity association were clearly observed in our study. Therefore, interventional measures should be employed in rural Northwest China to reduce the obesity epidemic that specifically takes into account gender and age differences.
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Affiliation(s)
- Leilei Pei
- Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University Health Science Center, No. 76 West Yanta Road, PO Box 46, Xi'an, Shaanxi, 710061, PR China.
| | - Yue Cheng
- Department of Nutrition and Food Safety Research, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, PR China.
| | - Yijun Kang
- Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University Health Science Center, No. 76 West Yanta Road, PO Box 46, Xi'an, Shaanxi, 710061, PR China.
| | - Shuyi Yuan
- Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University Health Science Center, No. 76 West Yanta Road, PO Box 46, Xi'an, Shaanxi, 710061, PR China.
| | - Hong Yan
- Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University Health Science Center, No. 76 West Yanta Road, PO Box 46, Xi'an, Shaanxi, 710061, PR China.
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Coll JL, Bibiloni MDM, Salas R, Pons A, Tur JA. Prevalence and Related Risk Factors of Overweight and Obesity among the Adult Population in the Balearic Islands, a Mediterranean Region. Obes Facts 2015; 8:220-33. [PMID: 26159577 PMCID: PMC5644906 DOI: 10.1159/000435826] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 04/23/2015] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE To assess the prevalence and risk factors of overweight (OW) and obesity (OB) by BMI and abdominal obesity (AO) by waist-to-height ratio, (WHtR) among the Balearic Islands' adult population. METHODS Cross-sectional nutritional survey carried out in the Balearic Islands (2009-2010). A random sample (n = 1,081) of young (18-35 years) and middle-aged adults (36-55 years) were interviewed and anthropometrically measured. OW (BMI 25.0-29.9 kg/m(2)) and OB (BMI ≥ 30 kg/m(2)) were defined according to WHO criteria. AO was defined as WHtR ≥ 0.5. Socio-economic and lifestyle determinants were considered. RESULTS The overall prevalence of OW/OB and AO was 29.4% (95% confidence interval (95% CI) 26.9-32.3%), 11.2% (95% CI 9.5-13.2%) and 33.1% (95% CI 30.4-36.0%), respectively. Men showed higher prevalence of OW (35.9%, 95% CI 31.6-40.5%) and AO (37.9%, 95% CI 33.6-42.5%) than women (OW 24.9%, 95% CI 21.7-28.4%; AO 29.7%, 95%CI 26.2-33.4%). Overall prevalence of OB was 11.8% (95% CI 9.1-15.1%) in men and 10.8% (95% CI 8.6-13.5%) in women. Age and no leisure-time physical activity (LTPA) were main risk factors associated with OW/OB and AO. Living with at least one child at home and to be married in men as well as to be unemployed, to be born in South America, and a low level of education in women were associated with AO. CONCLUSIONS Men showed higher prevalence of OW and AO than women. In both sexes, age is the main risk factor associated with OW/OB and AO; in men also the absence of LTPA plays a significant role.
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Affiliation(s)
- Josep L. Coll
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, IdISPa, and CIBERobn (Physiopathology of Obesity and Nutrition CB12/03/30038), Palma de Mallorca, Spain
| | - Maria del Mar Bibiloni
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, IdISPa, and CIBERobn (Physiopathology of Obesity and Nutrition CB12/03/30038), Palma de Mallorca, Spain
| | - Rogelio Salas
- Faculty of Public Health Nutrition, Autonomous University of Nuevo León, Monterrey, Mexico
| | - Antoni Pons
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, IdISPa, and CIBERobn (Physiopathology of Obesity and Nutrition CB12/03/30038), Palma de Mallorca, Spain
| | - Josep A. Tur
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, IdISPa, and CIBERobn (Physiopathology of Obesity and Nutrition CB12/03/30038), Palma de Mallorca, Spain
- *Dr. Josep A. Tur, Research Group on Community Nutrition and Oxidative Stress, Universitat de les Illes Balears, Guillem Colom Bldg, Campus, 07122 Palma de Mallorca, Spain,
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Kahn HS, Rissanen H, Bullard KM, Knekt P. The population distribution of the sagittal abdominal diameter (SAD) and SAD/height ratio among Finnish adults. Clin Obes 2014; 4:333-41. [PMID: 25826163 PMCID: PMC4445126 DOI: 10.1111/cob.12078] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 08/29/2014] [Accepted: 09/22/2014] [Indexed: 12/01/2022]
Abstract
Sagittal abdominal diameter (SAD; 'abdominal height' measured in supine position) may improve upon conventional anthropometry for predicting incident cardiometabolic diseases. However, the SAD is used infrequently by practitioners and epidemiologists. A representative survey of Finnish adults in 2000-2001 collected body measurements including SAD (by sliding-beam calliper) using standardized protocols. Sampled non-pregnant adults (ages 30+ years; 79% participation) provided 6123 SAD measurements from 80 health centre districts. Through stratified, complex survey design, these data represented 2.86 million adults at ages 30+ years. SAD ranged from 13.5 to 38.0 cm, with a population mean (standard error) of 21.7 (0.05) cm and median (interquartile range) of 21.0 (19.1-23.4). Median SAD was higher at ages 50+ years compared with ages 30-49 both for men (22.4 [20.5-24.6] vs. 20.8 [19.3-22.7]) and women (21.7 [19.6-23.9] vs. 19.4 [17.8-21.4]). The SAD/height ratio was similar (0.118) for both sexes at 30-39 years, rising more steeply with age for women than men. Attaining only a basic education, compared with a high level, was associated with increased mean (95% confidence interval) SADs for men (22.6 [22.3-22.8] vs. 22.0 [21.7-22.2]) and women (21.8 [21.5-22.0] vs. 20.6 [20.4-20.8]). Finland's early experience with nationally representative SAD measurements provides normative reference values and physiological insights useful for investigations of cardiometabolic risk.
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Affiliation(s)
- H S Kahn
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Bann D, Cooper R, Wills AK, Adams J, Kuh D. Socioeconomic position across life and body composition in early old age: findings from a British birth cohort study. J Epidemiol Community Health 2014; 68:516-23. [PMID: 24567442 PMCID: PMC4033171 DOI: 10.1136/jech-2013-203373] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Previous studies have reported associations between lower lifetime socioeconomic position (SEP) and higher body mass index in adulthood, but few have examined associations with direct measures of fat and lean mass which are likely to have independent roles in health and physical functioning. METHODS We examined associations of SEP across life with dual-energy X-ray absorptiometry measures of fat and lean mass at 60-64 years using data from a total of 1558 men and women participating in the Medical Research Council (MRC) National Survey of Health and Development. We also examined whether associations of childhood SEP with fat and lean mass were explained by preadulthood weight gain (birth weight, 0-7 and 7-20 years) and adult SEP. RESULTS Lower SEP across life was associated with higher fat mass and higher android to gynoid fat mass ratio. For example, the mean difference in fat mass index comparing the lowest with the highest paternal occupational class at 4 years (slope index of inequality) was 1.04 kg/m(1.2) in men (95% CI 0.09 to 1.99) and 2.61 in women (1.34 to 3.89), equivalent to a 8.6% and 16.1% difference, respectively. After adjustment for fat mass, lower SEP across life was associated with lower lean mass in women, while only contemporaneous household income was associated in men. Associations between childhood SEP and outcomes were partly explained by preadulthood weight gain and adult SEP. CONCLUSIONS This study identified lifetime socioeconomic patterning of fat and lean mass in early old age. This is likely to have important implications and may partly explain socioeconomic inequalities in health and physical functioning.
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Affiliation(s)
- David Bann
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK
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Cohen AK, Rai M, Rehkopf DH, Abrams B. Educational attainment and obesity: a systematic review. Obes Rev 2013; 14:989-1005. [PMID: 23889851 PMCID: PMC3902051 DOI: 10.1111/obr.12062] [Citation(s) in RCA: 257] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Revised: 05/14/2013] [Accepted: 05/28/2013] [Indexed: 01/17/2023]
Abstract
Although previous systematic reviews considered the relationship between socioeconomic status and obesity, almost 200 peer-reviewed articles have been published since the last review on that topic, and this paper focuses specifically on education, which has different implications. The authors systematically review the peer-reviewed literature from around the world considering the association between educational attainment and obesity. Databases from public health and medicine, education, psychology, economics, and other social sciences were searched, and articles published in English, French, Portuguese and Spanish were included. This paper includes 289 articles that report on 410 populations in 91 countries. The relationship between educational attainment and obesity was modified by both gender and the country's economic development level: an inverse association was more common in studies of higher-income countries and a positive association was more common in lower-income countries, with stronger social patterning among women. Relatively few studies reported on lower-income countries, controlled for a comprehensive set of potential confounding variables and/or attempted to assess causality through the use of quasi-experimental designs. Future research should address these gaps to understand if the relationship between educational attainment and obesity may be causal, thus supporting education policy as a tool for obesity prevention.
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Affiliation(s)
- A K Cohen
- Division of Epidemiology, University of California Berkeley School of Public Health, Berkeley, California, USA
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13
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Education is associated with lower levels of abdominal obesity in women with a non-agricultural occupation: an interaction study using China's Four Provinces survey. BMC Public Health 2013; 13:769. [PMID: 23962144 PMCID: PMC3844357 DOI: 10.1186/1471-2458-13-769] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Accepted: 08/14/2013] [Indexed: 01/22/2023] Open
Abstract
Background The prevalence of obesity is increasing rapidly in low- and middle-income countries (LMICs) as their populations become exposed to obesogenic environments. The transition from an agrarian to an industrial and service-based economy results in important lifestyle changes. Yet different socioeconomic groups may experience and respond to these changes differently. Investigating the socioeconomic distribution of obesity in LMICs is key to understanding the causes of obesity but the field is limited by the scarcity of data and a uni-dimensional approach to socioeconomic status (SES). This study splits socioeconomic status into two dimensions to investigate how educated women may have lower levels of obesity in a context where labour market opportunities have shifted away from agriculture to other forms of employment. Methods The Four Provinces Study in China 2008/09 is a household-based community survey of 4,314 people aged ≥60 years (2,465 women). It was used to investigate an interaction between education (none/any) and occupation (agricultural/non-agricultural) on high-risk central obesity defined as a waist circumference ≥80 cm. An interaction term between education and occupation was incorporated in a multivariate logistic regression model, and the estimates adjusted for age, parity, urban/rural residence and health behaviours (smoking, alcohol, meat and fruit & vegetable consumption). Complete case analyses were undertaken and results confirmed using multiple imputation to impute missing data. Results An interaction between occupation and education was present (P = 0.02). In the group with no education, the odds of central obesity in the sedentary occupation group were more than double those of the agricultural occupation group even after taking age group and parity into account (OR; 95%CI: 2.21; 1.52, 3.21), while in the group with any education there was no evidence of such a relationship (OR; 95%CI: 1.25; 0.92, 1.70). Health behaviours appeared to account for some of the association. Conclusion These findings suggest that education may have a protective role in women against the higher odds of obesity associated with occupational shifts in middle-income countries, and that investment in women’s education may present an important long term investment in obesity prevention. Further research could elucidate the mechanisms behind this association.
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Lahti-Koski M, Harald K, Saarni SE, Peltonen M, Männistö S. Changes in body mass index and measures of abdominal obesity in Finnish adults between 1992 and 2007, the National FINRISK Study. Clin Obes 2012; 2:57-63. [PMID: 25586048 DOI: 10.1111/j.1758-8111.2012.00035.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
UNLABELLED What is already known about this subject • Recent obesity trends across the world in adults are mixed, varying from showing signs of levelling off to a continuously increasing prevalence. • Secular trends in body mass index (BMI) and waist circumference may vary by sex and age. • Relying exclusively on BMI data may lead to underestimate the obesity epidemic. What this study adds • Adverse trends in obesity indicators have continued in Finland in the 2000s. • In older men, BMI remained quite stable and in older women BMI has decreased since 1997. • Steep upward trends in abdominal obesity (waist circumference and waist-to-height ratio, WHtR) have taken place in both men and women and in all age groups, especially during the past 10 years. • The impact of BMI adjustment on trends in abdominal obesity varied by age such that increases in BMI-adjusted waist circumference and WHtR were more prominent in older age groups. SUMMARY Signs that obesity trends will level off at the turn of the 21st century have been reported. In these studies, however, the definition of obesity has been based only on body mass index (BMI). We investigated obesity trends among Finnish adults over recent years by using BMI, waist circumference and waist-to-height ratio as indicators for obesity. Data were derived from the national FINRISK surveys, which are cross-sectional population surveys conducted at 5-year intervals between 1992 and 2007. Altogether, 20 551 randomly selected men and women aged 25-64 years participated in health examinations, where weight, height, and waist and hip circumferences were measured by trained nurses. Mean BMI increased in younger men and women (aged 25-44 years) between 1992 and 2007, whereas in older men, BMI remained quite stable and in older women BMI has decreased since 1997. Nevertheless, mean waist circumference and waist-to-height ratio increased in both men and women over the 15-year period. The upward trends took place in all age groups, especially during the past 10 years. Adverse trends in obesity indicators have continued in Finland in the 2000s. In particular, concerns are related to steep upward trends in abdominal obesity.
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Affiliation(s)
- M Lahti-Koski
- Finnish Heart Association, Helsinki, FinlandNational Institute for Health and Welfare (THL), Helsinki, FinlandDepartment of Psychiatry, Health Center, City of Helsinki, Helsinki, Finland
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Cuadros JL, Fernández-Alonso AM, Cuadros AM, Chedraui P, Pérez-López FR. Body mass index and its correlation to metabolic and hormone parameters in postmenopausal Spanish women. Gynecol Endocrinol 2011; 27:678-84. [PMID: 21133833 DOI: 10.3109/09513590.2010.521269] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To assess body weight composition in postmenopausal women and determine correlations with metabolic and hormonal parameters. METHODS Medical records of 574 postmenopausal Caucasian Spanish women first time attending a menopause clinic were retrospectively reviewed. Retrieved information included general demographic data, type of menopause, time since menopause onset and baseline hormonal and metabolic parameters. A body mass index (BMI) value of >28.8 kg/m(2) was used to define obesity. The metabolic syndrome (METS) was diagnosed with three or more criteria: fasting glycemia ≥ 100 mg/dL, high density lipoprotein cholesterol (HDL-C) <50 mg/dL, triglycerides (TG) ≥ 150 mg/dL, blood pressure ≥ 130/85 mmHg and obesity (as defined above). RESULTS Mean age of the whole cohort was 49.9 ± 6.1 years, with 66% having a natural menopause. A 38.9% and 23.1% of all women were obese or had the METS, respectively. Obese women were older, had a higher parity, smoked less, had more time since menopause onset and a higher rate of surgical menopause as compared to non-obese ones (p = 0.001). BMI values positively correlated with age, time since menopause, parity, and glucose, TG and systolic blood pressure levels; displaying an inverse correlation with HDL-C and SHBG levels. SHBG levels inversely correlated with glucose, TG, HDL-C and systolic blood pressure levels. CONCLUSION In this Spanish postmenopausal population BMI significantly increased with age, time since menopause and parity displaying significant correlations with hormonal and metabolic parameters.
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Affiliation(s)
- José L Cuadros
- Obstetrics and Gynecology Service, Faculty of Medicine, University of Granada, Hospital San Cecilio, Granada, Spain
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Vinknes KJ, de Vogel S, Elshorbagy AK, Nurk E, Drevon CA, Gjesdal CG, Tell GS, Vollset SE, Refsum H. Dietary intake of protein is positively associated with percent body fat in middle-aged and older adults. J Nutr 2011; 141:440-6. [PMID: 21248195 DOI: 10.3945/jn.110.133710] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Data on associations between dietary intake of macronutrients and body composition in the general population are sparse. This population-based, cross-sectional study of 4478 middle-aged (47-49 y) and elderly (71-74 y) men and women from the Hordaland Health Study in western Norway was conducted using a validated FFQ and measurements by dual-energy X-ray absorptiometry. The relation between macronutrient intake [percentage of total energy intake (E%)] and percent body fat was investigated in the total population and in a subgroup with intermediate BMI and stable weight (BMI within the 25th-75th percentile and weight change <5% during the last 6 y; n = 975). In the total population, protein intake (E%) was associated with higher percent body fat (partial r = 0.11; P < 0.001) in multivariate linear regression analysis. In the subgroup with intermediate BMI and stable weight, there was no association between protein intake (E%) and percent body fat. Fat intake (E%) was positively associated (partial r = 0.07) whereas carbohydrate intake (E%) was inversely associated (partial r = -0.07) with percent body fat (P = 0.042 for both) in the subgroup with intermediate BMI and stable weight. Both in the total population and in the stable weight group, physical activity was inversely related to adiposity (partial r = -0.15 and -0.12, respectively; P < 0.001). Our results may explain some of the conflicting data on the effects of macronutrients in different populations and suggest the potential importance of protein intake as a factor in obesity.
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Affiliation(s)
- Kathrine J Vinknes
- Department of Nutrition, Institute of Basic Medical Science, Faculty of Medicine, University of Oslo, 0316 Oslo, Norway.
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Korniloff K, Häkkinen A, Kautiainen H, Koponen H, Peltonen M, Mäntyselkä P, Oksa H, Kampman O, Vanhala M. Leisure-time physical activity and metabolic syndrome plus depressive symptoms in the FIN-D2D survey. Prev Med 2010; 51:466-70. [PMID: 20854837 DOI: 10.1016/j.ypmed.2010.09.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2010] [Revised: 09/09/2010] [Accepted: 09/12/2010] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To examine the association between leisure-time physical activity (LTPA) and simultaneous presence of metabolic syndrome (MetS) and depressive symptoms (DS) based on a population-based FIN-D2D cross-sectional survey conducted in 2007. METHODS 4500 randomly selected Finnish men and women aged 45-74 years were initially enrolled; 2868 (64%) attended a health examination. Participants with complete information (n=2778) were grouped into three LTPA categories: low, moderate and high. MetS was based on the National Cholesterol Education Program criteria and DS on the Beck Depression Inventory (≥10 points). RESULTS The prevalence of MetS and DS were 53% and 15%, respectively; the prevalence of simultaneous MetS and DS was 10%. The proportion of subjects with MetS, DS and simultaneous presence of MetS and DS increased with decreasing LTPA (p<0.001). On multivariate ordered analysis, LTPA was related to education years, household income, smoking, and the presence of MetS only, DS only and simultaneous MetS and DS. CONCLUSION The prevalence of simultaneous MetS and DS was higher in participants with low LTPA compared with participants with high LTPA. Furthermore, LTPA level was associated with socioeconomic status and other health related outcomes, outlining the importance of LTPA as part of the general health promotion.
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Affiliation(s)
- Katariina Korniloff
- Department of Health Sciences, University of Jyväskylä, PL 35, FI-40014 Jyväskylä, Finland.
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