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Bann D, Wright L, Hughes A, Chaturvedi N. Socioeconomic inequalities in cardiovascular disease: a causal perspective. Nat Rev Cardiol 2024; 21:238-249. [PMID: 37821646 DOI: 10.1038/s41569-023-00941-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/13/2023] [Indexed: 10/13/2023]
Abstract
Socioeconomic inequalities in cardiovascular disease (CVD) persist in high-income countries despite marked overall declines in CVD-related morbidity and mortality. After decades of research, the field has struggled to unequivocally answer a crucial question: is the association between low socioeconomic position (SEP) and the development of CVD causal? We review relevant evidence from various study designs and disciplinary perspectives. Traditional observational, family-based and Mendelian randomization studies support the widely accepted view that low SEP causally influences CVD. However, results from quasi-experimental and experimental studies are both limited and equivocal. While more experimental and quasi-experimental studies are needed to aid causal understanding and inform policy, high-quality descriptive studies are also required to document inequalities, investigate their contextual dependence and consider SEP throughout the lifespan; no simple hierarchy of evidence exists for an exposure as complex as SEP. The COVID-19 pandemic illustrates the context-dependent nature of CVD inequalities, with the generation of potentially new causal pathways linking SEP and CVD. The linked goals of understanding the causal nature of SEP and CVD associations, their contextual dependence, and their remediation by policy interventions necessitate a detailed understanding of society, its change over time and the phenotypes of CVD. Interdisciplinary research is therefore key to advancing both causal understanding and policy translation.
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Affiliation(s)
- David Bann
- Centre for Longitudinal Studies, Social Research Institute, IOE, UCL's Faculty of Education and Society, University College London, London, UK.
| | - Liam Wright
- Centre for Longitudinal Studies, Social Research Institute, IOE, UCL's Faculty of Education and Society, University College London, London, UK
| | - Alun Hughes
- MRC Unit for Lifelong Health & Ageing at UCL, Department of Population Science and Experimental Medicine, Institute of Cardiovascular Science, Faculty of Population Health Science, University College London, London, UK
| | - Nish Chaturvedi
- MRC Unit for Lifelong Health & Ageing at UCL, Department of Population Science and Experimental Medicine, Institute of Cardiovascular Science, Faculty of Population Health Science, University College London, London, UK
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de Roo M, Hartman C, Veenstra R, Nolte IM, Meier K, Vrijen C, Kretschmer T. Gene-Environment Interplay in the Development of Overweight. J Adolesc Health 2023; 73:574-581. [PMID: 37318409 DOI: 10.1016/j.jadohealth.2023.04.028] [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: 10/07/2022] [Revised: 03/24/2023] [Accepted: 04/20/2023] [Indexed: 06/16/2023]
Abstract
PURPOSE Overweight in youth is influenced by genes and environment. Gene-environment interaction (G×E) has been demonstrated in twin studies and recent developments in genetics allow for studying G×E using individual genetic predispositions for overweight. We examine genetic influence on trajectories of overweight during adolescence and early adulthood and determine whether genetic predisposition is attenuated by higher socioeconomic status and having physically active parents. METHODS Latent class growth models of overweight were fitted using data from the TRacking Adolescents' Individual Lives Survey (n = 2720). A polygenic score for body mass index (BMI) was derived using summary statistics from a genome-wide association study of adult BMI (N = ∼700,000) and tested as predictor of developmental pathways of overweight. Multinomial logistic regression models were used to examine effects of interactions of genetic predisposition with socioeconomic status and parental physical activity (n = 1675). RESULTS A three-class model of developmental pathways of overweight fitted the data best ("non-overweight", "adolescent-onset overweight", and "persistent overweight"). The polygenic score for BMI and socioeconomic status distinguished the persistent overweight and adolescent-onset overweight trajectories from the non-overweight trajectory. Only genetic predisposition differentiated the adolescent-onset from the persistent overweight trajectory. There was no evidence for G×E. DISCUSSION Higher genetic predisposition increased the risk of developing overweight during adolescence and young adulthood and was associated with an earlier age at onset. We did not find that genetic predisposition was offset by higher socioeconomic status or having physically active parents. Instead, lower socioeconomic status and higher genetic predisposition acted as additive risk factors for developing overweight.
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Affiliation(s)
- Marthe de Roo
- Faculty of Behavioral and Social Sciences, Department of Pedagogy and Educational Sciences, University of Groningen, Groningen, the Netherlands.
| | - Catharina Hartman
- Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - René Veenstra
- Faculty of Behavioral and Social Sciences, Department of Sociology, University of Groningen, Groningen, the Netherlands
| | - Ilja Maria Nolte
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Karien Meier
- Parnassia Psychiatric Institute, The Hague, the Netherlands; Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Charlotte Vrijen
- Faculty of Behavioral and Social Sciences, Department of Pedagogy and Educational Sciences, University of Groningen, Groningen, the Netherlands
| | - Tina Kretschmer
- Faculty of Behavioral and Social Sciences, Department of Pedagogy and Educational Sciences, University of Groningen, Groningen, the Netherlands
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3
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Hemmingsson E, Nowicka P, Ulijaszek S, Sørensen TIA. The social origins of obesity within and across generations. Obes Rev 2023; 24:e13514. [PMID: 36321346 PMCID: PMC10077989 DOI: 10.1111/obr.13514] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 09/10/2022] [Accepted: 10/06/2022] [Indexed: 11/06/2022]
Abstract
We propose a model for obesity development that traces a considerable part of its origins to the social domain (mainly different forms of prolonged social adversity), both within and across generations, working in tandem with a genetic predisposition. To facilitate overview of social pathways, we place particular focus on three areas that form a cascading sequence: (A) social adversity within the family (parents having a low education, a low social position, poverty and financial insecurity; offspring being exposed to gestational stress, unmet social and emotional needs, abuse, maltreatment and other negative life events, social deprivation and relationship discord); (B) increasing levels of insecurity, negative emotions, chronic stress, and a disruption of energy homeostasis; and (C) weight gain and obesity, eliciting further social stress and weight stigma in both generations. Social adversity, when combined with genetic predisposition, thereby substantially contributes to highly effective transmission of obesity from parents to offspring, as well as to obesity development within current generations. Prevention efforts may benefit from mitigating multiple types of social adversity in individuals, families, and communities, notably poverty and financial strain, and by improving education levels.
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Affiliation(s)
- Erik Hemmingsson
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | - Paulina Nowicka
- Department of Food Studies, Nutrition, and Dietetics, Uppsala University, Uppsala, Sweden
| | - Stanley Ulijaszek
- Unit for Biocultural Variation and Obesity, School of Anthropology and Museum Ethnography, University of Oxford, Oxford, UK
| | - Thorkild I A Sørensen
- Department of Public Health and Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Abstract
Obesity is in theory defined on the basis of the excess health risk caused by adiposity exceeding the size normally found in the population, but for practical reasons, the World Health Organization (WHO) has defined obesity as a body mass index (weight (kg)/height (m)2) of 30 or above for adults. WHO considers the steep increases in prevalence of obesity in all age groups, especially since the 1970s as a global obesity epidemic. Today, approximately 650 million adult people and approximately 340 million children and adolescence (5-19 years) suffer from obesity. It is generally more prevalent among women and older age groups than among men and younger age groups. Beyond the necessity of availability of food, evidence about causes of obesity is still very limited. However, studies have shown that obesity 'runs in families', where both genetics and environmental, and especially social, factors play important roles. Obesity is associated with an increased risk of many adverse medical, mental and social consequences, including a strong relation to type 2 diabetes. Type 2 diabetes and related metabolic syndrome and diseases are major contributors to the excess morbidity and mortality associated with obesity.
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Silventoinen K, Konttinen H. Obesity and eating behavior from the perspective of twin and genetic research. Neurosci Biobehav Rev 2021; 109:150-165. [PMID: 31959301 DOI: 10.1016/j.neubiorev.2019.12.012] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 11/11/2019] [Accepted: 12/09/2019] [Indexed: 12/21/2022]
Abstract
Obesity has dramatically increased during the last decades and is currently one of the most serious global health problems. We present a hypothesis that obesity is a neuro-behavioral disease having a strong genetic background mediated largely by eating behavior and is sensitive to the macro-environment; we study this hypothesis from the perspective of genetic research. Genetic family and genome-wide-association studies have shown well that body mass index (BMI, kg/m2) is a highly heritable and polygenic trait. New genetic variation of BMI emerges after early childhood. Candidate genes of BMI notably express in brain tissue, supporting that this new variation is related to behavior. Obesogenic environments at both childhood family and societal levels reinforce the genetic susceptibility to obesity. Genetic factors have a clear influence on macro-nutrient intake and appetite-related eating behavior traits. Results on the gene-by-diet interactions in obesity are mixed, but emerging evidence suggests that eating behavior traits partly mediate the effect of genes on BMI. However, more rigorous prospective study designs controlling for measurement bias are still needed.
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Affiliation(s)
- Karri Silventoinen
- Department of Social Research, University of Helsinki, Helsinki, Finland; Department of Public Health, University of Helsinki, Helsinki, Finland.
| | - Hanna Konttinen
- Department of Social Research, University of Helsinki, Helsinki, Finland
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6
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Reiband HK, Heitmann BL, Sørensen TIA. Adverse labour market impacts of childhood and adolescence overweight and obesity in Western societies-A literature review. Obes Rev 2020; 21:e13026. [PMID: 32431077 DOI: 10.1111/obr.13026] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 02/17/2020] [Accepted: 03/02/2020] [Indexed: 01/26/2023]
Abstract
Overweight and obesity among children and adolescents are major health issues of today with both somatic and psychosocial consequences in childhood, adolescence and adulthood and potentially adverse effects for adult social life. We conducted a narrative review of the literature about the association of overweight and obesity in childhood and adolescence with possible adverse impact on labour market in adulthood. By PubMed and Google Scholar searches, we identified 12 original, prospective studies from Western countries and extracted data from these studies. We discuss the possible explanations of the associations and the conceptual and methodological challenges in these studies. Despite inherent difficulties in interpreting results, partly due to differences in outcome definitions, ages at exposure, measurements of overweight and obesity, confounder control and societal differences, the studies indicate adverse labour market impacts on adult wage and employment. Furthermore, penalties seemed present even if the excessive weight was lost before adulthood, and women seemed more affected than men, especially when weight persisted into adulthood. While both health and lower education might contribute to explain the adverse labour market outcomes, also discrimination, stigmatization and the development of cognitive and noncognitive skills seemed to influence the outcomes. Prevention of these adverse labour market impacts likely requires multilevel efforts.
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Affiliation(s)
- Hanna Kruse Reiband
- Socialmedicinsk Centre, Bispebjerg and Frederiksberg Hospital, The Capital Region, Denmark
| | - Berit L Heitmann
- The Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospital, The Capital Region, Denmark.,Department of Public Health (Section for general Practise), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Thorkild I A Sørensen
- Novo Nordisk Foundation Center for Basic Metabolic Research (Section of Metabolic Genetics) and Department of Public Health (Section of Epidemiology), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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7
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Silventoinen K, Jelenkovic A, Latvala A, Yokoyama Y, Sund R, Sugawara M, Tanaka M, Matsumoto S, Aaltonen S, Piirtola M, Freitas DL, Maia JA, Öncel SY, Aliev F, Ji F, Ning F, Pang Z, Rebato E, Saudino KJ, Cutler TL, Hopper JL, Ullemar V, Almqvist C, Magnusson PKE, Cozen W, Hwang AE, Mack TM, Willemsen G, Bartels M, van Beijsterveldt CEM, Nelson TL, Whitfield KE, Sung J, Kim J, Lee J, Lee S, Llewellyn CH, Fisher A, Medda E, Nisticò L, Toccaceli V, Baker LA, Tuvblad C, Corley RP, Huibregtse BM, Derom CA, Vlietinck RF, Loos RJF, Knafo-Noam A, Mankuta D, Abramson L, Burt SA, Klump KL, Silberg JL, Maes HH, Krueger RF, McGue M, Pahlen S, Gatz M, Butler DA, Harris JR, Nilsen TS, Harden KP, Tucker-Drob EM, Franz CE, Kremen WS, Lyons MJ, Lichtenstein P, Jeong HU, Hur YM, Boomsma DI, Sørensen TIA, Kaprio J. Parental Education and Genetics of BMI from Infancy to Old Age: A Pooled Analysis of 29 Twin Cohorts. Obesity (Silver Spring) 2019; 27:855-865. [PMID: 30950584 PMCID: PMC6478550 DOI: 10.1002/oby.22451] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 01/31/2019] [Indexed: 01/30/2023]
Abstract
OBJECTIVE The objective of this study was to analyze how parental education modifies the genetic and environmental variances of BMI from infancy to old age in three geographic-cultural regions. METHODS A pooled sample of 29 cohorts including 143,499 twin individuals with information on parental education and BMI from age 1 to 79 years (299,201 BMI measures) was analyzed by genetic twin modeling. RESULTS Until 4 years of age, parental education was not consistently associated with BMI. Thereafter, higher parental education level was associated with lower BMI in males and females. Total and additive genetic variances of BMI were smaller in the offspring of highly educated parents than in those whose parents had low education levels. Especially in North American and Australian children, environmental factors shared by co-twins also contributed to the higher BMI variation in the low education level category. In Europe and East Asia, the associations of parental education with mean BMI and BMI variance were weaker than in North America and Australia. CONCLUSIONS Lower parental education level is associated with higher mean BMI and larger genetic variance of BMI after early childhood, especially in the obesogenic macro-environment. The interplay among genetic predisposition, childhood social environment, and macro-social context is important for socioeconomic differences in BMI.
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Affiliation(s)
- Karri Silventoinen
- Department of Social Research, University of Helsinki, Helsinki, Finland
- Osaka University Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Aline Jelenkovic
- Department of Social Research, University of Helsinki, Helsinki, Finland
- Department of Genetics, Physical Anthropology and Animal Physiology, University of the Basque Country UPV/EHU, Leioa, Spain
| | - Antti Latvala
- Department of Public Health, University of Helsinki, Helsinki, Finland
- Institute for Molecular Medicine Finland (FIMM), Helsinki, Finland
| | - Yoshie Yokoyama
- Department of Public Health Nursing, Osaka City University, Osaka, Japan
| | - Reijo Sund
- Department of Social Research, University of Helsinki, Helsinki, Finland
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Masumi Sugawara
- Department of Psychology, Ochanomizu University, Tokyo, Japan
| | - Mami Tanaka
- Center for Forensic Mental Health, Chiba University, Chiba, Japan
| | - Satoko Matsumoto
- Institute for Education and Human Development, Ochanomizu University, Tokyo
| | - Sari Aaltonen
- Department of Social Research, University of Helsinki, Helsinki, Finland
- Institute for Molecular Medicine Finland (FIMM), Helsinki, Finland
| | - Maarit Piirtola
- Department of Social Research, University of Helsinki, Helsinki, Finland
- Institute for Molecular Medicine Finland (FIMM), Helsinki, Finland
| | - Duarte L Freitas
- Department of Physical Education and Sport, University of Madeira, Funchal, Portugal
| | - José A Maia
- CIFI2D, Faculty of Sport, Porto, University of Porto, Portugal
| | - Sevgi Y Öncel
- Department of Statistics, Faculty of Arts and Sciences, Kirikkale University, Kirikkale, Turkey
| | - Fazil Aliev
- Psychology and African American Studies, Viginia Commonwealth University, Richmond, VA, USA
| | - Fuling Ji
- Department of Noncommunicable Diseases Prevention, Qingdao Centers for Disease Control and Prevention, Qingdao, China
| | - Feng Ning
- Department of Noncommunicable Diseases Prevention, Qingdao Centers for Disease Control and Prevention, Qingdao, China
| | - Zengchang Pang
- Department of Noncommunicable Diseases Prevention, Qingdao Centers for Disease Control and Prevention, Qingdao, China
| | - Esther Rebato
- Department of Genetics, Physical Anthropology and Animal Physiology, University of the Basque Country UPV/EHU, Leioa, Spain
| | - Kimberly J Saudino
- Boston University, Department of Psychological and Brain Sciencies, Boston, MA, USA
| | - Tessa L Cutler
- The Australian Twin Registry, Centre for Epidemiology and Biostatistics, University of Melbourne, Melbourne, Victoria, Australia
| | - John L Hopper
- The Australian Twin Registry, Centre for Epidemiology and Biostatistics, University of Melbourne, Melbourne, Victoria, Australia
- Department of Epidemiology, School of Public Health, Seoul National University, Seoul, Korea
| | - Vilhelmina Ullemar
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Catarina Almqvist
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Pediatric Allergy and Pulmonology Unit at Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Patrik KE Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Wendy Cozen
- Department of Preventive Medicine, Keck School of Medicine of USC, University of Southern California, Los Angeles, California, USA
- USC Norris Comprehensive Cancer Center, Los Angeles, California, USA
| | - Amie E Hwang
- Department of Preventive Medicine, Keck School of Medicine of USC, University of Southern California, Los Angeles, California, USA
| | - Thomas M Mack
- Department of Preventive Medicine, Keck School of Medicine of USC, University of Southern California, Los Angeles, California, USA
- USC Norris Comprehensive Cancer Center, Los Angeles, California, USA
| | - Gonneke Willemsen
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Meike Bartels
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | | | - Tracy L Nelson
- Department of Health and Exercise Sciences and Colorado School of Public Health, Colorado State University, Fort Collins, Colorado, USA
| | | | - Joohon Sung
- Department of Epidemiology, School of Public Health, Seoul National University, Seoul, Korea
- Institute of Health and Environment, Seoul National University, Seoul, South-Korea
| | - Jina Kim
- Department of Epidemiology, School of Public Health, Seoul National University, Seoul, Korea
| | - Jooyeon Lee
- Department of Epidemiology, School of Public Health, Seoul National University, Seoul, Korea
| | - Sooji Lee
- Department of Epidemiology, School of Public Health, Seoul National University, Seoul, Korea
| | - Clare H Llewellyn
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Abigail Fisher
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Emanuela Medda
- Centre for Behavioural Sciences and Mental Health, Istituto Superiore di Sanità - Rome, Italy
| | - Lorenza Nisticò
- Centre for Behavioural Sciences and Mental Health, Istituto Superiore di Sanità - Rome, Italy
| | - Virgilia Toccaceli
- Centre for Behavioural Sciences and Mental Health, Istituto Superiore di Sanità - Rome, Italy
| | - Laura A Baker
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Catherine Tuvblad
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
- School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden
| | - Robin P Corley
- Institute for Behavioral Genetics, University of Colorado, Boulder, Colorado, USA
| | - Brooke M Huibregtse
- Institute of Behavioral Science, University of Colorado, Boulder, Colorado, USA
| | - Catherine A Derom
- Centre of Human Genetics, University Hospitals Leuven, Leuven, Belgium
- Department of Obstetrics and Gynaecology, Ghent University Hospitals, Ghent, Belgium
| | | | - Ruth JF Loos
- The Charles Bronfman Institute for Personalized Medicine, The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - David Mankuta
- Hadassah Hospital Obstetrics and Gynecology Department, Hebrew University Medical School, Jerusalem, Israel
| | - Lior Abramson
- The Hebrew University of Jerusalem, Jerusalem, Israel
| | | | - Kelly L Klump
- Michigan State University, East Lansing, Michigan, USA
| | - Judy L Silberg
- Department of Human and Molecular Genetics, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Hermine H Maes
- Department of Human and Molecular Genetics, Psychiatry & Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Robert F Krueger
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Matt McGue
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Shandell Pahlen
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Margaret Gatz
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, USA
| | - David A Butler
- Health and Medicine Division, The National Academies of Sciences, Engineering, and Medicine Washington, DC, USA
| | | | | | - K Paige Harden
- Department of Psychology, University of Texas at Austin, Austin, TX, USA
| | | | - Carol E Franz
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - William S Kremen
- Department of Psychiatry, University of California, San Diego, CA, USA
- VA San Diego Center of Excellence for Stress and Mental Health, La Jolla, CA, USA
| | - Michael J Lyons
- Boston University, Department of Psychology, Boston, MA, USA
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Hoe-Uk Jeong
- Department of Education, Mokpo National University, Jeonnam, South Korea
| | - Yoon-Mi Hur
- Department of Education, Mokpo National University, Jeonnam, South Korea
| | - Dorret I Boomsma
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Thorkild IA Sørensen
- Novo Nordisk Foundation Centre for Basic Metabolic Research (Section of Metabolic Genetics), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Public Health (Section of Epidemiology), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jaakko Kaprio
- Department of Public Health, University of Helsinki, Helsinki, Finland
- Institute for Molecular Medicine Finland (FIMM), Helsinki, Finland
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Affiliation(s)
- Thorkild I A Sørensen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, University of Copenhagen, Copenhagen, Denmark. .,Department of Public Health, Section of Epidemiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
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Dhurandhar EJ, Pavela G, Kaiser KA, Dutton GR, Fontaine KR, Kim D, Shikany JM, Allison DB, Lewis CE. Body Mass Index and Subjective Social Status: The Coronary Artery Risk Development in Young Adults Study. Obesity (Silver Spring) 2018; 26:426-431. [PMID: 29280341 PMCID: PMC5783753 DOI: 10.1002/oby.22047] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 08/17/2017] [Accepted: 09/22/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Subjective social status (SSS), or perceived social status, may explain, in part, the relationship between socioeconomic status (SES) and obesity. The objective of this study was to test whether SSS mediates the relationship between two indicators of SES (income and education) and body mass index (BMI). METHODS A cross-sectional, structural equation path analysis was applied to the Coronary Artery Risk Development in Young Adults (CARDIA) study (n = 2,624). The analysis tested whether SSS (MacArthur scale), education, and income were associated with BMI at the year 20 examination (adjusting for sex, age, and race), and it was hypothesized that the associations of education and income with BMI would be at least partly mediated by SSS. RESULTS SSS had a significant direct effect on BMI (-0.21, P = 0.018). Education had a significant direct relationship with SSS (0.11, P < 0.001) and a small but significant indirect relationship with BMI through SSS (-0.02, P = 0.022). Although income did not have a significant direct relationship with BMI, it did have a significant indirect relationship through SSS (b = -0.05, P = 0.019). CONCLUSIONS Results are consistent with the hypothesized model in which SSS partially mediates the relationship between SES indicators and BMI.
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Affiliation(s)
- Emily J. Dhurandhar
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX
| | - Gregory Pavela
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL
- Nutrition Obesity Research Center, University of Alabama at Birmingham, Birmingham AL
| | - Kathryn A. Kaiser
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL
- Nutrition Obesity Research Center, University of Alabama at Birmingham, Birmingham AL
| | - Gareth R. Dutton
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham AL
| | - Kevin R. Fontaine
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL
- Nutrition Obesity Research Center, University of Alabama at Birmingham, Birmingham AL
| | - Daniel Kim
- Department of Health Sciences, Bouve College of Health Sciences, Northeastern University, Boston, MA
| | - James M. Shikany
- Nutrition Obesity Research Center, University of Alabama at Birmingham, Birmingham AL
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham AL
| | | | - Cora E. Lewis
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham AL
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10
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Richardson MB, Williams MS, Fontaine KR, Allison DB. The development of scientific evidence for health policies for obesity: why and how? Int J Obes (Lond) 2017; 41:840-848. [PMID: 28293021 PMCID: PMC5512272 DOI: 10.1038/ijo.2017.71] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 02/08/2017] [Accepted: 03/04/2017] [Indexed: 02/07/2023]
Abstract
Potential obesity-related policy approaches have recently been receiving more attention. Although some have been implemented and others only proposed, few have been formally evaluated. We discuss the relevance, and in some cases irrelevance, of some of the types of evidence that are often brought to bear in considering obesity-related policy decisions. We discuss major methods used to generate such evidence, emphasizing study design and the varying quality of the evidence obtained. Third, we consider what the standards of evidence should be in various contexts, who ought to set those standards, as well as the inherent subjectivity involved in making policy decisions. Finally, we suggest greater transparency from both academics and policymakers in the acknowledgment of subjectivities so they can distinguish and communicate the roles of empirical evidence and subjective values in the formulation of policy.
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Affiliation(s)
- Molly B. Richardson
- Department of Population Health Sciences, Virginia Polytechnic Institute and State University
- Nutrition Obesity Research Center, University of Alabama at Birmingham (UAB)
| | | | - Kevin R. Fontaine
- Nutrition Obesity Research Center, University of Alabama at Birmingham (UAB)
- School of Nursing, Auburn University
| | - David B. Allison
- Nutrition Obesity Research Center, University of Alabama at Birmingham (UAB)
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Abstract
Albert J. Stunkard's influential career in obesity research spanned over 50 years and included several landmark studies on social factors related to obesity. This review discusses the important contributions Stunkard made to research on the relationship between socioeconomic status socioeconomic status and obesity, extensions of his work, and reflects on Stunkard's role in the mentoring of succeeding generations of scientists.
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Affiliation(s)
- Gregory Pavela
- 227K, Ryals Public Health Building, Room 227K, University of Alabama at Birmingham, 1665 University Boulevard, Birmingham, Alabama 35294, , Phone: (205)-934-9325
| | - Dwight W. Lewis
- The University of Alabama School of Medicine (Tuscaloosa Regional Campus), 850 5th Ave East; Tuscaloosa, AL 35401,
| | - Julie Locher
- Departments of Medicine (Division of Gerontology, Geriatrics, and Palliative Care; Section of Social and Behavioral Sciences) and Health Care Organization and Policy, 1530 3 Avenue South; CH19-Room 218F; Birmingham, Alabama 35294-2041, Phone: 205.934.7542, Fax: 205.975.5870,
| | - David B. Allison
- Nutrition Obesity Research Center, Ryals Public Health Building, Room 140J, University of Alabama at Birmingham, 1665 University Boulevard, Birmingham, Alabama 35294
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12
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Grant JF, Chittleborough CR, Taylor AW. Parental Midlife Body Shape and Association with Multiple Adult Offspring Obesity Measures: North West Adelaide Health Study. PLoS One 2015; 10:e0137534. [PMID: 26355742 PMCID: PMC4565704 DOI: 10.1371/journal.pone.0137534] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 08/19/2015] [Indexed: 11/28/2022] Open
Abstract
There is compelling evidence that parental weight is a strong determinant of offspring weight status. The study used cross-sectional self-reported and measured data from a longitudinal cohort of Australian adults (n = 2128) from Stage 3 (2008-10) of the North West Adelaide Health Study (1999-2003, baseline n = 4056) to investigate the association between midlife parental body shape and four indicators of obesity and fat distribution. The analysis used measured body mass index (BMI), waist circumference (WC), waist hip ratio (WHR) and waist height ratio (WHtR) of adult offspring, together with pictograms for recall of parental body shape. Compared to both parents being a healthy weight, offspring were more likely to be overweight or obese if both parents were an unhealthy weight at age 40 (OR 2.14, 95% CI 1.67-2.76) and further, those participants whose mother was an unhealthy weight were more likely to be overweight or obese themselves (OR 1.50, 95% CI 1.14-1.98). There were similar but lower results for those with an overweight/obese father (OR 1.44, 95% CI 1.08-1.93). The effect of one or both parents being overweight or obese tended to be stronger for daughters than for sons across BMI, WC and WHtR. BMI showed the strongest association with parental body shape (OR 2.14), followed by WC (OR 1.78), WHtR (OR 1.71) and WHR (OR 1.45). WHtR (42-45%) and BMI (35-36%) provided the highest positive predictive values for overweight/obesity from parental body shape. Parental obesity increases the risk of obesity for adult offspring, both for overall body shape and central adiposity, particularly for daughters. Pictograms could potentially be used as a screening tool in primary care settings to promote healthy weight among young adults.
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Affiliation(s)
- Janet F. Grant
- Population Research and Outcome Studies, Discipline of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
| | | | - Anne W. Taylor
- Population Research and Outcome Studies, Discipline of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
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Lourenço BH, Villamor E, Augusto RA, Cardoso MA. Influence of early life factors on body mass index trajectory during childhood: a population-based longitudinal analysis in the Western Brazilian Amazon. MATERNAL & CHILD NUTRITION 2015; 11:240-52. [PMID: 23020806 PMCID: PMC6860355 DOI: 10.1111/mcn.12005] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Low- to middle-income countries may experience the occurrence of a dual burden of under and overnutrition. To better understand the overall progression of body mass index (BMI) during childhood, we estimated average BMI-for-age z-score (BAZ) growth curves in a population-based longitudinal study of 255 children living in the Brazilian Amazon. Children were aged 0.1-5.5 years at recruitment (2003). We collected data on socio-economic and maternal characteristics, children's birthweight and infant feeding practices. Child anthropometric measurements were taken in 2003, 2007 and 2009. BAZ differences among categories of exposure variables were calculated at 6 and 12 months, and 2, 7 and 10 years. At baseline, the mean (standard deviation) age was 2.6 (1.4) years; 12.9% were overweight and 3.9% thin. After adjustment, mean BAZ estimates were mostly negative. Boys were close to the median value for BAZ until 12 months, whereas girls were below the median (P=0.05). Children from households above the wealth median were 0.36 z- and 0.49 z-less underweight than poorer children at 7 and 10 years, respectively (P<0.01). Maternal BMI was positively associated with children's BAZ since 12 months old; BAZ in children from overweight mothers was higher by 0.69 compared with their counterparts at 10 years (P<0.01). Birthweight was positively related to BAZ up until 2 years (P=0.01). Socio-economic background and maternal nutritional status are important predictors of BAZ throughout childhood. Although excessive weight gain is a public health concern, it is critical to restrict inequities, while promoting healthier growth in developing countries.
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Affiliation(s)
- Barbara H. Lourenço
- Public Health Nutrition ProgramSchool of Public HealthUniversity of São PauloSão PauloBrazil
| | - Eduardo Villamor
- Department of EpidemiologyUniversity of Michigan School of Public HealthAnn ArborMichiganUSA
| | - Rosângela A. Augusto
- Public Health Nutrition ProgramSchool of Public HealthUniversity of São PauloSão PauloBrazil
| | - Marly A. Cardoso
- Department of NutritionSchool of Public HealthUniversity of São PauloSão PauloBrazil
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14
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Shaw SR, Gomes P, Polotskaia A, Jankowska AM. The relationship between student health and academic performance: Implications for school psychologists. SCHOOL PSYCHOLOGY INTERNATIONAL 2015. [DOI: 10.1177/0143034314565425] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Children who are unhealthy are at higher risk for school problems than students who are free from medical problems. Students with poor health have a higher probability of school failure, grade retention, and dropout. The relationship between student health and academic success is complex. Common manageable factors of student health are nutrition, maintaining healthy weight, and physical fitness. Through a comprehensive literature review the relationships among school achievement and nutrition, maintaining healthy weight, and physical fitness are examined. Furthermore, the efficacy of educational programs to improve nutrition, maintain healthy weight, and increase physical fitness is evaluated. The complexity of the relationship among variables is presented and areas for future research and practice for school psychologists are described.
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15
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Pavela G, Wiener H, Fontaine KR, Fields DA, Voss JD, Allison DB. Packet randomized experiments for eliminating classes of confounders. Eur J Clin Invest 2015; 45:45-55. [PMID: 25444088 PMCID: PMC4314392 DOI: 10.1111/eci.12378] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Accepted: 11/10/2014] [Indexed: 12/30/2022]
Abstract
BACKGROUND Although randomization is considered essential for causal inference, it is often not possible to randomize in nutrition and obesity research. To address this, we develop a framework for an experimental design-packet randomized experiments (PREs), which improves causal inferences when randomization on a single treatment variable is not possible. This situation arises when subjects are randomly assigned to a condition (such as a new roommate) which varies in one characteristic of interest (such as weight), but also varies across many others. There has been no general discussion of this experimental design, including its strengths, limitations, and statistical properties. As such, researchers are left to develop and apply PREs on an ad hoc basis, limiting its potential to improve causal inferences among nutrition and obesity researchers. METHODS We introduce PREs as an intermediary design between randomized controlled trials and observational studies. We review previous research that used the PRE design and describe its application in obesity-related research, including random roommate assignments, heterochronic parabiosis, and the quasi-random assignment of subjects to geographic areas. We then provide a statistical framework to control for potential packet-level confounders not accounted for by randomization. RESULTS Packet randomized experiments have successfully been used to improve causal estimates of the effect of roommates, altitude, and breastfeeding on weight outcomes. When certain assumptions are met, PREs can asymptotically control for packet-level characteristics. This has the potential to statistically estimate the effect of a single treatment even when randomization to a single treatment did not occur. CONCLUSIONS Applying PREs to obesity-related research will improve decisions about clinical, public health, and policy actions insofar as it offers researchers new insight into cause and effect relationships among variables.
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Affiliation(s)
- Greg Pavela
- Office of Energetics, Nutrition Obesity Research Center, University of Alabama at Birmingham, Birmingham, AL, USA
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16
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Hemmingsson E. A new model of the role of psychological and emotional distress in promoting obesity: conceptual review with implications for treatment and prevention. Obes Rev 2014; 15:769-79. [PMID: 24931366 DOI: 10.1111/obr.12197] [Citation(s) in RCA: 129] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Revised: 05/12/2014] [Accepted: 05/12/2014] [Indexed: 11/29/2022]
Abstract
The lack of significant treatment and prevention progress highlights the need for a more expanded strategy. Given the robust association between socioeconomic factors and obesity, combined with new insights into how socioeconomic disadvantage affects both behaviour and biology, a new causal model is proposed. The model posits that psychological and emotional distress is a fundamental link between socioeconomic disadvantage and weight gain. At particular risk are children growing up in a disharmonious family environment, mainly caused by parental socioeconomic disadvantage, where they are exposed to parental frustrations, relationship discord, a lack of support and cohesion, negative belief systems, unmet emotional needs and general insecurity. Without adequate resilience, such experiences increase the risk of psychological and emotional distress, including low self-esteem and self-worth, negative emotions, negative self-belief, powerlessness, depression, anxiety, insecurity and a heightened sensitivity to stress. These inner disturbances eventually cause a psycho-emotional overload, triggering a cascade of weight gain-inducing effects including maladaptive coping strategies such as eating to suppress negative emotions, chronic stress, appetite up-regulation, low-grade inflammation and possibly reduced basal metabolism. Over time, this causes obesity, circular causality and further weight gain. Tackling these proposed root causes of weight gain could potentially improve both treatment and prevention outcomes.
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Affiliation(s)
- E Hemmingsson
- Obesity Center, Karolinska University Hospital, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
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Dixon JB, Browne JL, Mosely KG, Rice TL, Jones KM, Pouwer F, Speight J. Severe obesity and diabetes self-care attitudes, behaviours and burden: implications for weight management from a matched case-controlled study. Results from Diabetes MILES--Australia. Diabet Med 2014; 31:232-40. [PMID: 23952552 DOI: 10.1111/dme.12306] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Revised: 07/08/2013] [Accepted: 08/12/2013] [Indexed: 11/29/2022]
Abstract
AIMS To investigate whether diabetes self-care attitudes, behaviours and perceived burden, particularly related to weight management, diet and physical activity, differ between adults with Type 2 diabetes who are severely obese and matched non-severely obese control subjects. METHODS The 1795 respondents to the Diabetes MILES--Australia national survey had Type 2 diabetes and reported height and weight data, enabling BMI calculation: 530 (30%) were severely obese (BMI ≥ 35 kg/m(2); median BMI = 41.6 kg/m(2)) and these were matched with 530 control subjects (BMI < 35 kg/m(2); median BMI = 28.2 kg/m(2)). Diabetes self-care behaviours, attitudes and burden were measured with the Diabetes Self-Care Inventory-Revised. Within-group and between-group trends were examined. RESULTS The group with BMI ≥ 35 kg/m(2) was less likely to achieve healthy diet and exercise targets, placed less importance on diet and exercise recommendations, and found the burden of diet and exercise recommendations to be greater than the group with BMI < 35 kg/m(2). The group with BMI ≥ 35 kg/m(2) was more likely to be actively trying to lose weight, but found weight control a greater burden. These issues accentuated with increasing obesity and were greatest in those with BMI > 45 kg/m(2). There were no between-group differences in other aspects of diabetes self-care: self-monitoring of blood glucose, use of medications and smoking. Moderate-to-severe symptoms of depression were independently associated with reduced likelihood of healthy diet and physical activity, and with greater burden associated with diet, physical activity and weight management. CONCLUSIONS Severely obese people with diabetes demonstrated self-care attitudes, behaviours and burdens that infer barriers to weight loss. However, other important diabetes self-care behaviours are supported equally by severely obese and non-severely obese individuals.
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Affiliation(s)
- J B Dixon
- Clinical Obesity Research, Baker IDI Heart and Diabetes Institute, Melbourne, Vic., Australia; School of Primary Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic., Australia
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18
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Kanazawa S. Childhood intelligence and adult obesity. Obesity (Silver Spring) 2013; 21:434-40. [PMID: 23404798 DOI: 10.1002/oby.20018] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Accepted: 06/01/2012] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Recent studies conclude childhood intelligence has no direct effect on adult obesity net of education, but evolutionary psychological theories suggest otherwise. DESIGN AND METHODS A population (n = 17,419) of British babies has been followed since birth in 1958 in a prospectively longitudinal study. Childhood general intelligence is measured at 7, 11, and 16, and adult BMI and obesity are measured at 51. RESULTS Childhood general intelligence has a direct effect on adult BMI, obesity, and weight gain, net of education, earnings, mother's BMI, father's BMI, childhood social class, and sex. More intelligent children grow up to eat more healthy foods and exercise more frequently as adults. CONCLUSION Childhood intelligence has a direct effect on adult obesity unmediated by education or earnings. General intelligence decreases BMI only in adulthood when individuals have complete control over what they eat.
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Affiliation(s)
- Satoshi Kanazawa
- Managerial Economics and Strategy Group, Department of Management, London School of Economics and Political Science, London, UK.
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Heitmann BL, Westerterp KR, Loos RJF, Sørensen TIA, O'Dea K, McLean P, Jensen TK, Eisenmann J, Speakman JR, Simpson SJ, Reed DR, Westerterp-Plantenga MS. Obesity: lessons from evolution and the environment. Obes Rev 2012; 13:910-22. [PMID: 22642554 DOI: 10.1111/j.1467-789x.2012.01007.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The 9th Stock Conference acknowledged the complex background of genetic, cultural, environmental and evolutionary factors of obesity. Gene-environment interactions underlie the flexibility in body-weight and body-fat regulation, illustrated by the hunter-gatherers' feast and famine lifestyle, the variation in physical activity over the lifespan being highest at reproductive age, the variation in energy intake through 'eating in the absence of hunger', while running the risk of exceeding the capacity of triacylglyceride storage, leading to lipotoxicity and metabolic problems. Perinatal metabolic programming for obesity via epigenetic changes in response to a 'Western diet' results in production of lipid-poor milk and metabolically efficient pups, contributing to the perpetuation of obesity throughout generations. Evolutionary insight from comparative physiology and ecology indicates that over generations activity-induced energy expenditure has remained the same compared to wild mammals, that energy balance might be dependant on protein balance, while the function of taste changed from detection of poison or energy to social drinking and social behaviour. At present, the impact of assortative mating on obesity prevalence is unambiguously positive. The complexity that appeared can only be fully appreciated by setting the data into the context of our evolutionary history.
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Affiliation(s)
- B L Heitmann
- Institute of Preventive Medicine, Centre for Health and Society, Copenhagen University Hospitals, Copenhagen, Denmark
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Kaiser KA, Smith DL, Allison DB. Conjectures on some curious connections among social status, calorie restriction, hunger, fatness, and longevity. Ann N Y Acad Sci 2012; 1264:1-12. [PMID: 22834696 PMCID: PMC3464393 DOI: 10.1111/j.1749-6632.2012.06672.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Many animal and human studies show counterintuitive effects of environmental influences on energy balance and life span. Relatively low social and/or economic status seems to be associated with and produce greater adiposity, and reduced provision (e.g., caloric restriction) of food produces greater longevity. We suggest that a unifying factor may be perceptions of the environment as “energetically insecure” and inhospitable to reproduction, which may in turn provoke adiposity-increasing and longevity-extending mechanisms. We elaborate on two main aspects of resources (or the perceptions thereof) on body weight and longevity. We first discuss the effects of social dominance on body weight regulation in human and animal models. Second, we examine models of the interactions between caloric restriction, body composition, and longevity. Finally, we put forth a relational model of the influences of differing environmental cues on body composition and longevity.
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Affiliation(s)
- Kathryn A Kaiser
- Office of Energetics, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama 35294, USA
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Ajslev TA, Angquist L, Silventoinen K, Gamborg M, Allison DB, Baker JL, Sørensen TIA. Assortative marriages by body mass index have increased simultaneously with the obesity epidemic. Front Genet 2012; 3:125. [PMID: 23056005 PMCID: PMC3458436 DOI: 10.3389/fgene.2012.00125] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2012] [Accepted: 06/21/2012] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The genetic predisposition to obesity may have contributed to the obesity epidemic through assortative mating. We investigated whether spouses were positively assorted by body mass index (BMI; = kg/m(2)) in late childhood, and whether changes in assorted marriage by upper BMI-percentiles occurred during the obesity epidemic. METHODS In the Copenhagen School Health Records Register (CSHRR) boys and girls with measures of BMI at age 13 years later became 37,792 spousal-pairs who married between 1945 and 2010. Trends in the spousal BMI correlations using sex-, age-, and birth cohort-specific BMI z-scores across time were investigated. Odds ratios (ORs) of marriage among spouses both with BMI z-scores >90th or >95th percentile compared with marriage among spouses ≤90th percentile were analyzed for marriages entered during the years prior to (1945-1970), and during the obesity epidemic (1971-2010). FINDINGS Spousal BMI correlations were around 0.05 and stayed similar across time. ORs of marriage among spouses with BMIs >90th percentile at age 13 were 1.21, 1.05-1.39, in 1945-1970, and increased to 1.63, 1.40-1.91, in 1971-2010 (p = 0.006). ORs of marriage among spouses both >95th BMI percentile were higher and increased more; from 1.39, 1.10-1.81, to 2.39, 1.85-3.09 (p = 0.004). INTERPRETATION Spousal correlations by pre-marital BMIs were small and stable during the past 65 years. Yet, there were assorted marriages between spouses with high BMI at age 13 years and the tendency increased alongside with the obesity epidemic which may increase the offsprings' predisposition to obesity.
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Affiliation(s)
- Teresa A Ajslev
- Institute of Preventive Medicine, Copenhagen University Hospital Copenhagen, Denmark
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Anderson GH, Foreyt J, Sigman-Grant M, Allison DB. The use of low-calorie sweeteners by adults: impact on weight management. J Nutr 2012; 142:1163S-9S. [PMID: 22573781 DOI: 10.3945/jn.111.149617] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The application of low-calorie sweeteners (LCS) in foods and beverages has increased over the past 35 y. At the same time, many characteristics of the American diet have changed, including variations in fat and carbohydrate content and composition, increased nutrient additions, and new dietary patterns due to changing lifestyles and attitudes toward food and the changing cost of food. During this same time period, the prevalence of overweight and obesity has increased from ~30 to 70% of adults in the United States. Clearly, these trends lead to a variety of hypotheses and efforts to explain the role of LCS in this association. The aim of this review is to gain clarity on the role of LCS in weight management and their impact on diet quality. In addition, because the majority of studies aimed at identifying associations between LCS and these outcomes are based on observational data, the pitfalls in designing and evaluating data from observational studies are also discussed. We conclude that there is no evidence that LCS can be claimed to be a cause of higher body weights in adults. Similarly, evidence supporting a role for LCS in weight management is lacking. Due to the confounders in most observational studies, randomized controlled trials are needed to advance understanding.
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Affiliation(s)
- G Harvey Anderson
- University of Toronto, Department of Nutritional Sciences, Toronto, Ontario, Canada.
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Abstract
The prevalence of overweight and obesity has markedly increased during the past few decades. Stress has been suggested as one environmental factor that may contribute to the development of obesity. In this review, we discuss the role that exposure to chronic stress may play in the development of obesity, with particular attention to the effects of chronic psychosocial stress. Of particular importance is the effect that social stress has on dietary preference, food consumption, and regional distribution of adipose tissue. We present evidence from human and animal studies that links sympathetic nervous system and hypothalamic-pituitary-adrenal axis hyperactivity with visceral obesity, and that stress tends to alter the pattern of food consumption, and promotes craving of nutrient-dense "comfort foods." Lastly, we discuss the visible burrow system, a model of chronic social stress used in our laboratory to assess the effects of social subordination on behavioral and metabolic profile.
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Affiliation(s)
- Karen A. Scott
- Department of Psychiatry and Behavioral Neurosciences, University of Cincinnati College of Medicine, 2170 East Galbraith Road, E 212, Cincinnati, OH 45237, USA
| | - Susan J. Melhorn
- University of Washington, Harborview Medical Center, 925 Ninth Avenue, Box 359780, Seattle, WA 98104, USA
| | - Randall R. Sakai
- Department of Psychiatry and Behavioral Neurosciences, University of Cincinnati College of Medicine, 2170 East Galbraith Road, E 212, Cincinnati, OH 45237, USA
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