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Heuchan GN, Lally PJ, Beeken RJ, Fisher A, Conway RE. Perception of a need to change weight in individuals living with and beyond breast, prostate and colorectal cancer: a cross-sectional survey. J Cancer Surviv 2024; 18:844-853. [PMID: 36701100 PMCID: PMC11081928 DOI: 10.1007/s11764-023-01333-0] [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: 10/03/2022] [Accepted: 01/05/2023] [Indexed: 01/27/2023]
Abstract
PURPOSE People living with and beyond cancer (LWBC) are advised to achieve a body mass index (BMI) within the healthy range (≥ 18.5 and < 25). Not perceiving a need for weight change may be a barrier to achieving a healthy weight. This study aimed to explore factors associated with perceived need for weight change among people LWBC. METHODS Adults diagnosed with breast, prostate, or colorectal cancer were recruited through National Health Service sites in Essex and London. Participants (N = 5835) completed the 'Health and Lifestyle After Cancer' survey, which included a question on perceived need to change weight. Associations between perceived need for weight change and BMI, and perceived need for weight change and health and demographic variables, were analyzed using chi-square tests and logistic regression, respectively. RESULTS The proportion of participants perceiving a need to lose weight differed according to BMI category: healthy weight (23%), overweight (64%), obese (85%) (P < 0.001). Having overweight or obesity but not perceiving a need to lose weight was associated with being older, male, non-white, not married or cohabiting, and having cancer that had spread, no formal qualifications, no comorbidities, and having received chemotherapy. CONCLUSIONS Perceived need to lose weight is prevalent among people LWBC with obesity and overweight. This group may be interested in weight management support. Demographic and health factors were associated with having obesity or overweight but not perceiving a need to lose weight. IMPLICATIONS FOR CANCER SURVIVORS Weight loss interventions for people LWBC are needed. A subset of people LWBC with overweight and obesity may need additional information or motivators to engage with weight management.
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Affiliation(s)
- Gabriella N Heuchan
- Research Department of Behavioural Science and Health, University College London, Gower Street, London, WC1E 6BT, UK
| | - Phillippa J Lally
- Research Department of Behavioural Science and Health, University College London, Gower Street, London, WC1E 6BT, UK
- Department of Psychology, University of Surrey, Guildford, Surrey, GU2 7HX, UK
| | - Rebecca J Beeken
- Research Department of Behavioural Science and Health, University College London, Gower Street, London, WC1E 6BT, UK.
- Leeds Institute of Health Sciences, University of Leeds, Leeds, LS2 9JT, UK.
| | - Abigail Fisher
- Research Department of Behavioural Science and Health, University College London, Gower Street, London, WC1E 6BT, UK
| | - Rana E Conway
- Research Department of Behavioural Science and Health, University College London, Gower Street, London, WC1E 6BT, UK
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Meyer E, Lönnroth K, Forsell Y, Lagerros YT. Discrepancy between Current, Desired, and Ideal Body Mass Index in Persons with Obesity: A Swedish Population-Based Study. Obes Facts 2023; 17:72-80. [PMID: 37984350 PMCID: PMC10836935 DOI: 10.1159/000535198] [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: 03/13/2023] [Accepted: 11/06/2023] [Indexed: 11/22/2023] Open
Abstract
INTRODUCTION Body weight dissatisfaction, when current and desired body mass index (BMI) do not align, is common in persons with obesity. The aim of this cross-sectional study was to explore factors associated with the differences between current and desired BMI, and ideal BMI (defined in the present study as BMI 25 kg/m2), in persons with obesity. METHODS Swedish citizens aged 20-64 years residing in the Stockholm County were randomly selected from the population register at five different and evenly separated occasions in the study period 1998-2000 and invited to provide self-reported data about their current weight, height, desired weight, and other characteristics such as depressive symptoms and alcohol intake. Among the 10,441 participants with a mean BMI of 24 kg/m2, differences between desired BMI and ideal BMI were calculated to determine the discrepancy between desired BMI and ideal BMI in participants with obesity (n = 808). The discrepancy between current and desired BMI was also determined. Using linear regression, factors associated with BMI discrepancies were determined. RESULTS Persons with BMI <40 kg/m2 desired a lower BMI than those with BMI ≥40 kg/m2 (26 ± 3 vs. 36 ± 14 kg/m2, p < 0.001). Women with obesity (n = 425) had a larger discrepancy between current and desired BMI, 32% ± 16, than men with obesity (n = 380), 24% ± 21 (p < 0.001). Persons with obesity and major depression had a 6.9% (95% CI: 2.5-11.4) larger discrepancy between current and desired BMI than persons with obesity but without major depression. Being born abroad, having a university degree, or hazardous alcohol use were not associated with discrepancy between current and desired BMI or desired BMI and ideal BMI (all p > 0.05). CONCLUSION Desired BMI and discrepancies between current, desired, and ideal BMI vary according to current BMI, sex, and presence of major depression. This underscores the significance of a patient-centered approach in the management of obesity, where the goals and needs of each patient should be considered.
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Affiliation(s)
- Elin Meyer
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Knut Lönnroth
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Yvonne Forsell
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Ylva Trolle Lagerros
- Clinical Epidemiology Division, Department of Medicine (Solna), Karolinska Institutet, Stockholm, Sweden
- Center for Obesity, Academic Specialist Center, Stockholm, Sweden
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Seth N, Seal A, Ruchin P, McGirr J. The Accuracy of Self-Perception of Obesity in a Rural Australian Population: A Cross-Sectional Study. J Prim Care Community Health 2022; 13:21501319221115256. [PMID: 35997321 PMCID: PMC9421221 DOI: 10.1177/21501319221115256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction: Obesity is a major public health concern. Accurate perception of body weight
may be critical to the successful adoption of weight loss behavior. The aim
of this study was to determine the accuracy of self-perception of BMI
class. Methods: Patients admitted to the acute medical service in one regional hospital
completed a questionnaire and classified their weight as: “underweight,”
“normal,” “overweight,” or “obese.” Reponses were compared to clinically
measured BMIs, based on the WHO Classification. Patients were also
questioned about health-related behavior. Data were analyzed via Pearson’s
Chi-squared test. Results: Almost 70% of the participating patient population (n = 90) incorrectly
perceived their weight category, with 62% underestimating their weight. Only
34% of patients who were overweight and 14% of patients with obesity
correctly identified their weight status. Two-thirds of patients who were
overweight and one-fifth of patients with obesity considered themselves to
be “normal” or “underweight.” Patients with obesity were 6.5-fold more
likely to misperceive their weight status. Amongst patients with
overweight/obesity, those who misperceived their weight were significantly
less likely to have plans to lose weight. Almost 60% had not made any recent
health behavior changes. This is one of the first regional Australian
studies demonstrating that hospitalized patients significantly misperceive
their weight. Conclusion: Patients with overweight/obesity had significantly higher rates of weight
misperception and the majority had no intention to lose weight or to
undertake any health behavior modification. Given the association between
weight perception and weight reduction behavior, it introduces barriers to
addressing weight loss and reducing the increasing prevalence of obesity in
rural Australia. It highlights that doctors have an important role in
addressing weight misperception.
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Affiliation(s)
- Nimish Seth
- Surgical Resident, Alfred Health, Melbourne, VIC, Australia
| | - Alexa Seal
- School of Medicine Sydney, Rural Clinical School, The University of Notre Dame Australia, Wagga Wagga, NSW, Australia
| | - Peter Ruchin
- School of Medicine Sydney, Rural Clinical School, The University of Notre Dame Australia, Wagga Wagga, NSW, Australia.,The University of New South Wales, Sydney, NSW, Australia.,Calvary Hospital Riverina, Wagga Wagga, NSW, Australia.,Mater Hospital, North Sydney, NSW, Australia.,Wagga Wagga Base Hospital, Wagga Wagga, NSW, Australia
| | - Joe McGirr
- School of Medicine Sydney, Rural Clinical School, The University of Notre Dame Australia, Wagga Wagga, NSW, Australia.,State Member of Parliament, Wagga Wagga, NSW, Australia
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How long do people stick to a diet resolution? A digital epidemiological estimation of weight loss diet persistence. Public Health Nutr 2020; 23:3257-3268. [PMID: 33308350 DOI: 10.1017/s1368980020001597] [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: 11/07/2022]
Abstract
OBJECTIVE To use Internet search data to compare duration of compliance for various diets. DESIGN Using a passive surveillance digital epidemiological approach, we estimated the average duration of diet compliance by examining monthly Internet searches for recipes related to popular diets. We fit a mathematical model to these data to estimate the time spent on a diet by new January dieters (NJD) and to estimate the percentage of dieters dropping out during the American winter holiday season between Thanksgiving and the end of December. SETTING Internet searches in the USA for recipes related to popular diets over a 15-year period from 2004 to 2019. PARTICIPANTS Individuals in the USA performing Internet searches for recipes related to popular diets. RESULTS All diets exhibited significant seasonality in recipe-related Internet searches, with sharp spikes every January followed by a decline in the number of searches and a further decline in the winter holiday season. The Paleo diet had the longest average compliance times among NJD (5.32 ± 0.68 weeks) and the lowest dropout during the winter holiday season (only 14 ± 3 % dropping out in December). The South Beach diet had the shortest compliance time among NJD (3.12 ± 0.64 weeks) and the highest dropout during the holiday season (33 ± 7 % dropping out in December). CONCLUSIONS The current study is the first of its kind to use passive surveillance data to compare the duration of adherence with different diets and underscores the potential usefulness of digital epidemiological approaches to understanding health behaviours.
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Freigang* R, Geier* AK, Lukas Schmid G, Frese T, Klement A, Unverzagt S. Misclassification of Self-Reported Body Mass Index Categories. DEUTSCHES ARZTEBLATT INTERNATIONAL 2020; 117:253-260. [PMID: 32449888 PMCID: PMC7268097 DOI: 10.3238/arztebl.2020.0253] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 05/30/2019] [Accepted: 01/06/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Overweight and obesity are an increasingly serious public health problem in Western societies, including Germany. The tendency of overweight and obese people not to classify themselves as such limits the efficacy of information on the health risks of these conditions and lessens the motivation to change behavior accordingly. In this article, we summarize the available study data on the selfperception of weight class. We present and discuss the differences between selfreported body-mass index (BMI) category and the actual category of the BMI when it is calculated from the individual's measured height and weight. METHODS We systematically searched the Medline, EMBASE, and Cochrane Library databases in August 2017 for pertinent publications. The study protocol was published in the PROSPERO register (CRD42017064230). Meta-analyses were calculable for a number of subgroup analyses. RESULTS A total of 50 studies from 25 countries were identified that contained findings on self-estimation of weight in a total of 173 971 study participants. The percentage of correct self-categorizations of BMI category varied from 16% to 83%, with marked heterogeneity of the population groups studied. In Europe, women overestimated their BMI category three times as often as men (RR: 3.22; 95% confidence interval: [2.87; 3.62], I2 = 0%). Most erroneous classifications were based on underestimates. Study participants of normal weight were more likely than others to categorize their BMI correctly. In European studies, 50.3-75.8% categorized their BMI correctly. Low socioeconomic status was associated with an incorrect perception of BMI. CONCLUSION The self-assignment of BMI categories is often erroneous, with underestimates being more common than overestimates. Physicians should take particular care to provide appropriate information to persons belonging to groups in which underestimating one's BMI is common, such as overweight people and men in general.
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Affiliation(s)
- Romy Freigang*
- * The two authors are co-first authors
- Department of General Practice, Faculty of Medicine, University of Leipzig, Leipzig
- Institute of General Practice and Family Medicine, Martin Luther University Halle-Wittenberg, Halle
| | - Anne-Kathrin Geier*
- * The two authors are co-first authors
- Department of General Practice, Faculty of Medicine, University of Leipzig, Leipzig
| | - Gordian Lukas Schmid
- Department of General Practice, Faculty of Medicine, University of Leipzig, Leipzig
- Institute of General Practice and Family Medicine, Martin Luther University Halle-Wittenberg, Halle
| | - Thomas Frese
- Institute of General Practice and Family Medicine, Martin Luther University Halle-Wittenberg, Halle
| | - Andreas Klement
- Institute of General Practice and Family Medicine, Martin Luther University Halle-Wittenberg, Halle
| | - Susanne Unverzagt
- Department of General Practice, Faculty of Medicine, University of Leipzig, Leipzig
- Institute of General Practice and Family Medicine, Martin Luther University Halle-Wittenberg, Halle
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Evans‐Hoeker EA, Ramalingam NS, Harden SM. Weight management perceptions and clinical practices among gynaecology providers caring for reproductive-aged patients. Obes Sci Pract 2019; 5:304-311. [PMID: 31452915 PMCID: PMC6700516 DOI: 10.1002/osp4.338] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 03/12/2019] [Accepted: 03/13/2019] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Research suggests that patient and provider conversations about healthy eating and physical activity behaviours may lead to patients' increased health behaviours, access to dietary and physical activity resources, and weight management. The American College of Obstetrics and Gynecology (ACOG) has a number of weight management intervention options, but it is unclear if providers have conversations about intervention options with their patients who are of reproductive age. The purpose of this work was to evaluate the degree to which gynaecology healthcare providers offer the weight management intervention options as recommended by ACOG. METHODS Cross-sectional study of gynaecology providers in Southwest Virginia utilizing an electronic survey to identify weight management perceptions and current clinical practices. Responses were measured using quantitative methods, and agreeability and frequency responses were measured using a 5-point Likert scale. RESULTS Twenty-three of the 31 eligible providers (74.2%) completed the survey. Providers acknowledge that patients need weight management discussions and they feel comfortable and are willing to have these discussions. While physical activity recommendations were consistent among providers, they did not reflect the complete physical activity recommendations for Americans. Consistency in dietary recommendations was lacking. Although providers make recommendations for physical activity and/or diet at least sometimes, they rarely utilize other methods of weight management as outlined in the ACOG recommendations, such as referrals to other providers, programmes or medications. CONCLUSIONS Areas for improvement in weight management practices include frequency of counselling, consistency in dietary counselling and frequency of utilization of weight loss medications and referrals to ancillary services. These results can be used to aid the development of methods for targeting these deficiencies.
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Affiliation(s)
- E. A. Evans‐Hoeker
- Department of Obstetrics and GynecologyCarilion ClinicRoanokeVirginiaUSA
- Department of Obstetrics and GynecologyVirginia Tech Carilion School of MedicineRoanokeVirginiaUSA
| | - N. S. Ramalingam
- Translational Biology, Medicine and HealthVirginia TechBlacksburgVirginiaUSA
- Department of Human Nutrition, Foods, and ExerciseVirginia TechBlacksburgVirginiaUSA
| | - S. M. Harden
- Department of Obstetrics and GynecologyVirginia Tech Carilion School of MedicineRoanokeVirginiaUSA
- Department of Human Nutrition, Foods, and ExerciseVirginia TechBlacksburgVirginiaUSA
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Mawardi G, Kirkland EB, Zhang J, Blankinship D, Heincelman ME, Schreiner AD, Moran WP, Schumann SO. Patient perception of obesity versus physician documentation of obesity: A quality improvement study. Clin Obes 2019; 9:e12303. [PMID: 30816010 DOI: 10.1111/cob.12303] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 01/11/2019] [Accepted: 01/19/2019] [Indexed: 01/22/2023]
Abstract
As the prevalence of obesity increases, the prevalence of associated comorbid diseases, obesity-related mortality rates and healthcare costs rise concordantly. Two main factors that hinder efforts to treat obesity include a lack of recognition by patients and documentation by physicians. This study evaluates the relationship between patient perception of obese weight and physician documentation of obesity. This quality improvement observational study surveyed patients of an academic internal medicine clinic on their perception of obesity. Responses were compared to longitudinal physician documentation of obesity and body mass index (BMI). A total of 59.9% of patients with obesity perceived their weight as obese. While 33.7% of patients with a BMI of 30 to 34.9 kg/m2 perceived themselves as having obesity, 71.4% of patients with a BMI of 45 to 49.9 kg/m2 perceived themselves as having obesity. A total of 42.4% of patients with obesity had physician documentation of obesity in the last year. While 25% of patients with a BMI of 30 to 34.9 kg/m2 had physician documentation of obesity, 85.7% of patients with a BMI of 45 to 49.9 kg/m2 had physician documentation of obesity. For patients with a BMI ≥50 kg/m2 , 52.9% perceived their weight to be obese and 76.5% had physician documentation of obesity in the last year. Both patient perception and physician documentation of obesity were significantly less than the prevalence of obesity. Patient perception of obesity and provider documentation of obesity increased as BMI increased until a BMI ≥50 kg/m2 . Both patients and providers must improve recognition of this disease.
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Affiliation(s)
- George Mawardi
- Division of General Internal Medicine and Geriatrics, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Elizabeth B Kirkland
- Division of General Internal Medicine and Geriatrics, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Jingwen Zhang
- Division of General Internal Medicine and Geriatrics, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
- Section of Health Systems Research and Policy, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Devin Blankinship
- Division of General Internal Medicine and Geriatrics, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Marc E Heincelman
- Division of General Internal Medicine and Geriatrics, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Andrew D Schreiner
- Division of General Internal Medicine and Geriatrics, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - William P Moran
- Division of General Internal Medicine and Geriatrics, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Samuel O Schumann
- Division of General Internal Medicine and Geriatrics, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
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8
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Vanelli CP, Miranda LDSP, Colugnati FAB, De Paula RB, Costa MB. Determinação do estado nutricional: qual o valor de peso e altura autorreferidos? HU REVISTA 2019. [DOI: 10.34019/1982-8047.2018.v44.13933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Introdução: Altas prevalências de sobrepeso e obesidade são descritas em diferentes populações. No entanto, grande parcela da população tem percepções imprecisas sobre seu peso corporal e, consequentemente, sobre a classificação nutricional. Objetivo: Comparar a percepção autorreferida do peso corporal frente à classificação nutricional baseada na aferição realizada por profissional de saúde em amostra representativa da população de cidade de grande porte do sudeste brasileiro. Material e métodos: Foi realizado estudo transversal por inquérito populacional em cidade de médio porte do sudeste brasileiro, sendo a coleta de dados realizada de junho/2014 a abril/2016. Utilizou-se amostragem domiciliar em três estágios e aproximadamente 4.800 domicílios foram visitados, a partir dos quais, 1.032 participantes foram aleatoriamente selecionados e incluídos na pesquisa. Resultados: A média de idade dos participantes foi de 44±13,2 anos, sendo 53,2% indivíduos do sexo feminino. Com base no autorrelato de peso e altura e cálculo do índice de massa corporal (IMC), observou-se que 58,7% da população se encontravam com excesso de peso. Dos 521 indivíduos que foi possível realizar a avaliação do peso e altura por profissionais de saúde vimos que ao se comparar a classificação nutricional baseada no autorrelato com aquela obtida a partir de dados mensurados pelos profissionais, observou-se que o número de casos de obesidade foi 7,1% maior. Conclusão: Diante dos dados do presente estudo, a autopercepção do excesso de peso pode não ser adequada como ferramenta para avaliação de populações em risco para obesidade/sobrepeso, além disso, os resultados reforçam a necessidade de educação sobre o uso do IMC assim como da importância das orientações por profissionais de saúde.
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Lang AY, Harrison CL, Boyle JA. Preconception Lifestyle and Weight-Related Behaviors by Maternal Body Mass Index: A Cross-Sectional Study of Pregnant Women. Nutrients 2019; 11:nu11040759. [PMID: 30935152 PMCID: PMC6521092 DOI: 10.3390/nu11040759] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 03/26/2019] [Accepted: 03/28/2019] [Indexed: 01/24/2023] Open
Abstract
Obesity is a rising global health challenge, particularly for reproductive-aged women. Our cross-sectional study of pregnant women (n = 223) examined associations between preconception body mass index (BMI) and socio-demographics, weight perceptions and lifestyle behaviors. Over half of women were overweight (33.2%) or obese (22.0%), 49.6% of which perceived their weight as normal. High proportions of women reported planning their pregnancies (70.0%) and were actively trying to lose or maintain their weight preconception (72.7%). Weight management approaches varied from reducing discretionary foods (63.7%) to professional support (8.1%). Obese women had significantly greater odds of reducing discretionary foods (odds ratio (OR) = 6.69 95% confidence interval (CI) 2.13–21.00, p = 0.001) and using structured diets (adjusted odds ratio (AOR) = 9.13 95% CI 2.90–28.81, p < 0.001) compared to normal-weight women. After adjusting for socio-demographics, compared to normal-weight women, overweight (AOR = 5.24 95% CI 2.19–12.56, p < 0.001) and obese (AOR = 2.85 95% CI 1.06–7.67, p = 0.04) women had significantly increased odds of exercising for weight management and significantly lower odds of taking folic-acid preconception (overweight: AOR = 0.40 95% CI 0.18–0.90, p = 0.01, obese: AOR = 0.38 95% CI 0.16–0.91, p = 0.03). Large proportions of women planning a pregnancy have an overweight/obese BMI, with associated suboptimal health behaviors and reduced health professional engagement preconception. Further research exploring women’s perspectives regarding preconception lifestyles is needed to inform effective preconception health promotion strategies.
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Affiliation(s)
- Adina Y Lang
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Melbourne, VIC 3004, Australia.
| | - Cheryce L Harrison
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Melbourne, VIC 3004, Australia.
| | - Jacqueline A Boyle
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Melbourne, VIC 3004, Australia.
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Opichka K, Smith C. Accuracy of self-reported heights and weights in a predominately low-income, diverse population living in the USA. Am J Hum Biol 2018; 30:e23184. [PMID: 30329190 DOI: 10.1002/ajhb.23184] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 07/30/2018] [Accepted: 08/28/2018] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES This study explored the accuracy of self-reported heights and weights and factors associated with self-reported bias in a diverse American sample. METHODS Demographic, self-reported, and measured height and weight data from different studies with the same PI were compiled into one SPSS file and analyzed with paired t-tests to detect differences between self-reported and actual values. Kruskal-Wallis tests followed by pairwise t-tests detected differences among age, ethnicity, sex, income, and education. Stepwise regression analyses were done using anthropometric differences as the dependent variable and age category, sex, and ethnicity as independent variables to explore which variable was most predictive of anthropometric differences. RESULTS Individuals over-reported height and under-reported weight leading to an under-calculated BMI from self-reported height and weight by 0.6-1 kg/m2 . These under-calculations of BMI led to misclassifications of obesity by 3, 6, 8, and 4% for African American, Euro-American, Native American women, and total women, and by 5, 6, 8, and 8% by African American, Euro-American, Native American men, and total men. Older individuals and males over-reported height more than younger individuals and females. African American females over-reported height to a lesser extent than other ethnicities. Asian males over-reported height to a lesser extent than other ethnicities. CONCLUSIONS Self-reported heights and weights lead to invalid results. Most individuals over-report height and under-report weight, resulting in an inaccurate underweight and obesity prevalence. Being misclassified into the incorrect BMI category could result in inappropriate healthcare treatment. Age, ethnicity, and sex appear to influence the misreporting of height and weight.
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Affiliation(s)
- Kate Opichka
- Department of Food Science and Nutrition, University of Minnesota, St. Paul, Minnesota
| | - Chery Smith
- Department of Food Science and Nutrition, University of Minnesota, St. Paul, Minnesota
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11
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Fitness versus adiposity in cardiovascular disease risk. Eur J Clin Nutr 2018; 73:225-230. [PMID: 30297762 DOI: 10.1038/s41430-018-0333-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 09/12/2018] [Indexed: 11/09/2022]
Abstract
Obesity and low cardiorespiratory fitness are both established predictors of cardiovascular disease morbidity and mortality. Whether the protective effects of fitness outweigh the deleterious effects of obesity, however, remains a topic of debate. To extend knowledge of the relative influence of fitness and fatness on cardiovascular disease outcomes, however, attention must be paid to measurement quality. Eliminating inherent bias of self-report and including the highest quality assessments of cardiorespiratory fitness and fatness simultaneously are imperative for head-to-head comparisons. Studies must move beyond body mass index and total body fat percentage to differentiate the heterogenous effects of various adipose tissue depots on cardiovascular risk. Imaging techniques that measure visceral adiposity and other risk-laden ectopic adipose depots while also quantifying cardioprotective adipose depots such as lower body subcutaneous fat and even non-adipose tissues such as skeletal muscle may further illuminate the influence of body composition on cardiovascular health. This review underscores key studies within a large body of literature that provide the foundation for the fit-vs.-fat debate in the context of cardiovascular disease risk, and identifies important considerations for future research.
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12
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Mundi MS, Patel J, McClave SA, Hurt RT. Current perspective for tube feeding in the elderly: from identifying malnutrition to providing of enteral nutrition. Clin Interv Aging 2018; 13:1353-1364. [PMID: 30122907 PMCID: PMC6080667 DOI: 10.2147/cia.s134919] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
With the number of individuals older than 65 years expected to rise significantly over the next few decades, dramatic changes to our society and health care system will need to take place to meet their needs. Age-related changes in muscle mass and body composition along with medical comorbidities including stroke, dementia, and depression place elderly adults at high risk for developing malnutrition and frailty. This loss of function and decline in muscle mass (ie, sarcopenia) can be associated with reduced mobility and ability to perform the task of daily living, placing the elderly at an increased risk for falls, fractures, and subsequent institutionalization, leading to a decline in the quality of life and increased mortality. There are a number of modifiable factors that can mitigate some of the muscle loss elderly experience especially when hospitalized. Due to this, it is paramount for providers to understand the pathophysiology behind malnutrition and sarcopenia, be able to assess risk factors for malnutrition, and provide appropriate nutrition support. The present review describes the pathophysiology of malnutrition, identifies contributing factors to this condition, discusses tools to assess nutritional status, and proposes key strategies for optimizing enteral nutrition therapy for the elderly.
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Affiliation(s)
- Manpreet S Mundi
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN, USA,
| | - Jayshil Patel
- Division of Pulmonary, Critical Care & Sleep Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Stephen A McClave
- Division of Gastroenterology, Hepatology and Nutrition, University of Louisville, Louisville, KY, USA
| | - Ryan T Hurt
- Division of Gastroenterology, Hepatology and Nutrition, University of Louisville, Louisville, KY, USA.,Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA.,Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
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Ratigan AR, Lindsay S, Lemus H, Chambers CD, Anderson CAM, Cronan TA, Browner DK, Wooten WJ. Community BMI Surveillance Using an Existing Immunization Registry in San Diego, California. J Community Health 2018; 42:558-564. [PMID: 27837356 DOI: 10.1007/s10900-016-0288-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study examines the demographic representativeness of the County of San Diego Body Mass Index (BMI) Surveillance System to determine if the BMI estimates being obtained from this convenience sample of individuals who visited their healthcare provider for outpatient services can be generalized to the general population of San Diego. Height and weight were transmitted from electronic health records systems to the San Diego Immunization Registry (SDIR). Age, gender, and race/ethnicity of this sample are compared to general population estimates by sub-regional area (SRA) (n = 41) to account for regional demographic differences. A < 10% difference (calculated as the ratio of the differences between the frequencies of a sub-group in this sample and general population estimates obtained from the U.S. Census Bureau) was used to determine representativeness. In 2011, the sample consisted of 352,924 residents aged 2-100 years. The younger age groups (2-11, 12-17 years) and the oldest age group (≥65 years) were representative in 90, 75, and 85% of SRAs, respectively. Furthermore, at least one of the five racial/ethnic groups was represented in 71% of SRAs. This BMI Surveillance System was found to demographically represent some SRAs well, suggesting that this registry-based surveillance system may be useful in estimating and monitoring neighborhood-level BMI data.
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Affiliation(s)
- Amanda R Ratigan
- Graduate School of Public Health, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182, USA.
- Department of Family Medicine and Public Health, University of California San Diego, School of Medicine, 9500 Gilman Drive, San Diego, CA, 92093, USA.
- Institute of Public Health, San Diego State University, 6505 Alvarado Road, #116, San Diego, CA, 92120, USA.
| | - Suzanne Lindsay
- Graduate School of Public Health, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182, USA
- Institute of Public Health, San Diego State University, 6505 Alvarado Road, #116, San Diego, CA, 92120, USA
| | - Hector Lemus
- Graduate School of Public Health, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182, USA
| | - Christina D Chambers
- Department of Family Medicine and Public Health, University of California San Diego, School of Medicine, 9500 Gilman Drive, San Diego, CA, 92093, USA
| | - Cheryl A M Anderson
- Department of Family Medicine and Public Health, University of California San Diego, School of Medicine, 9500 Gilman Drive, San Diego, CA, 92093, USA
| | - Terry A Cronan
- Department of Psychology, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182, USA
| | - Deirdre K Browner
- County of San Diego Health and Human Services Agency, 3851 Rosecrans Street, San Diego, CA, 92110, USA
| | - Wilma J Wooten
- County of San Diego Health and Human Services Agency, 3851 Rosecrans Street, San Diego, CA, 92110, USA
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Easton JF, Stephens CR, Román Sicilia H. The effect of a medical opinion on self-perceptions of weight for Mexican adults: perception of change and cognitive biases. BMC OBESITY 2017; 4:16. [PMID: 28469931 PMCID: PMC5414120 DOI: 10.1186/s40608-017-0152-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 03/17/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND This study analysed the relationship between perceived and actual Body Mass Index (BMI) and the effect of a prior identification of obesity by a medical professional for adults using difference in response for two distinct BMI self-perception questions. Typically, self-perception studies only investigate the relation with current weight, whereas here the focus is on the self-perception of weight differences. METHODS A statistical approach was used to assess responses to the Mexican ENSANUT 2006 survey. Adults in the range of BMI from 13 to 60 were tested on responses to a categorical question and a figure rating scale self-perception question. Differences in response by gender and identification of obesity by a medical professional were analysed using linear regression. RESULTS Results indicated that regardless of current BMI and gender, a verbal intervention by a medical professional will increase perceived BMI independently of actual BMI but does not necessarily make the identified obese more accurate in their BMI estimates. A shift in the average self-perception was seen with a higher response for the identified obese. A linear increase in perceived BMI as a function of actual BMI was observed in the range BMI < 35 but with a rate of increase much less than expected if weight differences were perceived accurately. CONCLUSIONS Obese and overweight Mexican adults not only underestimated their weight, but also, could not accurately judge changes in weight. For example, an increase of 5 kg is imagined, in terms of self-image, to be considerably less. It was seen that an identification of obesity by a health care professional did not improve ability to judge weight but, rather, served as a new anchor from which the identified obese judge their weight, suggesting that even those identified obese who have lost weight, perceive their weight to be greater than it actually is. We believe that these results can be explained in terms of two cognitive biases; the self-serving bias and the anchoring bias.
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Affiliation(s)
- Jonathan F Easton
- C3-Centro de Ciencias de la Complejidad, Universidad Nacional Autónoma de México, Circuito Centro Cultural s/n, Ciudad Universitaria, Col. Universidad Nacional Autónoma de México, Del. Coyoacán, C.P. 04510 Ciudad de México, Mexico
| | - Christopher R Stephens
- C3-Centro de Ciencias de la Complejidad, Universidad Nacional Autónoma de México, Circuito Centro Cultural s/n, Ciudad Universitaria, Col. Universidad Nacional Autónoma de México, Del. Coyoacán, C.P. 04510 Ciudad de México, Mexico.,Instituto de Ciencias Nucleares, Universidad Nacional Autónoma de México, Circuito Exterior s/n, Ciudad Universitaria, Col. Universidad Nacional Autónoma de México, Del. Coyoacán, A. P. 70-543, C.P. 04510 Ciudad de México, Mexico
| | - Heriberto Román Sicilia
- C3-Centro de Ciencias de la Complejidad, Universidad Nacional Autónoma de México, Circuito Centro Cultural s/n, Ciudad Universitaria, Col. Universidad Nacional Autónoma de México, Del. Coyoacán, C.P. 04510 Ciudad de México, Mexico
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15
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Easton JF, Stephens CR, Sicilia HR. An Analysis of Real, Self-Perceived, and Desired BMI: Is There a Need for Regular Screening to Correct Misperceptions and Motivate Weight Reduction? Front Public Health 2017; 5:12. [PMID: 28229069 PMCID: PMC5296358 DOI: 10.3389/fpubh.2017.00012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 01/20/2017] [Indexed: 11/23/2022] Open
Abstract
We study the relationship among real, self-perceived, and desired body mass index (BMI) in 21,288 adults from the Mexican National Health and Nutrition Survey 2012, analyzing the effect of sex and diagnosis of obesity/overweight by a healthcare professional. Self-perceived and desired BMI are analyzed via a figure rating scale question and compared to real BMI. Only 8.8 and 6.1% of the diagnosed and non-diagnosed obese, respectively, correctly identify themselves as such. For the obese, 20.2% of non-diagnosed and 12.7% of diagnosed perceive themselves as normal or underweight, while 49.1 and 37% of these are satisfied with their perceived BMI. Only 7.8% of the obese, whose real and perceived BMI coincide, have a desired BMI equal to their perceived one. In contrast, 43.2% of the obese, whose perceived BMI is normal, have a desired BMI the same as their perceived one. Although the average desired body figure corresponds to the normal BMI range, misperceptions of BMI correlate strongly with the degree of satisfaction associated with perceived BMI, with larger misperceptions indicating a higher degree of satisfaction. Hypothesizing that the differences between real, perceived, and desired weight are a motivator for weight change, one potential intervention could be the periodic assessment of real, perceived, and desired BMI in order to correct misleading weight misperceptions that could potentially obstruct positive behavioral change.
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Affiliation(s)
- Jonathan F Easton
- C3 - Centro de Ciencias de la Complejidad, Universidad Nacional Autónoma de México , Ciudad de México , México
| | - Christopher R Stephens
- C3 - Centro de Ciencias de la Complejidad, Universidad Nacional Autónoma de México, Ciudad de México, México; Instituto de Ciencias Nucleares, Universidad Nacional Autónoma de México, Ciudad de México, México
| | - Heriberto Román Sicilia
- C3 - Centro de Ciencias de la Complejidad, Universidad Nacional Autónoma de México , Ciudad de México , México
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Smalley KB, Warren JC, Morrissey BD. Discrepancy between Actual and Perceived Weight Status in Rural Patients: Variations by Race and Gender. J Health Care Poor Underserved 2017; 28:514-527. [PMID: 28239016 PMCID: PMC5588681 DOI: 10.1353/hpu.2017.0037] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The study's goal was to determine if differences in weight misperception by race and/or gender occur within a sample of economically disadvantaged rural patients with diabetes and/or hypertension. Diabetic and hypertensive patients were enrolled in the study from a network of federally qualified health centers (FQHCs) in the rural South. Multivari-ate logistic regression analysis suggests that, even when controlling for age, education level, employment status, and poverty, rural African American patients with chronic disease are more likely than their White counterparts to misperceive their weight status (OR = 1.709, p = .037). This difference in perceived weight occurred despite the absence of an underlying difference in actual weight status between African American and White patients (p = .171). In addition, rural men were much more likely than rural women to misperceive their weight status (OR = 2.688, p < .001). Implications for intervention development and implementation are discussed.
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Winkler LL, Christensen U, Glümer C, Bloch P, Mikkelsen BE, Wansink B, Toft U. Substituting sugar confectionery with fruit and healthy snacks at checkout - a win-win strategy for consumers and food stores? a study on consumer attitudes and sales effects of a healthy supermarket intervention. BMC Public Health 2016; 16:1184. [PMID: 27876025 PMCID: PMC5120526 DOI: 10.1186/s12889-016-3849-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 11/16/2016] [Indexed: 11/29/2022] Open
Abstract
Background The widespread use of in-store marketing strategies to induce unhealthy impulsive purchases has implications for shopping experience, food choice and possibly adverse health outcomes. The aim of this study was to examine consumer attitudes and evaluate sales effects of a healthy checkout supermarket intervention. The study was part of Project Sundhed & Lokalsamfund (Project SoL); a Danish participatory community-based health promotion intervention. Methods Consumer attitudes towards unhealthy snack exposure in supermarkets were examined in a qualitative pre-intervention study (29 short in-store interviews, 11 semi-structured interviews and three focus group interviews). Findings were presented to food retailers and informed the decision to test a healthy checkout intervention. Sugar confectionery at one checkout counter was substituted with fruit and healthy snacking items in four stores for 4 weeks. The intervention was evaluated by 48 short exit interviews on consumer perceptions of the intervention and by linear mixed model analyses of supermarket sales data from the intervention area and a matched control area. Results The qualitative pre-intervention study identified consumer concern and annoyance with placement and promotion of unhealthy snacks in local stores. Store managers were willing to respond to local consumer concern and a healthy checkout intervention was therefore implemented. Exit interviews found positive attitudes towards the intervention, while intervention awareness was modest. Most participants believed that the intervention could help other consumers make healthier choices, while fewer expected to be influenced by the intervention themselves. Statistical analyses suggested an intervention effect on sales of carrot snack packs when compared with sales before the intervention in Bornholm control stores (P < 0.05). No significant intervention effect on sales of other intervention items or sugar confectionery was found. Conclusions The present study finds that the healthy checkout intervention was positively evaluated by consumers and provided a ‘responsible’ branding opportunity for supermarkets, thus representing a win-win strategy for store managers and consumers in the short term. However, the intervention was too modest to draw conclusions on long-term sales and health implications of this initiative. More research is needed to assess whether retailer-researcher collaborations on health promotion can be a winning strategy for public health.
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Affiliation(s)
- Lise L Winkler
- Research Centre for Prevention and Health, Centre for Health, Capital Region of Denmark, Rigshospitalet-Glostrup, Ndr. Ringvej 57, Building 84/85, 2600, Glostrup, Denmark.
| | - Ulla Christensen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Charlotte Glümer
- Research Centre for Prevention and Health, Centre for Health, Capital Region of Denmark, Rigshospitalet-Glostrup, Ndr. Ringvej 57, Building 84/85, 2600, Glostrup, Denmark
| | - Paul Bloch
- Steno Health Promotion Research, Steno Diabetes Center, Niels Steensens Vej 8, 2820, Gentofte, Denmark
| | - Bent E Mikkelsen
- Department of Clinical Medicine, Aalborg University, Frederikskaj 10, Building B, B2,, 2450, Copenhagen, SV, Denmark
| | - Brian Wansink
- Marketing in the Department of Applied Economics, Management at Cornell University, 114 Warren Hall, Ithaca, NY, 14853, USA
| | - Ulla Toft
- Research Centre for Prevention and Health, Centre for Health, Capital Region of Denmark, Rigshospitalet-Glostrup, Ndr. Ringvej 57, Building 84/85, 2600, Glostrup, Denmark
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Abstract
Alterations in nutritional status are common and can be associated with increased morbidity and mortality. However, for healthcare providers, the definition of malnutrition is vague, insensitive, and poorly standardized. In contrast, nutrition risk is more easily defined, and recognizes that both poor nutritional status and disease severity contribute to increased morbidity and mortality. Clinicians need to identify patients who may already have evidence of nutrient deficiencies or have disease processes that affect nutrition risk. This article reviews risk assessment tools and provides practical tips to screen patients and identify those whose nutrition risk warrants specialized nutrition therapy.
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Affiliation(s)
- Ryan T Hurt
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA; Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA; Division of Gastroenterology, Hepatology and Nutrition, University of Louisville School of Medicine, 550 South Jackson Street, Louisville, KY 40292, USA
| | - Stephen A McClave
- Division of Gastroenterology, Hepatology and Nutrition, University of Louisville School of Medicine, 550 South Jackson Street, Louisville, KY 40292, USA.
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Kang HJ, Kwon S. Regional Disparity of Cardiovascular Mortality and Its Determinants. HEALTH POLICY AND MANAGEMENT 2016. [DOI: 10.4332/kjhpa.2016.26.1.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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